bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment outcome of N3 nodal head and neck squamous cell carcinoma
Authors: Chan Sor W. , Mukesh Bickol N , Sizeland Andrew 
Published: September 2022

OBJECTIVEThe aim of this study was to investigate the treatment outcome of N3 nodal disease.STUDY DESIGNA single institution retrospective nonrandomized study was conducted. A total of 53 patients with primary presentation of squamous cell carcinomas from various head and neck sites from 1980 to 1994 were recruited for this study. Eight patients with nasopharyngeal cancers who underwent treatment with palliative intent were excluded from the study. Treatment options were broadly divided into 4 treatment categories; postoperative radiotherapy; preoperative radiotherapy; surgery alone; and chemotherapy pre‐ or postoperatively with or without radiotherapy.RESULTSMean age of the participants was 63 years (SD = 8.2); 93% were men. Median follow‐up period was 12 months (range, 5 to 184 months). Of the 45 N3 patients, 21 patients had a recurrence in the neck after treatment, with 1 in the contralateral neck. The overall rates of control in the neck at 1, 3, and 5 years were 73.1%, 34.6%, and 26.9%, respectively. The 1, 3, and 5‐year neck control rates for each main group were 92.3%, 46.1%, and 46.1% with postoperative radiotherapy; 66.7%, 33.3%, and 11.1% with preoperative radiotherapy and 33.3%, 0%, and 0% with surgery alone. Overall survival rates at 1,3, and 5‐years were 52.8%, 25%, and 22.2%. Survival rates in those who received radiotherapy were better than those who only had surgery. The 5‐year survival rate was significantly higher for those who had postoperative radiotherapy (38.9%) compared with patients who had preoperative radiotherapy (9.1%) and surgery alone (0%).CONCLUSIONOur treatment outcomes, particularly those in the group receiving postoperative radiotherapy, were similar to other studies. The prognosis of N3 neck disease was poor but improved with radiotherapy, particularly postoperative radiotherapy. The role of definitive chemotherapy and/or radiotherapy and salvage surgery is difficult to evaluate as the results are inconsistent and the available data are limited. Future studies in particular with quality of life assessment are needed to evaluate the management of N3 head and neck cancer.
Congenital aural atresia surgery: Long‐term results
Authors: De La Cruz Antonio , Teufert Karen Borne 
Published: September 2022

OBJECTIVESThe study goal was to evaluate the stability of hearing results from short‐ to long‐term follow‐up in patients who underwent surgery for congenital aural atresia. We also reviewed complications such as external auditory canal stenosis, lateralization and perforation of the tympanic membrane, sensorineural hearing loss, and facial palsy.METHODSWe conducted a retrospective chart review of 116 patients who underwent congenital aural atresiaplasty between 1985 and 2002 at the House Ear Clinic. There were 116 atretic ears. Complication rates and short‐ and long‐term (up to 13.6 years) hearing results were evaluated for primary and revision cases.RESULTSClosure of the air‐bone gap (ABG) to 30 dB or less at short‐term follow‐up occurred in 58.5% of primary surgeries and 56% of revisions. The long‐term postoperative ABG was 30 dB or less in 50.8% of the primary cases and 39.1% of the revisions. Paired comparison analysis found no significant change in ABG from short‐ to long‐term follow‐up for either primary or revision cases. Soft tissue stenosis was seen in 8% of primary surgeries and 3.4% of revisions. Ossicular chain refixation was seen in 11.5% and 6.9% of primary and revision surgeries, respectively. There were no dead ears.CONCLUSIONAtresiaplasty surgery in individuals with congenital aural atresia can yield reliable, lasting hearing results with a low incidence of complications.
Middle ear epithelial mucin production in response to interleukin 1β exposure in vitro
Authors: Kerschner Joseph E. , Meyer Tanya K. , Wohlfeill Eric 
Published: September 2022

