bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost analysis of employing multi‐test allergy screening to guide serial endpoint titration (SET) testing versus SET alone
Authors: Shah Saurabh B. , Emanuel Ivor A. 
Published: September 2022

OBJECTIVEWe analyzed the cost differences between 2 different modalities of allergy testing.STUDY DESIGN AND SETTINGMaterial costs, labor costs, and overhead expenditures were compared for 2 different allergy‐testing algorithms. Fifty patients were placed in each group. The first group was tested for 14 allergens and 2 control substances by using multi‐test II. These patients were compared with 50 patients tested for similar allergens and control substances by using serial end‐point titration.RESULTSThe initial round of tests with serial endpoint titration was nearly 3 times as costly as the multi‐test for the 14 allergens and 2 control substances.CONCLUSION AND SIGNIFICANCEMulti‐testing is a cost‐effective initial testing modality that can screen out negative results and enable the identification of positive reactions. These results could then be further investigated by using serial endpoint titration or RAST to quantify the patient's sensitivity and establish a starting dose for immunotherapy.
Pharyngeal Flap Surgery: Protocols, Complications, and Outcomes at the University of Iowa
Authors: Canady John W. , Cable Benjamin B. , Karnell Michael P. , Karnell Lucy Hynds 
Published: September 2022

OBJECTIVEWe sought to assess complication rates and speech outcomes in patients undergoing pharyngeal flap surgery.STUDY DESIGN AND SETTINGWe conducted a retrospective chart and database review at a tertiary craniofacial center.PATIENTSEighty‐seven patients were identified as having pharyngeal flaps between January 1990 and December 2000.RESULTSComplications were rare, with an overall rate of 3.4% for all children. Craniofacial database records were identified with a follow‐up examination between 2 and 5 years. Forty‐four patients were identified. Of this group, 81.8% demonstrated no evidence of hypernasality or mild hypernasality, and 84.1% demonstrated no evidence of hyponasality or only mild hyponasality. Preoperative and postoperative assessments showed a statistically significant difference in hypernasality at P < 0.001 with no significant difference in hyponasality.CONCLUSIONSAlthough sphincter pharyngoplasty procedures have gained a great deal of attention in the recent otolaryngologic literature, pharyngeal‐flap procedures remain a valuable tool in the hands of surgeons dealing with velopharyngeal incompetence. (Otolaryngol Head Neck Surg 2003;129:321–6.)
Normal Features of Tissue‐Engineered Auricular Cartilage by Flow Cytometry and Histology: Patient Safety
Authors: Kamil Syed H. , Woda Marcia , Bonassar Lawrence J. , Novitsky Yuri W. , Vacanti Charles A. , Eavey Roland D. , Vacanti Martin P. 
Published: September 2022

BACKGROUNDCytokinetic abnormalities in DNA content, such as aneuploidy, haploidy, and tetraploidy, have been found to occur in human cartilaginous tumors. The high number of chondrocytes needed for tissue‐engineered cartilaginous implants requires the cells to be passaged repeatedly. The theoretical risk of changes in the normal diploid state of these cells during their growth in vitro and after generation of tissue‐engineered cartilage in vivo is not known.MATERIALS AND METHODSAuricular chondrocytes were obtained from 6 patients and cultured in vitro. Chondrocyte number was increased by repeated passaging. The passaged cells were implanted in nude mice for 8 weeks to generate tissue‐engineered cartilage. Fresh control chondrocytes along with the passaged cells and cells obtained from the tissue‐engineered constructs were collected and compared for DNA content by flow cytometry.RESULTSFlow cytometry demonstrated 100% diploidy with no evidence of aneuploidy, haploidy, or tetraploidy in all groups of cells. Histology of the tissue‐engineered cartilage also showed no evidence of cellular atypia.CONCLUSIONThe number of human auricular chondrocytes can be increased by repeated passaging and passaged chondrocytes can be safely used for implantation to generate tissue‐engineered constructs without a change in the normal diploid state of the cells. Histology of the cartilage generated showed normal features without atypia. (Otolaryngol Head Neck Surg 2003;129:390–6.)
Classification of Fungal Sinusitis in Immunocompetent Patients
Authors: Uri Nechama , Cohen‐Kerem Raanan , Elmalah Irit , Doweck Illana , Greenberg Elhanan 
Published: September 2022

