bluuebunny/crossref_metadata_2025_split huggingface dataset:
Minimally Invasive Head Holder to Improve the Performance of Frameless Stereotactic Surgery
Authors: Bale Reto J. , Vogele Michael , Freysinger Wolfgang , Gunkel Andreas R. , Martin Arno , Bumm Klaus , Thumfart Walter F. 
Published: November 2003

AbstractFrameless stereotactic procedures crucially depend on the firmness of immobilization. Once registered, shifting of the patient leads to inaccuracy, and the patient registration has to be realigned. To overcome the drawbacks of conventional invasive fixation for neurosurgery and the widely accepted fixation with surgical tape in ENT, the Vogele‐Bale‐Hohner (VBH) head holder has been developed. It permits rigid, noninvasive fixation of the head by using an individualized dental cast attached to the upper jaw by vacuum. Oral intubation is uncomplicated. In addition, a special registration device providing well defined reference points can be mounted to the mouthpiece. We report the first promising clinical applications of this device.
Genetic and Clinical Features of Sensorineural Hearing Loss Associated With the 1555 Mitochondrial Mutation
Authors: Usami Shin‐ichi , Abe Satoko , Kasai Miyo , Shinkawa Hideichi , Moeller Benjamin , Kenyon Judy B. , Kimberling, William J. 
Published: November 2003

AbstractFive Japanese families showing aminoglycoside‐induced hearing loss were genetically as well as clinically investigated. A mitochondrial mutation at nucleotide 1555 was found in 28 out of 32 subjects. One hundred American control subjects did not show any evidence of the mutation at nucleotide 1555, suggesting that the 1555 A→G (A1555G) mitochondrial mutation may be found more frequently among populations in the Asian continent. Many subjects who harbor this mitochondrial mutation exhibit a mild, high‐frequency, progressive hearing loss even without aminoglycoside injection. The results presented here appear to support the hypothesis that the A1555G mutation may play a more general role in causing hearing loss.
Growth Patterns of Piriform Sinus Carcinomas
Authors: Zbären Peter , Egger Christine 
Published: November 2003

AbstractAdvances in functional surgery have encouraged many head and neck surgeons to treat piriform sinus carcinomas, whenever possible, by conservation surgery. An increased understanding of the histopathologic growth pattern and spread of piriform sinus carcinomas is needed to define criteria for appropriate application of voice preservation surgery. The purpose of this study was to analyze the patterns of tumor spread to laryngeal and parapharyngeal structures. A total of 42 specimens obtained by laryngopharyngectomy were subjected to a whole‐organ section study. Carcinomas confined to the lateral wall tended to extend laterally beyond the thyroid ala and rarely infiltrated the intrinsic laryngeal muscles. As a result, conservation surgery could be possible in many cases, including T4 carcinomas. Carcinomas confined to the medial wall or occupying the whole piriform sinus tended to infiltrate laryngeal structures early, and hemilaryngeal fixation was observed in 61% of these cases; tumor spread to the contralateral side in 64%. The hemilarynx fixation was due to an invasion of intrinsic laryngeal muscles. An isolated perineural or cricoarytenoid joint involvement was never observed. For these tumors, conservation surgery would be inadequate in most cases, as they often present extensive laryngeal involvement with spread to the contralateral side.
A Cost‐Effective and Rational Surgical Approach to Patients With Snoring, Upper Airway Resistance Syndrome, or Obstructive Sleep Apnea Syndrome
Authors: Utley David S. , Shin Edward J. , Clerk Alex A. , Terris David J. 
Published: November 2003

AbstractThe past decade has seen several innovations in the surgical techniques available for treatment of patients with sleep‐disordered breathing. Outpatient techniques such as laser‐assisted uvulopalatoplasty (LAUP) and more aggressive procedures designed to address hypopharyngeal and base of tongue obstruction (genioglossus advancement and hyoid myotomy) have been developed and proven successful. We describe the efficacy of LAUP for snoring (72.7%), upper airway resistance syndrome (81.8%), and mild (mean[±SD] respiratory disturbance index [RDI] = 12 ± 8.1) obstructive sleep apnea (41.7%) in 56 patients who underwent 132 LAUP procedures in a 26‐month period. Thirty‐two patients with more significant obstructive sleep apnea (mean RDI = 41.8 ± 23.1) underwent multilevel pharyngeal surgery consisting of genioglossus advancement and hyoid myotomy combined with uvulopalatopharyngoplasty. The surgical success rate in this group of patients was 85.7% when commonly accepted criteria were applied. We recommend a stratified surgical approach to patients with sleep‐disordered breathing. Progressively worse airway obstruction marked by multilevel pharyngeal collapse and more severe sleep‐disordered breathing is treated with incrementally more aggressive surgery addressing multiple areas of the upper airway.
Efficacy and Cost‐Effectiveness of Multihole Fine‐Needle Aspiration of Head and Neck Masses
Authors: Mui Stanley , Li Tsuan , Rasgon Barry M. , Hilsinger Raymond L. , Rumore Greg , Puligandla Balaram , Sawicki John 
Published: November 2003

