bluuebunny/crossref_metadata_2025_split huggingface dataset:
Airway Growth After Cricotracheal Resection in a Rabbit Model and Clinical Application to the Treatment of Subglottic Stenosis in Children
Authors: Ward Robert F. , Triglia Jean Michel 
Published: November 2003

AbstractObjective To evaluate the effects of a partial resection of the anterior cricoid arch on the growth of the laryngotracheal complex in an animal model and to study the lumen caliber and cross sectional surface area following resection as the animals are allowed to grow. Laryngeal, subglottic, and tracheal measurements in the infant and pediatric larynges in autopsy specimens are also investigated.Design A controlled animal study was done comparing the operated rabbit group to the nonoperated group. Twenty‐nine infant rabbits were compared to a control group of ten rabbits. In addition, autopsy dissections were performed on infant and pediatric larynges to obtain measurements of various laryngeal and cricoid relationships.Methods Thirty‐nine pasteurella‐free New Zealand white female rabbits between the ages of 8 and 11 weeks were used in this study. In the experimental group, cricotracheal resections were performed by removing the anterior cricoid cartilage and the first tracheal ring. A primary anastomosis was then performed. The animals were kept alive for 4 months and then humanely euthanized. The laryngeal complex was then removed and histological sections of the cricotracheal region were mounted on glass slides and stained with H&E. Measurements were taken of the cricoid and upper tracheal lumen and cross‐sectional area.Results Twenty‐seven of the study group survived until the time of sacrifice. All of the control group survived during the study period. The two groups were comparable in regard to weight, lumen size, and cross‐sectional area. There were no statistical differences between the groups.Conclusions The e‐perimental data support the hypothesis that partial cricotracheal resections can be performed safely and effectively in young rabbits. The potential clinical significance is described in light of the autopsy data.
A Functional Model System of an Hypoxic Nerve Injury and Its Evaluation
Authors: Santos Perry M. 
Published: November 2003

AbstractObjectives/Hypothesis Develop an hypoxic peripheral nerve injury model with a controlled injury type and two types of clinically relevant physiological measurements of function during and after recovery. The model, controlling for injury and measurement variables, would have predictable outcomes in function. The functional model could test potential therapeutic interventions with greater sensitivity.Study Design Twenty‐one rats were used in preliminary studies evaluating peroneal nerve injury types and functional model evaluation. Forty‐eight rats were used in a controlled and blinded evaluation of the injury model followed by treatment with hyperbaric oxygen (HBO) as a potential therapeutic intervention and evaluated with functional models.Methods Preliminary studies compared nerve injuries: epineurectomy, epineurectomy with crush and transection with autograft for rate of return of function and final extent of return of function. The gait analysis model was also evaluated and modified to decrease variability. The final study evaluated peroneal epineurectomy and nerve crush injury with serial gait analysis during recovery, final elicited maximum force measurements, and histological analysis. Half of the animals were treated with HBO during recovery (ANOVA or regression statistical analysis were used to determine group differences.)Results Preliminary studies suggested that the peroneal nerve injury model of an epineurectomy with crush of specified length and a modification of the gait analysis model would yield a useful and predictable injury outcome. The final study resulted in predicted and consistent injury outcomes. In the HBO treatment group, a 12% improvement in function 5 days after HBO treatment was demonstrated (P < .03), but no long‐term or histological benefit was seen.Conclusion A reliable hypoxic nerve injury model has been developed and tested utilizing two functional methods as the primary outcome variables.
Epidermal Growth Factor Receptor–Mediated Stat3 Signaling Blocks Apoptosis in Head and Neck Cancer
Authors: Rubin Grandis Jennifer , Zeng Qing , Drenning Stephanie D. 
Published: November 2003

