bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unique Case Presentations of Acute Epiglottic Swelling and a Protocol for Acute Airway Compromise
Authors: Parsons David S. , Smith Russell B. , Mair Eric A. , Dlabal Luke J. 
Published: November 2003

AbstractAcute epiglottitis is a well‐described life‐threatening disease. Since the generalized use of the Haemophilus influenzae type B (HIB) vaccine, presentations of this disorder have decreased dramatically in children. Presentations of this and other acute epiglottic swelling can vary remarkably and may easily be misdiagnosed by physicians who have little or no experience with the acutely obstructed airway. Early suspicion and a proper evaluation is mandatory to prevent a life‐threatening crisis. Six patients are presented with unusual presentations of acute epiglottic swelling from differing etiologies; these include the following: case 1, recurrent epiglottitis; case 2, chronic epiglottitis; case 3, traumatic epiglottitis; case 4, caustic ingestion; and cases 5 and 6, simultaneous infection of family members. Because the incidence of acute epiglottitis is decreasing, it has become rare at most institutions. To help primary care and emergency room physicians, a formal written protocol should be available at medical facilities that might be faced with patients presenting with acute airway obstruction. An “acute airway obstruction protocol” used successfully for the last decade is offered. Use of such a written document might be lifesaving for patients with impending upper airway obstruction. The otolaryngologist is a key member of the recommended multidisciplinary team.Laryngoscope, 106:1287‐1291, 1996
Sudden Bilateral Sensorineural Hearing Loss
Authors: Fetterman Bruce L. , Luxford William M. , Saunders James E. 
Published: November 2003

AbstractMost cases of sudden sensorineural hearing loss (SHL) remain idiopathic, and the majority are unilateral. From 1989 to 1993, 823 patients with sudden SHL were evaluated. Of these, 14 (1.7%) had sudden bilateral SHL. We reviewed the charts of these 14 patients to compare sudden bilateral SHL with sudden unilateral SHL. Usually, bilateral SHL was asymmetric. Most bilateral cases received combined steroid and vasodilator treatment, while unilateral cases were more likely to receive only one of these treatments. By audiological criteria, 67% of bilateral SHL cases improved, while the improvement rate in unilateral SHL was 52%; however, this difference was not statistically significant. In bilateral SHL patients showing improvement, both ears responded. Bilateral SHL patients were older at the onset of hearing loss, had a higher incidence of vascular disease, and were more likely to have positive antinuclear antibody titer. Recognition of similarities and differences between sudden unilateral and bilateral SHL can help in counseling patients.
Submillimeter Magnetic Resonance Imaging of the Temporal Bone in Meniere's Disease
Authors: Welling D. Bradley , Clarkson Mark W. , Miles Beth A. , Schmalbrock Petra , Williams Philip M. , Chakeres Donald W. , Oehler Mary C. 
Published: November 2003

AbstractThe pathoetiology of Meniere's disease remains elusive. Histopathologic and imaging studies have implicated congenital or developmental abnormality of the endolymphatic duct as a likely predisposing factor to the development of endolymphatic hydrops and clinical Meniere's disease. Recently, improved high‐resolution magnetic resonance imaging (MRI) protocols have allowed better demonstration of the soft tissues of the endolymphatic duct and sac.This study is a prospective evaluation of the ability of submillimeter MRI to detect the endolymphatic duct in Meniere's disease patients and control subjects. In addition, the development of the temporal bone in the region of the endolymphatic sac and duct is evaluated by measurements of the distance from the posterior semicircular canal to the subarachnoid space and the distance from the vestibule to the subarachnoid space.Visualization of the endolymphatic duct was found to be significantly less frequent in the Meniere's disease patients (29%) than in the control subjects(91%). Temporal bone measurements in the region of the endolymphatic duct showed patients with Meniere's disease to have smaller dimensions than control subjects.
Closure of the Fibula Free Flap Donor Site With the Sure‐Closure™ Skin‐Stretching Device
Authors: Futran Neal D. 
Published: November 2003