AbstractTo determine whether the specimen from fineneedle aspiration (FNA) biopsy of head and neck masses has greater diagnostic accuracy when using multihole needles than when using conventional, single‐hole needles, we did a prospective, randomized, single‐blinded study comparing diagnoses obtained using both types of needles in FNA biopsies of head and neck masses. Eighty‐eight patients served as their own controls and had 91 FNA biopsies with both multihole and single‐hole, 22‐gauge needles. Order of biopsy was randomized and was unknown to the cytopathologist. No statistically significant differences were noted in quantity of specimen material obtained, quality of fixation, or diagnostic value between the multihole and conventional needle. We found no advantage in using the more costly multihole needle in FNA biopsy of head and neck masses.
An Efficiency Comparison of Four Heat and Moisture Exchangers Used in the Laryngectomized Patient
Authors: Grolman Wilko , Blom Eric D. , Branson Richard D. , Schouwenburg Paul F. , Hamaker Ronald C. 
Published: November 2003

AbstractBypassing the upper airway places the burden of humidification on the lower airway. For this reason passive heat and moisture exchangers (HMEs) are used in the laryngectomized patient in an attempt to minimize the effect of lost upper airway function. We measured efficiency and airflow resistance and calculated the costs of four HMEs used in the laryngectomized patient. The HMEs were measured according a modified International Standards Organization (ISO) 9360 standard. The airflow resistance was measured at flow rates of 15, 30, and 60 L/min. The measurements were repeated three times. Costs were calculated with two realistic scenarios. The study found that there are significant differences in moisture output and airflow resistance between the HMEs tested. There are major daily cost differences between these devices. This study shows that filter material and size influence the HME's moisture output efficiency and airflow resistance considerably. The construction differences and filter and housing type have great influence on the HME's daily costs. We believe that knowledge of the efficiency in combination with the average daily costs of the HMEs allows the clinician to make a balanced choice of which filter to use.
Three‐Dimensional Image‐Guided Endonasal Surgery With a Microdebrider
Authors: Gunkel Andreas Rüdiger , Freysinger Wolfgang , Martin Arno , Völklein Claudia , Bale Reto Josef , Vogele Michael , Thumfart Walter Franz 
Published: November 2003

AbstractWe report the first intraoperative use of a microdebrider as a stereotactic three‐dimensional (3D) navigation instrument in paranasal and frontobasal surgery. The microdebrider uses rotating blades and an integrated suction device for controlled removal of tissue under video‐endoscopic view. The ISG Viewing Wand uses the patient's computed tomography/magnetic resonance (CT/MR) data and a 3D reconstruction thereof and a highprecision position‐sensitive mechanical arm for intraoperative three‐dimensional navigation. We have linked the microdebrider to the Viewing Wand to transform it into a continuously available intraoperative stereotactic localizing device. We discuss the problems related to this extension of the Viewing Wand and demonstrate the practical use in an exemplary polypectomy.
Ingestion of Caustic Hair Relaxer: Is Endoscopy Necessary?
Authors: Cox Artemus J. , Eisenbeis John F. 
Published: November 2003

AbstractHair relaxer, a commercially available alkaline product, is commonly the offending agent in caustic ingestion. These patients often experience oral cavity and facial burns; however, no clinically significant esophageal injuries have been reported. Therefore, we questioned the therapeutic and economic efficacy of the “standard treatment protocol” that includes hospitalization and endoscopic evaluation. Twenty‐six patients over a 7‐year period presented to our institution having ingested hair relaxer. Presenting signs and symptoms, esophageal findings, and cost of the standard treatment protocol were reviewed. Also, we analyzed the caustic potential and current packaging of hair relaxer. Our findings support modifications in the standard treatment protocol for hair relaxer ingestion including elimination of hospitalization and endoscopy in most patients. We also question compliance with childproof packaging laws and suggest avenues for prevention of hair relaxer ingestion.
Pediatric Respiratory Papillomatosis: Prognostic Role of Viral Typing and Cofactors
Authors: Rimell Frank L. , Shoemaker David L. , Pou Anna Maria , Jordan Jeanne A. , Post J. Christopher , Ehrlich Garth D. 
Published: November 2003

