bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Passive‐Marker‐Based Optical System for Computer‐Aided Surgery in Otorhinolaryngology: Development and First Clinical Experiences
Authors: Klimek Ludger , Ecke Ulrich , Lübben Björn , Witte Jens , Mann Wolf 
Published: November 2003

AbstractObjectives:To develop a new type of optical computer‐aided surgery (CAS) device that overcomes some of the restrictions of common systems and to examine its accuracy and usability under laboratory and intraoperative conditions.Study Design:Prospective study using laboratory experiments and intraoperative data collection.Methods:An optical CAS system applying passive optical markers for coordinate determination was developed. Laboratory accuracy measurements were obtained on a Plexiglas model with known coordinates of fiducial markers, before and after predefined table movements. Intraoperative accuracy measurements were recorded from 24 patients undergoing endonasal surgery of the paranasal sinuses with two different referencing techniques (fiducial markers and mouthpiece).Results:The system demonstrated laboratory accuracy to within 0.86 mm (SD = 0.94 mm). After table movements, the accuracy decreased to 1.12 mm (SD = 0.99 mm), 1.05 mm (SD = 0.96 mm), 1.15 mm (SD = 1.04 mm), and 1.54 mm (SD = 1.25 mm), respectively, in four different positions. Intraoperative accuracy was within 1.14 mm (SD = 0.57 mm) (fiducial markers) and 2.66 mm (SD = 1.89 mm) (mouthpiece) (P< .05). One of the main advantages of the new technology was the possibility of using any common instrument or endoscope by adapting a marker array.Conclusions:Passive‐marker technology has been demonstrated to be useful for optical position determination in computer‐aided surgery.
Effects of Environmental Tobacco Smoke on Objective Measures of Voice Production
Authors: Lee Linda , Stemple Joseph C. , Geiger Diane , Goldwasser Rebecca 
Published: November 2003

AbstractObjective: The effects of passive smoking on the voice and laryngeal structures of 20 female passive smokers and 20 age‐matched nonsmokers were examined.Methods: The voice evaluation consisted of acoustic, aerodynamic, and videostroboscopic analyses.Results: Three passive smokers displayed mild edema or erythema. Passive smokers had higher mean flow rates and shorter mean maximum phonation times during sustained vowels at comfortable, low‐, and high‐pitch levels. However, means were only outside normal limits and significantly different from nonsmokers at high pitch. Variables such as the number of years and hours per day subjects were exposed to environmental tobacco smoke were considered.Conclusion: The majority of the variables indicated that vocal fold structure and function were not adversely altered by exposure to passive smoke. Differences between these results and clinical observations are highlighted.
Laryngeal Contact Granuloma
Authors: Wani Manish K. , Woodson Gayle E. 
Published: November 2003

AbstractObjective: To report outcomes of treatment for laryngeal contact granuloma.Study Design: Prospective treatment of 21 patients with laryngeal contact granulomas using proton‐pump inhibitor (PPI) medication.Methods: Patients were diagnosed and followed by office endoscopy and patient interview.Results: Three patients did not tolerate PPI medication and were managed by treatment with type 2 histamine (H2) blockers. The lesion completely resolved in 14 of the 18 patients maintained on PPI medication, and significantly regressed in the other 4. Residual granulomas were surgically excised in one patient. Lesions resolved in two patients following injection of botulinum toxin into one thyroarytenoid muscle. One patient had a residual lesion, but symptoms were controlled by medication, and he declined treatment with botulinum toxin. Of the three patients treated with H2‐blocker medication, the lesion resolved in only one.Conclusion: PPI medication is effective in the treatment of laryngeal contact granuloma, even in the absence of identifiable symptoms of gastroesophageal reflux.
Penetration of Cefuroxime Into Chronically Inflamed Sinus Mucosa
Authors: Dinis Paulo Borges , Monteiro Maria Conceição , Lobato Rosário , Martins Maria Luz , Gomes Augusto 
Published: November 2003

