bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Lateral Crural J‐flap Repair of Nasal Valve Collapse
Authors: O'Halloran Laurence R. 
Published: September 2022

OBJECTIVESNasal valve collapse is a common cause of nasal airway obstruction. Although many techniques have been devised to correct both the functional and aesthetic aspects of this problem, none is uniformly successful. I propose that the true locus and solution to the problem lies lateral to the nasal valve angle in the fibroareolar tissue that connects the lateral aspect of the lateral crus to the bony pyriform aperture. Age‐related or surgically induced weakening and loosening of these structurally important, fibroareolar connections result in a prolapse of the lateral aspect of the lateral crura away from the pyriform margin and toward the septum with a consequent narrowing of the nasal valve region. A new method of repair is described.METHODSBilateral marginal incisions are made following the curvature of the palpated caudal edge of the lower lateral cartilage starting at the dome region medially. The incision is extended laterally until the entire lateralmost aspect of the lateral crus is freed, generating a J‐shaped chondrocutaneous flap that is medially and superiorly based. Following this, supraperichondrial dissection of the lateral crus is carried out, exposing the dome region and the upper lateral cartilage. The J‐flap is then pulled caudally and laterally, and the excess overlapping tissue is evaluated. Two composite strips of vestibular skin and cartilage are resected: one parallel to the marginal incision and the second at the lateral edge of the J‐flap. The flap is transposed and sutured into position, pulling open the nasal valve angle.RESULTSPreliminary results are presented for 18 patients who underwent 19 lateral crural J‐flap repairs of nasal valve collapse. Nine patients underwent concomitant septal, sinus, or turbinate procedures. Two patients underwent unilateral J‐flap repair. One patient required revision. Eighty‐nine percent of patients reported markedly improved nasal airway patency and elimination of the subjective sensation of inspiratory collapse. Mean time to follow‐up was 257 days. There has thus far been no noticeable decrement in benefit over time.CONCLUSIONThis new technique for the treatment of nasal valve collapse may offer a simple and effective approach to the problem of nasal valve collapse with minimal morbidity and a high rate of success. The technique is based on a new view of the structural etiology of nasal valve collapse.
An Alternative Surgical Procedure for the Treatment of Vocal Fold Retention Cyst
Authors: Chang Hsin‐Pin , Chang Shyue‐Yih 
Published: September 2022

OBJECTIVEEnucleation is the standard surgical procedure for vocal fold retention cyst, but it is sometimes technically challenging when the cyst is large. A simple alternative procedure, which evolved from the concept of marsupialization of cystic lesions, is presented, and the treatment results are reported.METHODSTermed the “wide‐opening method,” this technique involves the removal of the medial half of the cyst with its overlying mucosa, which creates a large opening that prevents content retention. Twenty‐one consecutive patients with a cyst with a diameter of greater than 2 mm were treated by this method. Videostroboscopy and voice function assessments were performed preoperatively and postoperatively.RESULTSThe procedure was completed on all patients without difficulty. Voice function assessments showed statistically significant improvement postoperatively. Videostroboscopy showed improved vocal fold vibration postoperatively in all patients, although in 9 patients the postoperative wound with mild local stiffness was observable. Recurrence was noted in 1 patient.CONCLUSIONSThe wide‐opening method is simple in technique, especially when the cyst is large. Voice improvement can be achieved postoperatively, and the recurrence rate is low.
Evaluation of Sinusitis in the Intensive Care Unit Patient
Authors: Skoulas Ioannis G. , Helidonis Emmanuel , Kountakis Stilianos E. 
Published: September 2022

OBJECTIVEThe purposes of this study were to evaluate the effectiveness of radiologic studies in diagnosing sinusitis in the intensive care unit (ICU) patient and to compare it with the effectiveness of endoscopic examination of the middle meatus.METHODSWe conducted a prospective collection of data in 141 ICU patients consulted for sinusitis over a 5‐year period beginning in the 1994.RESULTSAntral lavage was performed at least unilaterally in 112 patients, with a total of 195 lavages performed. Plain films and computer tomography scans predicted purulence in 41% (χ2 = 2.9, P = 0.09) and 47% (χ2 = 2.2, P = 0.14) of the cases, respectively, whereas the presence of purulence in the middle meatus as seen on endoscopy predicted purulence in the maxillary sinus in 78% of the lavages (χ2 = 28.9, P = 8 × 10‐8). When there was no evidence of purulence in the middle meatus on endoscopy, 73% of the lavages were negative.CONCLUSIONThe most important predictor of a positive antral lavage in the ICU patient with suspected sinusitis is evidence of purulence on endoscopic examination of the middle meatus.
Nonmelanoma Cutaneous Malignancy with Regional Metastasis
Authors: Chu Angela , Osguthorpe J. David 
Published: September 2022

