bluuebunny/crossref_metadata_2025_split huggingface dataset:
Different Endoscopic Surgical Strategies in the Management of Inverted Papilloma of the Sinonasal Tract: Experience with 47 Patients
Authors: Tomenzoli Davide , Castelnuovo Paolo , Pagella Fabio , Berlucchi Marco , Pianta Luca , Delù Giovanni , Maroldi Roberto , Nicolai Piero 
Published: January 2004

AbstractObjective: To demonstrate the potentials and limitations of three different endoscopic procedures employed for treatment of inverted papilloma (IP) of the sinonasal tract.Study Design: Retrospective analysis of a cohort of patients treated at two University hospitals.Methods: From January 1992 to June 2000, 47 patients with IP underwent endoscopic resection. Preoperative workup included multiple biopsies of the lesion and imaging evaluation by computed tomography or magnetic resonance imaging. Massive skull base erosion, intradural or intraorbital extension, extensive involvement of the frontal sinus, abundant scar tissue caused by previous surgery, or the concomitant presence of squamous cell carcinoma were considered absolute contraindications for a purely endoscopic approach. Three types of resection were used: ethmoidectomy with wide antrostomy and sphenoidotomy (type 1) for IPs confined to the middle meatus, medial maxillectomy with ethmoidectomy and sphenoidotomy (type 2) for IPs partially invading the maxillary sinus, and a Sturmann‐Canfield operation (type 3) for IPs involving the mucosa of the alveolar recess or of the anterolateral corner of the maxillary sinus. All patients were followed by periodic endoscopic evaluations.Results: Type 1, 2, and 3 resections were performed in 26, 15, and 6 patients, respectively. No recurrences were observed after a mean follow‐up of 55 (range 30–132) months. One patient, who underwent a type 2 resection, developed a stenosis of the lacrimal pathways requiring endoscopic dacryocystorhinostomy.Conclusions: Our experience confirms that endoscopic surgery is an effective and safe method of treatment for most IPs. The availability of different endoscopic techniques allows the entity of the dissection to be modulated in relation to the extent of disease. Strict application of selection criteria, meticulous use of subperiosteal dissection in the involved areas, and regular follow‐up evaluation are key elements for success.
Comparison of Topical Medication Delivery Systems after Sinus Surgery
Authors: Miller Timothy R. , Muntz Harlan R. , Gilbert M Erik , Orlandi Richard R. 
Published: January 2004

AbstractObjectives: To compare the distribution patterns of topical medication delivery systems in the sinonasal region and upper respiratory tract after functional endoscopic sinus surgery.Study Design: Prospective descriptive evaluation.Methods: Four topical delivery systems (spray bottle, atomizer, nebulizer, and bulb syringe) were studied. Using a dye solution as a marker, we independently applied the four topical delivery systems to a population of patients with chronic rhinosinusitis who had undergone functional endoscopic sinus surgery. The anatomic distributions were videotaped using flexible fiberoptic endoscopy. Three blinded observers independently rated the anatomic distribution of dye using a 4 point scale. Statistical analysis was performed using analysis of variance (ANOVA) and Dunn posttesting.Results: Seven participants completed the study. All participants had undergone bilateral maxillary antrostomies, bilateral total ethmoidectomies, and bilateral sphenoidotomies. Five sinonasal sites and the larynx were evaluated for dye deposition. Interobserver agreement reached 95.6%. There was no statistical difference between the atomizer and spray bottle. The bulb syringe was statistically superior to the nebulizer in all sinonasal sites and statistically superior to the atomizer and spray bottle in the ethmoidal region. Dye was rarely seen within the larynx.Conclusions: The delivery systems tested were shown to have significant differences in their capability to place dye in specific sinonasal areas. Because topical medications are commonly administered to postoperative patients, these differences may have important clinical implications.
The Effects of Upper Airway Surgery for Obstructive Sleep Apnea on Nasal Continuous Positive Airway Pressure Settings
Authors: Masdon James Lee , Magnuson J Scott , Youngblood Garland 
Published: January 2004

