bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mandibular Reconstruction With Transforming Growth Factor‐β1
Authors: Sherris David A. , Murakami Craig S. , Larrabee Wayne F. , Bruce A. Gregory 
Published: November 2003

AbstractHypothesis: Transforming growth factor‐β1 (TGF‐β1) plus demineralized bone matrix (DBM) will reconstruct a critical mandibular defect devoid of periosteum in a canine model.Study Design: Randomized, blinded, placebo‐controlled, prospective animal pilot study.Methods: Canine critical mandibular defects devoid of periosteum were reconstructed with DBM (group 1, n = 3) and DBM plus TGF‐β1 (250 μg TGF‐β1/g DBM) (group 2, n = 3). Radiologic, histologic, and biomechanical testing was performed on the test group and control group specimens at 12 weeks after implantation.Results: A palpable bone bridge was present in the group 2 subjects 5 to 6 weeks after implantation and was never present in the group 1 subjects. Radiologic and histologic examination at the time of harvest (12 weeks after implantation) demonstrated a solid bone bridge in the group 2 subjects and a fibrous union in the group 1 subjects. Group 2 specimens demonstrated failure in four‐point bending testing at an average maximum moment of 9.9 ± 2.2 N‐m. This value was 9.4% of the maximum moment of the contralateral nonoperated side. Group 1 specimens were palpably flexible on plate removal and had a biomechanical strength of 0. The difference in strength between group 1 and group 2 was statistically significant (P < 0.02), supporting the hypothesis that the addition of TGF‐β1 to the DBM carrier resulted in the formation of significantly stronger bone in the critical gap.Conclusion: The addition of TGF‐β1 to DBM results in healing of a critical bone defect devoid of periosteum in a higher mammalian model.
Effects of Phenylephrine on Ciliary Beat in Human Nasal Respiratory Epithelium: Quantitative Measurement by Video‐Computerized Analysis
Authors: Min Yang‐Gi , Yun Yeong‐Seok , Rhee Chae‐Seo , Sung Myung‐Whun , Lee Kang‐Soo , Ju Myung Sil , Park Kwang‐Suk 
Published: November 2003

AbstractThe in vitro effects of phenylephrine solution on ciliary beat frequency (CBF) in terms of different concentrations and exposure times were investigated using a video‐computerized analysis technique. Nasal epithelial cells were taken from inferior turbinate of 10 volunteers by scraping the nasal mucosa with a cytology brush. CBF was measured in five different concentrations including 0.125%, 0.25%, 0.5%, 1%, and 2.5%. Each specimen was incubated in different solution for 6 days and CBF was measured at 30 minutes, 1 hour, 2 hours, 4 hours, 8 hours, 12 hours, 1 day, 2 days, 3 days, 4 days, 5 days, and 6 days. CBF decreased significantly after 12‐hour incubation in 0.125% phenylephrine solution and after 8‐hour incubation in 0.25% phenylephrine solution, both clinically used concentrations. There were significant decreases in CBF after incubation in 0.5% phenylephrine for 2 hours, in 1% for 1 hour, and in 2.5% for 30 minutes (P < 0.05, repeated measure analysis of variance [ANOVA]). CBF of the nasal respiratory ciliated cells significantly decreased with increasing concentrations of phenylephrine solution and with increasing incubation times at the same concentration (P < 0.05, repeated measure ANOVA). The results of this study suggest that phenylephrine may inhibit ciliary beat in vitro by its pharmacological effect at lower concentrations than clinically used ones.
Combining Free Flap Reconstruction and Craniofacial Prosthetic Technique for Orbit, Scalp, and Temporal Defects
Authors: Gliklich Richard E. , Rounds Mark F. , Cheney Mack L. , Varvares Mark A. 
Published: November 2003