AbstractObjectives: Despite its seeming relevance, limited information exists about antibiotic sinus tissue penetration and how it is affected by inflammation. Thus the reason for the present investigation.Study Design: A randomized, open, multiple‐dose, pharmacological study, employing cefuroxime axetil, an approved oral antimicrobial for the treatment of acute bacterial rhinosinusitis, was developed.Methods: Twenty subjects, selected for surgery because of chronic rhinosinusitis, were randomly allocated to receive either a short (3‐8 d) or a long (9‐14 d) preoperative treatment regime with 500 mg cefuroxime axetil BID, the last dosage being taken 3 to 4 hours before surgery. At the operation, tissue samples were collected at specific sinonasal sites for both pharmacological determination of antibiotic levels and histopathological assessment of the degree of inflammation. The blood levels of the drug were simultaneously assayed.Results: Cefuroxime kinetic behavior on chronically inflamed mucosa was shown to be, for the most part, dependent on the blood levels, regardless of the inflammatory state. Distribution was even throughout the different sinus cavities, and the tissue levels were still, 3 to 4 hours after dosing, above the reported minimum inhibitory concentration (MIC) values for some of the most prevalent sinus pathogens. The extended treatment course did not seem to add any extra histopathological or pharmacological benefit.Conclusions: Cefuroxime penetrates adequately and uniformly into chronically inflamed sinus mucosa, apparently unaffected by the degree of inflammation, in a way not dissimilar to its pharmacokinetic behavior in the normal state. Persistent MIC levels for common pathogens still warrant antimicrobial efficacy for a significant period of time after dosing.
Combined Arytenoid Adduction and Laryngeal Reinnervation in the Treatment of Vocal Fold Paralysis
Authors: Chhetri Dinesh K. , Gerratt Bruce R. , Kreiman Jody , Berke Gerald S. 
Published: November 2003

AbstractObjective/Hypothesis: Glottal closure and symmetrical thyroarytenoid stiffness are two important functional characteristics of normal phonatory posture. In the treatment of unilateral vocal cord paralysis, vocal fold medialization improves closure, facilitating entrainment of both vocal folds for improved phonation, and reinnervation is purported to maintain vocal fold bulk and stiffness. A combination of medialization and reinnervation would be expected to further improve vocal quality over medialization alone.Study Design: A retrospective review of preoperative and postoperative voice analysis on all patients who underwent arytenoid adduction alone (adduction group) or combined arytenoid adduction and ansa cervicalis to recurrent laryngeal nerve anastomosis (combined group) between 1989 and 1995 for the treatment of unilateral vocal cord paralysis. Patients without postoperative voice analysis were invited back for its completion. A perceptual analysis was designed and completed.Methods: Videostroboscopic measures of glottal closure, mucosal wave, and symmetry were rated. Aerodynamic parameters of laryngeal airflow and subglottic pressure were measured. A 2‐second segment of sustained vowel was used for perceptual analysis by means of a panel of voice professionals and a rating system. Statistical calculations were performed at a significance level of P = .05.Results: There were 9 patients in the adduction group and 10 patients in the combined group. Closure and mucosal wave improved significantly in both groups. Airflow decreased in both groups, but the decrease reached statistical significance only in the adduction group. Subglottic pressure remained unchanged in both groups. Both groups had significant perceptual improvement of voice quality. In all tested parameters the extent of improvement was similar in both groups.Conclusion: The role of laryngeal reinnervation in the treatment of unilateral vocal cord paralysis remains to be established.
Penicillin Reduces New Bone Formation in Acute Otitis Media
Authors: Cayé‐Thomasen Per , Tos Mirko 
Published: November 2003

