bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Resveratrol on Acoustic Trauma
Authors: Seidman Michael , Babu Seilesh , Tang Wenxue , Naem Emad , Quirk Wayne S. 
Published: September 2022

OBJECTIVEThe purpose of the study is to test the ability of resveratrol to protect the auditory system from reactive oxygen species (ROS)‐mediated noise damage. Oxidative stress is mediated by ROS, which are known to cause cellular and molecular damage. Interfering with this process, using ROS inhibitors/scavengers such as antioxidants has shown promise in protecting specific systems from oxidative damage. Among the antioxidants receiving recent attention is resveratrol, an active component in red wine.STUDY DESIGN AND SETTINGTen Fischer rats were used for this study. The experimental group (n = 5) received 7 weeks of resveratrol treatment (430/μg/kg/day), by gavage, and the control group (n = 5) received normal saline solution by gavage. Baseline auditory brainstem responses (3, 6, 9, 12 and 18 kHz) were determined for both groups. After 21 days, animals were exposed to noise (105 dB, 4500 to 9000 Hz for 24 hours). Postnoise auditory brainstem responses were assessed at 4 recovery time points: immediate, at 3 days, 7 days, and 4 weeks after noise exposure.RESULTSResults demonstrate that the resveratrol group showed reduced threshold shifts compared with the control group after noise exposure. These shifts were significantly different between groups at 6 and 9 kHz (P < 0.05), corresponding to the region most represented by the frequency of the traumatic noise.CONCLUSION/SIGNIFICANCEInitial studies in our laboratory as well as other investigators have shown the importance of specific antioxidant therapy in the prevention of ischemic, noise, and age related hearing loss. The current study demonstrates a protective effect of resveratrol on noise‐induced hearing loss.
Multicenter Study Assessing Effects of Heat and Moisture Exchanger Use on Respiratory Symptoms and Voice Quality in Laryngectomized Individuals
Authors: Ackerstaff Annemieke H. , Fuller D. , Irvin M. , MacCracken E. , Gaziano J. , Stachowiak L. 
Published: September 2022

OBJECTIVEA multicenter study based in the United States assessed the heat‐moisture exchanger effect on respiratory symptoms and “voice quality” of laryngectomees.PATIENTS AND MEASURESThe study group consisted of 81 consecutive laryngectomees (62 men and 19 women; mean age, 66 years; age range, 45 to 89 years), with a median follow‐up of 3.5 years (range, 0.5 to 24 years). A structured questionnaire was used to assess 3‐month results, and tally sheets recorded the frequency of cough‐expectoration during first and last trial weeks.RESULTSCompliance was 73% (n = 59); decrease in coughing, 68%; sputum production, 73%; forced expectoration, 60%; and need for stoma cleaning, 52% of these 59 patients. Regarding daily cough‐expectoration frequency, a statistically significant decrease (P < 0.0001) was found between the first and last trial weeks. Regarding influence on voice quality, 46% of regular users reported improvement in intelligibility, 30% in loudness, 37% in fluency, and 40% in telephone intelligibility. Fourteen patients (19%) reported skin irritation, with discontinuation of 7 patients.CONCLUSIONThe observed decrease in pulmonary symptoms and improvement in voice quality confirm earlier reports from the Netherlands, United Kingdom, and Spain indicating improvement in postlaryngectomy quality of life. (Otolaryngol Head Neck Surg 2003;129:705‐12.)
Overexpression of p53 predicts organ preservation using induction chemotherapy and radiation in patients with advanced laryngeal cancer
Authors: Bradford Carol R. , Zhu Shaobo , Wolf Gregory T. , Poore Judy , Fisher Susan G. , Beals Theodore , McClatchey Kenneth D. , Carey Thomas E. 
Published: September 2022

A critical research frontier in head and neck oncology involves defining the use of induction chemotherapy regimens to allow organ preservation and to avoid functionally debilitating surgical resections. Completed clinical trials in laryngeal cancer indicate that such an approach is feasible, but progress thus far has been limited by our inability to predict which patients are likely to respond to chemotherapy and preserve their larynx. Mutation of the p53 tumor‐suppressor gene is the most common genetic alteration identified thus far in human cancers, and it may be important in regulation of cell proliferation and chemosensitivity. To determine whether p53 overexpression predicts chemotherapy response, organ preservation, and survival in patients with advanced laryngeal cancer, we analyzed immunohistologic expression of p53 in tissue sections from 178 patients with advanced laryngeal cancer who were entered in the Department of Veterans Affairs Laryngeal Cancer Cooperative Study, a multiinstitutional clinical trial comparing induction chemotherapy (c/s‐platinum and 5‐fluo‐rouracil) plus radiation therapy (94 patients) to surgery plus postoperative radiation therapy (84 patients). Larynx preservation was significantly higher in the group of patients whose tumors overexpressed p53 (74% vs. 52.5%; p = 0.03). The presence of p53 overexpression did not predict survival in either the surgery or the chemotherapy groups (p = 0.82 and p = 0.53).
Brain abscess: With special reference to otolaryngologic sources of infection
Authors: Yen Pen‐Tung , Chan Shu‐Toa , Huang Tsun‐Sheng 
Published: September 2022