OBJECTIVE AND STUDY DESIGNWe performed a retrospective study of 28 patients to evaluate the management and outcome of regional metastasis from nonmelanoma cutaneous malignancies.RESULTSThere were 25 squamous cell, 1 basal cell, and 2 eccrine carcinomas. The most common primary locations were the temple, ear, and cheek. Median interval from primary resection to regional metastasis was 9 months, and such were commonly of the parotid, level IB, and level IIA nodes. Twenty‐four patients underwent parotidectomy and/or neck dissection; 19 patients, postoperative radiation. Ten patients (36%) died from the disease, 2 patients (7%) have persisting disease, 5 (18%) have died from intercurrent disease, and 11 (39%) have no evidence of disease (minimum follow‐up, 22 months; median, 34 months).CONCLUSIONS AND SIGNIFICANCENonmelanoma cutaneous malignancies with regional metastasis have a poor prognosis despite aggressive therapy. When high‐risk characteristics are detected, examination of the nearest “sentinel node,” prophylactic lymphadenectomy, and/or regional irradiation might be justified; further study is warranted.
Clinical Associations Between Tinnitus and Chronic Pain
Authors: Isaacson Jon E. , Moyer Matthew T. , Schuler H. Gregg , Blackall George F. 
Published: September 2022

OBJECTIVEWe sought to estimate the prevalence and severity of tinnitus in patients with chronic pain.STUDY DESIGN AND SETTINGWe conducted a prospective nonrandomized study in which a survey and the Tinnitus Handicap Inventory (THI) were distributed at a tertiary chronic pain clinic.RESULTSSeventy‐two patients participated. 50 women (mean age, 53 years) and 22 men (mean age, 47.5 years); 54.2% reported having tinnitus. There was an even distribution of patients reporting the onset of tinnitus as before versus after the onset of pain. Four patients reported a direct association between tinnitus and pain. The mean THI score was 27 (of 100) (n = 35). Fifteen subjects scored less than 16, indicating no handicap, and 4 scored over 58, indicating a severe handicap.CONCLUSION: The study results suggest a high incidence of tinnitus within this population. There were few strong associations between pain and tinnitus. Tinnitus does not significantly handicap the majority of these patients.SIGNIFICANCETinnitus is a common symptom in the chronic pain population but is not a significant problem for these patients.
Intralesional Cidofovir for the Treatment of Severe Juvenile Recurrent Respiratory Papillomatosis: Long‐Term Results in 4 Children
Authors: Milczukm Henry A. 
Published: September 2022

OBJECTIVEWe sought to determine the efficacy of intralesional injection of cidofovir in improving resolution of recurrent respiratory papillomatosis (RRP).STUDY DESIGN AND SETTINGWe conducted a prospective, observational trial at an academic tertiary children's hospital.RESULTSFour children with RRP requiring more than 6 surgical excisions per year were treated with intralesional cidofovir. Cidofovir (5 mg/mL) was injected into airway sites where papillomas had just been excised using sharp technique. Each patient had 6 treatments performed 6 to 8 weeks apart. Biopsies confirmed benign papilloma lesions in all cases. During treatment with intralesional cidofovir there was diminished growth of the papillomas in each patient. Once cidofovir treatment was stopped, the rate of regrowth and frequency of surgical excision returned to pretreatment levels in 3 of the 4 patients.CONCLUSIONSIntralesional cidofovir may provide benefit in reducing the rate of RRP growth while under treatment, but RRP severity returned to pretreatment levels once cidofovir treatment was stopped using this treatment program.
Cricothyroid Approximation and Thyroid Chondroplasty: A Patient Survey
Authors: Matai Vandana , Cheesman Anthony D. , Clarke Peter M. 
Published: September 2022