OBJECTIVESTo investigate the role of the inflammatory cytokine interleukin‐1β (IL‐1β) in the regulation of mucin secretion by middle ear epithelia.STUDY DESIGN AND SETTINGPrimary chinchilla middle ear epithelial cultures were established and exposed to IL‐1β in a dose‐ and time‐dependent manner. Mucin secretion was characterized by exclusion chromatography and liquid scintillation.RESULTSEpithelial cultures exposed to increasing doses of IL‐1β demonstrated greater amounts of mucin secretion (P = 0.007). Additionally, cultures exposed to IL‐1β at 50 ng/mL showed increased secretion of mucin over control noticeable at 6 hours, but significant at the 15‐ and 24‐hour time points (P >. 0001 for each).CONCLUSIONSIL‐1β upregulates mucin secretion from cultured middle ear epithelial cells in a dose‐and time‐dependent manner.SIGNIFICANCEElucidating the effect of specific cytokines on the regulation of mucin secretion is vital to understanding the pathophysiology of otitis media and the development of novel therapeutic strategies.
Endoscopic Modified Lothrop Procedure for the Treatment of Chronic Frontal Sinusitis: A Systematic Review
Authors: Scott N. Ann , Wormald Peter , Close David , Gallagher Richard , Anthony Adrian , Maddern Guy J. 
Published: September 2022

OBJECTIVEWe sought to assess the safety and efficacy of the endoscopic modified Lothrop procedure (EMLP), performed either wholly intranasally or in combination with an external approach, against the osteoplastic flap (OPF) procedure with or without fat obliteration.METHODSAll original, published studies on the EMLP and the OPF, with or without fat obliteration, were identified by searching Current Contents, Em‐base, MEDLINE, and The Cochrane Library. The search strategy for OPF was date‐restricted to articles published after 1979 until February 2001. For both EMLP and OPF, only studies of patients diagnosed with chronic frontal sinusitis were included for review. English‐language reports detailing randomized controlled trials, controlled clinical trials, case series, or case reports were included.RESULTSThe limited comparative data suggested that EMLP caused fewer adverse postoperative outcomes but was more likely to generate a perioperative cerebrospinal fluid leak than OPF. However, none of the morbidity traditionally associated with OPF was evident after EMLP. EMLP appeared to have a shorter operative time and a lower perioperative blood loss than OPF, but little could be determined regarding the long‐term efficacy and durability of EMLP because of the relatively short follow‐up of the majority of the studies.CONCLUSIONThe evidence base for EMLP was deemed inadequate to assess its safety and efficacy, and an audit of the procedure was recommended. Additional clinical recommendations were made regarding the development and current practice of EMLP during this audit phase.
The Role of Chromosomal Translocation (15;19) in the Carcinoma of the Upper Aerodigestive Tract in Children
Authors: Rahbar Reza , Vargas Sara O. , Miyamoto Christopher R. , Perez‐Atayde Antonio R. , French Christopher A. , Robson Caroline D. , Licameli Greg R. , Fletcher Jonathan A. , Marcus Karen C. , Grier Holcombe E. , McGill Trevor J. , Healy Gerald B. 
Published: September 2022

OBJECTIVETo further evaluate the role of chromosomal translocation (15;19) in the presentation of the carcinoma (CA) of the upper aerodigestive tract.STUDY DESIGN AND SETTINGA retrospective study at a tertiary care pediatric medical center.RESULTSSeven patients with a mean age of 12 years presented with CA of nasopharynx (N = 2), sinonasal region (N = I), parotid gland (N = 2), or larynx (N = 2). Treatments included combinations of surgery (N = 5), chemotherapy (N = 5), and radiation therapy (N = 4). One patient with sinonasal CA and one patient with laryngeal CA had chromosomal translocation (15;19); these patients both died of their disease with a mean survival of 6 months. The 5 patients without translocation (15;19) responded well to treatment and are disease‐free with a mean follow‐up of 47 months.CONCLUSIONThe preliminary results appear to indicate poor prognosis associated with the presentation of chromosomal translocation (15;19) despite aggressive multi‐modality treatment. Further investigation is needed to better understand the cause and relationship of the translocation (15;19) and aggressive behavior of these tumors. (Otolaryngol Head Neck Surg 2003;129:698‐704.)
Gastroesophageal Reflux Disease: Symptoms Versus pH Monitoring Results
Authors: Yorulmaz Irfan , Ozlugedik Samet , Kucuk Babur 
Published: September 2022

