bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Helicobacter Pylori Infection in the Cause of Squamous Cell Carcinoma of the Larynx
Authors: Aygenc Erdinc , Selcuk Adin , Celikkanat Serdar , Ozbek Cem , Ozdem Cafer 
Published: February 2003

OBJECTIVEHelicobacter pylori can cause chronic infection that has been linked to the development of both benign and malignant disease of the aerodigestive tract. The purpose of this study was to determine the link between H pylori infection and squamous cell carcinoma of the larynx (SCCL). METHODS: We estimated the presence of IgG antibodies against H pylori antigens by using ELISA technique in the sera of 26 patients with SCCL and 32 matched controls without carcinoma of the larynx.RESULTSThe incidence of seropositivity of patients with SCCL was 73.07% and of controls was 40.62%. These data support an etiologic role for H pylori infection on development of SCCL (χ2 = 4.85, P < 0.05).CONCLUSIONH pylori infection of the upper aerodigestive tract might result in mucosal disruption, allowing for subsequent transformation by known carcinogens such as tobacco and alcohol.
A New Device for Frontal Sinus Endoscopy: First Clinical Report
Authors: Iro Heinrich , Zenk J. 
Published: February 2003

OBJECTIVEEndoscopically or microscopically controlled paranasal sinus surgery currently represents the state of the art. For anatomic reasons the ostium of the frontal sinus and the frontal sinus itself are difficult to observe. Flexible endoscopes are often difficult to implement and do not provide enough light intensity to visualize all parts of the frontal sinus.MATERIALS AND METHODSA specially curved rigid endoscope with a working channel of 1.5 mm that allows passage into the frontal sinus has been developed to manage this problem. The system was used on 15 patients during paranasal sinus surgery to evaluate possible indications and its clinical usefulness.RESULTSThe endoscope could be introduced into the frontal sinus after an ethmoidectomy had been performed in all of the patients. The anatomy of the sinus could be visualized with sufficient light intensity in 14 patients. The shadowing of the frontal sinus seen in CT was not due to polyps of the mucosa of the frontal sinus in all cases, but rather due to secretion with otherwise normal mucosa. In the cases with polyps, it was necessary to irrigate with saline solution to prevent the buoyant polyps from collapsing over the endoscope. The following specific indications for this endoscopic version were established during this first test: intraoperative and postoperative control of the frontal sinus, clinical evaluation of tumor growth into the frontal sinus, biopsies within the frontal sinus, and evaluation of fractures.CONCLUSIONThe new device provides further insight within the field.
Refractory Chronic Sinusitis: Evaluation of Symptom Improvement after Denker's Procedure
Authors: Wreesmann Volkert B. , Fokkens Wytske J. , Knegt Paul P. 
Published: February 2003

OBJECTIVESAlthough there is ample literature describing various aspects of functional endoscopic sinus surgery (FESS) in relationship to its success rates, very little has been reported regarding possibilities in case of recurrent failure. We investigated subjective results of Denker's procedure used as a last resort for refractory chronic rhinosinusitis/polyposis.STUDY DESIGN AND SETTINGA retrospective questionnaire‐based study of 82 patients who underwent Denker's procedure between 1986 and 1997 at the Erasmus University Medical Center, The Netherlands, was conducted.RESULTSEighty‐four percent of patients reported reduction of overall symptomatology. A significant reduction of nasal obstruction, headache, feeling of fullness, post‐nasal drip, rhinorrhoea, facial pain, dental pain, and coughing was reported. In addition, symptoms of lower airway inflammation did improve significantly in asthmatic patients.CONCLUSIONSThese data suggest that radical surgery using Denker's approach should be considered in selected cases after recurrent failure of functional sinus surgery.SIGNIFICANCEA prospective study is warranted to validate this approach for refractory chronic rhino‐sinusitis.
Ocular Motility Complications after Endoscopic Sinus Surgery with Powered Cutting Instruments
Authors: Bhatti M. Tariq , Giannoni Carla M. , Raynor Eileen , Monshizadeh Ramin , Levine Lawrence M. 
Published: February 2003

