bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of the Caloric Test by Combining 3 Response Parameters
Authors: Maire Raphael , Daoui Ben , Van Melle Guy 
Published: September 2022

The slow‐phase velocity of nystagmus is one of the most sensitive parameters of vestibular function and is currently the standard for evaluating the caloric test. However, the assessment of this parameter requires recording the response by using nystagmography. The aim of this study was to evaluate whether frequency and duration of the caloric nystagmus, as measured by using a clinical test with Frenzel glasses, could predict the result of the recorded test. The retrospective analysis of 222 caloric test results recorded by means of electronystagmography has shown a good association between the 3 parameters for unilateral weakness. The asymmetry observed in the velocity can be predicted by a combination of frequency and duration. On the other hand, no relationship was observed between the parameters for directional preponderance. These results indicate that a clinical caloric test with frequency and duration as parameters can be used to predict the unilateral weakness, which would be obtained by use of nystagmography. We propose an evaluation of the caloric test on the basis of diagrams combining the 3 response parameters.
Kikuchi's Disease: A Review and Analysis of 61 Cases
Authors: Lin Hsin‐Ching , Su Chih‐Ying , Huang Chao‐Cheng , Hwang Chung‐Feng , Chien Chih‐YEN 
Published: September 2022

OBJECTIVEKikuchi's disease (KD), or histiocytic necrotizing lymphadenitis, is a rare self‐limiting disorder that typically affects the cervical lymph nodes. It has occasionally been misdiagnosed as malignant lymphoma or another serious diseases; hence, clinicians should be made more aware of this disease.METHODSFrom January 1986 to January 2001, a series of 61 patients who underwent a biopsy of a cervical lymph node and proved histologically to have KD were enrolled in this study. We retrospectively reviewed the clinical records and pathologic parameters of each patient. The patients were followed up from 6 months to 14.3 years (mean, 6.9 years).RESULTSThere were 34 women and 27 men (1.26:1 ratio; age range, 6 to 46 years; mean age, 21 years). The affected cervical lymph nodes were commonly located in the posterior cervical triangle (54 of 61, or 88.5%). Unilateral and bilateral cervical lymph nodes were affected in 54 and 7 patients, respectively. The dimensions of affected lymph nodes were commonly in the range of 0.5 to 4 cm (57 of 61, or 93.4%). In 2 patients, the size of the enlarged lymph nodes was greater than 6 cm. Leukopenia was observed in 14 patients (23%); fever, in 18 patients (29.5%). Five patients had a past history of tuberculosis. Two patients developed systemic lupus erythematosus, 1 month and 5 years later, respectively. The cervical lymphadenopathy usually resolved without any medical treatment within 6 months after definite diagnosis was made. In 3 patients, the enlarged lymph nodes eventually disappeared after more than 1 year. No recurrence has since been noted.CONCLUSIONThe results of this study support the theory that KD is a self‐limiting disorder that does not require any specific management. The female predominance was not as striking as in the studies performed in Western countries. We suggest that the patients with KD require a systemic survey and regular follow‐up for several years; 2 of our patients developed systemic lupus erythematosus. An effective communication between the otolaryngologist and pathologist is needed because the clinical and pathologic characteristics of KD are essential in making an accurate diagnosis.
Transient Rise in Intact Parathyroid Hormone Concentration after Surgery for Parathyroid Adenoma
Authors: Ferrer‐Ramirez M. J. , Domingo M. Arroyo , López‐Mollá C. , Solá E. Izquierdo , Garzón S. Pastor , Morillas C. Ariño , Hernández A. Mijares 
Published: September 2022

OBJECTIVEOur goal was to describe the course of parathyroid hormone (PTH) after surgery for primary hyperparathyroidism (PHPT). PTH levels drop to low values after parathyroidectomy for PHPT. However, in some patients, a rebound transient increase in PTH concentrations can occur.STUDY DESIGN AND SETTINGA prospective study included 72 patients who underwent surgical exploration for PHPT. A single adenoma was found in 57 patients (79.1%), 2 adenomas were found in 2 (2.7%), and parathyroid hyperplasia was found in 13 (18.05%). The postoperative PTH secretion was studied in those patients who had an adenoma excised.RESULTSThis phenomenon was noted in 18 (31.6%) patients between 4 and 12 weeks, although total calcium concentrations were normal (9.3 ± 0.6 mg/ dL). Before surgery these patients had a more remarkable hyperparathyroidism (clinical and biochemical) than the others, but differences were not significant.CONCLUSIONPostoperative increases in PTH concentration can occur after successful parathyroidectomy. These increases are transient and do not indicate persistent or recurrent disease.
Scarless Lip Rehabilitation for the Adynamic Lip
Authors: Bloch Dov C. , Scheuller Michael C. , Maas Corey S. 
Published: September 2022