AbstractChildren with recurrent respiratory papillomatosis vary greatly in their clinical disease course. Many have mild disease with eventual remission while others present with an early aggressive airway obstructive course. This study consisted of 24 pediatric patients whose specimens underwent polymerase chain reaction analysis for cytomegalovirus (CMV), herpes simplex virus (HSV), and human papillomavirus (HPV) type. Nineteen of 24 specimens contained enough DNA for this study. None of the specimens were found to contain DNA from HPV‐16, ‐18, ‐31, ‐33; CMV; or HSV, which contrasts with our previous findings in adults. Ten patients were infected by HPV‐11 and seven of these underwent tracheotomy because of an aggressive tumorigenic clinical course. Nine patients were infected by HPV‐6 alone of whom only two required a tracheotomy (P = 0.05, Fisher's Exact Test). The early airway obstructive course associated with HPV‐11, however, had no bearing on achieving eventual disease remission, with decannulation achieved in eight of nine children.
A New Technique for Hypoglossal‐Facial Nerve Repair
Authors: Atlas Marcus D. , Lowinger David S.G. 
Published: November 2003

AbstractHypoglossal reinnervation of the facial nerve may be required after a proximal facial nerve injury. The classic hypoglossal‐facial graft procedure involves transection of the donor hypoglossal nerve, resulting in hemiglottic paralysis that, in association with paralysis of other cranial nerves, may cause speech and swallowing difficulties. Multiple lower cranial nerve palsies in conjunction with facial paralysis, as may occur after procedures such as skull base surgery, contraindicate the use of such techniques. The successful use of XII‐VII “interposition jump grafts” without hemiglossal weakness has been described However, a prolonged recovery period and weaker facial reanimation have been seen. In order to attain maximum facial reinnervation while preserving hypoglossal function, we have developed a new technique of XII‐VII repair. This method involves mobilization of the intratemporal portion of the facial nerve remnant, achieving a single anastomosis with the hypoglossal nerve, which has been partially incised. This technique has been used in three patients to date, with 6 to 11 months follow‐up. In all cases facial tone and symmetry have been restored and voluntary facial expression accomplished. The authors conclude that by employing the techniques described highly satisfactory cosmetic and functional results may be expected, without compromising hypoglossal nerve function.
Revision Stapedectomy: Intraoperative Findings, Results, and Review of the Literature
Authors: Han Wade W. , Incesulu Armagan , McKenna Michael J. , Rauch Steve D. , Nadol Joseph B. , Glynn Robert J. 
Published: November 2003

AbstractSeventy‐four revision stapedectomies performed consecutively over 10 years (1986 to 1995) were reviewed retrospectively. The most common intraoperative findings were incus erosion, prosthesis displacement, and oval window closure. Incus erosion was more frequently associated with multiple revisions. The postoperative results were reported using the conventional method (postoperative air minus preoperative bone) as well as the guidelines recently published by the American Academy of Otolaryngology‐Head and Neck Surgery (postoperative air minus postoperative bone), with success rates of postoperative air‐bone gap closure to within 10 dB after revision surgery of 51.6% and 45.6%, respectively. Patients with persistent conductive hearing loss(large residual air‐bone gaps) after primary stapedectomy had poorer postrevision hearing results. Sensorineural hearing loss (defined as a drop in bone pure‐tone average of more than 10 dB) occurred in four cases (5.4%). The number of revision surgeries, variations in operative techniques using laser or drill, and the ossicle to which the prosthesis was attached did not statistically affect the postoperative air‐bone gaps. These results were compared with previously published data.
Vestibular Nerve Section: Long‐term Follow‐up
Authors: Pappas Dennis G. , Pappas Dennis G. 
Published: November 2003

