bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inhibition of matrix metalloproteinases in gerbil cholesteatoma: Preliminary findings
Authors: Lehman David A. , Wilmoth Jason G. , Prevatt Angela R. , Schultz Gregory S. , Antonelli Patrick J. 
Published: February 2003

OBJECTIVESThis study was conducted to examine the role of matrix metalloproteinases (MMPs) and the impact of a topical MMP inhibitor, ilomostat, on the development of tympanic membrane (TM) atelectasis in the gerbil model.METHODSEustachian tubes were cauterized bilaterally in 19 gerbils. Thereafter, both TMs received once‐daily topical treatment for 8 weeks with ilo‐mostat or vehicle or no treatment (n = 6 or 7 per group). TM atelectasis was serially graded, and TMs were harvested at 8 weeks. Gelatin zymograms were performed to determine MMP activity.RESULTSThe mean activity levels of proenzyme and active MMP‐9 and MMP‐2 and degree of atelectasis did not differ between groups. TM atelectasis did not correlate to levels of enzymes across individual samples.CONCLUSIONSTopical application of an MMP inhibitor did not significantly prevent the development of TM atelectasis. It remains to be determined whether the use of MMP inhibitors may prevent the progression of atelectasis in humans.
Role of the tongue base suspension suture with The Repose System bone screw in the multilevel surgical management of obstructive sleep apnea
Authors: Miller Frank R. , Watson Daniel , Malis David 
Published: February 2003

OBJECTIVEThe Repose System (tongue base suspension) is a new, minimally invasive technique for tongue base suspension in the treatment of obstructive sleep apnea. The purpose of this project was to describe our preliminary experience using this tongue base suspension system in conjunction with uvulopalatopharyngoplasty (UPPP) in the multilevel surgical approach to the management of obstructive sleep apnea (OSA).STUDY DESIGNWe conducted a retrospective analysis of 19 consecutive patients undergoing UPPP and The Repose System tongue base suspension for the management of obstructive sleep apnea during a 1‐year period (1998 through 1999).RESULTSFifteen patients (11 men and 4 women) had complete preoperative and postoperative polysomnographic data. A 46% reduction in the preoperative respiratory disturbance index (RDI) (38.7 ± 12.3) versus the postoperative RDI (21.0 ± 7.4, P < 0.05) was demonstrated at a mean of 3.8 months after surgery. The apnea index demonstrated a 39% reduction. The surgical cure rate was 20% (3 of 15 patients).CONCLUSIONSThe Repose System in conjunction with UPPP has been shown to produce significant reductions in the RDI and apnea index as well as a significant increase in O2 saturation. Despite the improvement in these objective parameters, the overall surgical cure rate was only 20% (3 of 15 patients) in this retrospective series. Further research is warranted to define the role of The Repose System in the management of obstructive sleep apnea patients with multilevel airway obstruction.
Management and outcome of early glottic carcinoma
Authors: Smith Jonathan C. , Johnson Jonas T. , Myers Eugene N. 
Published: February 2003

OBJECTIVE AND STUDY DESIGNWe designed a retrospective study to analyze treatment methods and outcomes for patients with lesions ranging from carcinoma in situ to invasive T1 glottic squamous cell carcinoma. Patients with nonsquamous cell carcinoma, verrucous variant of squamous cell carcinoma, anterior commissure involvement, and T2 lesions were excluded.SETTINGUniversity of Pittsburgh School of Medicine, a tertiary referral center.RESULTSFifty‐four patients met the inclusion criteria. Mean follow‐up was 49 months (range 24 to 96 months). Forty‐eight of 54 (89%) were treated with endoscopic excision. Forty of these 48 patients (83%) were successfully treated with endoscopic excision(s) as the only treatment modality. Four patients had persistence of disease despite multiple endoscopic excisions. Two of these patients underwent hemilaryngectomy, 1 received radiation treatment, and 1 received radiation therapy followed by a hemilaryngectomy. Four patients had recurrence of disease. Two patients with recurrence required radiation therapy and 2 patients required a total laryngectomy. With the selective application of multiple endoscopic excisions, radiation therapy, and more invasive operation, 100% of patients are without evidence of disease with a laryngeal preservation rate of 96%.CONCLUSIONSThis study supports the use of endoscopic excisional biopsy as the primary treatment modality for lesions ranging from carcinoma in situ to invasive T1 glottic carcinoma. This study also highlights the importance of close clinical follow‐up and the potential need for further treatment. By reserving open operation and radiation therapy to selective cases, we successfully treated all patients while limiting the disadvantages of radiation therapy and more invasive operation to the minority of patients.
Oncocytic Neoplasms of the Parotid Gland: A 16‐Year Institutional Review
Authors: Capone Randolph B. , Ha Patrick K. , Westra William H. , Pilkington Thomas M. , Sciubba James J. , Koch Wayne M. , Cummings Charles W. 
Published: February 2003

