bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Swallowing Side Effects of Botulinum Toxin Type A Injection in Spasmodic Dysphonia
Authors: Sedory Holzer Susan E. , Ludlow Christy L. 
Published: November 2003

AbstractBotulinum toxin type A (BOTOX®) injection of the thyroarytenoid muscle is used to control speech symptoms in patients with adductor spasmodic dysphonia. Transient difficulty in swallowing liquids is a common treatment side effect. Laryngeal movement durations were measured during swallowing in 13 adductor spasmodic dysphonia patients undergoing treatment and in 6 normal control subjects in order to determine the following: 1. whether, prior to the injection, laryngeal movement durations were longer in the spasmodic dysphonia patients than in the control subjects; 2. whether movement durations increased following the injections; 3. whether preinjection swallowing difficulties related to postinjection swallowing measurements and postinjection patient reports of swallowing problems.A piezoelectric movement transducer was shown to be accurate for noninvasive measurement of laryngeal movement duration in relation to muscle onset and offset for hyoid elevation and relaxation. Before botulinum toxin type A injection, no significant differences in swallowing duration were found between the patient and control groups. Four patients with swallowing complaints prior to injection had longer laryngeal movement durations than the other spasmodic dysphonia patients and the control subjects. Following injection, laryngeal movement durations increased in the patients with spasmodic dysphonia, and eight patients reported dysphagia for an average of 2 weeks.Relationships were found between the patients' initial reports of swallowing problems and increased laryngeal movement durations before and after botulinum toxin type A injection. Those patients initially reporting swallowing difficulties had severe dysphagia for 2 weeks after the injection. Patient reports of dysphagia prior to injection may indicate a greater likelihood of significant dysphagia following thyroarytenoid injection with botulinum toxin type A.
Vocal Capacities in Esophageal and Tracheoesophageal Speakers
Authors: Max Ludo , Steurs Wendy , de Bruyn Wendy 
Published: November 2003

AbstractThe present study investigated the vocal capacities of adult men who had undergone total laryngectomy. Esophageal (N = 10) and tracheoesophageal (N = 10) speakers were compared for the parameters maximum phonation time (MPT), maximum number of syllables that could be spoken on one air intake (SYLLS), dynamic range (DYN), frequency range (FREQ), and maximum intensity level (MIL). Statistical analyses yielded significant between‐group differences for the parameters MPT, SYLLS, and MIL but not for DYN and FREQ. Thus, although the groups did not differ with respect to range of intensity and frequency measures, maximum performance on the durational and intensity measures was always less for the esophageal speakers than for the tracheoesophageal speakers. Pearson's product‐moment correlations among these parameters were remarkably different for esophageal and tracheoesophageal subjects, suggesting that phonatory and aerodynamic factors interact differently in the two groups.
Computer‐Assisted Clinimetric Tool for the Study of Facial Expression
Authors: Holman Melisa L. , Neely J. Gail , Joaquin Allen H. 
Published: November 2003

AbstractClinimetrics is the measurement of clinical phenomena; more specifically, it is mensuration, the act of acquiring and labeling basic raw data that is used to describe or measure symptoms, signs, and other distinctly clinical phenomena.1Over the last 5 years, a new computer method for measuring facial expression has been developed. Refinement and validation of this technique are necessary before clinical applications are appropriate.Four hundred fifty data points from two human observers and the computed method were compared with one another by using indices of location, dispersion, and association within the framework of the logical construct of validity.These results suggest that the computed method is valid. This new method may be nearly ready for clinical applications as a primary or adjunctive clinimetric tool.
Quantitative Study of Vestibulotoxicity Induced by Gentamicin or Cisplatin in the Guinea Pig
Authors: Nakayama Meiho , Riggs Landon C. , Matz Gregory J. 
Published: November 2003