OBJECTIVEThe objective of this study was to review the subgroup classification of fungal sinusitis in immunocompetent patients.METHODSThe study design included 19 immunocompetent patients with fungal sinusitis who were operated on between 1993 and 1998.RESULTSTen of 19 patients showed a fungus ball. They underwent a limited surgical endoscopic procedure, and no further treatment was needed. Four patients had allergic fungal sinusitis and were treated postoperatively with irrigation, topical steroids, and oral steroids in 2 patients as well. Five patients had chronic sinusitis with significant bone erosion. All 5 underwent an extensive endoscopic procedure and were treated postoperatively by repeated irrigation, endoscopic cleaning, and no antifungal preparation. Two patients of this group are reported broadly.CONCLUSIONSFungal sinusitis in immunocompetent patients is not a rare condition and can be divided into 3 categories: 1) fungus ball, 2) chronic erosive (noninvasive) fungal sinusitis, and 3) allergic fungal sinusitis. The symptomatology, treatment, and prognosis varied significantly among the 3 different categories. (Otolaryngol Head Neck Surg 2003;129:372–8.)
Evaluation of Palatal Snoring Surgery in an Animal Model
Authors: Lafrentz John R. , Brietzke Scott E. , Mair Eric A. 
Published: September 2022

OBJECTIVEWe introduce an animal model to reproduce and measure palatal snoring and to assess the effectiveness of cautery‐assisted palatal stiffening operation and injection snoreplasty versus a control (no palatal intervention) on treatment of palatal flutter snoring.STUDY DESIGN AND SETTINGAn anesthetized laboratory canine model uses 2 simultaneous temporary tracheotomies. An inferior tracheotomy is cannulated with an endotracheal tube for ventilation. A superior tracheotomy is cannulated with a tube passed cephalad and seated in the hypopharynx. Negative pressure applied to the upper tube leads to partial collapse of the upper airway with palatal fluttering, and the anesthetized dog snores. Videostroboscopy records palatal flutter frequency before and after surgical intervention. Preoperative and postoperative palatal assessments are made on 15 beagles.RESULTSCautery‐assisted palatal stiffening operation and injection snoreplasty objectively stiffen the canine soft palate with diminished snoring compared with controls.CONCLUSION AND SIGNIFICANCEWe provide a reproducible animal model to experimentally measure new interventions to treat palatal flutter snoring. (Otolaryngol Head Neck Surg 2003;129:343–52.)
Head and Neck Reconstruction with Anterolateral Thigh Flap
Authors: Mäkitie Antti A. , Nigel J. P. , Neligan Peter C. , Lipa Joan , Gullane Patrick J. , Gilbert Ralph W. 
Published: September 2022

OBJECTIVEOur goal was to present our experience with the free anterolateral thigh flap for reconstruction of various cutaneous and mucosal defects of the head and neck.STUDY DESIGNWe conducted a retrospective review of 37 patients who underwent reconstruction between 1994 and 2002. Outcome measures included ethnicity, flap harvest technique, vascular anatomy, flap success, general surgical complications, and donor site morbidity.RESULTSThe majority of our patients were white (n = 33). The size of the 39 free anterolateral thigh flaps varied from 24 to 252 cm2. There was 1 arterial failure and flap loss (2.6%) and 2 venous occlusions that were both salvaged. The donor site was closed primarily in 37 cases and with a split‐thickness skin graft in 2 cases.CONCLUSIONSThis is the first report on using the free anterolateral thigh flap in whites. This free transfer has proved to be a versatile and reliable flap for reconstruction of the head and neck.
Resolution of Facial Stimulation in Otosclerotic Cochlear Implants
Authors: Rayner Mark G. , King Timothy , Djalilian Hamid R. , Smith Sharon , Levine Samuel C. 
Published: September 2022

