bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Fine‐cut Technique for Permanent Laryngeal Sectioning
Authors: Roy Soham , Lundy Donna S. , Marcillo Alex S. , Casiano Roy R. 
Published: February 2003

BACKGROUNDA new technique for permanent sectioning of the human spinal cord has provided superior images over those produced with traditional methods. Application of this technique for sections of the human larynx may yield cost‐effective, efficient, and accurate laryngeal anatomic dissections.STUDY DESIGN AND METHODSThis study was designed to evaluate this technique for dissections of the human larynx. Laryngeal sections from cadavers were submerged in a celloidin solution, a derivative of wallpaper plaster, and frozen to ‐15°C. After preparation, axial and coronal cuts of 100 μm were made with a Macrocut Tome sectioning system.RESULTSSections were completed in approximately 30 hours. Digitized photographs of the laryngeal sections provide detailed images of precise anatomic relationships.CONCLUSIONCelloidin‐based sectioning of the human larynx yields precise anatomic information beyond standard radiographic imagining and previous permanent laryngeal sectioning techniques in a cost‐efficient and timely manner. Black and white fine‐section photographs are provided.(Otolaryngol Head Neck Surg 2001; 124:31‐4.)
Investigation of the Ototoxic Effects of Interferon α2A on the Mouse Cochlea
Authors: Akyol Mehmet Umut , Sarac Sarp , Akyol Gulen , Atac Ahmet , Poyraz Aylar , Belgin Erol , Turan Ergin 
Published: February 2003

This prospective randomized study investigates the possible toxic effects of interferon (IFN) α2A on the mouse cochlea. Thirty‐six albino Swiss mice that were randomly assigned to 3 groups underwent baseline auditory brain stem response testing bilaterally to objectively assess baseline hearing levels. The first group received a single dose of 50,000 units, and the second group received 100,000 units of IFN‐α2A intraperitoneally, whereas the third group was given no medication. Repeat auditory brain stem response testing revealed a significant rise in mean baseline peak equivalent sound pressure level thresholds in the groups that received IFN (P < 0.001). Histologicallly, the cochleae of mice that received IFN had a decreased number of fibroblasts in the spiral limbus, as well as prominent cytoplasmic vacuolation of these cells, compared with control animals. Loss of hair cells was not observed. It is possible that reversible biochemical and metabolic changes in the cochlea, rather than morphologic abnormalities, manifest IFN ototoxicity. (Otolaryngol Head Neck Surg 2001;124:107‐10.)
Effect of Teflon Piston Diameter On Hearing Result After Stapedotomy
Authors: Sennaroglu Levent , Ünal Ö. Faruk , Sennaroglu Gonca , Gürsel Bülent , Belgin Erol 
Published: February 2003

This study compares hearing results after stapedotomy by 0.6 mm and 0.8 mm teflon pistons. Retrospective analysis studied 100 patients randomly selected who underwent stapedotomy for otosclerosis with insertion of 0.8 mm teflon piston prosthesis and 100 patients with 0.6 mm teflon piston prosthesis. Air‐conduction hearing level in both groups were measured before and after the procedure and the gain of the air conduction between the 2 groups at different frequencies were compared statistically. The group with the 0.8 mm prosthesis had better results that were statistically significant and more pronounced at lower frequencies.
Primary Radiation Therapy for Early Glottic Cancer
Authors: Barthel Steven W. , Esclamado Ramon M. 
Published: February 2003

OBJECTIVES/HYPOTHESISEarly glottic squamous cell carcinoma can be effectively treated with either radiation or surgical intervention. We evaluated our experience treating early glottic cancer with primary radiation therapy and our vertical hemilaryngectomy (VHL) salvage experience.STUDY DESIGN/METHODSRetrospectively, patient records between January 1986 and December 1994 were reviewed and 45 patients with early glottic squamous cell carcinoma who received fullcourse radiation therapy at the Cleveland Clinic Foundation were identified.RESULTSLocal control after radiation therapy was 80% overall, 87.5% for T1 lesions, and 75% for T2 lesions. Four patients underwent VHL for salvage after local recurrence; 1 was successfully salvaged with VHL. Five patients underwent total laryngectomy salvage after radiation therapy; all were successful. Only 1 of the 6 patients who were originally candidates for VHL before radiation therapy was successfully salvaged with the larynx preserved.CONCLUSIONSOur local control rates using primary radiation therapy are consistent with prior published series, but voice sparing salvage is poor. (Otolaryngol Head Neck Surg 2001; 124:35‐9.)
Financial Support for Research in Otolaryngology
Authors: Odland Rick M. 
Published: February 2003