AbstractObjectives Upregulation of epidermal growth factor receptor (EGFR) is critical for the loss of growth control in a variety of human cancers including squamous cell cancers of the head and neck (SCCHN). In these tumor cells in culture, EGFR stimulation initiates signaling via persistent activation of STAT proteins, particularly Stat3. The present study was conducted to study the association between EGFR stimulation and constitutive activation of Stat3 in SCCHN in vivo and to investigate the proliferative and apoptotic consequences of Stat3 downmodulation in SCCHN cells in vitro.Methods SCCHN tumor xenografts were analyzed using electrophoretic mobility shift assay. A dominant‐negative mutant Stat3 expression construct or a Stat3 antisense plasmid was transfected into SCCHN cells using lipofectamine. Cell growth and apoptosis were determined by vital dye exclusion and flow cytometry, respectively.Results In vivo liposome‐mediated gene therapy with an EGFR antisense plasmid efficiently inhibited Stat3 activation in a head and neck xenograft model. Downmodulation of Stat3 using a dominant‐negative or antisense approach inhibited tumor cell growth and stimulated apoptosis.Conclusions These findings provide evidence that constitutively activated Stat3 is linked to EGFR signaling in SCCHN in vivo, which contributes to the loss of growth control by an anti‐apoptotic mechanism.
State of the Art Review: Current Status of Topical Nasal Antimicrobial Agents
Authors: Goh Yau Hong , Goode Richard L. 
Published: November 2003

AbstractThe nasal cavity and paranasal sinuses are probably one of the last frontiers in the head and neck region where the use of topical antimicrobial agents is not yet established. Although the anatomy of the nasal cavity and the paranasal sinuses can theoretically be exploited for the administration of antimicrobials in rhinosinusitis, very few studies have been conducted to test the feasibility of this mode of therapy. We review the anatomical and physiological factors that should be considered in the use of topical nasal antimicrobial agents and the current status of topical nasal antimicrobial usage, and we make recommendations for the administration of topical nasal antimicrobial agents.
Candidate's Thesis: Universal Newborn Hearing Screening in an Inner‐City, Managed Care Environment
Authors: Isaacson Glenn 
Published: November 2003

AbstractObjectives/Hypothesis Universal neonatal hearing screening (UNHS) programs aim to identify and treat educationally significant hearing loss in the first months of life. Several states have mandated UNHS for all newborns. Such programs have been successful in small, homogeneous populations. As larger states attempt to implement such programs, important obstacles have arisen, particularly in sparsely populated rural environments and in the inner city, where poverty, unstable living situations, and inadequate access to health care make follow‐up of infants failing initial testing difficult.Study Design We performed a prospective longitudinal study e‐amining the effects of increasingly comple‐ and e‐pensive interventions designed to ensure that children failing initial hearing screening returned for complete evaluation and habilitation.Methods A UNHS program based on transient evoked otoacoustic emissions testing was implemented at Temple University Hospital, with 2,000 births per year. At 6 months into the program, efficacy was assessed and modifications in follow‐up methodology were made in an attempt to improved rate of return of infants failing newborn screening. The effect of these interventions was reassessed 6 months later.Results In its first 12 months, the Temple University Infant and Young Child Hearing Intervention Initiative successfully screened 95% (2,031) of all newborns using transient evoked otoacoustic emissions. Collecting a complete database profile for each newborn, establishing rapport with the family, and offering immediate follow‐up appointments yielded a 61% return rate after discharge. The addition of a dedicated project secretary, free day‐care for siblings, and cab vouchers for transportation and the elimination of a requirement for health maintenance organization referrals increased follow‐up yield to 75%.Conclusion Given adequate resources and planning, UNHS can be successful, even in economically depressed environments.
Candidate's Thesis: Quality of Life and Recurrence Concern in Survivors of Head and Neck Cancer
Authors: Campbell Bruce H. , Marbella Anne , Layde Peter M. 
Published: November 2003