AbstractObjectives: To identify factors leading to successful application of prosthetic techniques following free flap reconstruction of the orbit, scalp, and temporal region.Study Design: Retrospective review.Methods: Twenty‐eight patients who underwent free flap reconstruction for defects of these regions between 1989 and 1996 were reviewed for clinical parameters, flap loss, patient survival, and implant loss rate. Prosthetic usage rates were compared before and after introduction of a site‐specific reconstructive algorithm.Results: Free flap success rate was 93%, whereas osseointegrated implant loss rate was 11%. In addition to implants, a reconstructive strategy that provided thin, vascular tissue between bone and skin, a flat platform in the temporal region, and preservation of orbital cavity depth led to increased prosthetic usage.Conclusions: Craniofacial prosthetic techniques can significantly augment the results of free flap surgery for the orbit, scalp, and temporal region. Successful combination of these techniques requires a site‐specific surgical approach.
Identification of p53 and Human Papilloma Virus in Schneiderian Papillomas
Authors: Mirza Natasha , Montone Kathleen , Sato Yuichi , Kroger Hans , Kennedy David W. 
Published: November 2003

AbstractSchneiderian papilloma of the nose is an unusual neoplasm with the propensity for local tissue destruction, recurrence, and malignant degeneration. Human papilloma virus (HPV) is related to a subset of sinonasal papillomas and has been implicated in the pathogenesis of cancer by interaction with the host p53 protein. Detection of p53 and HPV could be clinically useful as tumor markers for lesions with oncogenic potential. Thirty specimens for p53 were studied and nine (30%) stained positive. HPV was detected in six (20%). In the presence of p53, an odds ratio for carcinoma was 1.19:1, or 19% higher than expected. In the presence of HPV the odds ratio for carcinoma was 11.5:1, or 11.5 times higher than expected. In the presence of HPV an odds ratio for finding an elevated amount of p53 was 2.2:1. The data support the hypothesis that HPV and p53 may interact in a novel manner and elevate the risk for neoplasia.
Effect of Intratympanic Steroid Application on the Development of Experimental Cholesteatoma
Authors: Sennaroglu Levent , Özkul Ayhan , Gedikoglu Gökhan , Turan Ergin 
Published: November 2003

AbstractBy introducing certain irritants into the middle ear it is possible to produce cholesteatoma. Propylene glycol, the main agent used for this purpose, produces a long‐standing inflammation that causes hyperplasia and migration of the epithelium through an intact tympanic membrane. In the present investigation topical prednisolone was used in order to inhibit the production of cholesteatoma. The results indicate that there is a marked decrease in inflammation and hence experimental cholesteatoma production when prednisolone is administered into the middle ear.
Short‐ and Long‐term Results of Stapedectomy In Children
Authors: Lippy William H. , Burkey John M. , Schuring Arnold G. , Rizer Franklin M. 
Published: November 2003

AbstractStudies have indicated that stapedectomy can be an effective procedure in children for correcting conductive hearing losses due to juvenile otosclerosis. However, because childhood otosclerosis is rare and children commonly choose to use hearing aids in lieu of undergoing surgery, little outcome data are available. The purpose of this retrospective study was to provide additional outcome data in both the short and the long term. Stapedectomies were performed on 47 children. Preoperative hearing results were compared with 6‐month postoperative hearing results. Hearing results for the children who had long‐term follow‐up (5 years or more) were compared with the 6‐month postoperative results. Stapedectomy was successful (postoperative air conduction pure‐tone average [PTA] within 10 dB of the preoperative bone conduction PTA) in 91.7% of the cases. The mean over‐closure of the preoperative bone conduction PTA by the postoperative air conduction PTA was 0.2 dB. The mean PTA hearing improvement was 32.8 dB. Results from the 21 children (28 ears) who had long‐term follow‐up indicated an average 0.7 dB/year PTA worsening from the 6‐month postoperative PTA. Results from this study provide additional evidence that stapedectomy can be an effective procedure for correcting conductive hearing losses due to juvenile otosclerosis.
Is the Presence of Transient Evoked Otoacoustic Emissions in Ears With Acoustic Neuroma Significant
Authors: Ferber‐Viart Chantal , Colleaux Bernard , Laoust Laurent , Dubreuil Christian , Duclaux Roland 
Published: November 2003