AbstractObjectives/Hypothesis: The objectives were to determine whether upper airway surgery lowers nasal continuous positive airway pressure (CPAP) settings for patients who require CPAP postoperatively for unresolved obstructive sleep apnea and to assess CPAP tolerability after upper airway surgery.Study Design: Retrospective chart review.Methods: Patients who underwent upper airway surgery with preoperative and postoperative polysomnography at the University of Alabama at Birmingham (Birmingham, AL) between 1995 and 2000 were the focus of the study. Upper airway surgery was defined as uvulopalatopharyngoplasty alone or in addition to septoplasty and turbinoplasty. Recommended CPAP settings were recorded from preoperative and postoperative polysomnography studies to determine whether CPAP settings were decreased following surgery. A response to surgery was defined as a decrease of the recommended CPAP setting by at least 1 cm of water. A telephone interview was conducted to determine whether upper airway surgery improved CPAP comfort.Results: In 51.4% of the patients, CPAP settings were decreased following surgery. Continuous positive airway pressure settings were increased in 28.6% of patients and unchanged in 20%. Of the six patients who consistently used CPAP before and after surgery, four reported increased comfort postoperatively.Conclusion: Upper airway surgery does not predictably reduce CPAP settings in the patient who requires postoperative CPAP for unresolved obstructive sleep apnea. Upper airway surgery may improve CPAP tolerability.
Outpatient Endoscopic Zenker Diverticulotomy
Authors: Gross Neil D. , Cohen James I. , Andersen Peter E. 
Published: January 2004

AbstractObjectives/Hypothesis: Staple‐assisted, endoscopic Zenker diverticulotomy has been shown to decrease both cost of treatment and length of convalescence when compared with the standard open approach. Although the endoscopic technique is generally considered to be safe, the feasibility of outpatient endoscopic Zenker diverticulotomy has never been reported.Study Design: Retrospective cohort study.Methods: All endoscopic Zenker diverticulotomy procedures performed at Oregon Health and Science University (Portland, OR) between 1998 and 2002 were reviewed. The study group was limited to patients whose surgeries were planned on an outpatient basis. Medical charts were reviewed for indications, demographics, operative findings, complications, and resolution of symptoms.Results: Of the 51 patients who underwent endoscopic, staple‐assisted Zenker diverticulotomy, 40 were treated with the intent of outpatient management. Thirty‐two cases were primary surgeries, and eight cases were revision treatments. The average patient age was 68 years (age range, 35–91 y), and the mean follow‐up period was 5.9 months (range, 1–37 mo). Eight (20%) complications were noted in the study group. Intraoperative complications included 3 patients (7.5%) with mucosal disruptions. These patients underwent uneventful suture repair of small hypopharyngeal mucosal tears encountered intraoperatively and were temporarily observed in the hospital. One patient was admitted for postoperative urinary retention and another for fever and tachycardia 48 hours after surgery. One patient sustained a myocardial infarction. The remainder of patients were fed immediately and discharged home on the day of surgery. Two patients (5%) had iatrogenic tooth fracture.Conclusion: Appropriately selected patients undergoing endoscopic, staple‐assisted Zenker diverticulotomy can be managed safely on an outpatient basis. Intraoperative complications, such as a mucosal disruption, warrant conversion to inpatient monitoring.
Endoscopic Vertical Partial Laryngectomy
Authors: Davis R Kim , Hadley Kevin , Smith Marshall E. 
Published: January 2004