AbstractObjectives/Hypothesis A cohort of 3‐year survivors of head and neck cancer was evaluated for persistent quality of life (QOL) concerns and long‐term treatment effects.Study Design Mailed questionnaire.Methods The questionnaire with the University of Washington Quality of Life (UWQOL) scale, the Performance Status Scale for Head and Neck Cancer (PSS‐HN), the Functional Assessment of Cancer Therapy (FACT) scale, and the Functional Assessment of Cancer Therapy Head and Neck (FACT‐HN) scale and locally prepared questions was sent to 111 3‐year disease‐free survivors. Analysis was performed to statistically evaluate the effect of stage, site, treatment type, surgery, and cancer concern on QOL. Current smoking information was gathered.Results Seventy‐two survivors completed the questionnaire. Advanced stage was correlated with lower QOL scores in the domains of disfigurement, chewing ability, speech, and eating in public. QOL scores did not vary by initial tumor site. Patients treated with irradiation alone had statistically better QOL scores than those treated with combined surgery/radiation therapy in the pain, disfigurement, chewing, and speech domains. Laryngectomy and composite resection survivors reported lower QOL scores than patients treated with irradiation alone. A low level of cancer concern persisted in about half of the long‐term survivors. Cancer concern was associated with continued pain, disfigurement, and limitations on eating in public. Three‐quarters of the tobacco users had quit by the time of the questionnaire. Nevertheless, the patients were not thoroughly convinced that tobacco had caused their cancer.Conclusions Long‐term survivors of head and neck cancer experience QOL effects well after completion of treatment. Effects are most pronounced in survivors who required combined surgery/radiation therapy. Continuing low levels of cancer concern persist in about half of the survivors. Many cancer survivors successfully quit smoking.
Surgical Management of Localized Amyloidosis
Authors: L Kennedy Thomas , Patel Niketu M. 
Published: November 2003

AbstractObjective To demonstrate the role of two‐dimensional reconstruction images on computed tomography (CT) in the treatment planning for laryngeal amyloidosis. To discuss the treatment for isolated laryngeal amyloidosis and compare the role of endoscopic versus an open surgical approach to management.Study Design Retrospective review.Methods The medical records from 1984 to the present with the diagnosis of localized respiratory tract amyloidosis at Geisinger Medical Center were reviewed.Results Five previously unpublished cases of localized laryngeal amyloidosis were identified with the supraglottic region the major site of involvement. Hoarseness and airway compromise were the presenting symptoms. CT two‐dimensional reconstruction imaging was used to evaluate two cases with extensive laryngeal involvement that required an external surgical approach to relieve symptoms.Conclusions Localized laryngeal amyloidosis is a rare disease that requires surgical management when symptomatic. CT two‐dimensional reconstruction can be helpful in detailing the extent of disease and planning surgery. A lateral external supraglottic approach has been found to be successful in treating patients with large supraglottic masses.
Neural Cell Adhesion Molecule Expression in Adenoid Cystic Carcinoma of the Head and Neck
Authors: Hutcheson James A. , Vural Emre , Korourian Sohelia , Hanna Ehab 
Published: November 2003

AbstractObjective To investigate whether there is a correlation between neural cell adhesion molecule (NCAM) expression and perineural spread in patients with adenoid cystic carcinoma of the head and neck (ACCHN).Study Design Retrospective review of medical records and immunohistochemical staining of specimens from 37 patients treated at the University of Arkansas in Little Rock from 1987 to 1997.Methods Sections from paraffin‐embedded specimens were e‐amined for the presence of NCAM using monoclonal anti‐NCAM antibody by avidin‐biotin‐pero‐idase immunohistochemical staining. NCAM staining was scored in each specimen and correlated with the data obtained from patient charts.Results Twenty‐five of 37 specimens (68%) showed histopathological evidence of perineural spread. All 37 specimens (100%) stained positive for NCAM, regardless of perineural spread status.Conclusion Our results suggested that the use of NCAM expression as a predictor of perineural spread is highly unlikely.
The Becker Technique for Otoplasty: Modified and Revisited With Long‐Term Outcomes
Authors: Lee Dennis , Bluestone Charles D. 
Published: November 2003