OBJECTIVESThe reason why some patients with gastroesophageal reflux disease (GERD) have symptoms of upper aerodigestive system irritation, while others mainly have gastroenterologic symptoms, is not well established. This retrospective case series study was designed to examine the existence of a correlation between symptoms and reflux characteristics, based on data obtained from esophageal pH monitoring.METHODSThe study population consisted of 139 patients; 97 patients presented with laryngopharyngeal symptoms of GERD, including unexplained hoarseness, throat clearing, chronic cough, laryngospasm, globus, throat pain, and 42 patients presented with gastroenterologic symptoms, including heartburn and regurgitation. The results of 24‐hour, double‐channel ambulatory esophageal pH monitoring were analyzed comparing 2 symptom groups. The incidence of abnormal acid reflux at the upper and lower esophageal segments and the effects of upright and supine positions on reflux parameters were evaluated.RESULTSThe incidence of laryngopharyngeal reflux was significantly higher in the laryngopharyngeal symptom group than in the other (52% versus 38%). The patients with laryngopharyngeal reflux from both groups showed no significant differences in terms of number of acid reflux episodes, percentage of times pH was <4, and esophageal acid clearance. Upright and supine parameters did not show significant differences between the patient groups. Upright acid reflux episodes were, however, common in both groups at the lower esophageal and laryngopharyngeal segments.CONCLUSIONRecent studies suggesting that otolaryngologic patients commonly show upright, daytime reflux with normal esophageal clearance and that typical GERD patients commonly have supine, nocturnal reflux with prolonged esophageal clearance are not supported by this study. This study indicates that acid reflux parameters and positional changes are not sufficient to explain why patients with GERD experience different symptoms. The regional symptoms of GERD may be attributed to the impairment of epithelial resistance, motor activity, and buffering systems for the esophageal antireflux barrier.
Intranasal anesthetic effects of lidocaine and tetracaine compared
Authors: Noorily Allen D. , Otto Randal A. , Noorily Susan H. 
Published: September 2022

The quality of nasal anesthesia obtained with two local anesthetic solutions (2% lidocaine in oxymetazoline and 1% tetracaine in oxymetazoline) was evaluated in this double‐blind, randomized study. Each local anesthetic mixture was applied to the nasal septum of healthy volunteers with medication‐soaked pledgets. Measurements of anesthetic effect (sensation threshold and pain perception) were made with Semmes‐Weinstein monofilaments (North Coast Medical, San Jose, Calif.). Measurements were performed before local anesthetic application and at 10 and 70 minutes after local anesthetic application. Subjects had greater increases in sensation threshold with tetracaine than with lidocaine at both 10 and 70 minutes (p = 0.0005 and p = 0.0001, respectively). Subjects had greater decreases in pain perception with tetracaine than with lidocaine at both time intervals (p = 0.0003 and p < 0.0001, respectively). Tetracaine mixed with oxymetazoline appears to be a superior topical anesthetic for nasal procedures.
Modified transnasal endoscopic lothrop procedure as an alternative to frontal sinus obliteration
Authors: Gross William E. , Gross Charles W. , Becker Daniel , Moore David , Phillips Douglas 
Published: September 2022

Persistent frontal sinusitis traditionally has been treated with external procedures such as osteoplastic frontal sinus obliteration or the Lynch procedure. Currently, functional endoscopic sinus surgery can be used in most cases to remove disease from the frontal recess, the most frequent site of frontal sinus obstruction, thereby relieving the sinusitis. In some cases, however, frontal recess exploration has failed to relieve the obstruction of the frontal sinus, necessitating an osteoplastic frontal sinus obliteration. We present our experience with a transnasal modification of the Lothrop procedure. The Lothrop procedure, first described in 1914, uses a combined external and transnasal approach to resect the median frontal sinus floor, superior nasal septum, and intersinus septum to drain the frontal sinus. This procedure was largely abandoned and forgotten by modern otolaryngologists. However, with the advent of the computed tomography scan and endoscopic techniques, we sought to reassess the basic tenant of the Lothrop procedure (i.e., wide median frontal sinus drainage). An anatomic study of cadaver heads was performed to quantify the surprisingly large potential opening and to better understand the pertinent anatomy. This procedure was performed on 10 patients, with no resulting complications and no failure to maintain patency of the frontal sinus drainage throughout the follow‐up period (mean, 7 months). We are encouraged by our initial favorable results and intend to use the procedure in the future as needs arise.
Levels of Eosinophil Cationic Protein and Myeloperoxidase from Chronic Middle Ear Effusion in Patients with Allergy and/or Acute Infection.
Authors: Hurst David S. , Venge Per 
Published: September 2022