OBJECTIVEParalysis of the marginal mandibular branch of the facial nerve can be a debilitating condition resulting in compromised speech and oral incompetence. We describe a static procedure performed to address the functional and cosmetic deficits seen with an adynamic lip.METHODSThree patients with complete facial nerve paralysis were evaluated after the scarless lip rehabilitation, a modification of the traditional wedge resection of the lower lip. The procedure is novel in that the removal of lip laxity and advancement of the contralateral innervated lip is achieved without an external facial skin incision.RESULTSAll 3 patients in the study reported improvement in oral competence and lip symmetry; however, articulation was less consistently affected. All 3 patients were able to drink from a glass without leaking from their oral commissure. No complications were seen in this series of patients.CONCLUSIONOral incompetence and asymmetry are often the overlooked sequelae from complete facial nerve paralysis. Scarless lip rehabilitation of the adynamic lip is a novel, safe, and effective means to improve these functional and aesthetic deficits.
Ethmoid Mucocele as a Late Complication of Endoscopic Ethmoidectomy
Authors: Busaba Nicolas Y. , Salman Salah D. 
Published: September 2022

OBJECTIVEOur goal was to describe ethmoid mucocele as a late complication of endoscopic ethmoidectomy.STUDY DESIGNThis was a retrospective review of 14 patients who were diagnosed with ethmoid mucoceles after endoscopic ethmoidectomy. Reviewed data included patient demographics, indication for the original surgery, presenting symptoms, computed tomography results, surgical treatment, operative findings, and recurrence of disease.RESULTSThe mucoceles were diagnosed 1 to 13 years after endoscopic ethmoidectomy. The most common presenting symptom was facial pressure or pain. Twelve patients had middle meatal adhesions. A round mass was seen by endoscopy in the ethmoid cavity in 5 patients. Nine mucoceles were located in the anterior ethmoid and 3 were located in the posterior ethmoid, and 2 involved both. The mucoceles were marsupialized via revision endoscopic ethmoidectomy in 12 patients, whereas 2 had both external and endoscopic approaches taken.CONCLUSIONEthmoid mucocele can form as a late complication of endoscopic ethmoidectomy. It is commonly associated with middle meatal adhesions.
Paper Patching for Chronic Tympanic Membrane Perforations
Authors: Golz Avishay , Goldenberg David , Netzer Aviram , Fradis Milo , Westerman S. Thomas , Westerman Liane M. , Joachims Henry Z. 
Published: September 2022

OBJECTIVEThis study was designed to evaluate the results of paper‐patch myringoplasty in patients with chronic perforations of the tympanic membrane of different sizes.STUDY DESIGN AND SETTING: A retrospective survey of paper‐patch myringoplasties performed in a tertiary referral academic medical center on 77 patients with chronic perforations of the eardrum was carried out. Data consisted of the causes of the perforations, time the perforations had been present, their size, number of patch applications, duration of application, and number of successfully closed perforations.RESULTSClosure rate was 63.2%, 43.5%, and 12.5% for small, medium, and large perforations, respectively. Small perforations needed the least number of repeated applications and the least time for closure.CONCLUSIONS AND SIGNIFICANCEPaper patching is technically simple, time saving, safe to perform, cost effective, and suitable as an outpatient procedure and has a good success rate, It should be tried in perforations smaller than 5 mm before a patient is referred for surgery.
Multiple‐Use Atomizers in Outpatient Otolaryngology Clinics are not Necessarily an Infectious Risk
Authors: Visosky Ann Marie B. , Murr Andrew H. , Ng Valerie , Dentoni Theresa , Weir Lucy , Haller Barbara L. 
Published: September 2022