AbstractObjective: To explain the significant difference between microlaryngoscopy with cordectomy and endoscopic vertical partial laryngectomy (EVPL), to describe the efficacy of EVPL on T1b and T2 glottic squamous cell carcinoma, and to evaluate EVPL with postoperative irradiation in T2 glottic cancer with impaired true vocal cord mobility.Study Design: Retrospective review.Methods: Twenty‐six patients seen at the University of Utah Health Science Center between 1987 and 2000 with bilateral T1 (T1b) or T2 squamous cell carcinoma of the glottic larynx underwent EVPL. T2 cancers were classified as follows: a = unilateral disease, b = bilateral disease; i = impaired mobility. T1b and T2a glottic cancer patients received surgery alone, whereas impaired mobility patients (T2ai + T2bi) patients received surgery followed by planned postoperative irradiation. Patients were assessed for primary site control, perioperative and long‐term complications, and ultimate cancer control.Results: Survival in the total group was 88.5%, with local control at 92.3%. The two recurrent patients were salvaged by total laryngectomy. For the whole group, anterior commissure involvement was present in 57.7% (15 of 26). Thirteen T2 (5 T2ai + 8 T2bi) carcinoma patients underwent combined therapy, with 8 (61.5%) of these patients having anterior commissure involvement. Two of these patients were upstaged at surgery, one to T3 and one to T4. Local control was 84.5%. Thirteen patients were treated by surgery only, with five of these patients having failed previous irradiation. Survival was 92.3% and local control 100%. This group included two T2bi patients, two patients upstaged to T4 on the basis of extension beyond the subglottis to the anterior wall of the trachea, 3 T2b, and 6 T2a patients. Anterior commissure involvement was seen in 7 (53.8%) of these patients.Conclusions: EVPL alone controlled all T1b and T2a glottic cancer patients, even in the presence of greater than 50% anterior commissure involvement. The significant difference between EVPL and classical microlaryngoscopy with cordectomy was carefully described. EVPL with planned postoperative irradiation resulted in an 85% local control rate in clinically staged T2ai and T2bi cancer patients, including the three upstaged patients.
Current Applications of Microarrays in Head and Neck Cancer Research
Authors: Warner Giles C. , Reis Patricia P. , Makitie Antti A. , Sukhai Mahadeo A. , Arora Shilpi , Jurisica Igor , Wells Richard A. , Gullane Patrick , Irish Jonathan , Kamel‐Reid Suzanne 
Published: January 2004

AbstractObjectives/Hypothesis: The objective was to introduce microarray technology and its applications in cancer research to the head and neck clinician.Study Design: Literature review combined with methodology and examples from the authors' experiences with microarray analysis of tumors of the head and neck.Methods: Search of literature and the authors' experience was made for technical details, alternative methods of data analysis, available bioinformatics tools, and applications of microarrays in cancer research.Results: Microarrays allow the simultaneous analysis of the expression of thousands of genes. The use of a well‐developed microarray study design leads to informative results. There are various bioinformatics resources widely available to aid in the analysis of microarray data. However, there is not yet a gold standard for analysis because this methodology is still evolving.Conclusion: Microarray studies may allow researchers to identify genetic changes relevant to diagnosis and prognosis in patients with head and neck cancer. Although still relatively new, this powerful methodology has immense potential to aid in understanding of the genetic changes that are important in head and neck cancer.
Myxoma of the Lateral Skull Base: Clinical Features and Management
Authors: Windfuhr J P , Schwerdtfeger F P 
Published: January 2004

AbstractObjective: To evaluate the clinical features and incidence of true myxomas affecting the lateral skull base.Material and Methods: Illustrative case report and review of the relevant literature. Included are all reports of myxomas according to the histopathologic definition of Stout.Results: Despite nine case reports, only four patients matched the histopathologic criteria of a true myxoma growing in the lateral skull base. Facial palsy occurred in three adults with additional otalgia in one and progressive hearing loss (HL) in another patient. Our patient initially presented with signs of recurrent otitis media. The mastoid cavity was involved in all patients.Conclusion: Differential diagnosis of lesions occurring in the lateral skull base should include true myxoma. Correct diagnosis should be based on immunohistopathology to rule out malignant tumors. Radical surgery is the treatment of choice, but surgeons should respect vital structures and esthetic consequences.
Experimental Sinusitis in a Rhinogenic Model
Authors: Kara Cüneyt Orhan , Çetin Çiğdem Banu , Demirkan Neşe , Şengül Mustafa , Topuz Bülent , Pnar Hilmi Şafak , Pakdemirli Emre 
Published: January 2004

