bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of the Facial Translocation Technique in the Management of Tumors of the Paranasal Sinuses and Skull Base
Authors: Hao Sheng‐Po , Pan Whei‐Lin , Chang Chen‐Nen , Hsu Yung‐Shin 
Published: September 2022

OBJECTIVEWe sought to assess the efficacy of facial translocation in the management of tumors of the skull base and paranasal sinuses.STUDY DESIGN AND SETTINGFrom July 1993 to December 1999, 75 patients, aged 3 to 102 years old, underwent facial translocation. Thirty‐three (44%) patients also underwent a combined neurosurgical procedure. Nineteen (25%) had previous surgery. These patients were followed up to 6 years.RESULTSThere were 21 benign and 54 malignant tumors. There were no perioperative deaths. The morbidity rate was 31%. Of the 54 patients with malignant tumors, the actuarial 3‐year survival rate was 59%, whereas the local control rate was 54%.CONCLUSIONThe facial translocation technique offers favorable exposure of the critical zones of the anterior and middle cranial base, thus facilitating extensive resection and reconstruction.SIGNIFICANCEThis study demonstrates that facial translocation is one of the best surgical approaches to the skull base.
Oncologic and Functional Results of Near‐Total Laryngectomy
Authors: Bernáldez Ricardo , García‐Pallares Marta , Morera Eduardo , Lassaletta Luis , del Palacio Antonio , Gavilán Javier 
Published: September 2022

OBJECTIVETo report the oncologic and functional outcome of patients undergoing near‐total laryngectomy.STUDY DESIGN AND SETTINGA retrospective analysis was carried out from 1991 through 1998.RESULTSEighty‐seven patients underwent near‐total laryngectomy. The Kaplan‐Meier overall survival, cause‐specific survival, and relapse‐free survival estimates at 5 years were 48.2%, 75.8%, and 72.4%, respectively. Univariate analysis revealed prognosis significance for location, stage, and pathologic cervical lymph node status. Five percent of the patients developed local recurrence, 16% recurrence in cervical lymph nodes, and 10% distant metastasis. Pharyngocutaneous fistula was the most frequent complication (48%). Seventy‐seven percent of cases achieved voice preservation. Symptomatic aspiration was noted in 12.3% of cases.CONCLUSIONNear‐total laryngectomy can be a successful surgical procedure for selected patients; it does not replace total laryngectomy but reduces its indications. Voice preservation can be achieved in most cases.SIGNIFICANCENear‐total laryngectomy enhances the speech rehabilitation options for the laryngectomy patient by adding a physiologic, nonprosthetic tissue technique.
Tuberculosis of the Lymph Glands of the Neck: A Limited Role for Surgery
Authors: Ammari Fuad F. , Hani Ashraf H. Bani , Ghariebeh Kamal I. 
Published: September 2022

BACKGROUND AND OBJECTIVEThe clinical problem of a neck mass in general and tuberculous lymph nodes in the neck in particular may present a diagnostic dilemma. This retrospective study was conducted to highlight clinical presentation, management, and outcome.PATIENTS AND METHODSAll patients (n = 59) diagnosed with tuberculosis of the cervical lymph node in Irbid governorate during the period 1996 through 2000 were reviewed for standard criteria, in addition to diagnostic and therapeutic modalities.RESULTSMedical records were reviewed and relevant data were included; all age groups were equally involved with a female/male ratio of 2:1. Most of the patients presented with a neck mass to the outpatient surgical clinic. The diagnosis was made mainly based on the clinical picture and results of the Mantoux test, Ziehl‐Neelsen staining, and culture of bacilli. Fine needle aspiration cytology and histologic examination of incisional or excisional specimens are the main objective diagnostic tools. All patients were treated with antituberculous drugs under directly observed therapy short‐course regimen with 83% cure rate.CONCLUSIONTuberculosis of the cervical lymph nodes responds well to antituberculous drugs and the surgical role is limited to guidance in fine needle aspiration, incision and drainage, and incisional and limited excisional biopsy. Major excisional procedures are not without complications and should be avoided.
Injection Snoreplasty: Extended Follow‐Up and New Objective Data
Authors: Brietzke Scott E. , Mair Eric A. 
Published: September 2022