OBJECTIVECricothyroid approximation is performed in male‐to‐female transsexuals to raise the pitch of the voice often accompanied by a thyroid chondroplasty, an aesthetic reduction of the thyroid cartilage. The survey was conducted to ascertain patient satisfaction with the procedures.STUDY DESIGN AND SETTINGFifty‐four patients had the procedures performed in our department over an 8‐year period; 45 patients were sent postal questionnaires to evaluate patient satisfaction with the appearance of the laryngeal prominence, pitch of the voice, and which they found more beneficial, the surgery or speech therapy.RESULTSA response rate of 93% was obtained; 86% of patients thought their laryngeal profile had improved, 79% thought their voice had improved, and 55% thought that surgery and 21% thought that speech therapy had helped more in improving the voice. Overall, 79% were satisfied with the results of the surgery.CONCLUSIONSCricothyroid approximation and thyroid chondroplasty have a high patient satisfaction rate.
Opening Plugged Tympanostomy Tubes: Effect of Tube Composition
Authors: Tsao Benjamin A. , Stevens Gary R. , Antonelli Patrick J. 
Published: September 2022

OBJECTIVEWe sought to determine if tympanostomy tube (TT) composition impacts the rate of clearing mucoid plugs.DESIGNThe study used an ex vivo model.METHODSTTs with a standard shaft length and inner diameter, varying only by composition materials, were studied. Thirty TTs of each biomaterial (stainless steel, titanium, silicone, fluoroplastic, ion‐bombarded silicone, and phosphorylcholine‐coated fluoroplastic) were plugged with middle‐ear mucus and placed in a model ear chamber. Ofloxacin otic solution was instilled into the chamber to cover the plugged TT. Time to clear each plug was recorded.RESULTSIon‐bombarded silicone TTs cleared more rapidly than plain silicone TTs (P=0.0042), but no other statistically significant difference among TT materials was observed.CONCLUSIONSTT composition does not significantly affect the rate or “ease”with which TTs may be opened after they become plugged with mucus ex vivo. The higher rate of plug clearance observed with ion‐bombarded silicone relative to untreated silicone suggests that improvements may be possible with alterations in either TT composition or surface preparations.
Second primary malignancies in patients with cancer of the head and neck
Authors: Vaamonde Pedro , Martin Carlos , Del Rio Maria , Labella Torcuato 
Published: September 2022

OBJECTIVEClinical study of second primary malignancies (SPM) in patients with cancer of the head and neck (HNC).STUDY DESIGN AND SETTINGRetrospective study over 48 patients with SPMs culled from 636 with HNC seen in 122 months. The minimum follow‐up was 18 months, and the setting for the study was the institutional referral center.RESULTSThere was association between the sites of first and second tumor. The SPMs were diagnosed with a constant rate throughout the period of study. Five year‐survival rate was 29%. SPM in an advanced stage either outside of the head and neck or synchronous had poor survival.CONCLUSIONThe SPMs are a growing problem with better survival after treatment of the first malignancy.SIGNIFICANCERegular follow‐up is necessary in HNC patients to improve their survival, giving special attention to the development of SPM.
Psychosocial adjustment in patients surgically treated for laryngeal cancer
Authors: Ramirez Maria Jose Ferrer , Ferriol Enrique Estelles , Domenech Fernando Guallart , Llatas Marina Carrasco , Suarez‐Varela Maria Morales , Martinez Ramon Lopez 
Published: September 2022

OBJECTIVETo assess the psychosocial adjustment in 62 patients surgically treated for cancer of the head and neck.STUDY DESIGN AND SETTINGForty‐one patients were grouped as having had radical surgery (total laryngectomy) and 21 as having had functional surgery (horizontal supraglottic laryngectomy or partial vertical surgery). The Psychosocial Adjustment to Illness Scale‐Self Report (PAIS‐SR) was used for the evaluation.RESULTSNo significant differences were found between groups when global adjustment or domain adjustment was compared. Patients did not consider the permanent stoma and voice loss to be the most important determinant of quality of life. Work and family relationship were the domains with poorest adjustment.CONCLUSIONSocial and medical support are important factors in improving patients' self‐confidence and satisfaction, playing an important role in recovering useful phonation, psychological adjustment, and global quality of life.SIGNIFICANCEInformation collected in this way may facilitate improved rehabilitation and thus better quality of life.
Effect of amoxicillin or clindamycin on the adenoids bacterial flora
Authors: Brook Itzhak , Shah Kiran 
Published: September 2022