AbstractAlthough aminoglycoside vestibulotoxicity is well established, the question of cisplatin vestibulotoxicity is controversial. The goals of this study were 1. to determine whether cisplatin induces vestibulotoxicity as measured histologically, and 2. to compare the vestibulotoxicity between gentamicin and cisplatin. Guinea pigs' vestibular end‐organ hair bundles in control, gentamicin, and cisplatin groups were compared.In the lateral cristae of the cisplatin group, hair bundles decreased 21% on the central apex portion. In the gentamicin group, a slight decrease (17%) of hair bundles on the striola from the utricular maculae was observed, as was severe damage on the entire cristae, especially on the central apex (70%).These results indicate that gentamicin and cisplatin may not influence vestibular function of the otolithic membrane. However, gentamicin may severely damage and cisplatin may slightly damage the crista ampullaris hair bundles.
Scintigraphic Quantification of Aspiration Reduction With the Passy‐Muir Valve
Authors: Stachler Robert J. , Hamlet Sandra L. , Choi Jinho , Fleming Susan 
Published: November 2003

AbstractThe Passy‐Muir “speaking” tracheostomy valve has been noted to aid in swallowing, based on videofluoroscopy to assess aspiration. In this study scintigraphy was used to quantify the amount of material aspirated.Eleven patients were studied who currently had tracheostomy in place and were either known to aspirate or were suspected of aspirating. Most were post‐treatment head and neck cancer patients who were tumor free at the time of testing. Swallowing was evaluated using videofluoroscopy and scintigraphy. Videofluoroscopy was performed to assess anatomy and determine whether aspiration had occurred. Seintigraphic testing was then performed when the patient had the one‐way valve on, and again with it off and tracheostomy open.Following a swallow, the amount (%) of aspirate with the valve in place was found to be significantly less than with the tracheostomy open.A one‐way valve can be helpful in reducing aspiration in patients who are at risk for aspiration and who require that their tracheostomy be open.
Oral Lichen Planus and Its Association With Squamous Cell Carcinoma: An Update on Pathogenesis and Treatment Implications
Authors: Duffey Dianne C. , Eversole L.R. , Abemayor Elliot 
Published: November 2003

AbstractLichen planus of the oral mucosa (OLP) is characterized by lymphocytic mucositis, basal cell lysis, and lymphocyte transmigration into the epithelial compartment. Some reports have suggested a high incidence of oral squamous cell carcinoma (OSCCA) in OLP patients and have implicated OLP as a premalignant lesion. We describe five cases of OSCCA arising in patients with preexisting OLP. At our institution, the incidence of OSCCA in patients with OLP aproximates that reported in other series. The immunopathologic basis for OLP, its potential association with malignancy, and the variable clinical picture of OSCCA in patients with OLP are reviewed. Specific recommendations are given for treatment and follow‐up of lesions, including the role of future testing with viral and oncogene markers.
Intraoperative Electrophysiologic Monitoring of the Recurrent Laryngeal Nerve
Authors: Eisele David W. 
Published: November 2003

AbstractIntraoperative electrophysiologic monitoring of the recurrent laryngeal nerve was performed with a commercially available device consisting of an endotracheal tube with integrated stainless‐steel‐wire surface EMG electrodes positioned at the level of the true vocal cords. Forty‐two recurrent laryngeal nerves were successfully monitored with this system in 31 patients undergoing thyroidectomy or parathyroidectomy. In all cases, evoked EMG responses were elicited by direct electrical recurrent laryngeal nerve stimulation. Stimulus thresholds for evoked responses ranged from 0.2 to 0.6 mA (mean 0.3 mA) for the 37 nerves with preoperative ipsilateral normal vocal cord mobility. Mechanically evoked potentials with acoustic signals were also detected during the surgical procedures related to recurrent laryngeal nerve manipulation. It may be concluded that surface electrode monitoring of the recurrent laryngeal nerve with this system provides a simplified, noninvasive technique that is as sensitive as monitoring with intramuscular laryngeal electrodes.
Mucociliary Clearance Following Segmental Tracheal Reversal
Authors: Delaere Pierre R. , Liu Ziying , Delanghe Geertrui , Gyselen Kristien , Jorissen Mark , Feenstra Louw 
Published: November 2003