OBJECTIVEThe purpose of this study was to describe 2 unique cases of ocular motility dysfunction after powered endoscopic sinus surgery and identify potential risk factors for extraocular muscle injury.STUDY DESIGNInterventional case series. RESULTS: Patient 1 developed a restrictive global ophthalmoplegia after inadvertent entry into the medial orbit during powered endoscopic sinus surgery. Patient 2 had complete loss of adduction of the left eye as a result of transection of the medial rectus muscle by a powered cutting instrument.CONCLUSIONSDespite advances in endoscopic sinus surgery technique and instrumentation, serious ophthalmic complications may still occur. Inadvertent entry into the medial orbital wall can result in ocular motility complications. Furthermore, it is possible that attraction of orbital contents into the tip of a powered cutting instrument may occur without significant entry into the orbital cavity.SIGNIFICANCEIt is important for endoscopic sinus surgeons to be aware of the intimate anatomical relationship between the orbit and sinuses, as well as the potential risks of the current instruments used in endoscopic sinus surgery.
Use of Immunotherapy in Previously Treated Patients with Allergic Fungal Sinusitis
Authors: Bassichis Benjamin A. , Marple Bradley F. , Mabry Richard L. , Newcomer Mark T. , Schwade Nathan D. 
Published: February 2003

OBJECTIVESixty patients with a diagnosis of allergic fungal sinusitis were studied. The objective was to show whether, after initial surgical removal of allergic mucin and polyps, immunotherapy decreases re‐operation rates and office visits that require medical intervention.STUDY DESIGN AND SETTINGSixty patients with adequate follow‐up for at least 1 year were evaluated: 24 patients who did not receive immunotherapy and 36 patients whose treatment included postoperative immunotherapy.RESULTSThe re‐operation rates were 33.0% in those not receiving immunotherapy versus 11.1% in the treated group. Furthermore, the total number of postoperative office visits that required medical therapy decreased from 4.79 per patient to 3.17 with the addition of immunotherapy.CONCLUSION/SIGNIFICANCEThese results indicate that immunotherapy is a beneficial part of the overall treatment regimen for allergic fungal sinusitis.
Pathologic Analysis of Routine Tonsillectomy and Adenoidectomy Specimens
Authors: Strong E. Bradley , Rubinstein Brian , Senders Craig W. 
Published: February 2003

OBJECTIVESRecent literature has suggested that histopathologic analysis of routine tonsillectomy and adenoidectomy (T&A) specimens may be unnecessary. This study investigates T&A specimen handling practices in the United States between 1989 and 1999.METHODSSurveys were sent to 4715 members of the American Academy of Otolaryngology. Surveys assessed practice type, pathologic processing practices (full, gross, no pathology), and reasons for change. The authors also performed a retrospective analysis of 1583 pediatric T&A specimens for evidence of occult malignancy.RESULTSPractice types were 80% private, 12% academic, 6% salaried, and 2% military. Chi squared analysis revealed a significant increase (P < 0.001) in respondents ordering “gross only” and “no pathology.” The retrospective analysis found no occult malignancies.CONCLUSIONSThere is a statistically significant increase in the number of otolaryngologists sending routine T&A specimens for “gross only” and “no pathology.” There was no correlation between the type of practice and changes in pathologic analysis performed.
Occult Mucosal Injuries with Radiofrequency Ablation of the Palate
Authors: Terris David J. , Chen Vince 
Published: February 2003

OBJECTIVETo determine the true incidence of mucosal injury after radiofrequency ablation of the palate (RFAP) for snoring and mild obstructive sleep apnea, and to evaluate the consequences of this injury.STUDY DESIGN AND SETTINGA prospective, nonrandomized analysis of RFAP was undertaken at Stanford University Hospital. Endoscopic examinations of the nasal surface of the palate and of the posterior pharyngeal wall were performed to supplement the routine oral cavity examinations in the postoperative period. Visual analog scales of pain were completed by the patients. Twenty‐three patients underwent a total of 54 RFAP procedures using the Somnus system at the recommended level of energy (600 J in the midline palate, and 300 J to each lateral palate).RESULTSFourteen of the 23 first stage procedures were associated with a total of 16 mucosal injuries representing an incidence of 60.9%. Mucosal injury at the 1st stage prompted a reduction in energy at the 2nd stage to 500 J in the midline and 250 J laterally; there were 4 injuries among 19 2nd stage procedures (21.1%). The overall incidence of mucosal injury, including stage 3 and 4 procedures, was therefore 42.6%; 37% of these were “occult” (only visualized endoscopically).CONCLUSIONS AND SIGNIFICANCERFAP, although intended to be mucosa‐sparing, is nevertheless associated with a high incidence of mucosal injuries, many of which are occult. The occurrence of these mucosal ulcers is usually associated with only a trivial degree of increased pain postoperatively.
Prevalence of Hypersensitivity to Specific Fungal Allergens as Determined by Intradermal Dilutional Testing
Authors: Stroud Robert H. , Calhoun Karen H. , Wright Steven T. , Kennedy Kyle L. 
Published: February 2003