The number of brain abscesses has been reduced since the preantibiotic era. This was accomplished by judicious use of antibiotics, by the advent of computed tomography, and by improvements in patient care and surgical techniques. Analysis from 122 patients with brain abscess demonstrated this trend of progress. Our series had a 3.2‐to‐1 male predominance. The underlying conditions included otolaryngologic infections (26 cases), cyanotic heart diseases (27 cases), implantation abscess (25 cases), lung infections (5 cases), meningitis (4 cases), osteomyelitis (2 cases), decreased immunity from chronic systemic diseases (12 cases), and unknown causes (21 cases). Otolaryngologic subgroups can be detailed as chronic otitis media with cholesteatoma (15 cases), chronic otitis media with mastoiditis (4 cases), sinusitis (2 cases), esophageal stenosis (3 cases), cheek cellulitis (1 case), and nasopharyngeal carcinoma (1 case). The initial symptoms and signs were headache (46 cases), fever (36 cases), altered consciousness (30 cases), neurologic deficits (33 cases), vomiting (11 cases), and seizure (17 cases). Of the brain abscesses treated, multiple brain abscess represented 16.4% of all cases. The overall percentage of patients with full recovery was 52.5%, whereas 84.8% of otolaryngologic subgroup recovered fully. The overall mortality was 19.7%. The mortality rate of brain abscess from otolaryngologic sources was 3.8%, whereas that from nonotolaryngologic sources was 24%.
Comparison of Modified PhadezymRAST,* ImmunoCAP,* and serial dilution titration skin testing by receiver operating curve analysis
Authors: Corey Jacquelynne P. , Nelson Rita S. , Lai Vincent 
Published: September 2022

Improved technology in in vitro tests for allergen‐specific immunoglobulin E has led to increased efficiency and faster turnaround times. ImmunoCAP (Pharmacia Diagnostics, Clayton, N.C.) is an in vitro‐specific immunoglobulin E test that uses a three‐dimensional cellulose solid allergen phase, which allows quick results in 6 hours. In comparison, modified PhadezymRAST (Pharmacia Diagnostics) uses a two‐dimensional solid phase, and results take 3 days to obtain. This study compares the sensitivity and specificity of CAP with that of modified RAST in the detection of specific immunoglobulin E, and it assesses the correlation of the individual class scores of CAP and modified RAST with end points obtained from skin‐dilutional end‐point titration. The reproducibility of CAP was also assessed. Patients evaluated at the University of Chicago Allergy Clinic who had a history and physical examination consistent with immunoglobulin E‐mediated allergy and in whom skin testing was clinically indicated as part of their allergy management, were asked to donate some blood for simultaneous in vitro testing by PhadezymRAST and ImmunoCAP. Testing was performed in batches. Random samples from the CAP batches were chosen for duplicate runs under conditions blinded to the technician. Receiver operating curve analysis was used for comparison of the sensitivity and specificity of RAST vs. that of CAP. We used Pearson product‐moment correlation coefficients to compare the correlation of RAST and CAP classes with the end points from skin testing. Our results indicate that the sensitivity and specificity of RAST and CAP are similar, that the classes of these two tests correlate well with the end points from skin testing, and that duplicate samples of CAP also correlate well.
Nystagmus and postural instability after headshake in patients with vestibular dysfunction
Authors: Michael S. Panosian Maj , Paige Gary D. 
Published: September 2022