AbstractOne hundred sixty‐eight patients admitted for acoustic neuroma removal were involved in this study. In all cases, the size of the tumor and the presence or absence of tinnitus and vertigo or dizziness were evaluated. Investigated functional procedures included bilateral measures of pure‐tone audiometry (PTA), auditory brainstem response (ABR), electronystagmography (ENG), and transient evoked otoacoustic emissions (TEOAEs). Thirty‐five patients (21%) had normal preoperative TEOAEs in the affected ear, whereas 133 patients (79%) failed to show reproducible responses. The aims of this study were 1. to evaluate what distinguishes patients with preoperative TEOAEs in the pathological ear (group A) from those who had no TEOAE (group B); and 2. to determine in cases of attempted hearing preservation whether preoperative TEOAE presence in the neuroma ear (group C) was predictive of postoperative hearing preservation compared with the group of patients without TEOAEs (group D). The presence of vertigo or dizziness was significantly less frequent, the age was lower, and preoperative mean PTA loss in both ears was lower in group A compared with group B. Frequency of the other studied parameters and ABR threshold were similar in both groups. When hearing preservation was attempted, the mean preoperative PTA loss of group C patients was lower in both ears compared with group D. However, postoperative mean PTA loss did not significantly differ in the two groups. In group C, the percentage of hearing preservation (66.6%) was significantly higher than the percentage of deafness (33.4%), whereas in group D the percentage of postoperative preserved audition and deafness did not significantly differ (respectively 44.4% and 55.6%). The findings suggest that 1. TEOAEs in ears with acoustic neuromas are found in younger patients with a lower preoperative mean PTA loss and are accompanied by fewer functional complaints, perhaps because preserved TEOAEs indicate a better preservation of inner ear vasculature; and, 2. along with radiological and electrophysiological investigations, TEOAE presence in the pathological ear could provide an additional criterion or predictive factor for the successful outcome of attempted hearing‐conservation surgery in ears with acoustic neuromas.
Functional Endoscopic Sinus Surgical Outcomes for Contact Point Headaches
Authors: Parsons David S. , Batra Pete S. 
Published: November 2003

AbstractHeadaches secondary to sinonasal anatomic abnormalities continue to remain a difficult entity to diagnose and to manage. This retrospective study analyzed the outcome of care for 34 patients who presented with headaches as one of their primary sinonasal complaints and were subsequently found to have contact points between the nasal septum and one or more turbinates on nasal endoscopy and/or computed tomography scan. Following functional endoscopic sinus surgery to relieve the contact points, these patients were interviewed regarding preoperative and postoperative intensity and frequency of the headaches and the overall response of the chronic sinusitis and headaches to surgery, after a mean follow‐up period of 13.9 months. After surgery, reduction in intensity and frequency of headaches was experienced in 91% and 85% of the patients, respectively. This investigation demonstrates that surgical management of contact point headaches can make a significant impact on the headache symptomatology in children and adults.
Primary Subglottic Cancer
Authors: Dahm J. David , Sessions Donald G. , Paniello Randal C. , Harvey Joseph 
Published: November 2003

AbstractThis retrospective study reviews 39 patients with primary subglottic cancer seen between 1955 and 1988 by the Department of Otolaryngology at Washington University. This number constitutes 1.8% of laryngeal cancer cases diagnosed during this period. Twenty‐eight patients (71.8%) had epidermoid cancer, of which 19 (67.9%) had “early” disease (stages I and II), and nine (32.1%) had “advanced” (stages III and IV). Overall 5‐year survival was 57.7%. Disease‐free survival was 46.2%. Patients treated with radiotherapy alone, surgery alone, or both had disease‐free 5‐year survivals of 22.2%, 41.7%, and 100%, respectively. Combination therapy showed a significantly higher (P < .01) disease‐free survival than radiotherapy alone.
Radiation Therapy for Early Stage (T1‐T2) Sarcomatoid Carcinoma of True Vocal Cords: Outcomes and Patterns of Failure
Authors: Ballo Matthew T. , Garden Adam S. , El‐Naggar Adel K. , Gillenwater Ann M. , Morrison William H. , Goepfert Helmuth , Ang K. Kian 
Published: November 2003