OBJECTIVESThis project describes the use of computer‐assisted searches of medical literature in an attempt to track the prevalence and type of funding of medical research.STUDY DESIGN AND SETTINGThe study is a computer‐assisted observational survey of the medical literature. To establish a database and track funding trends, a computer‐assisted Medline search (CAMS) of the literature from 1986 to 1991 and 1992 to August 1996 was undertaken for 3 areas of interest: (1) sources of support, (2) comparison with other specialties, and (3) the validity of CAMS. A journal‐based search examined the field of otolaryngology, which includes all the head and neck related sciences, and an institution‐based search examined the clinical specialty of otolaryngology.RESULTSBy selected journal search, the field of otolaryngology has about one‐third funding (34% of 20,751 papers), and about one‐half of that is supported by the National Institutes of Health. This proportion of federal support increased over time. By institution line search, the specialty of otolaryngology is less well funded (26% of 15,480 papers) as might be expected. However, in contrast to basic sciences, there is a trend of decreased funding over the 11‐year period of the study.SIGNIFICANCEIt appears that while the field of otolaryngology (basic scientists and clinicians) may be enjoying increasing support of research, the clinical specialty of otolaryngology is among the many specialties that exhibit a trend of decreasing level of NIH support.CONCLUSIONSComputer‐assisted surveys are an effective method of tracking funding for research in otolaryngology and other specialties. CAMS may be a valuable tool for monitoring efforts to improve funding resources for otolaryngology.
Skin Metastases in Squamous Cell Carcinoma of the Head and Neck
Authors: Yoskovitch Adi , Hier Michael P. , Okrainec Allan , Black Martin J. , Rochon Louise 
Published: February 2003

Distant metastases in squamous cell carcinoma of the head and neck (SCCHN) are most often to the lung, liver, and bone. SCCHN rarely metastasizes to skin sites.OBJECTIVETo ascertain the significance of skin metastases (SM) on the prognosis of patients with SCCHN.METHODSA retrospective review of all patients between 1987 and 1999 with SCCHN was conducted. Patients in whom SM developed were identified. Data pertaining to demographics, primary tumor staging, SM development, and outcome were investigated.RESULTSIn 798 consecutive patients diagnosed with SCCHN between 1987 and 2000, 19 developed SM. The average time of onset of the SM was 17.65 months. The average survival time was 7.2 months after the development of SM. The overall survival time of patients who developed SM from the initial presentation of the primary tumor was 24.85 months. The 1‐year survival rate from the time of development of SM was 0%.CONCLUSIONSMetastasis to skin sites is an uncommon feature of SCCHN. SM may represent the first clinical evidence of impending loco‐regional recurrence or distant metastasis. The development of SM is an ominous sign associated with an extremely poor prognosis, similar to the development of distant metastasis at more typical sites. Both the development of SM and survival of patients developing SM are independent of primary tumor stage. Current treatment options of SM are limited in their efficacy.
Normal Standard Curve for Acoustic Pharyngometry
Authors: Ibrahim Kamal 
Published: February 2003

Pharyngeal size, compliance, and the dynamic behavior of the upper airway are important factors in the production of obstructive sleep apnea. Assessment of the upper airway for possible site(s) of obstruction is one of the keys to a successful management of the condition. Acoustic pharyngometry has the potential for localizing such sites, however, standardizing the operating technique and producing a standard normal curve is a prerequisite before exploring the potential of this equipment. A total number of 350 normal volunteers (271 males and 79 females) were examined by acoustic pharyngometry and a coefficient of variance of 5% to 7% was obtained from each of them. Mean and standard deviation of pharyngeal area at each point of X‐axis (distance) was obtained and analyzed statistically to produce a general standard curve. Using special techniques during examination, the oropharyngeal junction and glottis were located, and thus a mapped acoustic pharyngogram was produced. Mean pharyngeal area was 3.194 cm2 in males (SD 0.311) and 2.814 cm2 in females (SD 0.331). Mean glottic area was 1.06 cm2 in males (SD 0.119) and 0.936 cm2 in females (SD 0.108). A minimal pharyngeal area is probably needed as a “golden standard” to evaluate patients with obstructive sleep apnea.
Modified Retrolabyrinthine Approach With Partial Labyrinthectomy: Anatomic Study
Authors: Magliulo Giuseppe 
Published: February 2003