Nystagmus after rapid head‐shaking (post‐headshake nystagmus) is often seen in patients with vestibulopathy. Post‐headshake nystagmus is transient and is frequently associated with symptoms of dizziness, dysequilibrium, or vertigo. The phenomenon presumably reflects headshake‐induced asymmetry in vestibulo‐ocular reflex pathways, which persists after head‐shaking stops. We postulated that the same vestibular imbalance that underlies post‐headshake nystagmus might produce an equivalent in postural instability. To test this hypothesis, we investigated the effect of headshake on postural control and eye movements in patients who exhibited post‐headshake nystagmus, vestibulopathy, or both. Postural instability was quantified with a dynamic platform device, whereas eye movements were recorded with electrooculography. Ten normal controls and 21 patients with a history of post‐headshake nystagmus or unilateral vestibulopathy were evaluated. Subjects were tested for 20 seconds before and immediately after passive horizontal headshake (±30‐degree amplitude) at 2 Hz for 20 seconds. Postural stability was assessed while subjects stood with eyes closed, and the floor was modulated proportionally with sway. The difference in normalized peak‐to‐peak sway (equilibrium score) before and after headshake was assessed in all subjects and compared between groups. Post‐headshake nystagmus was documented by electro‐oculography recorded during posturography. Results for normal controls and vestibulopathic subjects without post‐headshake nystagmus showed only a small transient decline in postural stability after headshake. Those with post‐headshake nystagmus (regardless of caloric asymmetry) showed a robust decline in postural stability. The most dramatic decline, together with an increased number of “falls” (step‐out responses), occurred in those patients with both a vestibulopathy (caloric response asymmetry) and post‐headshake nystagmus. These findings illustrate that the vestibular imbalance underlying post‐headshake nystagmus shares a counterpart in the form of headshake‐induced postural instability.
Lipoinjection in the Paralyzed Feline Vocal Fold: Study of Graft Survival
Authors: Saccogna Phillip W. , Wernimg John W. , Setrakian Sebouh , Strauss Melvin 
Published: September 2022

Six adult domestic strain cats were used to study the long‐term histologic outcome of injected autologous fat for augmentation of the paralyzed vocal fold. Each animal had surgically induced left vocal cord paralysis via sectioning of the recurrent laryngeal nerve, followed by injection of 0.1 to 0.2 ml of autologous fat into the paralyzed vocal fold. The animals were killed at 6 weeks, and at 4, 6, 8, and 12 months after the injection. Photographic and videolaryngoscopic data were obtained. Histologic studies of the larynges were performed. The results documented histologic viability and persistence of a portion of the injected adipose tissue graft at 8 months after the injection, but only minimal graft survival at 12 months. The outcome suggests that autologous lipoinjection has potential use for short‐term (several months) augmentation of the paralyzed vocal cord. Further investigation is warranted before recommending this technique for such use or as an alternative to currently available long‐term injectable laryngeal biomaterials.
Nebulized Surfactant for Experimentally Induced Otitis Media with Effusion
Authors: Nemechek Andrew J. , Pahlavan Nima , Cote Donald N. 
Published: September 2022

Eustachian tube dysfunction frequently results in clinical evidence of otitis media with effusion (OME). Surface active substances, surfactants, are hypothesized to play a role in normal eustachian tube function. Recent work in a rodent model has demonstrated improved eustachian tube function with topical application of surfactants to the middle ear. A novel, noninvasive, and clinically practical method of delivering surfactant to the eustachian tube was studied in a gerbil model of OME. Otitis media with effusion was experimentally induced in 20 gerbils by transtympanic inoculation of heat‐killed Streptococcus pneumoniae. This represents a well established model for creating a serous effusion in the gerbil that significantly increases eustachian tube opening pressure. Effusion developed in 27 of 40 ears (67.5%) after inoculation. An inhaled nebulized surfactant was used to treat the animals with microscopically confirmed OME in one or both ears. The treatment period was 5 days. Eustachian tube opening studies were performed on both affected and nonaffected animals. Successful eustachian tube opening pressures were obtained in 30 of 36 ears (83.3%). The mean opening pressure for ears without effusion (healthy ears) was 42.8 mmHg. The mean opening pressure for ears with effusion in animals treated with nebulized surfactant was 41.4 mmHg. The difference between these mean values was not statistically significant (t = 0.32; p > 0.50). This pilot study suggests that inhaled nebulized surfactant may be efficacious in treating eustachian tube dysfunction when manifested in disorders such as OME.
Obstructive Sleep Apnea Surgery: Risk Management and Complications
Authors: Riley Robert W. , Powell Nelson B. , Guilleminault Christian , Pelayo Rafael , Troell Robert J. , Li Kasey K. 
Published: September 2022