AbstractSarcomatoid carcinoma of head and neck mucosal sites is a rare high‐grade malignancy that may cause diagnostic and therapeutic controversies. A characteristic of this entity consistently reported but not entirely validated is its relative radioresistance and the general belief is that surgery is the treatment of choice. The objective of this retrospective study was to determine if patients treated with radiation for early glottic sarcomatoid carcinoma had worse outcomes than those achieved with irradiation for the more typical squamous cell carcinoma. Twenty‐eight cases of early stage (T1‐T2) sarcomatoid carcinoma of the larynx treated with definitive doses of megavoltage irradiation between 1969 and 1995 at The University of Texas M. D. Anderson Cancer Center form the cohort for this analysis. All pathologic material was reviewed to confirm the diagnosis. All tumors manifested spindle cell features with marked cytomorphologic abnormalities characteristic of this entity. Sixteen tumors (57%) had the more typical polypoid gross morphology of sarcomatoid carcinoma. Twenty‐one patients (75%) were staged T1 and seven patients (25%) had stage T2 disease. All patients were treated with small laryngeal fields, median size 20 cm2, and to a median dose of 65 Gy. Follow‐up ranged from 1.5 to 24 years (median, 10 years). Four patients (14%) had local disease recurrence, and all had salvage total laryngectomies and remained free of local disease. The 5‐year actuarial local control rates for patients with T1 and T2 lesions were 94% and 54%, respectively. Only one patient developed regional and distant disease. The 10‐year actuarial disease‐specific and overall survival rates were 92% and 63%, respectively. Patients with early stage sarcomatoid carcinoma of the glottis treated with radiation had similar control rates to irradiated patients with similar volume disease with the more typical squamous cell carcinoma. The authors contend that the histologic diagnosis of sarcomatoid carcinoma by itself should not influence the decision to treat a patient with early stage glottic disease with irradiation.
Dr. Miller Goes to Washington: You Should, Too
Authors: Miller Robert H. 
Published: November 2003

AbstractOtolaryngologists, like most physicians, tend to avoid local, state, and national politics for a variety of reasons. Although physicians and their patients are frequently affected by policies made in these political arenas, physicians tend to avoid active participation because of inexperience, lack of time, lack of knowledge about ways to influence policy development, and a general distaste for the political process. Otolaryngologists need to participate in the process to ensure that their particular perspectives and concerns are heard. However, otolaryngologists also need to look beyond their personal or specialty interests to influence the broader health care debate. Before we are specialists, we are first physicians who have a fiduciary responsibility to mankind (our patients) to improve the health care system for all Americans. We have a moral and ethical obligation to address, influence, and support health care beyond the specialty level. Health policy developed in an absence of physician input is missing the insight of expertise and experience.
Relationship Between Quality of Life and Depression in Patients With Head and Neck Cancer
Authors: D'Antonio Linda L. , Long Steven A. , Zimmerman Grenith J. , Peterman Amy H. , Petti George H. , Chonkich George D. 
Published: November 2003

AbstractObjective: This study describes the relationship between health‐related quality of life (HRQOL) and depression in patients following major surgery for head and neck cancer.Design: Cross‐sectional study using medical chart review, patient interview, and test administration.Method: Fifty patients were evaluated 6 months to 6 years following surgery using one global HRQOL measure (The Functional Assessment of Cancer Therapy‐General [FACT‐G]); three disease‐specific measures of HRQOL (the HN module of the FACT [FACT‐HNS], The University of Washington Quality of Life Scale [UWQOL], and The Performance Status Scale for Head and Neck Cancer); and one measure of depression (The Beck Depression Inventory [BDI]).Results: The study population showed a high occurrence of depressive symptoms (22%). A negative correlation existed between the BDI and HRQOL as measured by the FACT‐G (r = −0.49, P < .001) and the UWQOL (r = −0.44, P = .003). When somatic symptoms of depression were removed, the BDI remained correlated with HRQOL and was most highly correlated with the Emotional Well‐Being (EWB) subscale of the FACT‐G (r = −0.42, P = .003). There was no correlation between clinician judgments of EWB and any patient‐rated measures of HRQOL or depression.Conclusions: Results demonstrate an inverse relationship between patient‐reported HRQOL and depression. The lack of correlation between physician and patient ratings of HRQOL and EWB stresses the importance of obtaining patient ratings in addition to traditional clinician ratings when assessing outcomes. Finally, the multidimensional construction of the FACT with its specific subscales may make it a useful clinical tool for assessing patient status and augmenting patient interviews.
Effect of Pulse Duration on Wound Healing Using a CO2 Laser
Authors: Fortune D. Scott , Huang Shan , Soto Joe , Pennington Brent , Ossoff Robert H. , Reinisch Lou 
Published: November 2003