OBJECTIVEWe sought to determine the risk of bacterial transmission from multiple‐use atomizers in an outpatient otolaryngology clinic.STUDY DESIGN AND SETTINGAtomizers in 6 examination rooms were analyzed for bacterial contamination. Sterility of associated tubing from 1 atomizer was assessed. Multidose drug solutions in the atomizers (phenylephrine and tetracaine) were cultured multiple times over a 2‐week period. Serial dilutions of the original sample were cultured to minimize inhibitory effects of antiseptic agents in the drug formulations.RESULTSNo bacteria were recovered from tubing cultures. Only 2 (0.6%) of 336 cultures of the drug solutions yielded bacterial growth. In both cases, coagulase‐negative Staphylococcus was recovered in 1 of the dilutions prepared from original samplings.CONCLUSIONMultiple‐use atomizers that contain phenylephrine and tetracaine solutions with bacteriostatic preservatives in an outpatient otolaryngology clinic do not yield significant bacterial growth and, when used as described, do not pose an infectious risk of bacterial transmission between patients.
Simple and Safe Puncture Technique for Voice Prosthesis Implantation
Authors: Lichtenberger György 
Published: September 2022

OBJECTIVEA simplified esophagotracheal (ET) puncture technique is described for use instead of the Blom‐Singer method for voice prosthesis implantation, with the aim to offer an easier alternative for the same purpose.STUDY POPULATIONOf 68 study patients, there were 10 women and 58 men (age range, 46 to 80 years) who had been operated on during a 5‐year period with use of this technique. Of the 68 patients, 57 were able to learn to speak in a fluent voice acceptable for everyday communication after the implantation. Seven of the 57 patients had a spasm in the cricopharyngeus muscles and were able to speak only after myotomy.METHODSSixty‐eight patients were implanted with voice prosthesis using the ET puncture technique as follows: through the laryngoscope, the distal bent blunt end of the endoextralaryngeal needle carrier is led into the esophagus. The needle with the leading thread (2–0 Prolene) is pushed through in the upper third of the tracheostoma from inside out. Afterward, the cone‐trocar catheter is pulled through the stitching canal in the upper third of the tracheostoma. Using the ET puncture technique, the puncture site is the same as with the use of the Blom‐Singer method, 5 to 8 mm below the mucocutaneous junction. Then the cone‐trocar is cut off from the 18 charrier catheter and the guide wire is pushed inside the catheter through the esophagus, pharynx, and mouth. The voice prosthesis will be fixed on the guide wire and then pulled back in the opening of the fistula.RESULTSThere were no problems or complications with this technique. In 4 cases, the ET puncture could be performed on patients in whom it was not previously possible with the Blom‐Singer technique.CONCLUSIONThis management approach offers an alternative to the Blom‐Singer technique. The advantage of the ET puncture is that it is simple and safe and that the back wall of the pharynx or esophagus cannot be damaged. Using the ET puncture technique, the possibility of complications is eliminated.
The Clinical Effects of Hyaluronic Acid Ester Nasal Dressing (Merogel) on Intranasal Wound Healing after Functional Endoscopic Sinus Surgery
Authors: Miller Robert Sean , Steward David L. , Tami Thomas A. , Sillars Michael J. , Seiden Allen M. , Shete Mona , Paskowski Christopher , Welge Jeff 
Published: September 2022

OBJECTIVESWe sought to determine the efficacy of MeroGel, an absorbable hyaluronic acid nasal dressing (HA) in reducing synechia after functional endoscopic sinus surgery (FESS) compared with Merocel, a nonabsorbable packing (NAP) requiring removal.METHODSWe conducted a blinded, randomized, controlled trial of 37 patients requiring bilateral FESS for chronic sinusitis. Patients were randomized to placement of HA within the right or left middle meatus and NAP on the other side. Patients were evaluated at 2, 4, 6, and 8 weeks postoperatively.RESULTSBlinded evaluation revealed 5 patients (14%) with synechia at last follow‐up: 3 sides (8%) with HA and 3 (8%) with NAP. Thirteen patients (35%) had synechia at any visit, 10 sides (27%) with HA and 9 (24%) with NAP. Seven patients (19%) required lysis of synechia, 5 sides (14%) with HA and 3 (8%) with NAP.CONCLUSIONWe found no statistically significant difference between HA and NAP dressings.
Influence of sensitization to inhalative allergens on adenotonsillar disease
Authors: Hofmann Thiemo , Lackner Andreas , Berghold Andrea , Lang‐Loidolt Doris 
Published: September 2022