OBJECTIVETo determine fungal allergen reactivity prevalence by intradermal dilutional testing in patients with and without chronic rhinitis or rhinosinusitis symptoms.STUDY DESIGNProspective comparison of fungal allergen reactivity prevalence in symptomatic and asymptomatic patients.SETTINGUniversity medical center.METHODSGroup I (chronic rhinitis and/or rhinosinusitis symptoms) and Group II (asymptomatic) patients underwent intradermal dilutional testing with usual and fungal allergens.RESULTSFungal reactivity occurred in 65% (13/20) of Group I, and 13% (4/30) of Group II (P < 0.0002 by χ 2 testing). Group I was more reactive to non‐fungal allergens (85% vs. 33%, p < 0.0004), and to all allergens considered together (95% vs. 40%, p < 0.0001).CONCLUSIONSPatients with chronic rhinitis and rhinosinusitis symptoms were more reactive to fungal and nonfungal allergens. Fungal allergens were as likely as nonfungal to elicit reactivity.SIGNIFICANCEThese findings suggest a role for fungal hypersensitivity in chronic rhinitis and chronic rhinosinusitis.
Sepragel Sinus (Hylan B) as a Postsurgical Dressing for Endoscopic Sinus Surgery
Authors: Kimmelman Charles P. , Edelstein David R. , Cheng Han Jin 
Published: February 2003

OBJECTIVETo assess the safety and efficacy of Sepragel sinus, a hylan B gel (cross‐linked hyaluronic acid molecule), when used as a postoperative dressing after endoscopic sinus surgery as a facilitator of healing and a preventative for scarring and stenosis.STUDY DESIGNTen patients undergoing bilateral endoscopic ethmoidectomy in an outpatient specialty hospital operating room underwent complete filling of a randomly selected right or left ethmoidectomy cavity with Sepragel sinus. Outcome measures were synechiae, middle meatal stenosis, mucosal status, mucosal regeneration, transparency of Sepragel sinus, and subjective pain and congestion.RESULTSSepragel sinus significantly improved all outcome measures by week 2 and remained statistically significant for reduction of synechiae and stenosis.CONCLUSIONSepragel sinus is useful as a space‐occupying gel stent to separate sinus mucosal surfaces. The data strongly support the superiority of Sepragel sinus over no treatment in the control of postethmoidectomy synechiae and middle meatal stenosis, as well as early improvement in mucosal healing and postoperative pain.SIGNIFICANCEBecause of its biocompatibility, lack of inflammatory response, transparency, and ability to fill any complex volume, Sepragel sinus offers distinct advantages over currently used stenting materials.
High Incidence of Complications Encountered in Chronic Otitis Media Surgery in a U.S. Metropolitan Public Hospital
Authors: Greenberg Jayson S. , Manolidis Spiros 
Published: February 2003

OBJECTIVESTo examine the incidence and nature of complicating factors in surgery for chronic otitis media (COM) in a metropolitan public hospital in the United States.METHODSA retrospective review was performed over 2 years in a metropolitan public hospital to identify cases of surgery for chronic ear disease with the following complicating factors: intracranial or extracranial abscess, labyrinthine fistula, dural dehiscence with or without associated encephalocele or meningocele, or extensive involvement of the facial nerve by cholesteatoma with or without paralysis.RESULTSThirty‐three of 90 consecutive operations for COM (37%) met criteria for complicated chronic otitis media (CCOM). The majority (85%) of patients had cholesteatoma involvement. Most patients (73%) were managed by an extended modified radical mastoidectomy. An additional 31 procedures were required in these 33 patients for control of complications. There was no iatrogenic sensorineural hearing loss or facial paralysis.CONCLUSIONSThe incidence of CCOM in this large, U.S. metropolitan public hospital is similar to that observed in developing nations. CCOM significantly complicates chronic ear surgery and substantially increases the use of resources. Maintaining functional hearing is possible, but difficult, and should be considered secondary to prevention of further complications and eradication of disease. Access to health care and proper follow‐up are crucial in prevention of CCOM.
Reconstruction of the Ossicular Chain with Titanium Implants
Authors: Dalchow C. V. , Grün D. , Stupp H. F. 
Published: February 2003