AbstractThe authors investigated wound healing of incisions in the buccal mucosa of a canine model created using a CO2 laser with a short pulse structure (60 μs, 100 μs, and 120 μs) rather than a conventional continuous wave structure in a shuttered mode. The tissue from 10 animals was evaluated histologically and with tensiometry acutely and at postoperative days 3, 7, and 14. A Bonferroni‐Dunn corrected ANOVA analysis at a 95% significance level was used to compare the effect of pulse duration on histologic morphology and wound tensile strength. The data indicate that shorter laser pulse durations create less lateral thermal injury (p < .009) and wounds with greater tensile strength (p < .005), resulting in earlier wound healing. The results also show that heat, sufficient to damage tissue, was conducted to adjacent tissue during laser pulses of 100 μs and longer. These results demonstrate that surgical CO2 lasers with a short pulse structure of approximately 60 μs or less could offer more prompt wound healing while maintaining the advantages of a 10.6‐μm wavelength laser.
Tracheal Transplantation: Superior and Inferior Thyroid Artery Perfusion Territory
Authors: Salmeron Jesse , Gannon Patrick J. , Blackwell Keith E. , Shaari Christopher M. , Urken Mark L. 
Published: November 2003

AbstractObjective: To determine the perfusion territories of the superior and inferior thyroid arteries in humans. Tracheal transplantation is a potential option for management of long‐segment tracheal stenosis. However, the maximum length of vascularized trachea that can be reliably transplanted has not been established.Study Design: The tracheal vascular territory of individual superior and inferior thyroid arteries was determined separately in 10 humans postmortem.Methods: India ink was infused unilaterally under controlled pressure into the superior (n = 5) and inferior (n = 5) thyroid arteries of cadaveric tracheas. Tracheas were sectioned longitudinally and the caudalmost extent of mucosal dye staining was determined via microscopic assessment.Results: The tracheal perfusion territory of the superior thyroid artery was two to five rings (1.7 ± 0.5 cm) and the inferior thyroid artery, nine to 13 rings (6.5 ± 1.1 cm). In both cases, the tracheal mucosa on the contralateral side was stained to the same caudal level.Conclusions: The inferior thyroid artery was shown to perfuse the trachea maximally to the 13th ring (8.1 cm). As such, the unilateral inferior thyroid artery would serve as a suitable vascular component for long‐segment tracheal transplantation in humans.
Correlation of Laryngeal Chemoreflex Severity With Laryngeal Muscle Response
Authors: Goding George S. 
Published: November 2003

AbstractObjectives: To examine the relationship between the severity of the laryngeal chemoreflex (LCR) and the pattern of laryngeal muscle activity during an LCR‐induced apnea.Methods: The laryngeal mucosa of 20 piglets aged 17 to 20 days was stimulated under both hypoxic and normoxic conditions. Respiration, blood pressure, and activity of the thyroarytenoid (TA) and posterior cricoarytenoid (PCA) muscles were monitored during the LCR‐induced apnea.Results: Hypoxemia resulted in a shorter average apnea duration but a greater degree of hypotension. All piglets recovered spontaneously following normoxic LCR stimulation. Hypoxic stimulation resulted in two divergent apneic responses: transient with a spontaneous recovery (17 piglets) or profound requiring resuscitation (three piglets). An increase in TA muscle activity and a decrease in PCA muscle activity was the most common response to LCR stimulation. The response of the TA and PCA muscles was maintained in piglets destined for spontaneous recovery. Decreasing TA activity and increasing PCA activity correlated with the development of a profound response.Conclusions: The piglet demonstrates two distinct responses to hypoxic laryngeal chemostimulation that correlate with the activity of the intrinsic laryngeal muscles. Failure to maintain the activity of the TA and PCA muscles during a profound response is associated with the development of severe cardiovascular instability. This study suggests that the critical event involving the LCR is the development of complications secondary to hypoxia.