BACKGROUND AND OBJECTIVE: Allergy may play a role in the middle ear inflammation that leads to otitis media with effusion. The purpose of this study was to determine whether an elevated mediator correlated with the patient's disease and thus could be used to differentiate allergy vs. infection as the cause of the middle ear inflammation.METHODS: We evaluated 57 individuals with otitis media with effusion, 32 with persistent effusion but no recent acute infection, 14 with recent infection and purulent otitis media with effusion, and 11 healthy subjects. The mediator activity of eosinophils and neutrophils in effusion was studied in patients characterized as having allergy by positive intradermal skin test results and positive radioallergosorbent test results. Eosinophils were characterized by measurement of eosinophil cationic protein in the effusion. Neutrophils were characterized by measurement of myeloperoxidase in the effusion. The levels of eosinophil cationic protein and myeloperoxidase in patients with and without allergy were correlated to patient history.RESULTS: Significantly elevated levels of both eosinophil cationic protein and myeloperoxidase indicated that inflammation in the ear of patients with otitis media with effusion was characterized by a pronounced involvement of both eosinophils and neutrophils. Eighty‐nine percent of all patients with disease had allergy. A higher ratio of myeloperoxidase to eosinophil cationic protein in patients with purulent otitis media with effusion indicated that in patients with a superimposed acute infection, neutrophil activity was increased even further. The level of eosinophil cationic protein was elevated only during the effusion of patients with allergies as compared with controls (p < 0.01). Among 29 cases of nonpurulent otitis media with effusion, 96.5% had allergic immune‐mediated disease proved by skin testing, which was related clinically to their ear disease. Eighty‐nine percent (89.6%) of these patients had eosinophil cationic protein levels greater than 10 μg/L.CONCLUSION: Middle ear eosinophil cationic protein may be used as a marker of related allergy.
Otitis Media Incidence and Impact on the Auditory Brain Stem Response in Lipopolysaccharide‐Nonresponsive C3H/HeJ Mice
Authors: Mitchell Curtin R. , Kempton J. Beth , Scott‐Tyler Brenda , Trune Dennis R. 
Published: September 2022

Although mice of the C3H strain normally respond to bacterial lipopolysaccharide with appropriate immune system activation, mice of the C3H/HeJ substrain do not because of a gene defect. This suggests they may be more susceptible to opportunistic bacterial infections and more likely to have otitis media than a normally responding substrain, such as the C3H/HeSnJ. Therefore these two substrains were evaluated for incidence of spontaneous middle ear disease at 2, 4, 6, 10, 12, 15, and 18 months of age. Auditory brain stem response audiometry to pure tones of 4, 8, 16, 24, and 32 kHz was performed to establish the impact of middle ear disease on auditory function. None of the lipopolysaccharide‐responsive C3H/HeSnJ mice demonstrated middle ear disease. However, middle ear disease was present in 33% of the C3H/HeJ mice. The conductive loss caused by the otitis media resulted in auditory brain stem response threshold shifts of 15 to 40 dB SPL, lowered peak amplitudes, and increased latencies. Reduced lipopolysaccharide responsiveness by C3H/HeJ mice makes them less capable of reacting immunologically to bacterial infection and presumably underlies the failure to clear middle ear disease. The C3H/HeJ mouse may provide a valuable model in which to study lipopolysaccharide biologic activity and related middle ear inflammatory or immune mechanisms.
The Clavipectoral Osteomyocutaneous Free Flap
Authors: Seikaly H. , Calhoun K. , Rassekh Christopher H. , Slaughter D. 
Published: September 2022