OBJECTIVESWe examined the incidence of facial nerve stimulation in a population of patients with otosclerosis implanted with the Nucleus 22, Clarion 1.2, or Clarion High Focus (CHF) device.STUDY DESIGN AND SETTINGA retrospective chart review was used for 147 patients who had been implanted with electronic cochlear devices at the University of Minnesota between June 1986 and February 2001. Seventy‐four patients were implanted with the Nucleus 22, 41 patients were implanted with the Clarion 1.2 (without a positioner), and 32 patients were implanted with the CHF I or II.RESULTSEleven (14.9%) of the 74 patients implanted with the Nucleus 22 device had facial stimulation. There were 9 patients with otosclerosis. Seven (78%) of the 9 patients with otosclerosis had facial stimulation. One (2.4%) of the 41 patients implanted with the Clarion 1.2 device (without a positioner) had facial stimulation and that 1 (100%) patient in the group had otosclerosis. There were 4 patients in the CHF group with otosclerosis. One patient experienced stimulation, but it was possible to decrease maximum current levels and still use the electrode pair.CONCLUSIONFacial stimulation appears to be less problematic in patients with otosclerosis implanted with the CHF devices.
Clinical Predictors of Long‐Term Success After Endoscopic Sinus Surgery
Authors: Dursun Engin , Korkmaz Hakan , Eryilmaz Adil , Bayiz Ünal , Sertkaya Durdu , Samim Erdal 
Published: September 2022

OBJECTIVEDetermining the clinical predictors of long‐term success after endoscopic sinus surgery (ESS) would better guide the management of patients.METHODS One hundred‐thirty chronic rhinosinusitis (CRS) patients were evaluated retrospectively. Overall subjective improvement was 83% with a mean follow‐up of 60 months. Eighty percent had anatomic variations; 36.2%, allergy; 55.4%, nasal polyps; and 26.9%, history of previous operation. The improvement was 100%, 94%, 79.5%, and 69.7% in stages 0, I, II, and III, respectively. With other parameters, the success rates were 68.1% and 91.6% with and without allergy, 73.6% and 94.8% with and without polyps, 54.3% and 93.7% with and without previous history of surgery, 84.4% and 82.7% with and without anatomic variations, and 23.8% and 94.4% with and without recurrent polyps.CONCLUSIONIn multivariate Cox regression analysis, allergy (P < 0.05; relative risk, 4.6) and previous polypectomy (P < 0.05; relative risk, 9.9) were found to be predictors of poor prognosis in the long‐term follow‐up.
Ketoprofen for Postoperative Pain After Uvulopalatopharyngoplasty and Tonsillectomy: Two‐week Follow‐up Study
Authors: Nikanne Elina , Virtaniemi Jukka , Aho M. , Kokki Hannu 
Published: September 2022

OBJECTIVEIn our previous study, we reported that both uvulopalatopharyngoplasty (UPPP) and tonsillectomy are associated with unacceptable intense pain during the first 24 hours after surgery. To investigate the pain progression at home, we followed the same 53 patients for 14 days after surgery. Twenty‐two patients underwent tonsillectomy and 31 patients underwent UPPP.STUDY DESIGNA prospective, longitudinal, parallel‐group study was conducted.METHODSBeginning on the first postoperative day, the patients were allowed to use 50 mg ketoprofen capsules at a dosage of 5 mg/kg/24 hr. The patients evaluated their own pain four times a day for the first 5 days. Two weeks after the surgery during a follow‐up visit patients reported the present pain; and a total consumption of analgesics, and all adverse events for 14 days.RESULTSPatients in both study groups had significant pain, especially in the morning, for the first week after surgery. In half of the patients, severe pain interfered with eating and sleeping, and in one third of the patients, the pain lasted 2 weeks or longer. The need for ketoprofen was significantly higher after UPPP than that after tonsillectomy (P = 0.001). One patient after tonsillectomy and 3 patients after UPPP needed electrocautery to stop secondary bleeding.CONCLUSIONSBoth UPPP and tonsillectomy are associated with intense postoperative pain. Standard ketoprofen capsules are too short‐acting to ensure undisturbed sleep.
Sound Pressure Gain Produced by the Human Middle Ear
Authors: Kurokawa Hironobu , Goode Richard L. 
Published: September 2022