BACKGROUNDHypoxemia, hypertension, airway obstruction, and death have been associated with surgery for obstructive sleep apnea syndrome (OSAS). Patient analysis was undertaken to identify potential factors that could affect risk‐management outcome.METHODSOne hundred eighty‐two consecutively treated patients with OSAS undergoing 210 procedures were evaluated. Fifty‐four factors were analyzed.RESULTSGroup characteristics included a mean age of 48.2 years, a mean respiratory disturbance index of 42.3, and a mean low oxyhemoglobin desaturation (LSAT) of 77.5%. Surgery included a combination of uvulopalatopharyngoplasty (162 patients; 77%) and maxillofacial procedures (173 patients; 82%). Patients with a respiratory disturbance index greater than 40 and an LSAT less than 80% (117 patients; 64%) were maintained on nasal continuous positive airway pressure. Thirty‐nine patients (18.6% had difficult intubations. There was a positive correlation (p> 0.001) of difficult intubations, neck circumference (>45.6 cm) and skeletal deficiency (Sella‐Nasion‐Point B < 75 degrees). All tubes were removed with the patient awake in the operating room with two transient episodes of airway obstruction. One hundred forty‐eight of the patients (70.5%) required postoperative intravenous antihypertensive medications. Patients with a preoperative history of hypertension had a significantly increased risk (p> 0.01) of requiring intraoperative and postoperative intravenous antihypertensive medications. The mean hospital stay was 2.2 days (SD ± 0.9). Analgesia was achieved with intravenous morphine sulfate or meperidine HCI (intensive care unit) and oral oxycodone (non‐intensive care unit). There were no significant oxyhemoglobin desaturations, irrespective of severity of OSAS or obesity (mean LSAT day 1, 94.8% (SD ± 2.4); mean LSAT day 2, 95.5% (SD ± 1.6)). Complications Included postoperative bleeding (n= 4), infection (n= 5), seroma (n= 3), arrhythmia (n= 4), angina (n= 1), and loss of skeletal fixation (n= 1).CONCLUSIONIntraoperative airway risks can be reduced by use of fiberoptic intubation in patients with increased neck circumference and skeletal deficiency. Patients with OSAS are at a significantly increased risk for hypertension. Nasal continuous positive airway pressure eliminated the postoperative risk of hypoxemia, which allowed the use of adequate parenteral or oral analgesics.
A Cadaveric Study of the Motor Nerves to the Levator Scapulae Muscle
Authors: Frank Douglas K. , Wenk Eugene , Stern Jordan C. , Gottlieb Ron D. , Moscatello Augustine L. 
Published: September 2022

Understanding the surgical anatomic relationships of the motor nerves to the levator scapulae muscle is imperative for reducing postoperative shoulder dysfunction in patients undergoing neck dissection. To elucidate this relevant anatomy, cervical (C3, C4) and brachial (C5 via dorsal scapular nerve) plexi contributions to the levator scapulae were assessed with respect to posterior triangle landmarks in 37 human cadaveric necks. An average of approximately 2 (actual 1.92) nerves from the cervical plexus (range 1 to 4 nerves) emerged from beneath the posterior border of the sternocleidomastoid muscle in a cephalad to caudad progression to enter the posterior triangle of the neck on their way to innervating the levator scapulae. These cervical plexus contributions exhibited a fairly regular relationship to the emergence of cranial nerve XI and the punctum nervosum along the posterior border of the sternocleidomastoid muscle. After emerging from the posterior border of the sternocleidomastoid to enter the posterior triangle of the neck, cervical plexus contributions to the levator scapulae traveled for a variable distance posteriorly and interiorly, sometimes branching or coming together. Ultimately these nerves crossed the anterior border of the levator scapulae as 1 to 3 nerves (average 1.94) in a regular superior to inferior progression. The dorsal scapular nerve from the brachial plexus exhibited highly variable anatomic relations in the inferior aspect of the posterior triangle, and was found to penetrate or give branches to the levator scapulae in only 11 of 35 neck specimens. We have found that the levator scapulae receives predictable motor supply from the cervical plexus. Our data elucidate surgical anatomy useful to head and neck surgeons.
High‐resolution ultrasound associated with aspiration biopsy in the follow‐up of patients with differentiated thyroid cancer
Authors: Rodriguez J. M. , Reus M. , Moreno A. , Martinez M. , Soria T. , Carrasco L. , Parrilla P. 
Published: September 2022