OBJECTIVESSince 1994 more than 1300 titanium implants have been used to reconstruct the ossicular chain of the middle ear for chronic otitis media. Two different types of implants were used. First, a total and a partial implant of fixed length, available in numerous different lengths. And second, a total and partial implant that has an adjustable length. The implants are commercially available from 2 different companies. Patients were followed for a postoperative term from 6 to 72 months.METHODSA wide variety of patients aged 5 to 82 years received a tympanoplasty type III. Those patients whose ossicular chain had been reconstructed with titanium implants since 1994 were evaluated. As implants from one company are fixed in length; implants of a second company are trimmable inlength. All prostheses are lightweight and made of pure titanium, fitting most anatomical situations.RESULTSEarlier results already showed a very low complication rate. Extrusions occurred only in cases of middle ear atalectasis with resorption of interposed cartilage (<1%). No adverse reaction to the prostheses could be seen, even in histologic reviews. An average air‐bone gap less than 20 dB(A) for all calculated frequencies of 0.5, 1, 2, and 4 kHz was achieved for 76% of cases; 43% of cases showed a calculated air‐bone gap of less than 10 dB(A), only 10% higher than 30 dB(A).CONCLUSIONAll implants used offer the proven benefits of titanium, namely high biocompatibility and high stability at a very low complication rate with excellent hearing results for the patients. Titanium implants can highly be recommended to reconstruct the ossicular chain of the middle ear.
Transnasal Esophagoscopy
Authors: Belafsky Peter C. , Postma Gregory N. , Daniel Elena , Koufman James A. 
Published: February 2003

BACKGROUNDTransnasal esophagoscopy (TNE), a new diagnostic technology, allows comprehensive, in‐office examination of the esophagus without sedation.OBJECTIVETo report the authors' experience using TNE.METHODOLOGYRetrospective review of 100 consecutive patients undergoing TNE.RESULTSThe most frequent indications for TNE were screening examination of the esophagus in reflux, globus, and/or dysphagia patients (n = 79), biopsy of a lesion in the laryngopharynx, trachea, or esophagus (n = 8), screening examination of the esophagus in head and neck cancer patients (n = 5), tracheoscopy and bronchoscopy (n = 4), and evaluation for an esophageal foreign body (n = 2). Four procedures were aborted secondary to a tight nasal vault. Significant findings were found in 44% (42/96). The most frequent findings were esophagitis (n = 19), Barrett's (n = 6), hiatal hernia (n = 4), and carcinoma (n = 5).CONCLUSIONSTNE is safe and well tolerated by patients with topical anesthesia alone. TNE may replace radiographic imaging of the esophagus in otolaryngology patients with reflux, globus, and dysphagia.
Intratympanic Gentamicin Therapy for Persistent Vertigo after Endolymphatic Sac Surgery
Authors: Marzo Sam J. , Leonetti John P. 
Published: February 2003

OBJECTIVESTo evaluate the role of intratympanic gentamycin therapy (ITGM) in controlling vertigo in patients with refractory Meniere's who have recurrent or persistent vertigo after endolymphatic sac surgery.STUDY DESIGN AND SETTINGA retrospective review of 491 patients seen in a university balance clinic between July 1999 and July 2000. Of these, 68 patients had Meniere's disease; 4 patients had recurrent vertigo after endolymphatic sac surgery and were followed for at least 1 year. These 4 patients received a series of ITGM injections. Outcome measures included control of vertigo and audiometric results.RESULTSThree of 4 (75%) patients had control of their vertigo with ITGM therapy. The 1 patient who failed ITGM therapy underwent a successful vestibular neurectomy with ultimate control of his vertigo. No patients had progression of their sensorineural hearing loss.CONCLUSIONITGM therapy can be used to control vertigo in selected patients with Meniere's disease who have persistent vertigo after unsuccessful endolymphatic sac surgery.SIGNIFICANCEITGM therapy may reduce the need for vestibular neurectomy in patients with refractory Meniere's disease after endolymphatic sac surgery.
Recurrent Epithelial‐Myoepithelial Carcinoma of the Parotid with Direct Intracranial Extension
Authors: Amin Kay S. , McGuff H. Stan , Cashman Steve W. , Newman Richard 
Published: February 2003