The acoustic function of the middle ear is to match sound passing from the low impedance of air to the high impedance of cochlear fluid. Little information is available on the actual middle ear pressure gain in human beings. This article describes experiments on middle ear pressure gain in six fresh human temporal bones. Stapes footplate displacement and phase were measured with a laser Doppler vibrometer before and after removal of the tympanic membrane, malleus, and incus. Acoustic insulation of the round window with clay was performed. Umbo displacement was also measured before tympanic membrane removal to assess baseline tympanic membrane function. The middle ear has its major gain in the lower frequencies, with a peak near 0.9 kHz. The mean gain was 23.0 dB below 1.0 kHz, the resonant frequency of the middle ear; the mean peak gain was 26.6 dB. Above 1.0 kHz, the sound pressure gain decreased at a rate of −8.6 dB/octave, with a mean gain of 6.5 dB at 4.0 kHz. Only a small amount of gain was present above 7.0 kHz. Significant individual differences in pressure gain were found between ears that appeared related to variations in tympanic membrane function and not to variations in cochlear impedance.
Acoustic neuroma (vestibular schwannoma): Growth and surgical and nonsurgical consequences of the wait‐and‐see policy
Authors: Charabi Samih , Thomsen Jens , Mantoni Margit , Charabi Birgitte , Bjarne J⊘rgensen , Sven Erik B⊘rgesen , Gyldensted Carsten , Tos Mirko 
Published: September 2022

A prospective study of the consequences of the wait‐and‐see policy in patients with neuroradiologic diagnostic evidence of having vestibular schwannoma was conducted in a series of 123 patients (127 tumors) over a 20‐year period, from 1973 to 1993. The mean follow‐up period was 3.4 years, mean annual growth rate was 3.2 mm/year, mean annual volume growth rate was 0.72 ml/year, and mean annual relative growth rate was 41%. Tumor growth was observed in 90 (74%) patients (94 tumors), no growth was seen in 23 (18%) patients (23 tumors), and negative tumor growth was seen in 10 (8%) patients (10 tumors). Surgery due to tumor growth was performed in 35 (28%) patients (35 tumors), 7 (6%) patients (7 tumors) were treated with γ‐radiation and/or shunt insertion, 7 (6%) patients died of brain stem herniation induced by tumor compression, 9 (7%) patients died of non‐tumor‐related causes, 28 patients were classified as candidates for hearing preservation surgery, and 21 (75%) patients lost their candidacy during the observation period due to tumor growth and/or deterioration of hearing. The results may limit indications for allocation of patients with vestibular schwannoma to the wait‐and‐see group.
Cochlear Immunoglobulin in the C3H/lpr Mouse Model for Autoimmune Hearing Loss
Authors: Trune Dennis R. 
Published: September 2022

Immunoglobulin staining was conducted in cochlear tissue from the C3H/lpr autoimmune strain mouse to better understand the local immune processes underlying autoimmune inner ear disease. This mouse is a model for spontaneous systemic lupus erythematosus with coincident elevated cochlear thresholds. Cochleas were examined from C3H/lpr mice at 2 months of age, before disease onset, and at 8 months of age, when systemic disease and hearing loss are manifested. Sections of these cochleas, along with cochlear sections from age‐matched C3H/HeJ nonautoimmune controls, were immunocytochemically stained for IgG and IgM to identify areas of abnormal immunoglobulin activity. IgM immunoreactivity was similar in control and autoimmune cochlear tissue and did not appear to vary with disease progression. Staining was limited to the inside of capillaries in the stria vascularis and other areas within the cochlea. Similar staining patterns were seen in control animals stained for IgG. However, C3H/lpr mice with autoimmune disease showed extensive IgG immunoreactivity spreading out from the stria vascularis capillaries into the extracapillary spaces. This increased permeability suggested that breakdown of the blood labyrinth barrier was coincident with systemic autoimmune disease.
Tinnitus suppression in cochlear implant patients
Authors: Ito Juichi 
Published: September 2022

Tinnitus is sometimes suppressed by cochlear implantation. Tinnitus conditions were examined in 60 adult patients who underwent cochlear implantation in 1990 or later. Before surgery, 90% of these patients reported some type of tinnitus. The patients completed a questionnaire evaluating the loudness and duration of the tinnitus, immediately after the first electrical stimulation and 2 months later. The loudness of tinnitus was suppressed in 65% of the patients at first evaluation. Two months later, the tinnitus was suppressed in 93% of the patients. As for the duration of tinnitus, at first evaluation the tinnitus duration was suppressed in 41% of the patients. Two months later, the duration of tinnitus was suppressed in 61% of the patients.
Test‐Retest Reliability of Vestibular Autorotation Testing in Healthy Subjects
Authors: Guyot Jean‐philippe , Psillas Georges 
Published: September 2022