AbstractCiliated tracheal epithelium is arranged in a polarized pattern oriented according to the inferior‐superior axis of the trachea and is responsible for the transport of mucus toward the larynx. In this study, ciliary beat orientation and the influence of external factors on mucociliary clearance direction were studied in rabbit inverted cervical tracheas.The animals displayed normal respiration postoperatively. After 16 weeks, airway clearance was studied by observation of the movement of silicone particles placed in the inverted segment and in normal parts of the ciliated epithelium. Cilia exhibited unidirectional and coordinated movement within inverted tracheal segments. As shown by the direction of effective flow produced by beating cilia and by scanning electron microscopy, the cilia in the inverted segment beat in the opposite direction from the cilia in the remainder of the trachea. This study demonstrated that ciliary orientation is irreversibly determined, but the reversal of ciliary beating within the cervical trachea had no adverse effects on the survival of the animals.
Pathogenesis of Middle Ear Adhesions
Authors: Cayé‐Thomasen Per , Hermansson Ann , Tos Mirko , Prellner Karin 
Published: November 2003

AbstractMiddle ear adhesions are well‐known to the ear surgeon, although data on etiology, pathogenesis, and significance are lacking in current literature. This study on experimental acute otitis media presents histopathological data on these aspects. Pneumococci were inoculated in the right middle ear bulla of 25 rats; the left ear served as control. At days 4, 8, 16, 90, and 180, respectively, 5 rats were decapitated, and the bullae were removed, opened, and stained with periodic acid‐Schiff (PAS)/alcian blue. The entire middle ear mucosae were dissected from the bone, embedded as whole mounts in colophonium chambers, and examined by light microscopy. Representative parts of the mucosae were sectioned and examined in the same way. All inoculated ears from day 8 and later (20 in total), contained mucosal adhesions of various sizes, shapes, and locations. None were found in control ears. The site of predilection for the development of adhesions was the hypotympanum, followed by the anterior epitympanum, the attic, the drum, the interossicular spaces, and the tubal orifice. Based on present histopathological findings, we conclude that the middle ear adhesion is a pathological phenomenon caused by infection, and we propose a six‐stage hypothesis of pathogenesis: 1. Localized epithelial rupture; 2. Prolapse of subepithelial tissue; 3. Epithelialization of the prolapse, resulting in a polypous/fold‐like prominence; 4. Growth and elongation of the prominence; 5. Fusion of the end/tip of the prominence with another part of the mucosa; 6. Formation of an adhesion.
Echo‐Planar Magnetic Resonance Imaging of Deglutitive Vocal Fold Closure: Normal and Pathologic Patterns of Displacement
Authors: Gilbert Richard J. , Daftary Shrenik , Woo Peak , Seltzer Sharon , Shapshay Stanley M. , Weisskoff Robert M. 
Published: November 2003

AbstractAbnormalities of vocal fold closure during deglutition predispose to aspiration due to impairment of airway protection. Conventional assessment of deglutitive vocal fold motion with laryngoscopy does not permit visualization through a complete adduction‐abduction cycle. We determined spatiotemporal patterns of deglutitive vocal fold adduction through echo‐planar magnetic resonance imaging in 15 normal volunteers and 6 patients with vocal fold paralysis. In normal volunteers, deglutitive vocal fold adduction was synchronized with laryngeal elevation, with complete vocal fold closure at the apex. Patients with unilateral vocal fold paralysis demonstrated reduced elevation and medial movement of the involved vocal fold. At maximal laryngeal elevation the uninvolved vocal fold attained a position superior to the paralyzed fold, resulting in level differences and an interglottic gap. Patients with bilateral vocal fold paralysis demonstrated reduced elevation and medial movement of both vocal folds. These findings indicate that normal and abnormal patterns of vocal fold displacement can be distinguished noninvasively through the use of echo‐planar imaging.Laryngoscope, 106:568‐572, 1996
Comparison of Clinical Evaluation and Computed Tomographic Diagnostic Accuracy for Tumors of the Larynx and Hypopharynx
Authors: Thabet Hossam M. , Sessions Donald G. , Gado Mokhtar H. , Gnepp Douglas A. , Harvey Joseph E. , Talaat Mohammed 
Published: November 2003

AbstractNinety‐five patients with laryngeal and hypopharyngeal cancer were examined and staged preoperatively by clinical evaluation (CE) and computed tomography(CT). The CE and CT staging were compared to each other and to the pathologic(PT) staging of the tumors. The CT staging showed high accuracy in staging transglottic (88%), supraglottic (68%), and oropharyngeal tumors invading the larynx (68%) when compared to the PT findings. The CT staging was less effective in evaluating glottic tumors (46%), both overstaging (12%) and understaging (20%) cases. Combined CE‐CT evaluation showed higher accuracy in staging all tumors (84%) compared to CE alone (52%) or CT alone (68%). The findings suggest that combined CE‐CT should be used to evaluate laryngeal and hypopharyngeal tumors.Laryngoscope, 106:589‐594, 1996
Preventive Management of Cerebrospinal Fluid Leakage in Translabyrinthine Surgery
Authors: Meyerson Lance R. , Monsell Edwin M. , Rock Jack P. 
Published: November 2003