AbstractObjectives/Hypothesis: The objectives were to determine the optimal sinusitis induction period and to examine microbiological and histopathological changes of sinusitis recovery stage in a rhinogenic sinusitis model.Methods: A synthetic sponge was inserted into the right‐side nasal cavities of rabbits. The sponge was impregnated with a Streptococcus pneumoniae strain in group 1 and with sterile saline solution in groups 2 and 3. After the fourth day of sponge insertion, sinuses were examined by coronal computed tomography scans at two‐day intervals until any radiological evidence of sinusitis was observed. When sinusitis was detected radiologically, five rabbits each from groups 1 and 2 were killed for histological examination. To determine the recovery period of sinusitis, sponges were removed from the rest of the rabbits in groups 1 and 2. Rabbits were selected randomly and killed on the 15th and the 30th days of the recovery period, immediately after radiological examinations. Group 3 was considered a sham group.Results: Sinusitis induction was performed in all rabbits in groups 1 and 2 until the 8th day. After the sponges were removed, inflammation persisted until the 30th day of the study.Conclusion: In a rhinogenic sinusitis model, although histological features of sinusitis were demonstrated, further studies are required to standardize this model and to examine whether or not the studied bacterial strain spreads from nasal cavity into sinus.
Effect of Clarithromycin on Nuclear Factor‐κB and Transforming Growth Factor‐β in Chronic Rhinosinusitis
Authors: Wallwork Ben , Coman William , Mackay‐Sim Alan , Cervin Anders 
Published: January 2004

AbstractObjectives: Long‐term, low‐dose macrolide therapy is effective in the treatment of chronic rhinosinusitis. It is believed that macrolide antibiotics produce this benefit through an anti‐inflammatory effect. In this study, the effect of clarithromycin treatment on the expression of transforming growth factor (TGF)‐β and the key pro‐inflammatory nuclear transcription factor, NF‐κB, was examined in vitro and in vivo.Study Design and Methods: In vitro: nasal mucosa was obtained from 10 patients with chronic sinusitis and was cultured for 24 hours in the presence of clarithromycin or control. Cellular expression of TGF‐β and NF‐κB was determined by immunohistochemistry. In vivo: 10 patients with chronic rhinosinusitis were treated for 3 months with clarithromycin. Nasal mucosal biopsies were taken pre‐ and posttreatment. Cellular expression of TGF‐β and NF‐κB was again determined by immunohistochemistry.Results: Clarithromycin, when applied to nasal biopsies in vitro, reduced cellular expression of TGF‐β and NF‐κB. Nasal biopsies taken before and after clarithromycin treatment showed no differences in cellular expression of NF‐κB or TGF‐β.Conclusion: Clarithromycin can reduce cellular expression of TGF‐β and NF‐κB when applied in vitro, but its action during clinical therapy is less clear. Clarithromycin is capable of inhibiting pro‐inflammatory cytokines in vitro, and reductions of TGF‐β and NF‐κB may represent additional mechanisms by which macrolides reduce inflammation in chronic airway disease. Discrepancies between the actions of clarithromycin on nasal biopsies in vitro and after clinical therapy warrant further investigation.
Juvenile Angiofibromas: Changing Surgical Concept Over the Last 20 Years
Authors: Mann Wolf J. , Jecker Peter , Amedee Ronald G. 
Published: January 2004

AbstractObjectives: Nasopharyngeal angiofibroma is a rare tumor. Several surgical approaches have been established, including transpalatal, lateral rhinotomy, craniofacial, and midface degloving procedures. More recently, less invasive endonasal approaches have been used. In a retrospective study, we analyzed the outcome of surgical treatment for angiofibroma to determine whether an endonasal approach was as effective as other, more invasive techniques for removing the tumors.Methods: Thirty patients with histologically confirmed angiofibromas were treated by surgical removal at two institutions during a 20‐year period. Tumors were staged according to size and extension on the basis of imaging and surgical findings using the Fisch classification. Specific analysis of the operative approaches and recurrence rate by stage were included. Recurrent or residual disease was handled by surgical excision.Results: The number of patients treated increased during the last 10 years in both institutions, but no major changes in distribution of tumor stages were observed. In the most recent years, the endonasal approach has been favored. All 30 patients remain alive and free of disease.Conclusions: During the last 12 years, we have undergone a marked shift toward endonasal procedures while the tumor stages of the patients treated remained the same. Our results demonstrate that angiofibromas may be managed successfully using less invasive techniques, thereby reducing morbidity, without increasing the chance of recurrence.
Optimum Tension for Partial Ossicular Replacement Prosthesis Reconstruction in the Human Middle Ear
Authors: Morris David P. , Bance Manohar , van Wijhe Rene G. , Kiefte Michael , Smith Rachael 
Published: January 2004