BACKGROUNDOncocytic neoplasms of the parotid gland are a rare collection of salivary gland tumors that include oncocytosis, oncocytoma, and oncocytic carcinoma. Mounting evidence has linked the presence of oncocytes to acquired mitochondrial dysfunction.OBJECTIVESThe study goals were to further delineate this poorly understood group of salivary gland tumors and to search for genetic alterations indicative of mitochondrial dysfunction.METHODSCases were identified by search of the surgical pathology archival files from 1984 through 2000. Corresponding medical records were reviewed. Tumor mitochondrial DNA (mtDNA) was evaluated for mtDNA mutations within the control region (C‐tract).RESULTSTwenty‐one parotid oncocytic neoplasms were identified. Oncocytoma was the most frequent morphology (62%), followed by oncocytosis (28.5%) and oncocytic carcinoma (9.5%). One specimen displayed synchronous oncocytic morphologies (oncocytoma, oncocytosis, and oncocytic metaplasia). One oncocytoma specimen displayed the mtDNA C‐tract alteration.CONCLUSIONSOncocytic neoplasia of the parotid gland is a rare form of salivary gland disease with obscure etiology. The presence of multiple oncocytic morphologies in a single specimen is suggestive of transition between forms. Although oncocytic tumorigenesis secondary to acquired mitochondrial dysfunction is a plausible mechanism, few of these tumors actually harbor mtDNA alterations within the control region.
Long‐Term Effects of Cochlear Implants in Children
Authors: Waltzman Susan B. , Cohen Noel L. , Green Janet , Roland J. Thomas 
Published: February 2003

OBJECTIVESince 1987, when the use of multichannel cochlear implants was initiated in children, candidacy has expanded; many thousands of children have received these devices, and results have revealed a wide range of performance. However, few long‐term studies exist on a large population of these children. There have been concerns expressed that cochlear implant function might degrade over time, that devices and electrodes might migrate and extrude in the growing child, or that there might even be a deleterious effect of long‐term stimulation of the cochlear nerve. The purpose of this study was to explore the long‐term effects of implantation as a function of performance over time, reimplantation, and educational factors.STUDY DESIGN AND SETTINGWe studied 81 children who received implants at a major academic medical center and were followed for 5 to 13 years.RESULTSResults revealed significant gains in speech perception, use of oral language, and ability to function in a mainstream environment. There was no decrease in performance over time and no significant incidence of device or electrode migration or extrusion, and device failure did not cause a deterioration in long‐term outcome.CONCLUSIONSMultichannel cochlear implants in children provide perception, linguistic, and educational advantages, which are not adversely affected by long‐term electrical stimulation.
Factors Predictive of Poor Functional Outcome after Chemoradiation for Advanced Laryngeal Cancer
Authors: Staton Jonathan , Robbins K. Thomas , Newman Lisa , Samant Sandeep , Sebelik Merry , Vieira Francisco 
Published: February 2003