Epithelial‐myoepithelial carcinoma (EMC) is a rare malignant salivary gland neoplasm. First described in 1972 by Donath et al,1 it was recognized as a distinct pathologic entity by the World Health Organization Classification in 1991.2 It is thought to represent about 1% of all salivary gland tumors.2EMC is a low‐grade malignancy, however, recurrences and metastases to periparotid and cervical lymph nodes, as well as to distant sites, have occurred.2 Metastasis to the brain has been reported.2 To the best of our knowledge, direct intracranial extension has not been observed. We report a case of recurrent epithelial‐myoepithelial carcinoma of the parotid gland that exhibited local aggressive behavior with direct intracranial invasion.
The Association between Periodontal Disease and Peritonsillar Infection: A Prospective Study
Authors: Georgalas Christos , Kanagalingam Jeeve , Zainal Azida , Ahmed Hamid , Singh Arvind , Patel Kalpesh S. 
Published: February 2003

OBJECTIVETo study the relationship between periodontal status and peritonsillar disease/recurrent tonsillitis.STUDY DESIGN AND SETTINGA total of 158 patients presenting over a 3‐year period with peritonsillar abscess (PTA) confirmed by needle aspiration and a control group of 112 patients booked for elective tonsillectomy for recurrent tonsillitis (RT) were examined in terms of their periodontal status using the WHO Community Periodontal Index of Treatment Needs (CPITN).RESULTSThe mean CPITN index was 2.81 (Standard Deviation [SD], 1.10) in patients with PTA and 1.41 (SD, 0.92) in patients with RT. One hundred seven of 158 patients with PTA had significant periodontal pathology (CPITN, 3 or 4) compared with 12 of 112 patients with RT. These differences were statistically significant.CONCLUSIONPatients with peritonsillar abscess had an increased prevalence of periodontal disease as compared with patients with recurrent tonsillitis.SIGNIFICANCEThere is a need to further explore this correlation and determine its nature, although it could be the result of common pathogenic factors, a causal relation cannot be excluded.
Vertebral Hydatid Disease Presenting as a Parapharyngeal and Neck Mass: A Case Report
Authors: Bilgen Cem , Öner Kazim , Övül Izzet , Kirazli Tayfun 
Published: February 2003

Echinococcus granulosus is a cestode causing disease in human beings. Both the vertebral column and cervicofacial region are uncommon sites for hydatid involve‐ment, even in countries of the Middle East, South America, Australia, and New Zealand, where Echinococcus infestation is high.1 It was stated that only 1 in 1000 cases will exhibit cervical spine infestation, if the spine is infected in 1% to 2% of hydatid cases.12
Tracheal Stenosis after Percutaneous Dilational Tracheotomy
Authors: Bartels Sande , Mayberry John C. , Goldman Robert K. , Askew Judah A. , Wax Mark K. 
Published: February 2003

OBJECTIVEIn many critical care units percutaneous dilational tracheotomy (PDT) has become an alternative to open tracheotomy. Although significant tracheal stenosis after PDT has been reported, the exact incidence is unknown. We report our findings on endoscopic laryngotracheoscopy for a group of patients who had undergone PDT more than 6 months before their examination.STUDY DESIGN AND SETTINGWe did a retrospective review of 108 trauma patients who underwent PDT at least 6 months before enrollment in the study. Twenty‐eight patients were either deceased or ineligible. Participation requests were mailed to the last recorded address of 80 patients. Thirty‐four of those patients were contacted by phone, and 14 indicated their willingness to participate. Only 10 patients were able to make it to the clinic for examination. After transorally anesthetizing the hypopharynx and larynx with 4% lidocaine, each patient underwent flexible laryngotracheoscopy. Findings were categorized as normal or tracheal stenosis (<25%, 25% to 50%, or >50%).RESULTSThe tracheotomy site was virtually undetectable in 5 patients. In 4 patients, a scar was visible at the tracheotomy site, but there was no decrease in cross‐sectional area. In 1 patient there was a 25% to 50% stenosis. All patients were completely asymptomatic with regard to airway and voice quality.CONCLUSIONOne out of 10 patients in our series had a significant but asymptomatic stenosis after PDT. The risk of tracheal stenosis in PDT appears to be the same as that of open tracheotomy.