OBJECTIVEWe sought to determine the influence of IgE‐mediated sensitization on adenotonsillar disease in children. We compared follow‐up after tonsillectomy/adenoidectomy of atopic and nonatopic children.STUDY DESIGN AND SETTINGA prospective study of 293 children consecutively undergoing tonsillectomy/adenoidectomy was conducted at a university hospital center. Preoperative and postoperative (1‐year follow‐up) allergy‐related symptom scores were obtained by parents. Intraoperative total serum IgE, the screening test sx1 (Pharmacia), and, if positive, serum specific IgE to inhalative allergens were carried out.RESULTSSixty‐seven children (22.9%) showed positive RAST results to inhalative allergens (class 1 to 6). In both sensitized and nonsensitized groups, the general health was improved in more than 89% at 1 year postoperatively. No significant difference of postoperative nasal symptoms between the atopic and nonatopic groups was found.CONCLUSIONBoth atopic and nonatopic children with adenotonsillar disease improve health after adenoidectomy or adenotonsillectomy. In our opinion, routine allergy tests before adenotonsillectomy or adenoidectomy are not justified. Only if allergy is suspected due to clinical findings or family history should an allergy test be carried out.
Clinical Effectiveness of Coblation Inferior Turbinate Reduction
Authors: Bhattacharyya Neil , Kepnes Lynn J. 
Published: September 2022

OBJECTIVEWe sought to determine the safety and clinical effectiveness of coblation (short for “cold ablation”) inferior turbinate reduction for turbinate hypertrophy.METHODSA consecutive series of adult patients with inferior turbinate hypertrophy were treated with the coblation technique in the office setting. Subjective symptoms were assessed prior to treatment and at the 3‐ and 6‐month intervals after treatment with the Rhinosinusitis Symptom Inventory (RSI) and a short nasal symptom questionnaire.RESULTSTwenty‐four of 26 treated patients completed the protocol. At the 3‐month follow‐up, statistically significant decreases in the nasal and overall symptom domains of the RSI were noted (changes of −10.5 and −8.7, with P = 0.018 and P = 0.015, respectively). These improvements were also significant at the 6‐month follow‐up (‐20.1 and −15.8 with, P < 0.001 and P < 0.001, respectively). At the 3‐month interval, nasal obstruction and amount of time with nasal obstruction were significantly decreased (P = 0.006 and P = 0.011, respectively). These decreases remained statistically significant and slightly larger in magnitude at 6 months (P = 0.001 and P = 0.006, respectively). Postoperative epistaxis occurred in 2 of 24 (8.3%) of patients.CONCLUSIONCoblation inferior turbinate reduction is an effective procedure for inferior turbinate hypertrophy. The clinical benefit persists at 6 months after the procedure.
Transtympanic Iontophoresis of Gadopentetate Dimeglumine: Preliminary Results
Authors: Christodoulou Panagiotis , Doxas Panagiotis G. , Papadakis Chariton E. , Prassopoulos Panos , Maris Thomas , Helidonis Emmanuel S. 
Published: September 2022

OBJECTIVEWe sought to demonstrate the feasibility of using iontophoresis to deliver pharmaceutical agents into the middle and inner ear for the treatment of middle and inner ear diseases, which is proved in this study by the successful iontophoresis of the ferromagnetic contrast agent gadopentetate dimeglumine.STUDY DESIGN AND SETTINGEight rabbits were iontophoresed using gadopentetate dimeglumine solution 469 mg/mL. Then, all rabbits underwent magnetic resonance imaging for the detection of gadopentetate dimeglumine in the middle and inner ear structures. The study was conducted in the tertiary referral center the University Hospital of Crete.RESULTSThe high signal intensity of the gadopentetate dimeglumine solution was demonstrated within the middle ear cavity and inner ear structures of all iontophoresed ears and in none of the non‐iontophoresed ones.CONCLUSIONSTranstympanic iontophoresis could be an effective method for the passage of pharmaceutical agents into the middle and inner ear for the treatment of middle and inner ear diseases. (Otolaryngol Head Neck Surg 2003;129:408–13.)
Intracapsular Tonsillar Reduction (Partial Tonsillectomy): Reviving a Historical Procedure for Obstructive Sleep Disordered Breathing in Children
Authors: Koltai Peter J. , Solares C. Arturo , Koempel Jeffery A. , Hirose Keiko , Abelson Tom I. , Krakovitz Paul R. , Chan James , Xu Meng , Mascha Edward J. 
Published: September 2022