Vestibulo‐ocular reflex rotational chair testing in the high‐frequency range is seldom performed because it requires specialized and powerful systems. But today a new method of sweep‐frequency vestibulo‐ocular reflex testing, the Vestibular Autorotation Test system (Western Systems Research, Inc., Pasadena, Calif.), based on active head movements increasing from 2 to 6 Hz, is available on the market. The goal of this study was to evaluate the test‐retest variability of this test in healthy subjects. Twelve young adults (22 to 42 years old) without any history of auditory or vestibular dysfunction were included in the study. Subjects underwent five tests under standardized conditions with a 1 ‐week interval. Each test consisted of three measurements of the gain and phase of the vestibulo‐ocular reflex in the horizontal and vertical planes. Statistical analysis shows that the test‐retest reliability of the Vestibular Autorotation Test is poor. Therefore this method cannot be used routinely to evaluate precise vestibulo‐ocular reflex anomalies.
Principles of Facial Reconstruction
Authors: Papel Ira D. 
Published: September 2022

Editor's Note: The reviewers have rated the books on a scale of one to five stars. The highest ratings are given to books that fulfill their objectives and skillfully convey information to the chosen audience. Books are judged on appropriateness and completeness of detail for the targeted audience, quality of writing, editorial skill (especially multiauthored books), illustrations, and photography. If is hoped this code will aid the reader in selecting books for his or her permanent library. The rating scale is as follows: ***** Outstanding, a classic, should be on the shelf of anyone interested in the subject; **** Strong, well‐written book with major contributions in some areas; *** Informative book that should be read, if not owned, by individuals with interest in the field; ** Some worthwhile information, but with deficiencies in writing style or completeness; * Major shortcomings, not recommended.Principles of Facial Reconstruction, by Wayne F. Larrabee, Jr, and David A. Sherris. 256 pages with illustrations. Lippincott‐Raven, Philadelphia, 1995. $95.00.
The Multichannel Auditory Brain Stem Implant: Performance in Twenty Patients
Authors: Otto Steven R. , Shannon Robert V. , Brackmann Derald E. , Hitselberger William E. , Staller Steven , Menapace Christine 
Published: September 2022

The auditory brain stem implant has been used effectively to provide hearing sensations to individuals deafened by bilateral auditory nerve tumors (neurofibromatosis type 2). During tumor removal, the auditory brain stem implant is implanted into the lateral recess of the fourth ventricle by a translabyrinthine approach and is intended to stimulate auditory neurons of the cochlear nucleus complex. A new eight‐electrode multichannel auditory brain stem implant was developed and evaluated in 20 patients who had at least 3 months' experience with the device. Mild nonauditory sensations (primarily tingling in the head or torso) were encountered in some instances but could be managed by changing the stimulus characteristics or excluding electrodes. Testing of perceptual performance indicated significant benefit from the device for communication purposes, including sound‐only sentence recognition scores in three patients ranging from 49% to 58% and ability to converse on the telephone. These results indicate that significant auditory benefit can be derived from direct multichannel electrical stimulation of the auditory portion of the human brain stem.
The HPV 6 E6/E7 Transforming Genes are Expressed in Inverted Papilloma
Authors: Harris Monte O. , Beck Jill C. , Lancaster Wayne , Gregoire Lucie , Carey Thomas E. , Bradford Carol R. 
Published: September 2022

A role for human papilloma virus (HPV) infection in the pathogenesis of head and neck neoplasms has gained support in recent years. Expression of two early‐region HPV genes, E6 and E7, is widely accepted as essential for viral‐induced carcinomas of the genital tract. These oncoproteins interact with the products of the cellular tumor suppressor genes, p53 and retinoblastoma, and inactivate them. Examining E6/E7 transforming gene expression is an important step toward elucidating the pathogenesis of HPV in head and neck neoplasms. We introduce nasal inverted papilloma (IP) as a novel system for evaluating viral genomic expression and transforming gene regulation of tumorigenesis by virtue of its association to HPV infection and potential for malignant progression. We describe here a reverse transcriptase‐polymerase chain reaction approach for the detection of HPV E6/E7‐specific transcripts in RNA extracted from IP. A primer pair flanking previously mapped HPV 6 E6/E7 splice donor/acceptor sites was used to direct amplification of cDNA. Reverse transcriptase‐polymerase chain reaction experiments generated products representing the 1.2 Kb E1∧E4 splice transcript and a smaller unclassified fragment in IP from two patients. These results provide evidence for HPV 6 E6/E7 expression in IP with the potential to encode transforming proteins.