AbstractObjective: Previous studies have shown that acute otitis media alters modeling dynamics in bone tissue structures surrounding the middle ear cavity. Initial resorption is followed by formative activity, which is seen as massive osteoneogenesis. However, neither resorptive nor formative activity occurs in the otic capsule, supporting the theory on existence of a perilymphatic barrier of specialized bone.Study Design: To investigate the effect of penicillin administration on the pathological bone modeling in acute otitis media, we employed a rat model of acute pneumococcal otitis media.Methods: Five rats were sacrificed on postinoculation days 4, 8, 16, 90, and 180, preceded by oral administration of penicillin V 100 mg/kg per day, initiated on day 2 and lasting 5 (2) days. Using a light microscope, bone histomorphology was registered and the thickness measured in four well‐defined localities, followed by comparison with a previous study of untreated animals.Results: Measured bone thickness was unaffected by treatment on day 4, but significantly reduced in two localities on day 8 and in all localities on following days of sacrifice. Bone cytomorphology and histomorphology were otherwise unaffected by penicillin administration.Conclusion: Penicillin reduces new bone formation in acute otitis media, leaving other features of histomorphology unchanged.
Cochlear Microphonics for Hearing Preservation in Vestibular Schwannoma Surgery
Authors: Noguchi Yoshihiro , Komatsuzaki Atsushi , Nishida Hiroaki 
Published: November 2003

AbstractObjectives: To determine whether cochlear function is beneficial in decision‐making concerning the selection of hearing preservation surgery for vestibular schwannoma.Study Design: Retrospective review of 44 patients undergoing tumor resection with a middle fossa approach.Methods: Cochlear microphonics in electrocochleography together with tumor size, pure‐tone average (PTA), speech discrimination score (SDS), auditory brainstem response (ABR), and compound action potentials were examined. As acoustic stimuli, short tone‐bursts with frequencies of 0.5, 1, and 2 kHz were employed to measure cochlear microphonics and a click was used to obtain compound action potentials. We determined detection thresholds of cochlear microphonics and action potentials.Results: The overall rate of preservation of serviceable hearing was 59.1% (26/44). There were significant differences between patients with and without serviceable postoperative hearing in PTA, SDS, finding of ABR, compound action potential detection threshold, and mean cochlear microphonic detection threshold (at 0.5, 1, and 2 kHz). However, tumor size was unrelated to hearing outcome. Serviceable hearing was preserved in 23 (76.7%) of 30 patients, with a mean cochlear microphonic detection threshold of 40 dB nHL or less, suggesting normal or slightly impaired cochlear function. Hearing recovery was recognized in three patients, who also had a mean cochlear microphonic detection threshold of 40 dB nHL or less. Of the three patients, two had lower cochlear microphonic detection thresholds than audiometric thresholds, demonstrating the existence of a retrocochlear component in their hearing loss.Conclusions: The cochlear microphonic detection threshold predicts not only hearing preservation but also hearing improvement in patients with vestibular schwannomas.
Increased Expression of Inducible Nitric Oxide Synthase in Nasal Epithelial Cells in Patients With Allergic Rhinitis
Authors: Kawamoto Hiroko , Takeno Sachio , Yajin Koji 
Published: November 2003

AbstractObjectives: Although ciliated epithelial cells of human nose and paranasal sinuses have recently been reported to be the major source of locally detected nitric oxide (NO), changes to the NO production by these cells and their functional roles remain uncertain in relation to allergic rhinitis. The objective of this study is to investigate differences in the ability of induction of nitric oxide synthase (NOS) isoforms by nasal epithelial cells.Study Design: Epithelial cells of the inferior turbinate taken from 12 normal subjects and 12 allergic patients against house dust mite were used. Samples from the house dust group were taken both before and after antigen provocation.Methods: Immunoreactivity for two NOS isoforms, inducible NOS (iNOS) and endothelial NOS (eNOS), was examined by the laser scanning confocal microscope. The labeled cells were processed into digital images, and the fluorescence intensity was assessed quantitatively.Results: The degree of iNOS expression of the epithelial cells was significantly elevated in the house dust group compared with that of the control group. The expression appeared identical both before and after antigen provocation in the house dust group. On the other hand, there was no significant difference in eNOS expression between the two groups.Conclusions: We assume that the increased iNOS expression of the epithelial cells in the house dust group might result from stimulated secretion of proinflammatory cytokines during allergic responses. This further suggests profound contribution of nasal epithelial cells to modifying the airway clearance through the production of high levels of NO.
Accessory Nerve Function After Modified Radical and Lateral Neck Dissections
Authors: Köybasioglu Ahmet , Tokcaer Ayse Bora , Uslu S. Sabri , Ileri Fikret , Beder Levent , Özbilen Suat 
Published: November 2003