AbstractObjectives To demonstrate a modification of the Becker technique for otoplasty and to evaluate the long‐term results.Study Design Case series with follow‐up survey assessment.Methods A sample of 16 patients treated by a single surgeon at an academic pediatric referral center who met the inclusion criteria was reviewed for surgical results and patient/parental satisfaction.Results A total of 30 ears underwent repair. Patients ranged from 4 to 17 years (mean age, 8.2 y) with an average follow‐up of 4.6 years. One patient had an immediate postoperative hematoma from blunt trauma that was treated with good long‐term results. No cases required revision surgery. Preservation of the antihelix with good to excellent ear symmetry was obtained in all patients at follow‐up. All patients were happy or very happy with the surgical procedure. All patients had at least five of the six criteria for surgical success as defined by the survey.Conclusions This modification of the Becker technique of otoplasty is efficacious for correction of protruding ears with excellent long‐term results.
Development of a Staging System for Inverted Papilloma
Authors: Krouse John H. 
Published: November 2003

AbstractObjectives Inverted papillomas of the nose and sinuses are uncommon neoplasms. In the past decade there has been a trend toward the use of endoscopic surgical techniques in the management of these tumors, in contrast to the extensive open procedures recommended previously. This trend has not been without controversy, given the association of inverted papillomas with malignancy. It has been difficult to compare surgical approaches to these neoplasms, because of the absence of a uniformly applied staging system representing the extent of disease. It was the purpose of this study to develop such a system that could be easily applied in outcomes research.Study Design This study involved an integrated literature review and a synthesis of findings from a number of studies.Methods Previous and current clinical studies examining the treatment of inverted papilloma were reviewed. Findings were organized, and a staging system was framed based on this review.Results A simple, easily applied staging system was developed based on the extent of tumor involvement noted on endoscopic examination of the nasal cavity and computed tomography (CT) scan evaluation.Conclusions Stage I disease is limited to the nasal cavity alone. Stage II disease is limited to the ethmoid sinuses and medial and superior portions of the maxillary sinuses. Stage III disease involves the lateral or inferior aspects of the maxillary sinuses or extension into the frontal or sphenoid sinuses. Stage IV disease involves tumor spread outside the confines of the nose and sinuses, as well as any malignancy.
Morbidly Obese Patients With Severe Obstructive Sleep Apnea: Is Airway Reconstructive Surgery a Viable Treatment Option?
Authors: Li Kasey K. , Powell Nelson B. , Riley Robert W. , Zonato Adriane , Gervacio Lindsay , Guilleminault Christian 
Published: November 2003

AbstractObjective To evaluate the outcomes of airway reconstructive surgery for the treatment of severe obstructive sleep apnea in the morbidly obese patient.Methods Retrospective review of consecutively treated patients. Variables examined include age, sex, body mass index (BMI), respiratory disturbance index (RDI), lowest oxygen saturation (LSAT), cephalometric data, and complications.Results Twenty‐one patients (13 men) with a mean age of 42.6 ± 7.9 years and mean BMI of 45 ± 5.4 kg/m2 were identified. The mean RDI improved from 83 ± 30.1 to 10.6 ± 10.8 events per hour with an improved mean apnea index from 38.4 ± 31.3 to 1.2 ± 1.8 events per hour. The mean LSAT improved from 63.9 ± 17.7% to 86 ± 7.9%. The mean BMI at the 6‐month postoperative polysomnographic recording was 43 ± 4.3 kg/m2 (P < . 001). Seventeen patients (81%) were successfully treated (RDI < 20 and with minimal desaturation < 90%). The mean follow‐up was 21.8 ± 15.4 months (range, 7–66 mo). Coexisting obesity‐hypoventilation syndrome was related to treatment failure in two patients. One patient noted recurrence of daytime fatigue after significant weight gain 4 years after surgery and the polysomnographic recordings demonstrated the recurrence of obstructive sleep apnea.Conclusion Airway reconstruction is an effective treatment for severe obstructive sleep apnea in the morbidly obese patient. Careful patient selection and identifying potential coexisting obesity‐hypoventilation syndrome, as well as counseling on weight reduction and avoiding continual weight gain will improve treatment outcomes.
Microbiology of Healthy and Diseased Adenoids
Authors: Brook Itzhak , Shah Kiran , Jackson William 
Published: November 2003