AbstractVestibular nerve section is considered an effective modality in the treatment of refractory and incapacitating vertigo. Typically nerve section results are described on the basis of short‐term follow‐up. We have reviewed 41 cases of vestibular nerve section spanning an 18‐year period. Although the majority of cases involved classic Meniere's disease, delayed endolymphatic hydrops, vestibular neuritis, and Meniere's syndrome secondary to head trauma were also included. Surgical approaches included translabyrinthine (20 cases), retrolabyrinthine (14 cases), retrosigmoid (six cases), and middle fossa (one case) procedures. Postoperative follow‐up time averaged 102 months, with 46% of patients followed for a minimum of 9 years. Results are reported according to standards set forth by the American Academy of Otolaryngology‐Head and Neck Surgery. Vertigo was cured or markedly improved in 88% of cases (90% in patients with Meniere's disease) at 18 to 24 months postoperatively. These vertigo results were sustained at the time of latest follow‐up. Functional level was also preserved over time despite the development of bilateral symptoms in several cases. The rate of bilateral disease reached 22% of cases. Although vertigo results remained stable, long‐term follow‐up of successful hearing preservation cases demonstrated deterioration over time. Postoperative continuation of medical treatment is urged to optimize and sustain the vestibular neurectomy result.
Acoustic Effect of Malleus Head Removal and Tensor Tympani Muscle Section on Middle Ear Reconstruction
Authors: Asai Masanori , Roberson J.B. , Goode Richard L. 
Published: November 2003

AbstractIn the reconstruction of ears with a missing incus, an incus replacement prosthesis (IRP) is commonly used to connect malleus and stapes. In some cases, it is necessary to resect the malleus head and/or section the tensor tympani muscle (TTM) tendon. The acoustic effects of these maneuvers have not been well studied. We performed experiments in a temporal bone model to measure the effect of these maneuvers on middle ear sound transmission. Measurements of umbo and stapes displacement were made before and after malleus head removal and TTM section plus incus replacement with an IRP. After malleus head removal, there was a peak gain in stapes displacement of 6 dB below 0.5 kHz and 8 dB above 2.5 kHz. TTM section had a similar but lesser effect. A clinical example is described.
Prognostic Indicators for Squamous Cell Carcinoma of the Oral Cavity: A Clinicopathologic Correlation
Authors: Gluckman Jack L. , Pavelic Zlatko P. , Welkoborsky Hans‐Jurgen , Mann Wolf , Stambrook Peter , Gleich Lyon , Wilson Keith , Righi Paul , Portugal Louis G. , McDonald John , Biddinger Paul , Steward David , Gartside Peter 
Published: November 2003

AbstractFifty‐three patients with T1 squamous cell cancer of the floor of mouth and ventral surface of the tongue with a known clinical outcome were retrospectively analyzed and arbitrarily divided into “aggressive” and “nonaggressive” groups based on their clinical behavior. Various host and tumor factors were then evaluated in an attempt to determine whether the tumor behavior could have been predicted. The paraffin‐embedded tumor specimens were evaluated for tumor differentiation, tumor thickness and tumor invasion, microvessel density, and p53 expression. In addition, a composite morphologic grading score was obtained by combining cell differentiation, nuclear polymorphism, mitosis activity, depth of infiltration, type of infiltration, and lymphatic infiltration. No single technique appeared capable of identifying “aggressive” behavior, although possibly an evaluation of composite factors might show promise in the future.
Internal Jugular Vein Patency in Patients Undergoing Microvascular Reconstruction
Authors: Wax Mark K. , Quraishi Huma , Rodman Susan , Granke Ken 
Published: November 2003

AbstractThe objective of this study was to determine the incidence of internal jugular vein thrombosis in patients undergoing free flap reconstruction and simultaneous neck dissection. Patients underwent Doppler ultrasound examination of their internal jugular veins on postoperative days 1 and 7 after functional neck dissection and free flap transfer. Long‐term follow up was obtained at a minimum of 3 months. The incidence of internal jugular vein thrombosis in patients undergoing free flap reconstruction with simultaneous neck dissection is similar to that of patients undergoing just neck dissection. A significant number of these veins recanalize and have excellent long term patency. There does not seem to be a correlation between venous thrombosis and free flap survival.
Laryngopharyngeal Sensory Testing With Modified Barium Swallow As Predictors of Aspiration Pneumonia After Stroke
Authors: Aviv Jonathan E. , Sacco Ralph L. , Mohr J.P. , Thompson J.L.P. , Levin Bruce , Sunshine Susan , Thomson Jeanne , Close Lanny G. 
Published: November 2003