AbstractA simple technique can be used to prevent cerebrospinal fluid (CSF) leakage through the nose and the wound in translabyrinthine surgery. This method, evolved from Glasscock's technique of packing the eustachian tube, adds only 5 to 10 minutes to the procedure. The procedure was modeled in the temporal bones of 20 human cadavers, and the findings are described. With this technique, no nasal CSF leaks occurred in a consecutive series of 25 patients who underwent acoustic tumor surgery. Factors thought to be necessary for the success of the technique are discussed.Laryngoscope, 106:610‐613, 1996
A Histopathologic Review of Temporal Bone Exostoses and Osteomata
Authors: Fenton J. E. , Turner J. , Fagan P. A. 
Published: November 2003

AbstractIt is widely accepted that external auditory canal exostoses and osteomata are separate clinical entities that differ in their gross appearance. Disagreement still exists as to whether external auditory canal exostoses and osteomata should be considered similar or separate histopathologic entities. A chart review was performed of all patients who had external auditory canal exostoses or temporal bone osteomata excised from January 1991 to November 1994 at St. Vincent's Hospital, Sydney. A histologic examination was undertaken with a blind study method of the patients whose pathological specimens were suitable for assessment. Eight exostoses and five osteomata were available for examination. The results of this study demonstrate that exostoses and osteomata of the external auditory canal cannot be reliably differentiated by routine histopathological examination.Laryngoscope, 106:624‐628, 1996
The Communicating Vein and Its Use in the Radial Forearm Free Flap
Authors: Valentino Joseph , Funk Gerry F. , Hoffman Henry T. , McCulloch Timothy J. 
Published: November 2003

AbstractThrombosis is the most frequent cause of failure in microvascular free‐tissue transfer. The large communicating vein of the cubital fossa connects the deep and superficial venous drainage of the radial forearm free flap (RFFF). This vein allows the surgeon to simultaneously drain both systems by means of the large veins of the cubital fossa. We prospectively collected data on the venous anatomy of the cubital fossa in 40 consecutive RFFFs over a 3‐year period. We then retrospectively reviewed available data from the 14 cases preceding the cases in the prospective series. At least 78% of our patients had a communicating vein that facilitated dual venous drainage; 87% of our RFFFs were drained by both the superficial and deep venous systems, and 90% of our RFFFs had two or more venous anastomoses. We had no RFFF failures in our series of 54 flaps. We present our venous anatomy findings in this series of forearms as well as the venous anastomoses of our 54 patients. The surgical‐flap harvest, including the communicating vein and its use, may provide an advantage in the dependability and quality of venous outflow.Laryngoscope, 106:648‐651, 1996
Expanded Polytetrafluoroethylene Augmentation of the Lower Face
Authors: Sherris David A. , Larrabee Wayne F. 
Published: November 2003

AbstractMost options for rejuvenation of the lower face use soft‐tissue fillers that augment the appropriate sites. Each of these options has associated risks and benefits. The U.S. Food and Drug Administration recently approved the use of expanded polytetrafluoroethylene (E‐PTFE) as a soft‐tissue filler in the face.From January 1991 through December 1993, the authors used E‐PTFE soft‐tissue patches for lower facial augmentation in 41 patients at 115 implant sites. Postsurgical follow‐up has ranged from 2.5 to 4.5 years; during this time, complications have occurred in 4 patients. One implant had to be removed because of a seroma (1 patient), 4 implants required further secondary augmentation (2 patients), and 1 implant required revision because of malposition (1 patient). There have been no cases of implant infection, extrusion, long‐term inflammation, or capsule formation.In this article, the authors review the technical aspects of E‐PTFE use and discuss issues relating to the long‐term efficacy of this new option for soft‐tissue augmentation. The technique is also compared with other options for rejuvenation of the lower face.
Evaluation of Random Skin Flap Survival in a Porcine Model
Authors: Pratt Michael F. 
Published: November 2003