OBJECTIVEWe sought to compare the effect on the adenoid bacterial flora of patients with recurrent otitis media of antimicrobial therapy with amoxicillin (Am) or clindamycin (C).PATIENTS AND METHODSForty‐five children scheduled for elective adenoidectomy participated in a prospective randomized study. They were divided into 3 groups of 15 each to receive either no therapy (control) or 10 days of therapy with Am or C. Core adenoid tissues was quantitatively cultured for aerobic and anaerobic bacteria.RESULTSPolymicrobial aerobic‐anaerobic flora were present in all instances. The predominant aerobes in all groups were α‐hemolytic and γ‐hemolytic streptococci, Haemophilus influenzae, Staphylococcus aureus, group A β‐hemolytic streptococci, and Moraxella catarrhalis. The prominent anaerobes were Peptostreptococcus, Prevotella, and Fusobacterium spp. The number of isolates was significantly reduced in those treated with Am (n = 110, P < 0.05) or C (n = 58, P < 0.001) compared with control (n = 148). The number of bacteria per gram/tissue was lower in those treated with either antibiotics. The number of potential pathogens was lower in those treated with C compared with the other 2 groups (P < 0.001). The number of β‐lactamase‐producing bacteria was lower in those treated with C than in those treated with Am (P < 0.025) or control (P < 0.001).CONCLUSIONSThese data illustrate the ability of C and, to a lesser degree, of Am to reduce the bacterial load as well as potential pathogens and β‐lactamase‐producing bacteria from the adenoids of children with recurrent otitis media.
Tympanic Membrane Metalloproteinase Inflammatory Response
Authors: Wilmoth Jason G. , Schultz Gregory S. , Antonelli Patrick J. 
Published: September 2022

OBJECTIVEThe goal of this study was to determine whether expression of matrix metalloproteinases (MMP) in tympanic membranes (TM) is stimulated by host tumor necrosis factor‐± (TNF‐±) and bacterial toxin (lipopolysaccharide, LPS), which may play a role in the pathogenesis of cholesteatoma.STUDY DESIGNGerbil TMs (n = 48) were cultured in the presence of either TNF‐± or LPS. Quantitative analysis of TNF‐± and MMPs was performed on both the homogenized TMs and the culture media supernatant.RESULTSLevels of TNF‐± and MMPs did not increase significantly in TMs with exposure to inflammatory mediators. TNF‐± levels in supernatant were elevated (P < 0.007) with more concentrated LPS exposure. Supernatant levels of MMP2 were increased (P < 0.007) at most concentrations of LPS and TNF‐±.CONCLUSIONCultured TMs expressed MMPs in response to bacterial and host inflammatory mediators. These findings support a link between inflammation and the secretion of potentially destructive MMPs in the TM, which may contribute to the pathogenesis of cholesteatoma.
Comparisons of two Intranasal Corticosteroid Preparations in Treating Allergic Rhinitis
Authors: TAI Chih‐Jaan , Wang PA‐Chun 
Published: September 2022

OBJECTIVESIntranasal corticosteroid preparations can relieve symptoms of allergic rhinitis. Different aqueous corticosteroid forms have been developed for intranasal use. The objectives of this study were to compare efficacy and safety between fluticasone propionate and budesonide in the treatment for patients with allergic rhinitis.METHODSThe study was conducted in a prospective and randomized manner; a total of 24 adult patients were enrolled. All patients received MAST allergen test at entry and again at 2 months after treatments. Fourteen patients received fluticasone propionate 200 μg once daily, and 10 patients received budesonide 200 μg twice daily. To investigate the efficacy of fluticasone propionate and budesonide, a subjective scoring system was designed to evaluate the symptom improvement of patients. Adverse events were recorded on a diary card then were analyzed. Mann‐Whitney U test and Kruskal‐Wallis 1‐way analysis of variance were used for statistical analysis.RESULTSAnalysis on patient‐based symptom scores revealed that both fluticasone propionate and budesonide were equally efficacious in improving the symptoms of nasal blockage, sneezing, nasal itching, and watery rhinorrhea. There were no significant side effects reported for both groups during this follow‐up period. However, analysis showed that the fluticasone propionate group demonstrated significantly greater improvement in some MAST allergen tests (Candida, mite, house dust; P < 0.05).CONCLUSIONClinically, fluticasone propionate 200 μg once daily was efficacious as budesonide 200 μg twice daily in the relief of allergic rhinitis symptoms. However, fluticasone propionate can achieve greater immunologic improvement. Both preparations showed no evidence of short‐term side effects.
Comparing a Mechanical Device with Medicinal Leeches for Treating Venous Congestion
Authors: Hartig Gregory K. , Connor Nadine P. , Heisey Dennis M. , Conforti Michael L. 
Published: September 2022