OBJECTIVEInjection snoreplasty was recently introduced as a safe, effective, and minimally invasive treatment for primary snoring. Extended follow‐up data (19 months) are presented from the initial pilot study cohort, and pretreatment/posttreatment objective data are presented on a new prospective patient cohort.STUDY DESIGN AND SETTINGThe successfully treated patients from the initial pilot study (n = 25) were surveyed regarding their current snoring level, overall discomfort, and overall satisfaction. A new patient cohort with primary snoring (Respiratory Disturbance Index <10) was prospectively treated with injection snoreplasty. Snoring was objectively measured pretreatment and posttreatment using a take‐home acoustical analysis device.RESULTSSubjective success dropped from 92% to 75% at a mean of 19‐month follow‐up with a snoring relapse rate of 18%. Objective analysis of a new patient cohort (n = 17) confirmed statistically significant decreases in palatal flutter snoring and palatal loudness after injection. Preprocedure measurements were highly correlated to eventual treatment success.CONCLUSIONS AND SIGNIFICANCESuccess and snoring relapse rates of injection snoreplasty are similar to those of other current treatments. Objective analysis confirms the procedure is effective in reducing palatal flutter snoring. Preprocedure snoring analysis may predict patient response to palatal stiffening treatments.
Systematic Approach to Benign Paroxysmal Positional Vertigo in the Elderly
Authors: Angeli Simon I. , Hawley Rose , Gomez Orlando 
Published: September 2022

OBJECTIVEWe evaluated the effectiveness of a management approach that combines the canalith repositioning maneuver (CRM) and vestibular rehabilitation (VR) in the treatment of benign positional paroxysmal vertigo (BPPV) in elderly persons.STUDY DESIGN AND SETTINGForty‐seven patients (>70 years old) with the diagnosis of unilateral posterior semicircular canal BPPV formed the study population. This study has 2 parts. In the first part, patients were randomly assigned to 1 of 2 groups: the CRM and avoidance (no treatment). Patients were evaluated 1 month after the first visit. Those patients not responding to treatment were enrolled in the second part of the study, treated with an individualized combination of CRM and VR, and then reevaluated 3 months later.RESULTSStatistically significant improvement of vertigo and provoked nystagmus in 64% of patients in the CRM group compared with the no‐treatment group. After the addition of VR, 77% of all patients improved.CONCLUSIONA combination of CRM and VR improves BPPV in the elderly.SIGNIFICANCEThese findings suggest that although CRM is more effective than no treatment, VR can be added to improve the results in the treatment of BPPV.
Prognostic value of otoacoustic emissions in children with middle ear effusion
Authors: Yeo Sang W. , Park Shi‐Nae , Park Yong Soo , Suh Byung Do 
Published: September 2022

The amplitude and frequency spectra of otoacoustic emissions are influenced by the condition of the middle ear. These are noninvasive measurements of cochlear function that are accurate, rapid, and simple to perform. In this study, prognostic value of otoacoustic emissions in children with middle ear effusion (MEE) was investigated. A total of 49 children aged 3.5 to 11.2 years with MEE were included. Spontaneous otoacoustic emission, transient evoked otoacoustic emission (TEOAE), and distortion product (DP) otoacoustic emission measurements were performed on each ear before medical treatment and were compared according to the responsiveness of medical treatment (medicine responder vs medicine nonresponder groups). Responses of spontaneous otoacoustic emissions and DP audiogram showed no significant difference between the 2 groups but TEOAE response was significantly decreased in medicine nonresponders (P > 0.05). Positive responses of the DP Input‐Output function curve in geometric mean frequencies at 5 and 6 kHz using a primary tone of 55 dB SPL were significantly detected in medicine responders (P > 0.01). The sensitivity, specificity, and predictive values of TEOAE and the DP I‐O function curve in geometric mean frequency at 6 kHz using a primary tone of 55 dB SPL showed the high prognostic value of these tests in terms of predicting response to medical treatment in the patients with MEE. This suggests that otologists may have to be more aggressive in their treatment of children with MEE who showed no response.
Color duplex sonography for the monitoring of vascularized free bone flaps
Authors: SchöN Ralf , Schramm Alexander , Gellrich Nils‐Claudius , Maier Wolfgang , Jürgen Düker , Schmelzeisen Rainer 
Published: September 2022