AbstractFibula osseocutaneous free tissue transfer represents state‐of‐the‐art reconstruction of the oromandibular complex following oncologic resection. The width of the fibula skin paddle is usually limited by the ability to achieve primary wound closure. In some cases the donor site requires skin grafting and subsequent surgical procedures to achieve effective closure, or placement of a tissue expander. The recent development of an indexed tissue advancement system(Sure Closure™) makes it possible to take advantage of the viscoelastic properties of skin to close large wound deficits in a single procedure. The system secures and brings together wound edges by applying graduated pressure with a metered force approximator. A series of 12 fibula osseocutaneous free flap defects is presented, which have been successfully closed using this simple, convenient, and safe device.
Contraction Patterns of Intrinsic Laryngeal Muscles Induced by Orderly Recruitment in the Canine
Authors: Broniatowski Michael , Vito Kenneth J. , Shah Bharat , Shields Robert W. , Secic Michelle , Dessoffy Ray , Strome Marshall 
Published: November 2003

AbstractThe specific performance of intrinsic laryngeal muscles has been difficult to evaluate, especially in living subjects. To reproduce natural contractions, we artificially induced orderly recruitment of their innervating axons according to the size principle. In 5 dogs, both recurrent laryngeal nerves(RLNs) were stimulated with 50 through 10 Hz, 300 to 1000 μA currents while 600 Hz, 1000 to 0 μA decreasing blocking currents were administered. Surface electromyography electrodes placed on the thyroarytenoid, posterior cricoarytenoid, and lateral cricoarytenoid muscles were used to determine the amplitudes (in mA) of compound muscle action potentials. There was a highly statistically significant difference (P<.004) between the thyroarytenoideus which had the fastest rate of recruitment (8.38%), and posterior cricoarytenoideus, which had the slowest (4.81%). There was an intermediate recruitment rate (6.72%) of the lateral cricoarytenoideus, a divergence attributed to a more equal distribution in fast and slow types of myofibers and a smaller sample. We submit that RLN axons can be recruited in an orderly manner according to their sizes and that the rates are unique to the muscle classes they innervate. The parameters defining these contraction patterns may offer key information for laryngeal pacing.
Experimental Study on Reinnervation of Vocal Cord Adductors With the Ansa Cervicalis
Authors: Zheng Hongliang , Li Zhaoji , Zhou Shuimiao , Cuan Yi , Wen Wu , Lan Jingshang 
Published: November 2003

AbstractThe purpose of this study was to reestablish the adduction of the paralyzed vocal cord through reinnervation of the adductor muscles for unilateral vocal cord paralysis. In nine dogs, the adductor branch of the recurrent laryngeal nerve was anastomosed to the main branch of the ansa cervicalis. Six months later, various techniques of observation showed that seven of nine cases had excellent to good adduction during whining. Adduction was caused by reinnervation of the adductor muscles from the ansa cervicalis as demonstrated by laryngeal spontaneous and evoked electromyography, contraction tension, and various histologic findings. Therefore, the new technique could be a good treatment of unilateral vocal cord paralysis.
Endoscopic Sinus Surgery in the Treatment of Cystic Fibrosis With Nasal Polyposis
Authors: Rowe‐Jones Julian M. , Mackay Ian S. 
Published: November 2003

AbstractWe have performed endoscopic sinus surgery on 46 patients with chronic, polypoid rhinosinusitis since 1989. Follow‐up ranged from 1 month to 6 years(mean, 28.2 months). Overall, our patients had a 50% chance either of their symptoms returning to preoperative severity or of undergoing a second endoscopic sinus procedure, by 18 to 24 months of postoperative follow‐up. Patients with predominantly infective symptoms of mucopurulent rhinorrhea and pain had a significantly better outcome than those with predominantly nasal blockage. The chance of the former group of patients suffering symptom deterioration back to the preoperative state or undergoing a second endoscopic sinus operation was 37% of that of the latter group. The extent of disease on computed tomography scan had no relation to outcome.
Effect of Cortisporin Otic Suspension on Cochlear Function and Efferent Activity in the Guinea Pig
Authors: Perry Brian P. , Smith David W. 
Published: November 2003

