bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gene Polymorphisms in Detoxification Enzymes as Susceptibility Factor for Head and Neck Cancer?
Authors: Gronau S. , Koenig‐Greger D. , Jerg M. , Riechelmann H. 
Published: September 2022

OBJECTIVEImpaired detoxification of carcinogens found in tobacco smoke appears to increase the risk for tobacco associated cancer. The objective of this study was to investigate concomitant polymorphisms in genes encoding for various detoxification enzymes in patients with head and neck squamous cell carcinoma (HNSCC).METHODSIn 187 patients with HNSCC and in 139 healthy control subjects, the polymorphisms of cytochrome P450 1A1 (CYP1A1), cytochrome P450 2D6 (CYP2D6), and glutathione S‐transferase μ1 and θ (GSTM1, GSTT1) were detected by polymerase chain reaction.RESULTSNo significant association were identified between CYP1A1 and CYP2D6 gene polymorphisms and HNSCC. Patients with laryngeal cancer revealed the GSTM1 null genotype more frequently than did the control subjects (P < 0.05). The coincidence of GSTM1 and GSTT1 null genotype was found twice as great in patients as in control subjects (P < 0.05).CONCLUSIONSIt is assumed that detoxification enzymes are functionally redundant and only the simultaneous deficiency of several detoxification enzymes increase the risk for HNSCC in alcohol‐ and tobacco‐exposed individuals.
Acoustic Assessment of the Voice Quality before and after Medialization Thyroplasty Using the Titanium Vocal Fold Medialization Implant (TVFMI)
Authors: Schneider Berit , Denk Doris‐Maria , Bigenzahn Wolfgang 
Published: September 2022

OBJECTIVEThis study was designed to objectify the vocal outcome in patients with unilateral vocal fold paralysis. Acoustic parameters were evaluated and compared to perceptual voice sound assessments before and after medialization thyroplasty using the titanium vocal fold medialization implant (TVFMI®).STUDY DESIGN AND SETTINGTwenty‐eight patients underwent external medialization thyroplasty using TVFMI®. Prior to and after surgery videostroboscopy, perceptual voice evaluation and acoustic analysis based on the computerized “hoarseness diagram” were performed.RESULTSIn videostroboscopy, most patients showed an almost complete glottal closure after thyroplasty. The statistical analysis revealed a significant improvement in the perceptual voice parameters (p<0.001). The acoustic measurements could objectify the positive impact on the voice after thyroplasty (p≤0.001).CONCLUSIONThe results confirm that the TVFMI® is an excellent and individually adjustable device for medialization thyroplasty. The “hoarseness diagram” allows the vocal outcome after surgery to be documented and objectified in an easy and reliable manner.
Evaluation of Middle Meatal Stenting after Minimally Invasive Sinus Techniques (MIST)
Authors: Catalano Peter J. , Roffman Eric J. 
Published: September 2022

OBJECTIVESIn this study, we compared postoperative synechia rates and morbidity for different middle meatal (MM) stents after minimally invasive sinus techniques(MIST).STUDY DESIGNIn a prospective study, we included 100 patients with bilateral chronic sinusitis undergoing MIST at a tertiary care facility with a single surgeon.METHODSFor all patients, MeroGel stents were placed in the right MM, Gelfilm stents were placed in the left MM. Follow‐up consisted of 3 postoperative visits between weeks 1 and 12 with endoscopic evaluation for synechia, granulation tissue, stent retention, nasal obstruction, headache, and infection.RESULTSSynechia developed in 4 patients on the left and in none on the right (P= 0.04). There were no significant side‐specific differences regarding postoperative nasal congestion, headache, or sinusitis. Mean stent retention time was 7.9 days for MeroGel and 5.6 days for Gelfilm (P= 0.0004).CONCLUSIONCompared with Gelfilm, Merogel MM stents produced less synechia; Merogel retains its position in the MM longer than Gelfilm; and the incidence of postoperative MM synechia can be reduced when absorbable MM stents are used in conjunction with MIST.
Microvascular flap reconstruction of the mandible: A comparison of bone grafts and bridging plates for restoration of mandibular continuity
Authors: Head Christian , Alam Daniel , Sercarz Joel A. , Lee Jivianne T. , Rawnsley Jeffrey D. , Berke Gerald S. , Blackwell Keith E. 
Published: September 2022