OBJECTIVEWhen vascular complications are suspected after the microsurgical transfer of free buried fibular bone flaps without a skin island, revision surgery often proves to be unnecessary. We sought to determine the efficacy of color duplex sonography in the close observation of bone graft patency postoperatively.STUDY DESIGNTwelve free fibular bone flaps without a skin island were postoperatively monitored through color duplex sonography with a 7.5‐MHz scanner.RESULTSWith color duplex sonography, the rate of perfusion in the vascular pedicle could be visualized in all 12 fibular flaps. In 3 patients, vascular complications and flap failure were suspected. However, because adequate perfusion of the vascular pedicle was observed immediately after surgery and in the daily follow‐up examinations, revision surgery was not necessary.CONCLUSIONSColor duplex sonography is not time‐consuming; in fact, it is a reliable, noninvasive, and inexpensive method for the postoperative monitoring of free bone flaps.
Histologic changes to olfactory epithelium in hypothyroid rats
Authors: Dhong Hun‐Jong , Kim Hyo Yeol , Ha Byung Suk 
Published: September 2022

OBJECTIVEThe purpose of this study was to immunohistochemically evaluate the effects of thyroid hormones on the olfactory epithelium (OE) in adult rats.STUDY DESIGN AND SETTINGHypothyroidism was induced in rats by propylthiouracil (PTU) administration. Animals were grouped into 5 consisting of a control group, and 4 groups that had been treated with PTU for 3, 6, 9, or 12 weeks, respectively. The thickness and cell densities of the OE were examined according to the duration of PTU treatment. Changes to OE cell properties were investigated with immunohistochemical stains.RESULTSNo statistically significant differences were found in the thickness and cell densities of the OE among the 5 groups. The number of olfactory receptor neurons positive for neuron‐specific enolase or protein gene product 9.5, however, decreased with increasing duration of PTU treatment.CONCLUSIONThyroid hormones play an important role in the maturation of olfactory receptor neurons.
Uvulopalatal Flap for Snoring on an Outpatient Basis
Authors: Neruntarat Chairat 
Published: September 2022

OBJECTIVESnoring is now seen as one end of a spectrum of sleep‐related breathing disorders, and in its extreme form, snoring can cause obstructive sleep apnea syndrome. Since the introduction of uvulopalatopharyngoplasty, many other procedures have been introduced to alleviate palatal abnormalities seen in patients with obstructive sleep apnea syndrome. A reversible uvulopalatal flap (UPF) achieves the same results as the uvulopalatopharyngoplasty but with less postoperative discomfort. The purpose of this study was to assess the safety and efficacy of UPF for the treatment of simple snoring on an outpatient basis.METHODSUFP was performed on an outpatient basis under local anesthesia. The mucosa on the lingual surface of the uvula and soft palate was removed with cold knife dissection. The uvular tip was amputated. The uvula was reflected back toward the soft palate and sutured. Most of the patients were male with simple snoring by history and confirmed by polysomnographic study. Data on patients were compared from preoperative to postoperative assessment points. Statistic analysis was performed.RESULTSFifty‐six patients tolerated the procedure well, and it was performed in an average of 20 minutes. Patients had a mean age of 48 years and a mean body mass index of 26.5 kg/m2. The mean follow‐up was 14 months (range, 12 to 20 months). Significant improvement was observed in snoring scale (8.2 ± 3.4 versus 2.6 ± 1.4, P < 0.05). Mean snoring index decreased from 245.8 ± 40.8 to 42.5 ± 20.7 events/hr (P < 0.001). The correlations between the changes in the subjective and objective snoring assessments were statistically significant. Postoperative complications included transient nasal regurgitation (4%) and foreign body sensation (2%). Bleeding, dysphagia, infection, and nasopharyngeal stenosis were not observed. Most patients had mild to moderate pain (visual analog scale, ≤7) for 5 to 7 days after the procedures. The overall success rate was 88%.CONCLUSIONSnoring, as reported by subjective and objective results, decreased after UPF. It appears to be a safe and effective procedure, which can be easily performed under local anesthesia on an outpatient basis, in carefully selected patients. (Otolaryngol Head Neck Surg 2003;129:353–9.)
Hot Versus Cold Tonsillectomy: A Systematic Review of the Literature
Authors: Leinbach Robert F. , Markwell Stephen J. , Colliver Jerry A. , Lin Sandra Y. 
Published: September 2022