AbstractTo predict cochlear receptor cell insult from therapeutic aminoglycoside antibiotics, we sought to determine whether the presence of subtoxic concentrations of Cortisporin otic suspension in the cochlea can be detected by measuring changes in efferent suppression of compound action potentials recorded from the round window. Olivocochlear efferent suppression in an earlier study was reversibly inhibited by injections of gentamicin in guinea pigs. Using that same technique, we found that 2.0 μL of Cortisporin otic suspension (neomycin, polymyxin B, hydrocortisone) placed on the round window of guinea pigs in varying concentrations causes a rapid, permanent alteration in thresholds. Solutions of Cortisporin otic suspension diluted to a concentration of 1:20 yield a reversible loss of efferent suppression without measurable changes in compound action potential. These data suggest that the presence of Cortisporin otic suspension can be detected functionally in the cochlea at very low concentrations prior to the development of a threshold shift.
Extended Use of Topical Nasal Decongestants
Authors: Yoo John K. , Seikaly Hadi , Calhoun Karen H. 
Published: November 2003

AbstractUse of sympathomimetic topical nasal decongestants to treat nasal obstruction is usually restricted to 3 to 5 days to avoid potential rebound swelling (rhinitis medicamentosa). In this study, 10 healthy volunteers used oxymetazoline (long‐acting topical nasal decongestant) nightly for 4 weeks. Subjects who used antihistamines, oral or topical decongestants, or systemic steroids or who had active sinusitis were excluded from the study. Weekly history, physical examination, and anterior rhinomanometry revealed no adverse effects. Eight (80%) subjects developed nightly nasal obstruction a few hours before the evening dose; the obstruction resolved within 48 hours if no more decongestant was used. All subjects remained responsive to oxymetazoline 4 weeks and 8 weeks after the study began. This finding suggests that long‐acting decongestants may be safely used for longer than the recommended 3 to 5 days without adverse effects if used once nightly.
The Effects of 13‐cis Retinoic Acid on Squamous Cell Carcinoma Proliferation and Adhesion to Extracellular Matrix Proteins
Authors: Speyer Matthew T. , Jackson Jon A. , Burkey Brian B. 
Published: November 2003

AbstractTo understand the role of retinoids in chemoprevention, the authors examined the effects of 13‐cis retinoic acid (cRA) on squamous cell carcinoma proliferation and adhesion to extracellular matrix proteins. The antiproliferative effects of cRA were first seen on day 11 (66% inhibition) and progressed through day 19 (96% inhibition).Using an adhesion assay, the authors then investigated the effects of cRA and transforming growth factor‐beta1 (TGF‐β1) on cellular adhesion to purified type IV collagen, fibronectin, and laminin matrices. Cells treated for 4 days with TGF‐β1 increased adhesion by 15% to 29%, and cells treated with cRA increased adhesion by 19% to 39%. However, the use of cRA alone resulted in a decrease in adhesion when tumor cells were treated for 7 days (20% to 32%) and 15 days (25% to 40%).The authors also discuss how cRA acts as a differentiating agent on squamous cell carcinoma.
Use of the KTP‐532 Laser in Acoustic Neuroma Surgery
Authors: Nissen Alan J. , Sikand Ashley , Welsh Joseph E. , Curto Frank S. 
Published: November 2003

AbstractThe potassium titanyl phosphate (KTP‐532) laser has been applied to otologic surgery with a proven record of both safety and efficacy. The aim of this study was to demonstrate the use, safety, and advantages of laser dissection in the surgical treatment of acoustic neuromas. The authors' experience with 111 patients in whom laser surgery was used in acoustic neuroma is presented, with emphasis on surgical technique employed and facial nerve functional outcome. The method of laser dissection did not result in deleterious neurologic sequelae or laser‐specific complications. In addition, laser dissection afforded certain advantages to traditional techniques, especially in larger tumors. The facial nerve functional outcome as assessed by the House‐Brackmann grading system revealed that 90.2% of small tumors, 72.2% of medium tumors, and 75.0% of large tumors achieved satisfactory (grades I and II) functional results. These results compare favorably with the literature describing nonlaser dissection techniques. The observations and results reported in this article demonstrate the safety of the KTP‐532 laser in the posterior cranial fossa, and specific advantages that this technology may offer to the surgical armamentarium of the neuro‐otologist are outlined.
Myringotomized Mice Develop Myringosclerosis in the Pars Flaccida and Not in the Pars Tensa
Authors: Mattsson Cecilia , Carlsson Lena , Marklund Stefan L. , Hellström Sten 
Published: November 2003