AbstractObjective To determine the qualitative and quantitative microbiology of core adenoid tissue obtained from four groups of 15 children each, with recurrent otitis media (ROM), recurrent adenotonsillitis (RAT), obstructive adenoid hypertrophy (OAH), and occlusion or speech abnormalities (controls).Methods Core cultures of surgically removed diseased adenoids and of healthy controls were cultured for aerobic and anaerobic bacteria.Results Polymicrobial aerobic‐anaerobic flora were present in all instances. Ninety‐four organisms were isolated from control specimens, and 148 from ROM, 142 from RAT, and 149 from OAH specimens. The predominant aerobes in all groups were α‐hemolytic and γ‐hemolytic streptococci, Haemophilus influenzae, Staphylococcus aureus, group A β‐hemolytic streptococci, and Moraxella catarrhalis. The prominent anaerobes were Peptostreptococcus, Prevotella, and Fusobacterium species. The number, concentration and distribution of types of most organisms did not vary among the three groups of diseased adenoids. However, the number of those that are potential pathogens and those that produced β‐lactamase was lower in the control than the diseased adenoids (P < .001).Conclusion The study highlights the importance of the bacterial load in the adenoids in contributing to the etiology of ROM, RAT, and OAH.
Fat Augmentation for Glottic Insufficiency
Authors: Hsiung Ming‐Wang , Woo Peak , Minasian Amy , Schaefer Mojica Jacqueline 
Published: November 2003

AbstractObjectives Fat lipoinjection augmentation for glottic insufficiency has been used in patients with vocal fold paralysis. Relatively little information is available on the effectiveness of fat injection in patients with vocal atrophy, intubation trauma, and post‐hemilaryngectomy defects.Study Design This paper retrospectively compares the efficiency of fat injection in patients with vocal cord paralysis (n = 9), vocal scar (n = 13), and vocal atrophy (n = 11).Methods The perceptual acoustic, phonatory function, and videolaryngostroboscopic data were evaluated before and after fat augmentation in 33 patients.Results Mean follow‐up time was 9.7 months. Nineteen patients had excellent results. Three patients had no change. Five patients had late failure. Six patients were lost to follow‐up. Phonatory function showed significant improvement in jitter, shimmer, noise‐to‐harmonic ratio, maximal phonation time, grade, asthenia, and breathiness (P < .05). Videolaryngostroboscopic rating showed significant improvement in right linearity of the vocal fold edge, amplitude of vocal fold vibration, excursion of the mucosal wave, vibratory behavior, and phase symmetry (P < .05). Anterior defects did better than posterior defects. Small vocal fold defects did better than large defects.Conclusions Fat injection is a good autogenous implant and may be considered as an option in management of patients with vocal fold scar, defect, or atrophy. Reabsorption of fat is a problem, but the procedure may be repeated.
Endoscopic Terminal Dacryocystorhinostomy
Authors: Sham Cheuk Lun , Andrew van Hasselt Charles 
Published: November 2003

AbstractObjective Traditional endoscopic dacryocystorhinostomy (DCR) involves creation of a lacrimal sac side hole that may close down in the presence of a partially patent lower lacrimal drainage system. Endoscopic terminal DCR is a modified DCR procedure designed to prevent this problem.Methods From September 1996 to June 1999, 16 patients (17 sides) had endoscopic terminal DCR that involved resection of the lacrimal sac‐duct junction to achieve total separation of the lacrimal sac from the nasolarcrimal duct and creation of a terminal DCR opening.Results Ten of the 17 DCRs were primary and 7 were revisions. The follow‐up ranged from 3 to 36 months. There were two failures. One failure was due to canalicular obstruction and the other was due to prolapse of orbital fat hindering proper fashioning of the mucosal flap. The overall success rate was 88%.Conclusions Instead of creating a side hole in the lacrimal sac as proposed by most endoscopic DCR studies, we advocate total diversion of tear flow by performing a terminal DCR opening that would further improve the success rate of endoscopic DCR, particularly in cases of idiopathic and partial obstruction.