Microvascular free tissue transfer has revolutionized head and neck reconstruction and currently is considered the most successful and reliable method of primary oromandibular reconstruction. This study was designed to assess the feasibility of full thickness free vascularized transfer of the clavicle based on the clavicular branch of the thoracoacromial artery and the soft tissue component associated with the thoracoacromial axis. Forty dissections of the pectoral region were performed on 26 cadavers. The anatomic relations of the region and the thoracoacromial arterial and venous systems were documented in detail. Selective ink injections of the thoracoacromial arterial branches were also performed on fresh cadavers. The clavicle was supplied mainly by the clavicular artery (medial three quarters), with minor contribution from the deltoid artery (lateral quarter). An average of 16.1 cm (range of 12 to 20 cm) was obtained with total clavicular harvest and the clavicle had sufficient width and height to support dental implants. Two soft tissue donor sites were associated with the thoracoacromial artery: the sternocostal head of the pectoralis major muscle, with the overlying skin supplied by the pectoral artery, and the clavicular head of the pectoralis major muscle, with the overlying skin supplied by the deltoid and clavicular arteries. Sensory innervation of the upper chest was supplied through the supraclavicular nerves, whereas the lateral pectoral nerve supplied motor innervation to both heads of the pectoralis major muscle. The anatomy of the clavipectoral donor site and the first case of full thickness free clavicular transfer for mandibular reconstruction in the English literature are presented. The donor site is an excellent source of well vascularized, thin, pliable, hairless, potentially innervated (motor and sensory) soft tissue, along with up to 20 cm of clavicular bone. The surgical anatomy is familiar to the head and neck surgeon. The harvesting does not require repositioning of the patient and is amenable to a two‐team, simultaneous approach. The functional and cosmetic donor site morbidity is minimal even with clavicular harvest. The major disadvantage of this flap is the relatively short pedicle. The authors conclude that the thoracoacromial system provides a free flap with osseous and soft tissue components that are well suited for oromandibular reconstruction.
Clinical Correlations with Allelotype in Supraglottic Squamous Cancer
Authors: Scholnick Steven B. , El‐Mofty Samir K. , Shaw Martha E. , Sunwoo John B. , Haughey Bruce H. , Sun Paul C. , Piccirillo Jay F. , Zequeira Maria R. 
Published: September 2022

Frequent allelic loss at a genetically polymorphic locus in tumors is an established marker for the presence of a tumor suppressor gene in the neighboring chromosomal region. This technique can be used to identify novel tumor suppressor genes and to monitor their status before the cloning of the gene itself. We have used the polymerase chain reaction and microsatellite loci on all 39 nonacrocentric autosomal chromosomal arms to identify sites of frequent allelic loss in squamous cell carcinomas of the supraglottic larynx. Our allelotype identified seven chromosomal arms (3p, 5q, 8p, 9p, 9q, 13q, and 17p) likely to contain tumor suppressor genes frequently inactivated during squamous tumorigenesis in the larynx. We tested for associations between allelic losses on these chromosomal arms and the clinical and histopathologic features of these tumors. There were no correlations with either T or N classifications. Allelic loss on chromosomal arm 13q is significantly associated with a number of histopathologic features characteristic of poorly differentiated or histologically aggressive tumors. Allelic loss on this arm also exhibits statistical trends toward association with early tumor recurrence and poor survival. The association with survival was substantiated by a multivariate Cox proportional hazards model.
A choking(?) engine of war: Human agency in military targeting reconsidered
Authors: Danielsson Anna , Ljungkvist Kristin 
Published: September 2022

AbstractThis article explores the question of human agency in military targeting. Targeting is one of the key drivers of war. When studied by academic disciplines, much interest has been devoted to the ethics and effects of military targeting. Less debated, but focused here, is the question of the conditions of human agency within military targeting. In the literature that does exist on this topic, there is a questioning of the traditional conception of human agency but at the same time a lack of closer conceptualisation of different kinds of articulations of human agency in the targeting process. In this article, we propose a recentring of human agency in critical scholarship on military targeting. With inspiration from Theodore Schatzki's work on ‘practice’, by analytically approaching targeting as a practice, and through various examples from Operation Iraqi Freedom, the article develops and illustrates a framework for the conceptualisation of human agencies in targeting. This framework distinguishes articulations of agency based on whether they furthered the (temporary) ordering of the targeting practice or challenged its internal organising elements. The study of military targeting is significant not least since the phenomenon is one of the key ‘engines’ and drivers of war's constant becoming.