AbstractThe pathophysiology of random skin flap necrosis in the pig model was studied the effects of several drugs on skin flap survival were examined. The investigated drugs included acetylsalicylic acid (ASA), pentoxifylline (PTX), prostaglandin E2 (PGE2), and an experimental 21‐aminosteroid, U‐74389G. Each drug altered different parameters known to be associated with tissue necrosis.Demonstrated mechanisms of skin flap failure included the alteration of erythrocyte flexibility and platelet function and the activation of neutrophils with resultant accumulation of damaging oxygen‐free radicals. Random skin flap survival did not improve with ASA but did improve significantly with PTX, PGE2, and U‐74389G.The results of this study underscore the importance of neutrophil‐mediated necrosis in the pathophysiology of skin flap failure. The data further demonstrate the need to develop drugs aimed at reversing or preventing the tissue damage from oxygen‐free radicals in order to enhance the survival of random skin flaps.
Myology of the Pharyngoesophageal Segment: Gross Anatomic and Histologic Characteristics
Authors: Kelly James H. , Kuncl Ralph W. 
Published: November 2003

AbstractAlthough numerous studies have been performed on the function and dysfunction of the pharyngoesophageal segment, few studies have investigated features of the musculature in this area. Thus, the purpose of this study was to systematically examine the structure (gross anatomy and histology) in this area and to relate these findings to the functions of the pharyngoesophageal segment.Twenty‐one autopsy and surgery patients underwent careful measurement and observation of 1. the vertical (cephalad‐caudad) height of the cricopharyngeus muscle (CP); 2. the presence or absence of Killian's dehiscence; and 3. the separation or blending of the CP with the upper esophageal circular muscles. Of the 21 subjects, muscle specimens were removed from 8 (4 autopsy, 4 surgical) to include a muscle strip from the upper esophageal circular muscles, CP, and inferior pharyngeal constrictor and submitted to a battery of histological and histochemical tests.Gross anatomic measurements of the vertical height of the CP were substantially longer than those reported elsewhere. Killian's dehiscence was shown to be present in fewer than one third of the specimens. Histology of these muscles also showed significant differences from the muscles discussed in other published reports, particularly when fresh and autopsy material were compared. These specialized muscles, therefore, require further detailed study.
Avascular Tympanojugular Paraganglioma
Authors: Balli Ruggero , Dallari Stefano , Bergamini Giuseppe , Maiorana Antonio 
Published: November 2003

AbstractThe avascular paraganglioma described in this article appears to be the second such tumor reported in the international literature and the first to be reported in the tympanojugular region. Despite a highly suggestive history and clinical appearance, the tumor showed no signs of vascularization on radiologic studies. The pathologic postoperative study confirmed the diagnosis of paraganglioma with extensive stromal fibrosclerosis and without the typical well‐vascularized thin fibrous septa. In the authors' opinion, this observation is notable because of the difficulties encountered in the correct diagnostic interpretation of an avascular mass in the tympanojugular region. In such cases, the possibility of a paraganglioma should always be considered.
Age Dependency of the Composition of Immunocompetent Cells and the Expression of Adhesion Molecules in Rat Laryngeal Mucosa
Authors: Jecker Peter , Ptok Martin , Pabst Reinhard , Westermann Jürgen 
Published: November 2003

AbstractClinical evidence shows that laryngeal infections in infants differ significantly from those in adults. Therefore, the composition of the mucosal immune system (granulocytes, macrophages, dendritic cells, natural killer cells, and T and B lymphocytes) and the epithelial expression of class II‐MHC molecules and adhesion molecules ICAM‐1, VCAM‐1, and E‐selectin were studied in the larynx of newborn, 5‐week‐old, and 3‐year‐old rats.With the exception of macrophages, the immunocompetent cells began to immigrate into the laryngeal mucosa after birth, indicating that the laryngeal mucosa in newborn rats is immature. In contrast, ICAM‐1 was already expressed. The number of immunocompetent cells and the expression of epithelial class II‐MHC and ICAM‐1 increased with age. Immunocompetent cells and epithelial class II‐MHC and ICAM‐1 expression were mainly detected in the subglottic region, but were almost absent in the vocal fold region.