OBJECTIVETo compare mechanical device therapy to medicinal leech therapy for treating venous congestion.STUDY DESIGNFasciocutaneous flaps of 9 × 7‐cm (porcine model, n = 11) were elevated and the associated veins clamped for 15 hours. Device‐treated flaps (n = 6) were treated with up to 3 devices/flap. Leech‐treated flaps (n = 5) were treated with 75 leeches/flap (5 leeches/hour). Treatment evaluation parameters included: blood volume removed, skin color, surface perfusion, tissue oxygen tension, and endpoint histology.RESULTSNo significant differences were seen in blood volume removed, surface perfusion, and oxygen tension. However, significant differences were seen in skin color change over time. Histological assessment showed mild congestion in 5/5 leech‐treated flaps and 2/6 device‐treated flaps.CONCLUSIONDevice therapy was comparable to leech therapy for decongesting a 9 × 7‐cm flap over a 15‐hour period. However, digital images and significant differences in skin color change over time demonstrate that device therapy promotes more global decongestion versus leech therapy.
Thyroid Function Studies in Patients with Cancer of the Larynx: Preliminary Evaluation
Authors: Aimoni C. , Scanelli G. , D'Agostino L. , Pastore Antonio 
Published: September 2022

OBJECTIVEOur goal was to evaluate thyroid function before and after surgery only or radiotherapy plus surgery for laryngeal neoplasms.STUDY DESIGN AND SETTINGThe study group consisted of a total of 30 patients with laryngeal cancer (22 treated with surgery only and 8 treated with surgery plus radiotherapy) who were evaluated by ultrasensitive thyroid‐stimulating hormone, free T4, and antithyroid antibodies both preoperatively and at 6 and 12 months after surgery.RESULTSAll patients had normal thyroid function before treatment (1 patient had elevated antithyroid autoantibodies); after 1 year, 4 (13.34%) patients were hypothyroid. In 3 patients, it was sub‐clinical (ie, elevated thyroid‐stimulating hormone with normal free T4), and in 1 patient, it was symptomatic.CONCLUSIONOur preliminary data suggest that hypothyroidism occurs in a small but substantial proportion of patients undergoing surgery with or without adjuvant radiotherapy for laryngeal cancer.SIGNIFICANCEThyroid hormone dosing should be routinely included in the assessment of patients with laryngeal cancer, because it is simple and inexpensive and may allow the early diagnosis and management of hypothyroidism. (Otolaryngol Head Neck Surg 2003;129:733‐8.)
Surgical Management of Amiodarone‐Induced Thyrotoxicosis
Authors: Franzese Christine B. , Fan Chris Y. , Stack Brendan C. 
Published: September 2022

OBJECTIVEAmiodarone can cause thyroid dysfunction in patients with or without previous thyroid disease. With increased use from its placement in advanced cardiac life support guidelines and cardiac transplant programs, the incidence of amiodarone‐induced thyrotoxicosis (AIT) will likely increase. Medical management is complex and nonuniform and frequently fails. This study investigates the role of surgery in AIT and proposes indications for surgical management.STUDY DESIGN AND SETTINGTwo AIT case reports at a tertiary care institution and 31 surgical AIT cases in the world literature are reviewed.METHODSThe 2 AIT cases involved patients with cardiomyopathy and resistant arrhythmias. Despite medical therapy, both patients' conditions failed to improve. Thirty‐one surgical cases of AIT in the literature are evaluated with respect to symptoms and onset, medical therapy, AIT classification, pathology, perioperative management, and complications.RESULTSBoth patients underwent total thyroidectomy without difficulty or complication, one as an overnight stay and one as an inpatient with an intraaortic balloon pump. One patient received a successful cardiac transplant and the other remains a viable candidate. In the literature, the majority (80%) of surgical cases are AIT type II (less common type) with no underlying thyroid disease. Range and duration of symptoms varied, in addition to type and duration of medical management. Almost all patients underwent total thyroidectomy, and all were successful with no mortality and minimal morbidity.CONCLUSIONAIT can develop in any patient during or after amiodarone therapy. Medical management is extremely difficult due to the absence of a proven therapeutic armamentarium, and surgery offers a safe, viable option. Surgical management should play a larger role in treatment algorithms and should be strongly considered for patients whose conditions necessitate continuation of amiodarone, or with severe symptoms resistant to medical therapy.