AbstractThe development of myringosclerosis has been correlated with increased production of oxygen‐derived free radicals. For the present study, we used a null mutant mouse lacking extracellular superoxide dismutase to test the hypothesis that increased production of free radicals can cause the development of myringosclerosis. Null mutant mice and wild‐type, control mice were myringotomized and kept in ambient air for 3 weeks. Both groups developed myringosclerosis in the pars flaccida, but not in the pars tensa. The sclerotic lesions were visible in both the light and the electron microscope but not in the otomicroscope. In particular, the localization of the sclerotic deposits was found beneath both the inner and outer epidermal epithelium. No difference concerning the extent or number of sclerotic lesions between the null mutant and the wildtype mice could be distinguished.
Demonstration of Autoantibodies to the Endolymphatic Sac in Meniere's Disease
Authors: Alleman Anthony M. , Dornhoffer John L. , Arenberg I. Kaufman , Walker Patrick D. 
Published: November 2003

AbstractRecent evidence suggests that immune mechanisms may underlie some cases of Meniere's disease. This study was conducted to determine whether an autoimmune mechanism is involved. Sera from 30 patients with Meniere's disease were reacted with human endolymphatic sacs and examined by indirect immunohistochemistry and fluorescence microscopy. Three of the samples (10%) showed positive staining, indicating immunoglobulin G (IgG) binding against the sac. No positive staining occurred when sera from healthy individuals or phosphate‐buffered saline was used as a control. Clinical data showed an association between immunoreactivity and extent of disease (worse hearing over a shorter disease course and bilateral involvement). This study suggests that, in some cases of Meniere's disease, autoantibodies directed against human endolymphatic sac are present in the sera, supporting the theory that a specific autoimmune reaction takes place in a minority of patients with Meniere's disease.
Comparison of Anti‐Heat Shock Protein 70 (Anti‐hsp70) and Anti‐68‐kDa Inner Ear Protein in the Sera of Patients with Meniere's Disease
Authors: Shin See‐Ok , Billings Peter B. , Keithley Elizabeth M. , Harris Jeffrey P. 
Published: November 2003

AbstractThe 68‐kDa antigen detected in the sera of patients with autoimmune inner ear disease is known to represent the highly inducible heat shock protein 70 (hsp70). To evaluate the existence of anti‐hsp70 in the sera of patients with Meniere's disease and to develop a more reliable method to detect this antibody, the sera of patients and controls were examined.Bovine kidney (MDBK) cells were cultured and some of them were heat shocked. Proteins in the cells were separated using sodium dodecyl sulfate polyacrylamide gel electrophoresis. Sera were reacted simultaneously with the blots of non‐heat‐shocked cells and heat‐shocked cells. The serum was considered positive if the band in the 70‐kDa location was denser in the lane with heat‐shocked cells relative to non‐heat‐shocked cells. Presence of the antibody against the 68‐kDa protein was compared with the result of immunoblotting with MDBK cells.In immunoblotting with MDBK cells, 33.3% of patients with Meniere's disease had anti‐hsp70, while in the control group, only 5% had this antibody. Of the 60 cases, 13 were positive against both hsp70 and the 68‐kDa protein, whereas 7 were positive only against hsp70 and 6 only against the 68‐kDa protein. These differences appeared to result from the greater sensitivity of the differential anti‐hsp assay and from difficulties in interpreting the results in blots with bovine inner ear extracts because of faint, broad, or overlapping multiple bands.Quite a number of patients with Meniere's disease have anti‐hsp70, and it may be indicative of an immune etiology of the disease. The Western blot using heat‐shocked and non‐heat‐shocked cells could be a reliable method to detect this antibody.
Clinical Classification as a Guide to Treatment of Sinusitis in Children
Authors: Weinberg Ellen A. , Brodsky Linda , Brody Alan , Pizzuto Michael , Stiner Holly 
Published: November 2003