OBJECTIVEThe study goal was to determine whether pretreatment parameters can be used to predict poor outcomes related to laryngeal function among survivors after organ preservation therapy for advanced laryngeal cancer.DESIGNA retrospective analysis of patients treated in an ongoing chemoradiation trial.SETTINGAcademic tertiary care referral medical center.PATIENTS AND METHODSAmong the 65 patients receiving concomitant intra‐arterial cisplatin and radiation therapy for stage III and IV laryngeal cancer between 1993 and 1999, we identified 45 who were available for follow‐up and were disease free 6 months after the completion of therapy. A nominal logistic regression analysis was performed to study the effect of age, gender, T and N classification, vocal cord fixation, massive cartilage destruction, and neck dissection on the likelihood of requiring a tracheostomy tube for breathing and/or a gastrostomy tube for feeding at 6 months after the completion of therapy.MAIN OUTCOME MEASUREPersistent use of gastrostomy tube feedings and/or tracheostomy at 6 months after the completion of therapy.RESULTSSixteen patients (36%) required a feeding tube and/or a tracheostomy (tracheostomy 13, gastrostomy 13, both 10). Regression analysis of all pretreatment factors indicated vocal cord fixation as being the strongest predictor of a poor functional outcome (defined as the persistent need for a feeding tube and/or tracheostomy at 6 months after therapy). Among the 27 patients in this subset, 15 (56%) had a poor functional outcome. In contrast, only 1 (6%) of 18 patients without vocal cord fixation had poor laryngeal function. Although the history of pulmonary disease was not a significant parameter by itself, when combined with vocal cord fixation, 6 of 8 patients had a poor functional outcome.CONCLUSIONPretreatment parameters may be used to predict a poor functional outcome after chemoradiation. Because of the high likelihood of poor function, laryngeal cancer patients seeking organ preservation therapy with chemoradiation should be cautioned if they present with a fixed vocal cord.
Comparison of Thinprep versus Conventional Smear Cytopreparatory Techniques for Fine‐Needle Aspiration Specimens of Head and Neck Masses
Authors: Ford Lloyd , Rasgon Barry M. , Hilsinger Raymond L. , Cruz Raul M. , Axelsson Karen , Rumore Gregory J. , Schmidtknecht Thomas M. , Puligandla Balaram , Sawicki John , Pshea William 
Published: February 2003

OBJECTIVESDiagnostic accuracy of the ThinPrep process (Cytyc, Boxborough, MA) was compared with that of conventional (smear) cytopreparation for fine‐needle aspiration (FNA) of head and neck masses.METHODSIn a prospective, randomized, single‐blinded study, 209 patients served as their own controls and underwent 236 FNAs using ThinPrep and conventional (smear) cytopreparatory techniques.RESULTSThinPrep produced less air‐drying artifact and less mechanical distortion than the conventional method. The conventional technique was diagnostic in 63% of samples; the ThinPrep technique was diagnostic in 55% of samples. When all results were combined, pathologists subjectively preferred the conventional technique but accepted use of ThinPrep as the only cytopreparatory technique for most head and neck masses.CONCLUSIONSFor adequately experienced cytopathologists, ThinPrep is acceptable for FNA of salivary masses, neck cysts, metastatic lymph nodes, and thyroid lesions. Conventional smear technique should be used for FNA of nonmetastatic lymphoid lesions. Use of ThinPrep can complement use of the conventional (smear) cytopreparatory technique when aspirate is nondiagnostic or bloody, when the patient has a blood‐borne infectious disease, when the clinician is inexperienced, or when aspirate has entered the syringe.
Acoustic Rhinometry Findings in Patients with Mild Sleep Apnea
Authors: Houser Steven M. , Mamikoglu Bulent , Aquino Benjamin F. , Moinuddin Rizwan , Corey Jacquelynne P. 
Published: February 2003

BACKGROUNDNasal obstruction may contribute to the development of obstructive sleep apnea (OSA). Acoustic rhinometry (AR) measures nasal patency and congestion, which are useful parameters in objectively evaluating nasal obstruction. The nasal obstruction produced by allergic rhinitis may contribute to the development of OSA and can be easily assessed with AR.OBJECTIVEThis study was undertaken to assess the degree of nasal obstruction seen in allergic patients with and without OSA.STUDY DESIGN AND SETTINGThis study was a retrospective data analysis from a tertiary referral center. The AR data from 10 patients with and 40 patients without mild OSA were compared.RESULTSThe mean congestion factors at the first cross‐sectional area (CSA1) on the AR graph were found to be significantly higher in the OSA group than in the non‐OSA group (P= 0.03). The classification of change in congestion factors demonstrated significant differences at CSA1, CSA2, and CSA3 and in volume (tdistributions <0.001, 0.0312, <0.001, and <0.001, respectively). The non‐OSA patients noted a significant subjective improvement in nasal congestion after topical nasal decongestion, whereas the OSA patients did not (P< 0.0001 and 0.064, respectively).CONCLUSIONAlthough the role of nasal obstruction in OSA is controversial, our study lends evidence to the thought that the nasal obstruction associated with allergic rhinitis is associated with the presence of mild OSA.SIGNIFICANCEWhether allergic rhinitis is a direct cause of OSA is debatable, but we have shown that greater nasal congestion is related to the presence of OSA in a population of patients with allergic rhinitis.
Tympanoplasty Results in Patients with Cleft Palate: An Age‐ and Procedure‐Matched Comparison of Preliminary Results with Patients without Cleft Palate
Authors: Gardner Edward , Dornhoffer John L. 
Published: February 2003