AbstractObjectives: Evaluate preoperative and postoperative electrophysiological changes related to the accessory nerve with reference to dissection technique, modified radical neck dissection, and lateral neck dissection.Study Design: Prospective electrophysiological analysis of accessory nerve function in a total of 20 laryngeal carcinoma patients after neck dissection, 12 being lateral neck dissection (4 bilateral) and 8 being modified radical neck dissection.Methods: Distal latencies, compound muscle action potentials, and electromyography findings were investigated before surgery and, in early and late postoperative periods in 20 laryngeal carcinoma patients. Results were evaluated by Student t test and χ2 test for intragroup and intergroup differences.Results: In the lateral neck dissection group, postoperative distal latencies were longer, without statistical significance, whereas in the modified radical neck dissection group postoperative latencies were statistically longer. Postoperative compound muscle action potentials were significantly lower in both groups. Electromyographic work‐up showed deterioration in early postoperative periods and improvement in late postoperative periods. When intergroup differences were compared, both postoperative compound muscle action potential and electromyographic findings were worse in the lateral neck dissection group.Conclusions: The accessory nerve function after modified radical neck dissection is better than function after lateral neck dissection because of increased stress applied to the nerve during retraction of the sternocleidomastoid muscle for achievement of a better exposed surgical field in lateral neck dissection.
Characteristic Distribution Patterns of Tenascin in Laryngeal and Hypopharyngeal Cancers
Authors: Juhász Attila , Bárdos Helga , Répássy Gábor , Ádány Róza 
Published: November 2003

AbstractObjectives: Progression of malignant neoplasias is accompanied by alteration of the extracellular matrix (ECM) composition. Tenascin is known as a member of the adhesion‐modulating family of ECM macromolecules; thus its expression and distribution may have significant influence on tumor cell proliferation and invasiveness.Study Design: The present study was carried out to determine the distribution pattern of tenascin in laryngeal and hypopharyngeal cancer samples.Methods: In double and triple immunofluorescent staining reactions the detection of tenascin was combined with labelings for cytokeratin (marker protein of epithelial cells), for CD‐34 (endothelial cell surface glycoprotein), and for a reaction with Ki‐67 monoclonal antibody (nuclear antigen in proliferating cells).Results: In laryngeal cancers, in early stages of tumor growth a markedly enhanced production of tenascin at the tumor host interphase was observed. In the later stages of tumor progression, a high number of blood vessels located in the tumorous tissues were also strongly labeled for tenascin. Around these vessels a significant number of proliferating tumor cells could be detected. In contrast, in hypopharyngeal cancers this vasculature‐associated staining pattern could be observed from the very early stage of tumor development. In laryngeal and in hypopharyngeal cancers, tenascin upregulation strongly correlated with metastasis formation, early tumor recurrence, and lethal outcome of the disease.Conclusions: Clinical and immunohistologic data indicate that the accumulation of tenascin in the tumor blood vessels is an unfavorable prognostic indicator in laryngeal and hypopharyngeal cancers.
Aspiration of Nasal Secretions Into the Lungs in Patients With Acute Sinonasal Infections
Authors: Özagar Altuğ , Dede Fuat , Turoğlu H. Turgut , Üneri Cüneyt 
Published: November 2003

AbstractObjectives: To compare the amounts of nasal secretions aspirated into the lower airway by patients with acute sinonasal infection with that aspirated by healthy adults during sleep.Study Design: Sixteen patients who had received a diagnosis of acute sinonasal infections by accurate history, anterior rhinoscopic examination, and radiological assessment and 13 healthy volunteers, aged 14 to 45 years.Methods: A 10‐mCi dose of technetium 99m‐labeled macroaggregated albumin (Tc‐99m MAA) with a concentration of 1 mCi/mL was prepared at midnight, just before sleep. Each subject was administered two puffs of this spray. At 8 AM the next morning transmission and emission views of the thorax were taken with a gamma camera.Results: No significant difference between the two groups was observed in the amounts of nasal secretions aspirated into the lungs.Conclusions: The amount of nasal secretions aspirated does not increase during acute sinonasal infection. However, by irritating the mucosa of the lower respiratory tracts, bacteria, toxins, and inflammatory products existing in purulent secretions may play a major role in the pathophysiology of asthma and sinusitis.
Apoptosis and Phagocytosis of Tissue‐Dwelling Eosinophils in Sinonasal Polyps
Authors: Davidsson Åke , Andersson Tina , Hellquist Henrik B. 
Published: November 2003