OBJECTIVETo assess the value of ultrasound in the follow‐up of patients undergoing surgery for differentiated thyroid carcinoma.SUBJECTSThe study included 89 patients (70 women and 19 men) with differentiated thyroid carcinoma (76 papillary and 13 follicular cancer).METHODSHigh‐frequency ultrasound (US) was used in the evaluation of 89 subjects who underwent surgery for thyroid carcinoma. Fine‐needle aspiration was performed in cases with positive US. In addition, determinations of thyroglobulin (Tgb) in serum, scintigraphy with 131I, and cervical palpation were evaluated. We determined sensitivity, specificity, and overall accuracy for each of these diagnostic methods.RESULTSUltrasonography was positive in 22 subjects, 16 in the nodal area and 6 in the thyroid bed. Twenty‐two subjects received fine‐needle aspiration with US control; 13 (59%) of 22 were positive for cancer. The results of the US for detecting neoplastic disease showed a sensitivity of 65%, specificity of 86%, and overall accuracy of 82%. The overall accuracy for scintigraphy was 88% and for Tgb, 91%.CONCLUSIONWe concluded that US can be included in the follow‐up protocol for patients undergoing surgery for differentiated cancer of thyroid, as a valuable tool to localize the recurrence. This technique is particularly useful in the evaluation of patients who are found to have elevated Tgb levels.The treatment of differentiated thyroid cancer includes surgery and, in some cases, the ablation of residual thyroid tissue with therapeutic doses of iodine 131I.1 The posttreatment search for recurrence or metastases is based on periodic body scanning with 131I and determination of serum thyroglobulin (Tgb) levels.2,3High‐resolution ultrasound (US; 10 MHz) has been found to have a high sensitivity in diagnosing nonpalpable cervical masses.4–6 Thus the possibility exists that including it in the protocols for follow‐up of differentiated thyroid cancer may be valuable.The aim of our study was to assess the value of high‐resolution US (associated with directed fine‐needle aspiration [FNA] biopsy) in the follow‐up of patients undergoing surgery for papillary and follicular thyroid cancer.
Laryngeal Melanosis: Report of Four Cases and Literature Review
Authors: Gonzalez‐vela M. carmen , Fernandez Fidel A. , Mayorga Marta , Rodriguez‐iglesias Julio , Val‐bernal J. fernando 
Published: September 2022

OBJECTIVELaryngeal melanosis is a rare condition defined by the presence of melanocytes within the laryngeal epithelial lining. Our aims were (1) to review our cases together with those in the literature, and (2) to determine whether melanocyte incidence is increased with exposure to irritant stimuli such as tobacco.METHODSA retrospective study of all cases diagnosed with laryngeal melanosis in our hospital from January 1, 1990, to December 31, 1996, was accomplished. To determine the melanocyte incidence in the normal larynx as well as the influence of tobacco in development of laryngeal melanosis, 16 age‐matched controls, 8 of whom were smokers and 8 of whom were not, were chosen, and a histochemical and immunohistochemical study was performed. The following antibodies were used: S‐100 protein, CD 1a, and HMB‐45. A comparative study of the melanocyte incidence between patients with laryngeal melanosis and the controls was carried out. Also, a comparative study between smoking and nonsmoking patients was performed.RESULTSLaryngeal melanosis was diagnosed in 4 patients at our hospital during this period of time. In the comparative study, the number of melanocytes in the 4 patients with laryngeal melanosis was higher than in the 8 smoking (p< 0.01, Mann‐Whitney U test) and 8 nonsmoking (p< 0.01) controls, and there was a trend toward a higher number of melanocytes in the 8 smoking patients than in the 8 nonsmoking (p= 0.064) controls.CONCLUSIONSLaryngeal melanosis was more frequent in smoking men older than 50 years. Our observations underline the association of LM with larynx carcinoma and its relation to a stimulus such as tobacco. In fact, we have found activated melanocytes in our cases of laryngeal melanosis. They were identified by immunoreactivity for HMB‐45.
Ameloblastoma of the Maxilla: A Series of Three Cases
Authors: Kieserman Stefan P. , Baker Paul , Eberle Robert 
Published: September 2022

Ameloblastoma is an aggressive tumor of the maxilla. We reviewed several ameloblastomas of the maxilla that had been surgically removed. The English literature was reviewed to evaluate the appropriate treatment and success with these aggressive tumors.Maxillary ameloblastoma is a tumor that can behave malignantly. There is a definite correlation between histopathologic appearance and tumor activity. The unicystic type of ameloblastoma responds well to complete resection. The treatment for an ameloblastoma of the maxilla is radical resection. Limited removal of the cyst/tumor initially is not adequate, and a secondary operation will be required. Ameloblastoma of the maxilla requires aggressive radical excision at the time of initial diagnosis.