AbstractObjective: Hearing results from ossiculoplasty are unpredictable. There are many potentially modifiable parameters. One parameter that has not been adequately investigated in the past is the effect of tension on the mechanical functioning of the prosthesis. Our goal was to investigate this parameter further, with the hypothesis that the mechanical functioning of partial ossicular replacement prostheses (PORP) from the stapes head to the eardrum will be affected by the tension that they are placed under.Methods: Fresh temporal bones were used to reconstruct a missing incus defect with a PORP‐type prosthesis. Three different lengths of PORP were used, and the stapes vibrations were measured with a laser Doppler vibrometer using a calibrated standard sound in the ear canal. Eight temporal bones were used.Results: Tension had a very significant effect on stapes vibration. In general, loose prostheses resulted in the best overall vibration transmission. The effects were most marked at the lower frequencies. There was a slight advantage to tight prostheses in the higher frequencies, but much less than the decrement in lower frequencies with tight prostheses.Conclusion: In ossicular reconstruction, best stapes vibration results in our model are achieved by shorter prostheses, which result in lower tension.
Long‐Term Effects of Cerebellar Retraction in the Microsurgical Resection of Vestibular Schwannomas
Authors: Kim Harold H. , Johnston Ross , Wiet Richard J. , Kumar Arvind 
Published: January 2004

AbstractObjective: To determine the long‐term effects, if any, of the greater cerebellar retraction that is required for retrosigmoid vestibular schwannoma versus resection as compared with the minimal, if any, cerebellar retraction required for translabyrinthine versus resection.Study Design: Retrospective case control.Methods: All patients who underwent retrosigmoid versus resection between 1988 to 2000 by one surgeon were identified. These patients were contacted and asked to complete the Dizziness Handicap Inventory (DHI). These patients were then matched to patients who underwent translabyrinthine versus resection according to age at surgery, age at time of study, sex, and size of tumor. Total DHI and subcategory DHI scores were compared using the Student t test.Results: Thirty‐three patients underwent the retrosigmoid approach, and 27 were contacted for completion of the survey, with a 81.3% response rate. Forty‐six patients who underwent translabyrinthine versus resection were matched to the retrosigmoid group. Thirty‐six were contacted and completed the survey for a 75% response rate. Twenty‐seven patients that most closely matched the retrosigmoid group comprised the translabyrinthine group used for comparison. Minimal differences were seen between the two groups. Mean total DHI score for the retrosigmoid group was 17.6, which was not significantly different from the mean score of 16.8 seen in the translabyrinthine group (P = .888). When comparing small tumors (<1.5 cm), total DHI scores were not found to be significantly different (P = .859). We observed similar findings in those with intermediate‐sized tumors (1.5–3 cm).Conclusion: The significantly greater cerebellar retraction that is necessary for retrosigmoid versus resection does not result in greater long‐term balance and disability as compared with those patients who have undergone the translabyrinthine approach.
Ebselen‐Mediated Protection From Single and Repeated Noise Exposure in Rat
Authors: Lynch Eric D. , Gu Rende , Pierce Carol , Kil Jonathan 
Published: January 2004

AbstractObjectives/Hypothesis: Ebselen, a glutathione peroxidase mimic, is a candidate compound for the prevention of noise‐induced hearing loss.Study Design: Single‐blinded, placebo‐controlled study.Methods: Methods included single and repeated noise exposures on F‐344 female rats given oral or injected ebselen or vehicle before and after noise, evoked auditory brainstem responses using click and pure‐tone stimuli, light and fluorescence microscopy of cochleae stained with 4′,6‐Diamidino‐2‐phenylindole (DAPI) and fluorescein isothiocyanate–phalloidin, and statistical power determined by ANOVA.Results: Auditory brainstem response indicated that ebselen provided significant protection from both temporary and permanent threshold shifts following single and repeated noise exposure. On average, three times more outer hair cells were lost in control versus ebselen‐treated animals.Conclusion: Ebselen reduces noise‐induced hearing loss in rats.