OBJECTIVETo compare the efficacy of vascularized bone grafts and bridging mandibular reconstruction plates for restoration of mandibular continuity in patients who undergo free flap reconstruction after segmental mandibulectomy.STUDY DESIGN AND SETTING. A total of 210 patients underwent microvascular flap reconstruction after segmental mandibulectomy. The rate of successful restoration of mandibular continuity in 151 patients with vascularized bone grafts was compared to 59 patients with soft tissue free flaps combined with bridging plates.RESULTSMandibular continuity was restored successfully for the duration of the follow‐up period in 94% of patients who received bone grafts compared with 92% of patients with bridging mandibular reconstruction plates. This difference was not statistically significant. In patients who received bone grafts, most cases of reconstructive failure occurred during the perioperative period and were due to patient death or free flap thrombosis. In patients who received bridging plates, all instances of reconstructive failure were delayed for several months and were due to hardware extrusion or plate fracture.CONCLUSIONSVascularized bone‐containing free flaps are preferred for reconstruction of most segmental mandibulectomy defects in patients undergoing microvascular flap reconstruction. However, use of a soft tissue flap with a bridging mandibular reconstruction plate is a reasonable alternative in patients with lateral oromandibular defects when the nature of the defect favors use of a soft tissue free flap.SIGNIFICANCEBoth bone grafts and bridging plates represent effective methods of restoring mandibular continuity following segmental mandibulectomy, with the former being the preferred technique for patients undergoing microvascular reconstruction.
p21, p53, andp27Kip1 alterations in benign and malignant tumors of sinonasal epithelium
Authors: Keles Nesil , Erdamar Burak , Kaur Ahmet , DeĞEr Kemal 
Published: September 2022

OBJECTIVEThe goal of this study was to investigate alterations of cell cycle‐related molecules, includingp27, p21, andp53, in inverted papillomas (IPs) and squamous cell carcinomas (SCCs) of the sinonasal epithelium.STUDY DESIGNSixteen IPs and 6 SCCs of the sinonasal epithelium, surgically resected at Istanbul Faculty of Medicine, Department of Otorhinolaryngology, from 1992 to 2000 were immunohistochemically investigated (p27, p21, andp53).RESULTSA significant decrease inp27nuclear staining was observed for SCCs of paranasal sinus compared with inverted papillomas (P= 0.0072). In SCCs there was no association betweenp27expression and the presence of keratinization and tumor grade.p21andp53expressions were not associated with IPs (dysplastic and nondysplastic) and SCCs.CONCLUSIONReduced levels ofp27expression correlate with increased cell proliferation in tumors of sinonasal region. Our findings indicate thatp27immunohistochemistry can be recommended to analyze the dysregulation of cell kinetics in these tumors.
The Efficacy of Anatomically Based Multilevel Surgery for Obstructive Sleep Apnea
Authors: Kao Yi H. , Shnayder Yelizaveta , Lee Kelvin C. 
Published: September 2022

OBJECTIVEMost reports in the literature focus on the efficacy of a single procedure for obstructive sleep apnea (OSA). We review the overall efficacy of a surgical methodology based on localizing the level of anatomic obstruction for each patient and surgical correction of the nasal, oropharyngeal, or hypopharyngeal obstruction.STUDY DESIGN AND SETTINGRetrospective review of cases performed by a single practitioner using a systematic approach to surgery for OSA with pre‐operative and postoperative sleep studies.RESULTSForty‐two patients with a respiratory disturbance index (RDI) greater than 15 were included in the study. Surgery involved at least 2 levels of obstruction usually performed in 2 stages. All patients reported symptomatic improvement. Overall, 83.3% (35 of 42) of patients were cured according to the accepted RDI criteria of more than 50% reduction and final RDI of less than 20. All 21 patients with mild OSA (RDI, <29), 73% of patients with moderate OSA (RDI, 30 to 49), and 50% of patients with severe OSA (RDI, >50) were cured.CONCLUSIONThe use of an anatomically based methodology in approaching patients with OSA seems to offer a higher efficacy than a single procedure as reported in the literature. (Otolaryngol Head Neck Surg 2003;129:327–35.)
Preliminary Findings from a Prospective, Randomized Trial of Two Tongue‐Base Surgeries for Sleep‐Disordered Breathing
Authors: Thomas Adrian J. , Chavoya Martha , Terris David J. 
Published: September 2022