This study was undertaken to evaluate the feasability of the modified retrolabyrinthine approach (traditional retrolabyrinthine approach plus resection of the posterior semicircular canal) to expose the entire fundus of the internal auditory canal (IAC). This approach is advocated by its proponents to manage acoustic neuromas reaching the lateral IAC and with the preservation of hearing as the goal. Little anatomic data directly estimate the limitations of this exposure. Measurements were recorded from 25 cadaver temporal bones dissected with this modified approach. The distances were taken between the porus acousticus (inferior and superior portions), the dome of the jugular bulb, the midportion of the sigmoid sinus, and the fundus of the IAC (inferior and superior portions). All of the measurements were then compared with those of the translabyrithine approach. The current study shows that despite the sacrifice of the posterior semicircular canal, the superior lateral fundus cannot be completely visualized. There is a distance (on average 1.1 mm) that differentiates the superior area of the IAC accessible with translabyrithine and modified retrosigmoid techniques. This value is smaller than that observed in the classic retrosigmoid approach indicating that the modified technique affords a more adequate, even if not ideal, exposure to minimize the risk of recurrence. The modified retrolabyrinthine approach provided an optimal exposure of the inferior half of the IAC. A superior blind area, smaller than that of the traditional retrolabyrinthine technique, cannot be completely approached via this route. We believe that this approach can be considered as an alternative technique in selected cases especially for tumors involving the inferior vestibular nerve.
Frontal Sinus Obliteration with the Pericranial Flap
Authors: Parhiscar Afshin , Har‐El Gady 
Published: February 2003

BACKGROUNDFrontal sinus obliteration is often accomplished by autologous grafts such as fat, muscle, or bone. These avascular grafts carry an increased risk of resorption and infection as well as donor site morbidity. Vascular regional flaps may be used to obliterate small sinuses with less morbidity.OBJECTIVESTo review our experience with the use of the pericranial flap for obliteration of the frontal sinus.METHODSThe records of 10 patients who underwent obliteration of the frontal sinus with the pericranial flap were reviewed. Demographics, indications for frontal sinus obliteration, immediate and late complications, and long‐term outcome were recorded. These results were compared with those in the current literature.RESULTSTen sinuses were obliterated with the pericranial flap. Indications included frontal sinus mucocele, mucopyocele, frontal sinus osteomyelitis, and frontal sinus fracture. The median follow‐up was 3 years. There was 1 short‐term complication of persistent headache for 1 month, and there was asymptomatic recurrence of a neofrontal sinus in 1 case.CONCLUSIONSThe pericranial flap is a vascularized local flap that is easily harvested. The use of the pericranial flap avoids donor site morbidity associated with free fat or cancellous bone grafts. The pericranial flap arms the head and neck surgeon with an effective alternative to other methods of frontal sinus obliteration.
Oncologic Rationale for Bilateral Tonsillectomy in Head and Neck Squamous Cell Carcinoma of Unknown Primary Source
Authors: Koch Wayne M. , Bhatti Nassir , Williams Mark F. , Eisele David W. 
Published: February 2003

OBJECTIVETo demonstrate an oncologic basis for the recommendation to perform bilateral tonsillectomy as a routine measure in the search for a primary mucosal lesion in patients presenting with cervical nodal metastasis of squamous cell carcinoma (SCC).STUDY DESIGNA case series of individuals selected from a 3‐year period is reported.SETTINGAcademic medical center.RESULTSEach individual presented with metastatic squamous cell carcinoma in a cervical lymph node from an unknown primary source. In each case, the primary source was identified in a tonsillectomy specimen, either located contralateral to the node, or in both tonsils.CONCLUSIONSThe rate of contralateral spread of metastatic cancer from occult tonsil lesions appears to approach 10%. For this reason, bilateral tonsillectomy is recommended as a routine step in the search for the occult primary in patients presenting with cervical metastasis of SCC and palatine tonsils intact.
Chronic Tinnitus as Phantom Auditory Pain
Authors: Folmer Robert L. , Griest Susan E. , Martin William Hal 
Published: February 2003