AbstractImproved diagnostic tests that can accurately identify subjects at high risk for aspiration pneumonia (AP) are needed. One measure of this accuracy is the false‐negative rate (FNR), which determines the failure of a test to identify a group at high risk. This study compares FNRs for AP among dysphagic stroke patients for two prognostic techniques: modified barium swallow (MBS) alone and MBS combined with laryngopharyngeal sensory discrimination testing(MBS + LPSDT). MBS and LPSDT were performed within 4 weeks of stroke in 20 subjects who were prospectively followed for at least 2 years to identify the frequency of AP. MBS identified 10 patients as not at risk based on the finding of no aspiration on initial MBS; four of these patients developed AP (FNR = 40%). MBS + LPSDT identified five patients as not at risk based on the findings of neither aspiration nor bilateral sensory deficits; none of these patients developed AP (FNR = 0%). The combination of MBS criterion (aspiration) with the LPSDT criterion (bilateral sensory deficits) improves prognostication of outcome in dysphagic stroke patients by identifying a subgroup at high risk for developing AP (nonaspirators with bilateral deficits).
Endoscope‐Assisted Second‐Stage Tympanomastoidectomy
Authors: Youssef Tarek F. , Poe Dennis S. 
Published: November 2003

AbstractIntact canal wall mastoidectomy techniques for cholesteatoma are often followed by a planned second look for residual disease and possible ossicular reconstruction. Endoscopic techniques may reduce morbidity but introduce new concerns. Twenty‐five consecutive second‐look procedures were performed from July 1994 to July 1996 utilizing endoscopes in 19 cases and avoiding or terminating their use in the others because of known difficult anatomy, inadequate exposure, or excessive bleeding. Thirteen cases were prospectively explored first through a planned exclusively endoscopic approach and then opened for a conventional second look in comparison. In one of the 13 cases, endoscopy was abandoned. There were no cases in which endoscopy yielded a false‐negative result. Endoscopes underestimated the size of recurrence in one case. Our experience, indications, and precautions for endoscope‐assisted second‐stage tympanomastoidectomy are presented.
Validation of Objective Measures for Facial Paralysis
Authors: Helling Tiffany D. , Gail Neely J. 
Published: November 2003

AbstractA shift from subjective scales to objective measures of facial paralysis requires physical models against which to validate and calibrate the new objective techniques. The purpose of this report was to demonstrate such a model and to test the capacity of an objective computer system to accurately measure physical change. The physical model consisted of an advancing edge of a spreading gelatin film. The model was measured in submillimeter increments. Concurrent measurements were made using the computed system. Ten trials were conducted. The objective system proved to be exquisitely sensitive (0.03 mm) and highly correlated with the physical criterion model (Pearson's product moment correlation coefficient [r]=0.9849). Sensitive and calibrated objective methods of analysis of facial motion are crucial to the design of clinical trials, clinical studies of nerve regeneration, and comparisons of reanimation techniques.
Gastroesophageal Reflux, Motility Disorders, and Psychological Profiles in the Etiology of Globus Pharyngis
Authors: Hill John , Stuart Robert C. , Fung Hin K. , Ng Enders K.W. , Cheung Fanny M. , Chung Sidney C.S. , Andrew van Hasselt C. 
Published: November 2003

AbstractThe aim of this study was to investigate the origin of globus pharyngis with particular reference to esophageal disorders such as gastroesophageal reflux disease (GERD), motility disorders, structural abnormalities, other gastrointestinal tract diseases, and psychological profile. Previous studies on this subject using 24‐hour pH monitoring give conflicting results and are hampered by the high background prevalence of asymptomatic GERD in the normal Western population. The local Chinese population is known to have a very low background level of GERD and therefore is an ideal study population. Twenty‐six patients with globus pharyngis underwent 24‐hour ambulatory pH monitoring, esophageal manometry, and esophagogas‐troduodenoscopy with lower esophageal biopsy. A control group of 20 patients presenting with non‐ulcer dyspepsia was similarly investigated. Personality profiles of the globus pharyngis subjects and an appropriate control group were assessed. Eight of the globus pharyngis group (30.7%) had evidence of GERD, whereas only one of the controls (5%) demonstrated GERD on 24‐hour esophageal pH monitoring (P < 0.05). The manometric and personality profile studies did not show significant differences between study and control groups. We concluded that the finding of GERD in patients with globus pharyngis is not a coincidental finding but that there is a true association between GERD and globus pharyngis.