OBJECTIVEBecause of continued eustachian tube abnormalities, the presence of a cleft palate repair has been thought to be associated with poor outcomes after tympanoplastic surgery. However, little published data exist regarding the results of major otologic surgery in patients with cleft palate. The objective of this study was to review our results of otologic surgery in these patients and compare results with those of age‐ and procedure‐matched controls.METHODSOur otologic database was used to identify patients with a repaired cleft palate who underwent otologic surgery between March 1994 and December 1999. Two control patients were identified for each cleft palate patient. Results of hearing, graft take, and need for postoperative pressure‐equalizing tubes were compared.RESULTSNo significant difference existed between patients with a repaired cleft palate and control patients with regard to postoperative air‐bone gap (P = 0.6805), graft survival rate (P = 1.00), and need for postoperative intubation (P = 0.457).CONCLUSIONResults in patients with cleft palate appear to be similar to those in patients without cleft palate.
Promoter Hypermethylation: An Important Epigenetic Mechanism for hMLH1 Gene Inactivation in Head and Neck Squamous Cell Carcinoma
Authors: Liu Kela , Huang Huaiyun , Mukunyadzi Perkins , Suen James Y. , Hanna Ehab , Fan Chun‐Yang 
Published: February 2003

OBJECTIVEThe hMLH1 gene is one of the mismatch DNA repair genes. Inactivation of the hMLH1 gene has been implicated in the tumorigenesis of many types of human cancers. In most sporadic forms of human cancers, promoter hypermethylation is responsible for hMLH1 gene inactivation. Lack of hMLH1 protein expression has been found in a subset of head and neck squamous cell carcinomas (HNSCCs). The purpose of this study was to investigate whether promoter hypermethylation causes hMLH1 gene inactivation in HNSCCs.STUDY DESIGNhMLH1 protein expression was determined by immunohistochemical staining in 62 cases, whereas hMLH1 gene promoter methylation was analyzed by methylation‐sensitive restriction enzyme digestion, followed by polymerase chain reaction, in 35 cases of HNSCCs.RESULTSSixteen (26%) of 62 cases of HNSCCs showed near‐complete loss of hMLH1 protein expression on immunohistochemical staining. Twelve (92%) of 13 cases that were negative for the hMLH1 protein displayed promoter hypermethylation, whereas 17 (77%) of 22 cases positive for the protein were free of promoter methylation.CONCLUSIONSPromoter hypermethylation may be an important mechanism for hMLH1 gene inactivation in a subset of HNSCCs.
Biomechanical Effects of Hydration in Vocal Fold Tissues
Authors: Chan Roger W. , Tayama Niro 
Published: February 2003

OBJECTIVEIt has often been hypothesized, with little empirical support, that vocal fold hydration affects voice production by mediating changes in vocal fold tissue rheology. To test this hypothesis, we attempted in this study to quantify the effects of hydration on the viscoelastic shear properties of vocal fold tissues in vitro.STUDY DESIGNOsmotic changes in hydration (dehydration and rehydration) of 5 excised canine larynges were induced by sequential incubation of the tissues in isotonic, hypertonic, and hypotonic solutions. Elastic shear modulus (G'), dynamic viscosity η' and the damping ratio ζ of the vocal fold mucosa (lamina propria) were measured as a function of frequency (0.01 to 15 Hz) with a torsional rheometer.RESULTSVocal fold tissue stiffness (G') and viscosity increased significantly (by 4 to 7 times) with the osmotically induced dehydration, whereas they decreased by 22% to 38% on the induced rehydration. Damping ratio (ζ) also increased with dehydration and decreased with rehydration, but the detected differences were not statistically significant at all frequencies.CONCLUSIONThese findings support the longstanding hypothesis that hydration affects vocal fold vibration by altering tissue rheologic (or viscoelastic) properties.SIGNIFICANCEOur results demonstrated the biomechanical importance of hydration in vocal fold tissues and suggested that hydration approaches may potentially improve the biomechanics of phonation in vocal fold lesions involving disordered fluid balance.
The Pedicled Superficial Temporalis Fascial Flap: A New Method for Reconstruction in Otologic Surgery
Authors: Olson Krista L. , Manolidis Spiros 
Published: February 2003