OBJECTIVESTo investigate similarities between patients who experience chronic tinnitus or pain and to formulate treatment strategies that are likely to be effective for patients who experience phantom auditory pain.STUDY DESIGNA total of 160 patients rated the severity and loudness of their tinnitus and completed the State‐Trait Anxiety Inventory (STAI) and an abbreviated version of the Beck Depression Inventory (aBDI). Patients received counseling, audiometric testing, and matched the loudness of their tinnitus to sounds played through headphones.SETTINGA specialized tinnitus clinic within an urban medical center.RESULTSTinnitus severity was highly correlated with patients’ degree of sleep disturbance, STAI, and aBDI scores. The self‐rated (on a 1‐to‐10 scale)–but not the matched–loudness of tinnitus was correlated with tinnitus severity, sleep disturbance, STAI, and aBDI scores.CONCLUSIONSThe severity of chronic tinnitus is correlated with the severity of insomnia, anxiety, and depression. These relationships are the same for many patients with chronic pain. Treatment recommendations are discussed in reference to these results.
Prospective Analysis of The Efficacy of Continuous Intraoperative Nerve Monitoring During Thyroidectomy, Parathyroidectomy, and Parotidectomy
Authors: Brennan Joseph , Moore Eric J. , Shuler Kurt J. 
Published: February 2003

OBJECTIVEContinuous intraoperative electromyographic monitoring was prospectively performed in all parotidectomies, thyroidectomies, and parathyroidectomies over approximately 5 years to assess the efficacy of this technology.STUDY DESIGN AND SETTINGContinuous intraoperative nerve monitoring with perioperative nerve assessment was performed. The postresection minimal stimulation level of the nerves was determined to evaluate if this level would predict nerve function postoperatively.RESULTSForty‐four parotidectomies and 70 thyroid/parathyroid operations were performed with 140 nerves at risk (44 facial, 96 recurrent laryngeal). The incidence of temporary facial paralysis was 15.9% (7 of 44) and the incidence of permanent paralysis was 0%. The incidence of temporary recurrent laryngeal nerve paralysis in terms of nerves at risk was 1.0% (1 of 96), and the incidence of permanent recurrent laryngeal nerve paralysis was 0%. All patients with normally functioning facial and recurrent laryngeal nerves postoperatively had minimal stimulation levels less than or equal to 0.4 mA.CONCLUSIONContinuous intraoperative nerve monitoring was associated with extremely low rates of temporary and permanent nerve paralysis in our series of 140 nerves at risk as compared to the rates documented in the literature.
Chlorpromazine Alters Outer Hair Cell Electromotility
Authors: Lue Allen Jung‐Chen , Zhao Hong‐Bo , Brownell William E. 
Published: February 2003

OBJECTIVEOuter hair cells (OHCs) of the inner ear rapidly convert electrical gradients into mechanical force, enhancing cochlear sensitivity and frequency selectivity. We investigated the effect of chlorpromazine, an antipsychotic medication that alters membrane biomechanics, on OHC electromotility.STUDY DESIGNIsolated guinea pig outer hair cells were perfused with chlorpromazine under whole‐cell patch‐pipette recording conditions. Electromotile responses were measured.RESULTSA dramatic, reversible, dose‐dependent depolarization of voltage at peak capacitance (VpkCm) was seen with chlorpromazine treatment. The gain of the electromotile response was maximal near VpkCm both before and after chlorpromazine application. Unlike the 3 other agents that alter electromotility (salicylate, lanthanides, membrane tension), chlorpromazine did not change peak capacitance (Cmpk), which varies directly with maximal electromotile gain.CONCLUSIONChlorpromazine changes the membrane voltage at which OHCs exhibit maximal electromotile gain, without changing the magnitude of electromotile responses.SIGNIFICANCEChlorpromazine may diminish hearing thresholds or otoacoustic emissions in large doses.
Adenotonsillar Histopathology After Organ Transplantation
Authors: Williamson Robert A. , Huang Robert Y. , Shapiro Nina L. 
Published: February 2003