OBJECTIVEWe sought to reintroduce a historical procedure—intracapsular tonsillar reduction (partial tonsillectomy or tonsillotomy)—for tonsillar hypertrophy causing obstructive sleep disordered breathing (OSDB) in children, as well as to determine whether partial tonsillectomy, compared with conventional (total) tonsillectomy when performed by more than one surgeon, is equally effective for the relief of OSDB while resulting in less pain and more rapid recovery.STUDY DESIGNWe conducted a retrospective case series at a tertiary children's hospital. The charts of children who underwent partial tonsillectomy and total tonsillectomy (1998 through 2002) for postoperative complications were reviewed. The caregivers were surveyed to assess postoperative pain, rapidity of recovery, and effectiveness of surgery for relieving symptoms of OSDB.RESULTSTwo hundred forty‐three children underwent partial tonsillectomy and 107 children underwent total tonsillectomy. There were no significant differences in immediate and delayed complications between the groups. Both operations were equally effective in relieving OSDB. Children who had partial tonsillectomy had significantly less postoperative pain and significantly more rapid recovery.CONCLUSIONIntracapsular tonsillar reduction with an endoscopic microdebrider relieves OSDB as effectively as conventional tonsillectomy, but results in less postoperative pain and a more rapid recovery.
Mandibular Reconstruction with an Alloplastic Bone Tray in Dogs
Authors: Strong E. Bradley , Rubinstein Brian , Pahlavan Nima , Martin Bruce , Kuntsi‐Vaattovaara Helena , Verstraete Frank J. M. 
Published: September 2022

OBJECTIVEMandibular alloplastic bone trays have an unacceptably high rate of extrusion. The introduction of resorbable mesh has renewed interest in such trays. This study evaluates the effect of resorbable trays on bone graft healing in a dog model.DESIGNUnilateral, 20‐mm mandibular body defects were created in 10 dogs, and repaired with cancellous bone grafts. A resorbable mesh bone tray was applied to 5 animals. All mandibles underwent gross examination, 4‐point stress testing, and histologic and radiographic analysis.RESULTSAll animals had excellent bony unions. There was one intraoral mesh exposure. There was no difference between the control and treatment groups with regard to clinical findings, radiologic analysis, stress testing (P = 0.17), or histologic analysis (P = 0.66).CONCLUSIONThe metabolic breakdown products of the resorbable mesh do not inhibit bone healing or strength. Resorbable mesh trays are a viable modality for reconstruction of segmental mandibular defects in a dog model.
Dose‐Response Relationship of Topically Applied Mitomycin C for the Prevention of Laser Myringotomy Closure
Authors: Jassir David , Odabasi Onur , Gomez‐Marin Orlando , Buchman Craig A. 
Published: September 2022

OBJECTIVEWe sought to determine a dose‐response curve for topical mitomycin C when used to prolong the patency of laser‐assisted myringotomies.STUDY DESIGN AND SETTINGBilateral myringotomies were performed using the argon laser in 40 guinea pigs with normal ears. Pledgets with (0.05, 0.2, 0.4, or 2.0 mg/mL) mitomycin C were applied topically. Monitoring consisted of weekly or biweekly otomicroscopy.RESULTSAs in previous studies, all saline‐treated myringotomies closed by day 7. By day 14, all myringotomies (100%) in the 0.05 mg/mL group were closed. By contrast, all myringotomies (100%) remained patent in the 0.2 and 0.4 mg/mL treatment groups, and 56% of the myringotomies remained patent in the 2.0 mg/mL group at day 14. By day 56, all myringotomies were closed in the 2.0 mg/mL group, 5 (50%) myringotomies were patent in the 0.4 mg/mL group, and 1 (11%) myringotomy was patent in the 0.2 mg/mL group. The study was terminated on day 84 (12 weeks). At that time, only the 0.4 mg/mL group had patent myringotomies (n = 3; 30%). The highest dose (2.0 mg/mL) of mitomycin was significantly associated with otorrhea. Otorrhea also appeared to be associated with earlier myringotomy closure.CONCLUSIONThere is a dose‐response curve for topical mitomycin C when used for prolonging my‐ringotomy patency in doses up to 0.4 mg/mL. Higher doses do not appear to prolong patency and are associated with greater otorrhea, suggesting middle ear toxicity.