OBJECTIVESThis study compares the efficacy of 2 tongue‐base surgical procedures in the treatment of patients with moderate to severe sleep‐disordered breathing.STUDY DESIGN AND SETTINGWe conducted a prospective, randomized crossover surgical trial at a university hospital.METHODSSeventeen patients with moderate to severe sleep‐disordered breathing and Fujita type II upper airway collapse for whom conservative treatment failed were enrolled into an institutional review board‐approved surgical protocol. They were randomly assigned to undergo palatopharyngoplasty combined with either tongue advancement (mandibular osteotomy) or tongue suspension. Parameters assessed included severity of sleep‐disordered breathing (polysomnography), sleepiness (Epworth Sleepiness Scale), and anatomic changes (upper airway endoscopy), as well as demographic factors. Patients not achieving satisfactory improvement in their condition were offered nonsurgical management or additional surgical treatment that varied based on the postoperative assessment but included crossing over to the other tongue surgical procedure.RESULTSNine of the 17 patients were randomized to the tongue suspension group, and 8 to the tongue advancement group. In the 9 tongue suspension patients, Epworth Sleepiness Scale scores fell from 12.1 to 4.1 (P = 0.007). Airway collapse for all 9 patients measured on Müller maneuver improved, by a mean of 64% (P = 0.0006) at the palate and 83% (P = 0.0003) at the base of the tongue. In the 8 tongue advancement patients, Epworth Sleepiness Scale scores fell from a mean of 13.3 to 5.4 (P = 0.004). Airway collapse for 5 of 8 patients measured on Müller maneuver improved by a mean of 31% (P = 0.1) at the palate and 75% (P = 0.03) at the base of the tongue.CONCLUSIONProspective, randomized trials of tongue‐base surgery for sleep‐disordered breathing are possible. Preliminary findings from the current protocol reveal a slight advantage of tongue suspension over tongue advancement.
Posterior Marginal Mandibulectomy in the Management of Cancer of the Oral Cavity and Oropharynx
Authors: Petruzzelli Guy J. , Knight Fanchon K. , Vandevender Darl , Clark Joseph I. , Emami Bahman 
Published: September 2022

OBJECTIVETo review a single institution's experience with posterior marginal (ramus) mandibulectomy for mandibular preservation in the management of patients with squamous cell carcinoma of the retromolar trigone or oropharynx. To review the history and surgical technique with emphasis on functional as well as oncologic outcomes.STUDY DESIGN AND SETTINGRetrospective review at a tertiary care academic referral center from 1996 to 2002.RESULTSBetween 1996 and 2002, 382 patients with squamous cell carcinoma of the oral cavity and oropharynx were surgically treated at the Loyola University Medical Center. Medical records were reviewed and 152 patients were identified who had some form of mandibular procedure (segmental resection, marginal resection, or mandibulotomy) performed in conjunction with their tumor resection. Eighteen posterior marginal mandibulectomies were performed for primary cancers of the retromolar trigone, tonsillar fossa, and/or base of the tongue. All patients received adjuvant radiotherapy. Bone invasion of the marginal mandibulectomy specimens by squamous cell carcinoma was observed in 2 cases, neither of which developed a local recurrence. Mean and median overall survivals were 41.4 and 37.5 months, respectively. Functional outcomes were determined by administering the University of Washington Quality of Life instrument administered at 12 months. Patients reported significant alterations in chewing, but all were able to maintain satisfactory oral intake and no patient required a gastrosotomy tube.CONCLUSIONSA posterior osteotomy of the mandibular ramus is a useful adjunct in the surgical treatment of cancer of the retromolar trigone or oropharynx. Negative surgical margins can be obtained even with focal invasion of mandibular bone. The loss of bone in this area does not significantly affect patients' appearance. Patients report deterioration in chewing following this procedure but are able to maintain a diet of solid food. (Otolaryngol Head Neck Surg 2003;129:713‐9.)
Endoscopic Removal of Juvenile Angiofibromas
Authors: Wormald John Peter , Van Hasselt Andrew 
Published: September 2022

BACKGROUNDAngiofibromas have traditionally been removed through open procedures. All tumors in this consecutive series of patients were removed endoscopically.SETTINGTertiary care hospital.MATERIALS AND METHODSSeven consecutive patients presenting with an angiofibroma between 1994 and 2000 were included in the study. Tumor size varied with 1 stage 1, 2 stage IIa, 3 stage IIb, and 1 stage IIC according to the Radkowski et al classification. The surgical technique is presented.RESULTSAfter an average of 3.75 years (SD, 1.9 years), there have been no tumor recurrences.CONCLUSIONEndoscopic removal of angiofibromas in the nasal cavity, with extension into the sinuses and pterygopalatine fossa and with limited extension into the infratemporal fossa, can be removed endoscopically with a good success rate. (Otolaryngol Head Neck Surg 2003;129:684‐91.)
Day Care and the Incidence of Otitis Media in Young Children
Authors: Marx Jonathan , Osguthorpe David J. , Parsons Gregory 
Published: September 2022