AbstractObjective: Sinonasal polyps contain numerous tissue‐dwelling eosinophils, but the mechanisms causing their accumulation, functional activities, and resolution are largely unknown.Study Design: Nasal polyp tissue from 14 patients was evaluated for cellular expression of CD95, CD68, and Annexin‐V, for the degree of apoptosis, and for phagocytosis of eosinophils.Material and Methods: Histological sections were immunostained as single stains for CD95, CD68, and Annexin‐V, and as an immunostaining for CD68 combined with a modified Vital New Red staining. The latter staining is specific for eosinophils. Other sections were stained by terminal d‐UTP nick end labeling (TUNEL) assay and routinely stained for H&E. Evaluation of the amount of stained cells was performed by counting the average number in 10 randomly chosen high‐power fields. The TUNEL positivity was in all cases confirmed with apoptotic morphology.Results: The inflammatory infiltrate consisted of numerous eosinophils but also a considerable amount of lymphocytes, mast cells, and macrophage‐like CD68+ cells. CD95 was frequently expressed on eosinophils, on numerous other inflammatory cells, and also on morphologically apoptotic cells. Annexin‐V‐positive eosinophils were not as frequent as CD95+ cells, but numerous Annexin‐V‐positive eosinophils were found. CD68+ cells approximately equalled the number of eosinophils. The number of cells phagocytosing eosinophils varied between polyps. Apoptosis of eosinophils (as evaluated by TUNEL combined with apoptotic morphology) was a common finding in six of the polyps.Conclusions: Previous in vitro and ex vivo findings of CD95 on eosinophils are now supported by demonstration of CD95 on eosinophils in this in vivo study. This investigation revealed a switch of the membrane‐bound phosphatidylserine of apoptotic cells, which is a novel observation. The study has demonstrated apoptosis of tissue‐dwelling eosinophils, and that CD68+ macrophage‐like cells phagocytose eosinophils within the sinonasal polyps.
A Multicenter Trial of Specific Local Nasal Immunotherapy
Authors: Motta Giovanni , Passali Desiderio , De Vincentiis Italo , Ottaviani Antonio , Maurizi Maurizio , Sartoris Alberto , Pallestrini Eugenio , Motta Sergio , Salzano Francesco A. 
Published: November 2003

AbstractObjective: To assess the efficacy and safety of specific local nasal immunotherapy (LNIT) in powder form in patients with allergic rhinitis, using subjective and objective parameters.Study Design: A double‐blind randomized multicenter trial of 102 patients with allergic rhinitis who were treated with specific LNIT for 8 consecutive months.Methods: After identifying allergens with the skin prick test and sensitization threshold dose with the specific nasal provocation test, 102 patients were selected, of whom 55 were allergic to mites and 47 were allergic to Graminaceae or Parietaria pollen. The specific treatments were self‐administered using an insufflator in two phases (phase 1: increasing doses; phase: 2, maintenance dose). Patients were evaluated before and after 32 weeks of treatment by subjective analysis of their self‐reported symptoms and by objective analysis of nasal provocation test, nasal resistance by anterior rhinomanometry, and mucociliary clearance time.Results: Clinical efficacy of LNIT for allergy to mites and pollens was confirmed by the differences in the symptoms score between the active group and the placebo group. The nasal provocation test results confirmed that this difference was statistically significant. The rhinomanometric analysis gave positive results for the treated group mainly in LNIT for mites. No differences in mucociliary clearance time were found.Conclusions: Specific LNIT is effective for allergic rhinitis and appears to offer considerable advantages over other hyposensitization methods. It can be done at home, patient compliance is good, and the treatment is safe.