OBJECTIVEWe systematically reviewed the literature comparing monopolar electrocautery versus cold knife dissection tonsillectomy.METHODSThe MEDLINE database was searched using the key words “tonsillectomy,” “hot,” “cold,” “sharp,” “bleeding,” and “cautery.” Selection criteria included prospective trials comparing electro‐dissection versus cold knife dissection on posttonsillectomy pain and hemorrhage. Six of the 815 articles met the selection criteria.RESULTSPooled data for the paired studies showed significantly more patients with pain worse on the electrodissection side (148 of 293 = 51%) than the cold knife side (33 of 293 (11%); P = 0.001) on postoperative days 4 to 10. There were significantly more analgesic doses after surgery with electrodissection (means 26.7 versus 19.2; P = 0.028) and higher pain scores for adults undergoing electrodissection (means, 2.6 versus 0.8; significance could not be determined). There were no differences in hemorrhage rates.CONCLUSIONSElectrodissection increases pain in comparison to sharp dissection for tonsillectomy. Postoperative hemorrhage rates are not significantly different when comparing the 2 methods. (Otolaryngol Head Neck Surg 2003;129:360–4.)
Coronal Computed Tomography Prevalence of Superior Semicircular Canal Dehiscence
Authors: Williamson Robert A. , Vrabec Jeffrey T. , Coker Newton J. , Sandlin Marlin 
Published: September 2022

OBJECTIVESThe relatively new clinical entity superior canal dehiscence syndrome (SCDS) is diagnosed by clinical symptoms and signs. Coronal computed tomography (CT) has been used to confirm the diagnosis. A consecutive series of temporal bone CT scans was reviewed to define the prevalence of a dehiscent‐appearing superior semicircular canal.STUDY DESIGN AND SETTINGTemporal bone CT scans performed over a 2‐year period at a university‐based tertiary referral center were reviewed independently by 3 individuals. Scans were excluded if coronal images were not obtained or reconstructed from axial images. Prevalence figures for dehiscent‐appearing superior semicircular canal were determined by consensus. Medical records of selected individuals with a dehiscent‐appearing canal were reviewed for study indications and otologic symptoms.RESULTSA dehiscent‐appearing superior semicircular canal was seen in 9% of studies. Correlation among examiners was greater than 94%. Medical records indicated symptoms suggestive of or compatible with the diagnosis of SCDS in rare cases.CONCLUSIONThe prevalence of a dehiscent‐appearing superior semicircular canal on coronal CT of the temporal bones performed with 1.0‐mm collimation is substantially greater than that predicted by temporal bone histologic study. Clinical symptoms compatible with the diagnosis were seldom recorded, suggesting low specificity. The high sensitivity and low specificity of CT scan create a risk for overdiagnosis of SCDS if the coronal CT scans are not correlated with clinical symptoms.
Transcutaneous cervical miniesophagostomy
Authors: Har‐El Gady , Balwally Atul N. 
Published: September 2022

Nasogastric tubes have been shown to cause damage to the pharyngolaryngeal complex, producing laryngeal inflammation, granulation, muscle damage, and even vocal cord immobility. The coexistence of nasogastric and tracheotomy tubes after conservation laryngeal surgery is especially harmful. The friction between these two semirigid structures may result in damage to the remaining part of the larynx. This may result in a significant delay in healing, oral feeding, and decannulation. Percutaneous endoscopic gastrostomy is a possible solution. This procedure requires time, special expertise, and cooperation between services. We present our experience with 17 transcutaneous cervical miniesophagostomies using a small‐caliber feeding tube, which were performed during conservation laryngeal and/or pharyngeal surgery. The rate of minor complications was 11.7%, or 0.40 complications per 100 tube days, and no major complications were related to the procedure. Transcutaneous cervical miniesophagostomy is a simple and quick procedure that may be performed during the primary cancer surgery. It is done by the head and neck surgeon and does not require special expertise. It takes about 5 minutes to perform and, if done correctly with tunneling under skin flaps, is associated with minimal or no postoperative morbidity.
Management guidelines for improvement of otolaryngology referrals from primary care physicians
Authors: Benninger Michael S. , King Frances , Nichols Richard D. 
Published: September 2022