OBJECTIVEThis study assesses whether day care is a significant risk variable for otitis media in children younger than 2 years in the United States after controlling for the number of children in the day care group.DESIGNThe computerized data source used is the 1988 Child Health Supplement (N = 17,110) of the National Health Interview Survey (NHIS‐CH).SETTINGThe NHIS‐CH data is a multistage probability sample with clustering and stratification. It represents the civilian, noninstitutionalized population of the United States.PARTICIPANTSThe NHIS‐CH sample consists of one randomly selected child from each NHIS household containing a child younger than 18 years. The overall response rate for the NHIS‐CH was approximately 90%, For this analysis the focus is on children younger than 2 years (N = 2294).MAIN OUTCOME MEASURESThe NHIS‐CH includes a direct questioning of an adult member of the household, usually the mother, about whether the child has ever had frequent or repeated ear infections.RESULTSAfter controlling for the total size of the day care group for children younger than 12 months, the previously established relationship between attending a day care center and frequent ear infections is reduced from an odds ratio of 3.17 (95% confidence interval, 1.50 to 6.71) to an odds ratio of 1.34 (not significant p = 0.60).CONCLUSIONThe total size of the day care group is an important intervening variable in the relationship between attending day care and frequent ear infections for children younger than 12 months. The size of the day care group rather than the day care per se is the primary “modifiable risk variable” for many working parents.
Staging of chronic hyperplastic rhinosinusitis: Treatment strategies
Authors: Friedman William H. , Katsantonis George P. , Bumpous Jeffrey M. 
Published: September 2022

In 1990 we reported an initial prospective study of 100 patients using a four‐stage system for classification of chronic rhinosinusitis. Between January 1988 and July 1992, we used this system in staging an additional 1814 patients, on whom 2980 intranasal sphenoethmoidectomies were performed. In this staging system a protocol trial of medication was given for 2 weeks, followed by axial and coronal computed tomography. Medication consisted of a second‐generation cephalosporin antibiotic, usually cefuroxime; a 4‐day burst of intraoral steroids, usually prednisone; and an antihistamine decongestant if not contraindicated. The stages of chronic hyperplastic rhinosinusitis included the stages described in the 1990 report (i.e., stage I, single‐focus disease; stage II, discontiguous disease throughout the ethmoid labyrinth; stage III, diffuse disease responsive to medication; and stage IV, diffuse disease unresponsive to or poorly responsive to medication). The results of this study have shown that the computed tomography staging system based on computed tomography extent of disease after medical therapy is a simple, easily remembered, and very effective modality for the classification of chronic sinusitis. This system provides a rationale for discussing and planning surgery with patients and physicians and is a convenient reference for the reporting of end results. More importantly, a linear relationship between disease stage and outcomes is demonstrated. This statistically highly significant feature of the staging system provides a firm basis for the production of outcomes after various treatment strategies, particularly ethmoidectomy and the treatment of sinusitis.
Diesel exhaust, diesel fumes, and laryngeal cancer
Authors: Muscat Joshua E. , Wynder Ernst L. 
Published: September 2022

A hospital‐based, case‐control study of 235 male patients with laryngeal cancer and 205 male control patients was conducted to determine the effects of exposure to diesel engine exhaust and diesel fumes and the risk of laryngeal cancer. All patients were interviewed directly in the hospital with a standardized questionnaire that gathered information on smoking habits, alcohol consumption, employment history, and occupational exposures. Occupations that Involve substantial exposure to diesel engine exhaust include mainly truck drivers, as well as mine workers, firefighters, and railroad workers. The odds ratio for laryngeal cancer associated with these occupations was 0.96 (95% confidence interval, 0.5 to 1.8). The odds ratio for self‐reported exposure to diesel exhaust was 1.47 (95% confidence interval, 0.5 to 4.1). An elevated risk was found for self‐reported exposure to diesel fumes (odds ratio, 6.4; 95% confidence interval, 1.8 to 22.6). No association was observed between jobs that entail exposure to diesel fumes, such as automobile mechanics, and the risk of laryngeal cancer. These results show that diesel engine exhaust is unrelated to laryngeal cancer risk. The different findings for self‐reported diesel fumes and occupations that involve exposure to diesel fumes could reflect a recall bias.
Mechanisms of Auditory Impairment During Acoustic Neuroma Surgery
Authors: Colletti Vittorio , Fiorino Francesco G. , Carner Marco , Tonoli Giovanni 
Published: September 2022