OBJECTIVESThe increasing number of surviving pediatric organ transplant recipients has resulted in a new clinical controversy surrounding the significance of adenotonsillar hypertrophy. The objective of this study is to evaluate adenotonsillar specimens, understand characteristic histopathology, and to examine the frequency and significance of this finding in this population.METHODSTwenty‐one cases of pediatric transplant recipients with adenoidal and/or tonsillar hypertrophy were reviewed retrospectively in a tertiary‐care setting. Particular attention was given to the histopathology of their surgical specimens, including any evidence of posttransplantation lymphoproliferative disorders (PTLD).RESULTSUsing morphologic, immunohistochemical, and molecular genetic analyses, 15 (71%) of 21 patients were noted to have Epstein‐Barr virus (EBV)‐related lymphoid hyperplasia, including 1 case (4.7%) of PTLD. Six (29%) of 21 had evidence of reactive follicular hyperplasia not related to EBV. B‐cell and T‐cell markers were nearly uniformly positive when tested for, except in the single patient with PTLD, who exhibited polymorphic, polyclonal B‐cell morphology. Kappa and lambda light‐chain clonality markers were positive in 11 (92%) of 12 patients.CONCLUSIONSEBV‐related lymphoid hyperplasia is frequently associated with adenotonsillar hypertrophy in pediatric organ transplant patients (71% of our cases); 92% of those cases tested exhibit polyclonal B‐cell populations. PTLD, an important cause of morbidity and mortality in this population, represented approximately 5% of our cases. The remainder of cases represent follicular hyperplasia unrelated to EBV or lymphoproliferative abnormalities. Characteristic histopathologic findings are presented.
Function of the Eustachian Tube After Weekly Exposure to Pepsin/Hydrochloric Acid
Authors: Heavner S. Brett , Hardy Stuart M. , White David R. , McQueen Chapman T. , Prazma Jiri , Pillsbury Harold C. 
Published: February 2003

OBJECTIVETo determine the effects of repeated pepsin/hydrochloric acid (HCl) exposure on the eustachian tube (ET).STUDY DESIGN AND SETTINGET function was studied in 22 rats. Group I (control) rats received transtympanic phosphate buffered saline solution; groups II (0.5 mg/ml) and III (2.0 mg/ml) received transtympanic pepsin/HCl. Test solutions were applied on day 0 with ET function evaluated on days 1, 2, 3, and 7 after exposure. Each 7‐day period represents 1 cycle; all groups underwent 4 cycles. ET function was evaluated using passive opening and closing pressure, and active clearance of positive and negative pressure tests.RESULTSRats exposed to pepsin/HCl had elevated passive opening pressures and a decreased ability to clear positive and negative pressure. A temporal relationship exists.CONCLUSIONThe results suggest middle ear exposure to pepsin/HCl leads to ET dysfunction in rats, and that this dysfunction is enhanced with repeated exposures.SIGNIFICANCEGastroesophageal reflux may induce ET dysfunction.
Ear Piercing for Individuals with Metal Hypersensitivity
Authors: Cornetta Anthony J. , Reiter David 
Published: February 2003

OBJECTIVETo describe and evaluate an ear piercing and earring retention method for individuals with metal hypersensitivity.SETTINGPrivate facial plastic surgery practice associated with a tertiary care medical center.METHODSThirty‐one patients with a history of hypersensitivity to metallic jewelry (62 ears) underwent earlobe piercing with an intravenous catheter.RESULTSNone of the patients experienced an infection or hypersensitivity reaction. All patients were able to wear nickel‐free earrings for short periods without using the shortened catheter.CONCLUSIONUsing the distal shaft of an intravenous catheter as an earring post sheath is a safe and effective technique that allows hypersensitive individuals to wear earrings in pierced ears on a limited basis.
Transtympanic Steroids for Treatment of Sudden Hearing Loss
Authors: Gianoli Gerard J. , Li John C. 
Published: February 2003

OBJECTIVESTo determine whether transtympanic steroid administration may be an effective treatment for sudden onset sensorineural hearing loss (SSNHL) in patients for whom systemic steroid treatment has failed or who were not candidates for systemic steroids.METHODSThe standard medical regimen for SSNHL usually involves systemic steroid therapy. Unfortunately, some patients do not respond successfully to or are poorly tolerant of systemic steroids. Transtympanic administration of steroids has been suggested as an alternative to systemic therapy. A prospective study was designed to evaluate the hearing outcomes in SSNHL patients treated with transtympanic steroids. Patients received transtympanic steroids if oral steroids had failed to work or if they were not able to tolerate oral steroids. Trans‐tympanic steroids were administered through a ventilation tube placed with the patient under local anesthesia. Steroid administration was performed on 4 separate occasions over the course of 10 to 14 days. Hearing was assessed immediately before therapy and within 1 to 2 weeks after therapy.RESULTSHearing improvement was documented in 10 of 23 patients (44%) who underwent transtympanic steroid administration. This represents a 44% hearing salvage in patients for whom steroid treatment would otherwise have been considered a failure.CONCLUSIONTranstympanic steroid therapy may be an alternative treatment for patients with SSNHL for whom systemic steroid therapy had failed or who could not tolerate systemic steroid therapy.