AbstractEvaluation of all 153 children undergoing CT scan of the paranasal sinuses for recalcitrant sinusitis symptoms between January 1988 and July 1992 was performed. Clinical categorization into groups of patients presenting with chronic sinusitis (CS) and recurrent acute sinusitis (RAS) was based upon pattern of disease and presentation. Clinical symptoms and signs, radiological examination, treatment, and outcome were compared between these distinct clinical groups. Eighty‐two (55%) children were categorized as RAS and 68 (45%) as CS. Children with CS presented more frequently with a persistent cough, purulent nasal discharge, immune deficiency, and more severe mucosal disease on CT than children with RAS. Medical therapy successfully controlled the symptoms of sinusitis in 79 (96%) with RAS versus 27 (40%) with CS. Surgery was performed in 44 children: 3 (3.6%) with RAS versus 41 (60%) with CS, p<0.01. At a mean follow‐up of 2.0 years, >80% of all the children were either asymptomatic or improved regardless of treatment modality. These data support the use of clinical classification as a guide to medical versus surgical therapy in children with sinusitis.
One‐Stage Reconstruction of Partial Laryngopharyngeal Defects
Authors: Schuller David E. , Mountain Rodney E. , Nicholson Roy E. , Bier‐Laning Carol M. , Powers Bret , Repasky Michael 
Published: November 2003

AbstractAdvanced‐stage lesions of the hypopharynx or tongue base often involve the larynx. The difficulty of reconstructing large partial laryngopharyngeal defects can result in total laryngectomy being performed to avoid the assumed problems with aspiration. This article describes the first reported experience using the pectoralis musculocutaneous flap for primary one‐stage reconstruction of laryngopharyngeal defects following resection of advanced‐stage lesions, to reconstruct both the laryngeal and the pharyngeal components of the defect. In this group of 21 patients, there were 16 with hypopharyngeal and 5 with tongue base cancers. Two had received prior treatment, and all received some form of postoperative radiotherapy and/or chemotherapy. Six patients experienced complications, including two fistulae, three wound infections, two myocardial infarctions, and one colon perforation. There were no instances of stenosis of the reconstructed segment. The length of hospitalization ranged from 9 to 60 days, the average being 17 days. Forty‐seven percent (21) of the patients were not tolerating an oral diet at the time of discharge. However, 15 patients (71%) ultimately were eating by mouth, with 13 (62%) achieving an oral intake of liquids and solids. This analysis supports the hypothesis that the pectoralis major musculocutaneous flap is an effective one‐stage primary reconstruction technique for laryngopharyngeal defects in patients either who have received prior therapy or who will receive postoperative therapy.
Combined Transconjunctival/Intranasal Endoscopic Approach to the Optic Canal in Traumatic Optic Neuropathy
Authors: Kuppersmith Ronald B. , Alford Eugene L. , Patrinely James R. , Lee Andrew G. , Parke Robert B. , Holds John B. 
Published: November 2003

AbstractSurgical decompression of the optic canal is indicated in patients with traumatic optic neuropathy who fail to respond to corticosteroids. Traditional surgical approaches to the orbital apex have been effective in achieving optic nerve decompression but require either a craniotomy, provide limited exposure with late identification and protection of the optic nerve, or require external incisions. The combined transconjunctival/intranasal endoscopic approach to the optic canal offers sufficient exposure, allows early identification and protection of the optic nerve, provides space for the use of multiple surgical instruments, obviates a craniotomy and external incisions, and can be performed quickly with minimal morbidity. The technique of combined transconjunctival/intranasal endoscopic optic nerve decompression will be described and the experience with nine cases will be presented.
Effect of Sinus Surgery on Pulmonary Function in Patients With Cystic Fibrosis
Authors: Madonna Dino , Isaacson Glenn , Rosenfeld Richard M. , Panitch Howard 
Published: November 2003

AbstractThe impact of sinus surgery on the pulmonary status of cystic fibrosis patients is unknown. This retrospective study reviewed the charts of the cystic fibrosis patients presenting to our institution's cystic fibrosis center with nasal obstruction, recurrent sinusitis, and nasal polyposis. This group subsequently underwent endoscopic ethmoidectomy and antrostomy. Fourteen of the 15 patients, ages 5‐24 years, received preoperative and postoperative pulmonary function testing obtained by spirometry. The data were compiled and analyzed statistically. Our results suggested no significant improvement in the pulmonary function of cystic fibrosis patients after sinus surgery.