OBJECTIVESOur goal was to describe a novel fascial flap of the temporal region and its use for reconstruction in otologic and neurotologic surgery.METHODSThe superficial temporalis fascia has an axial blood supply derived from the middle temporal artery and can be raised independently from the overlying temporoparietal fascia or the underlying deep temporalis fascia. This flap was used on 15 consecutive patients to solve a wide variety of reconstructive problems after otologic procedures.RESULTSNo additional morbidity was observed from the use of this flap. There were no complications related to the reconstruction. Adequate exposure for raising this flap was obtained using standard incisions for the otologic procedures. Follow‐up ranges from 2 to 25 months.CONCLUSIONSThis fascial flap provides a wide surface area of tissue on a narrow‐based pedicle capable of a wide arc of rotation. It provides thin, pliable tissue that can be adapted to the needs of various reconstructive otologic/neurotologic problems.
Prevalence of Heat Shock Protein in Patients with Meniere's Disease and Allergy
Authors: Derebery M. Jennifer 
Published: February 2003

OBJECTIVEThe study purpose was to investigate the prevalence of elevated heat shock protein 70 (HSP‐70) in patients with Meniere's disease who have milk allergy compared with those who are not allergic to milk.METHODSFifty‐five patients with Meniere's disease and allergy in whom milk allergy had been confirmed by intradermal progressive dilutional food testing or skin testing to milk antigen were included. Blood serum was tested for HSP‐70 elevation with a Western blot assay using bovine renal extract. The 29 women and 26 men ranged in age from 29 to 76 years (mean age 52.8 years). Forty percent of the patients had bilateral Meniere's disease.RESULTSOverall prevalence of HSP‐70 elevation was 29.1%. This was higher in bilateral patients (50%) than unilateral patients (15%) (P ≤ 0.007). The effect was based primarily on elevated HSP‐70 in bilateral (62.5%) and unilateral (7.7%) patients in those with no milk allergy (P ≤ 0.006). The prevalence of HSP‐70 elevation was actually lower in those with milk allergy (19.2%) than in those with no milk allergy (37.9%). This difference was statistically significant only in the subset of patients who were <50 years old (0% vs 33.3%, respectively; P ≤ 0.04).CONCLUSIONSWe found no relationship between the presence of antibodies to HSP‐70 and allergy to milk. The significance of elevated HSP‐70 in patients with Meniere's disease has yet to be defined.
The Effect of Optical Design on Micromanipulator Spot Size Using CO2 Laser Irradiation
Authors: Chao Kenneth K. H. , Cheung Eric , Armstrong William B. , Wong Brian J. F. 
Published: February 2003

OBJECTIVEThe study goal was to compare the laser spot size created using reflective and refractive micromanipulators with a CO2 laser and to determine the sensitivity of spot size to laser power.STUDY DESIGN AND SETTINGA CO2 laser and operating microscope (400‐mm focal length) was coupled to either a reflective (Cassegrain‐like) or refractive micromanipulator. Laser spot size was determined by measuring the region of ablation created by laser irradiation of wood (dry tongue depressors), exposed photographic film, and agar gel using optical micrometry. Laser power varied from 0.5 to 20 W with pulse durations of 0.1 and 0.5 second.RESULTSThe reflective micromanipulator demonstrated overall smaller spot sizes for a given laser power and lower incremental change in spot size with increasing power. The reflective design demonstrated less sensitivity to increases in laser power.CONCLUSIONSMicromanipulator optical design can result in significant differences in laser spot size. The reflective device used in this study demonstrated less sensitivity to increasing laser power.
Round Window Application of D‐Methionine Provides Complete Cisplatin Otoprotection
Authors: Korver Kurtis D. , Rybak Leonard P. , Whitworth Craig , Campbell Kathleen M. 
Published: February 2003

OBJECTIVECisplatin is a widely used, very effective chemotherapeutic agent that can cause severe ototoxicity. In this study, D‐methionine was tested as an otoprotectant via round window membrane (RWM) application in the chinchilla.METHODSA minute amount of cisplatin alone, or D‐methionine followed by cisplatin, was applied topically directly to the intact RWM of anesthetized adult chinchillas. Auditory brainstem responses were measured before and 1 week after topical round window application. Animals were killed, and the cochleas were examined.RESULTSThe ears pretreated with D‐methionine were completely protected from hearing loss and hair cell loss in the organ of Corti compared with controls. The ears receiving cisplatin without D‐methionine protection sustained nearly complete hearing loss with threshold shifts of >60 dB, with extensive outer hair cell loss throughout the organ of Corti but particularly in the basal turn.CONCLUSIONThese results demonstrate that topical D‐methionine provides excellent otoprotection against cisplatin‐induced ototoxicity both electrophysiologically and structurally.