OBJECTIVE AND DESIGNA prospective evaluation of the effectiveness of otolaryngology evaluation, treatment, and referral guidelines developed collaboratively by otolaryngologists and primary care physicians on referrals and access to otolaryngology. Comparisons of appropriate to unnecessary referrals, the percentage of patients referred with disorders addressed to those without disorders addressed in the guidelines, access to otolaryngology, and questionnaire evaluations of primary care physician and patient satisfaction were measured before and after guideline implementation.RESULTSA significant decrease in appropriate to unnecessary referrals was seen, from 55% before to 12% after guidelines. The percentage of patients seen within 1 month of scheduling improved from 39% to 59%. Guideline‐addressed disorders decreased from 63% to 40%. The need for patients to see another physician for the referred symptom while waiting to see an otolaryngologist decreased from 31 % to 3%. Patient satisfaction with wait times improved. Eighty‐six percent of the primary care physicians used the guidelines, and 85% wanted to expand the guidelines to other specialty areas.CONCLUSIONSManagement and referral guidelines are effective in improving patient access and the ratio of appropriate to unnecessary referrals. Such guidelines are well accepted and used by primary care practitioners in this setting.
Assessment of bone formation during osteoneogenesis: A canine model
Authors: Klotch Douglas W. , Ganey Timothy M. , Slater‐Haase Alicia , Sasse Joachim 
Published: September 2022

Distraction osteoneogenesis, callotasis, has been demonstrated to be an effective means of lengthening long bones. A variation of Ilizarov's technique produces a transport disk from one cut surface of bone within a defect and advances the disk to the opposite surface to close the defect. This process, previously described by Costantino et al. (Arch Otolaryngol Head Neck Surg 1990; 116:535‐45), demonstrated bone formation within the distraction site. The precise mechanism of bone formation has not yet been described for the mandible. Four conditioned beagles were studied, with one control dog maintained in neutral fixation and three dogs distracted at 0.25 mm every 8 hours. A two‐cm defect was closed, and dogs were kept in fixation for 1 week after closure, after which they were killed. Three sites were evaluated: (1) the distraction seam, (2) the interface of the cortical and distracted bone, and (3) the cortexes at the closed defect. Each site was bisected, and one half was decalcified for immunohistochemical and hematoxylin and eosin pathologic evaluation. The vascular basement membrane was labeled for laminin and type IV collagen. Both of these substances demonstrate the differentiation of the vascular matrix component predisposing primary bone formation. Labels were intense at the distraction seam where intense angiogenesis occurred. No hyalin cartilage was observed at the distraction site, which indicates that the fixation was stable and that ossification occurred primarily without intermediate callous formation. This model demonstrated that osteoclasts within the canine model produce bone through primary bone formation within an angiogenic matrix rich in basement membrane laminin and type IV collagen. Likewise, bone is species specific in mineral composition for dog mandible. Understanding the formation and composition of distracted bone is essential for understanding application of this technique within the clinical setting.
Outpatient Biopsies of the Palatine Tonsil: Access to Lymphoid Tissue for Assessment of Human Immunodeficiency Virus RNA Titers
Authors: Faust Russell A. , Henry Keith , Dailey Peter , Melroe Holly , Sullivan Christopher , Erice Alejo , Haase Ashley T. , Boies Lawrence R. 
Published: September 2022

OBJECTIVESOur objective was to assess the feasibility of using tonsillar lymphoid biopsy specimens obtained on an outpatient basis to quantitate a patient's lymphoid human immunodeficiency virus (HIV) RNA titers.DESIGNA pilot cohort study was performed.PATIENTSWe evaluated ten HIV‐seropositive patients who ranged in age from 26 to 48 years and had CD4+ cell counts ranging from 110 to 833 at enrollment.MAIN OUTCOME MEASURESThe main outcome measures were tolerance and safety of outpatient tonsil biopsies and quantitation of HIV RNA titers in tonsillar lymphoid biopsy specimens, plasma, and peripheral blood mononuclear cells determined by a new method of HIV RNA signal amplification with branched DNA probes.RESULTSOutpatient tonsil biopsies were well tolerated and were performed without complications. Nine of 10 tonsil biopsies from the HIV‐seropositive patients examined were positive for significant concentrations of HIV RNA, ranging from 106 to 109 HIV RNA equivalents per gram of tissue. All of the HIV RNA‐positive tonsillar lymphoid specimens had HIV RNA titers that were 102 to 104 times greater than those recovered from plasma (per milliliter) of the same patient obtained at the time of biopsy.CONCLUSIONSSufficient tonsillar tissue can be obtained in an outpatient clinic setting to quantitate lymphoid HIV titers by the new branched‐DNA signal amplification method with relative ease and without complication. The biopsy method described here affords ready access to the lymphoreticular system, which may help to advance our understanding of the pathogenesis of myriad immune diseases without the need for excisional node biopsies.