Hearing loss during removal of acoustic neuroma (AN) may be due to labyrinthine and/or neural and/or vascular damage. Surgical maneuvers relating to perioperative and postoperative hearing may give rise to mechanisms of auditory impairment. Recording action potentials from the intracranial portion of the cochlear nerve (CN) has proven particularly useful for identifying the mechanisms of iatrogenic auditory injury. In this paper intraoperative and postoperative auditory impairments are investigated in relation to surgical steps in a group of 47 subjects with AN (size ranging from 5 to 25 mm) undergoing removal by a retrosigmoid‐transmeatal approach. Drilling of the Internal auditory canal (IAC), removal of the AN from the IAC fundus, coagulation close to the CN, lateral to medial tumor traction, separation of the CN from the facial nerve, and stretching of the CN have proven to be the most critical surgical steps in hearing preservation. On the other hand, maneuvers such as intracapsular tumor removal, vestibular neurectomy, suction close to the AN, and closure of the IAC defect did not correlate with changes in auditory potentials. Predisposing factors to postoperative hearing deterioration were IAC enlargement greater than 3 mm, IAC tumor size greater than 7 mm, extracanalar tumor size greater than 20 mm, labyrinth medial to the IAC fundus, severe involvement of the CN in the IAC, preoperative abnormal auditory brainstem responses, and normal vestibular reflectivity. Age and preoperative hearing did not prove to be statistically related to postoperative hearing. The variations in morphology and latency of CNAPs are discussed in relation to the mechanisms of iatrogenic injury.
Sinus Mucoceles: Is Marsupialization Enough?
Authors: Har‐el Gady , Balwally Atul N. , Lucente Frank E. 
Published: September 2022

Traditional teaching in the United States has emphasized the need for complete removal of sinus mucoceles to achieve a cure. In Europe, however, many rhinologic surgeons have been treating sinus mucoceles by draining and marsupializing them. We present our experience with the treatment of 16 patients with sinus mucoceles. This series includes nine frontal, two ethmoid, two sphenoid, one sphenoethmoid, and two maxillary sinus mucoceles. All patients were treated transnasally under telescopic control. All mucoceles were marsupialized, and 11 were stented. Intraoperative transillumination as well as intraoperative lateral x rays (for sphenoethmoid lesions) and anteroposterior x rays (for frontal mucoceles) were used to ensure complete marsupialization of the lesion and to confirm proper placement of the stent. There were no complications associated with the procedure. Follow‐up periods ranged from 8 to 62 months (median, 32 months). No evidence of recurrent mucocele has been seen in any of the patients.
Adenoid Bacteriology and Sinonasal Symptoms in Children
Authors: Lee Dennis , Rosenfeld Richard M. 
Published: September 2022

OBJECTIVETo study the correlation between sinonasal symptoms in children and the prevalence of bacterial pathogens in the adenoid core.DESIGNProspective cross‐sectional survey.SETTINGTertiary referral center.PATIENTSConsecutive sample of 84 children, aged 2 to 12 years, scheduled for adenoidectomy between July 1995 and November 1995. A blocked recruitment scheme was used to ensure a balanced distribution of sinonasal symptoms in the study sample.METHODSA caregiver‐completed quality‐of‐life survey was used to measure the frequency and severity of baseline sinonasal, ear, obstructive, and behavioral symptoms. Standard microbiologic techniques were used for qualitative and quantitative adenoid bacteriology.OUTCOME MEASURESPathogenic and nonpathogenic bacteria isolated, percentage of specimens with no growth, colony‐forming units of pathogens per gram of adenoid tissue, dominant bacterial organism, and number of pathogenic species per adenoid with concentration greater than 105 colony‐forming units.RESULTSOne or more bacterial pathogens were recovered from core samples of all adenoids, with a concentration greater than 105 colony‐forming units in 31 specimens (26%). Haemophilus influenzae, group A β‐hemolytic streptococcus, and Staphylococcus aureus were encountered most often. Multivariate analysis revealed a significant correlation of sinonasal infection symptom scores with colony‐forming units of adenoid core pathogens (R2 = 0.48, p < 0.0001), adjusted for the confounding effects of nasal obstructive symptoms and adenoid size (specimen weight).CONCLUSIONSSinonasal infectious symptoms explain 48% of the variability in quantitative bacteriology of the adenoid core, independent of adenoid size. Although longitudinal studies are required, our results support a potential role for adenoidectomy in the management of refractory pediatric sinusitis.