bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Epidermal Growth Factor on Tympanic Membranes with Chronic Perforations: A Clinical Trial
Authors: Ramsay Hans A. , Heikkonen Erkki J. , Laurila Pekka K. 
Published: September 2022

Epidermal growth factor is an important modulator of cell growth, and its role in normal wound healing is well documented. Epidermal growth factor receptors have been identified in tympanic membranes of different animals. The ability of epidermal growth factor to promote healing of tympanic membrane perforations has recently been shown in experimental animals. We performed a double‐blind, placebo‐controlled study of the effect of epidermal growth factor applied locally on the tympanic membrane for 1 week in patients with chronic perforations. Seventeen adult patients took part in the study, eight in the epidermal growth factor group and nine in the placebo group. Three placebo‐treated patients were later treated with epidermal growth factor, and five patients received repeated epidermal growth factor treatment. Perforation size was measured as a percentage of the tympanic membrane area before and at least 1 month (mean, 2.6 months) after treatment. One perforation in the placebo group healed completely, but none of the epidermal growth factor‐treated perforations closed. Perforations became slightly smaller in both groups (mean decrease, 0.3% and 2.7% for epidermal growth factor and placebo, respectively), but these changes in size were not statistically significant for either group. At otomicroscopy, a proliferation reaction with thickening of the tympanic membrane and pseudomembrane formation at the perforation edge could be seen in some ears. Histologically, a sample from one epidermal growth factor‐treated ear demonstrated signs of hypertrophic epithelium when compared with the morphology of a placebo‐treated tympanic membrane. The only complications were two mild infections in the placebo group. Hearing remained stable after epidermal growth factor treatment.
Surgical treatment of cholesteatoma in children
Authors: Mutlu Cemil , Khashaba Ahmad , Saleh Essam , Karmarkar Sandeep , Bhatia Sanjaya , Dedonato Giuseppe , Russo Alessandra , Sanna Mario 
Published: September 2022

Treating cholesteatoma in children is still controversial. This article reviews 93 cases of pediatric cholesteatoma operated on from 1983 to 1991 in the Gruppo Otologico, Piacenza, Italy, and details the results in 83 children who underwent the intact canal wall technique. During second‐stage surgery, residual cholesteatoma was detected in 38% of patients. Recurrent cholesteatoma was detected in 10% of patients treated with the intact canal wall technique. Residual cholesteatoma was seen in the middle ear cleft in 63%, in the epitympanum in 26%, and in the mastoid in 11% of cases. Social hearing level (< 25 dB) was achieved in 85% of cases with suprastructure, whereas only 53% of patients without suprastructure had these levels. In the treatment of cholesteatoma in children by use of the intact canal wall technique, a preplanned second‐look operation is mandatory to eradicate the disease.
False‐positive magnetic resonance imaging of small internal auditory canal tumors: A clinical radiologic, and pathologic correlation study
Authors: Arriaga Maj Moises A. , Carrier Ltc David , Houston Col Glenn D. 
Published: September 2022

Magnetic resonance imaging with gadolinium facilitates the early diagnosis of internal auditory canal tumors at a small enough stage to permit increasing application of hearing preservation surgical techniques. Surgeons report successful removal of tumors as small as 3 mm, which are diagnosed with enhanced magnetic resonance imaging. A retrospective study was performed to determine the risk of false‐positive “tumor” diagnosis with enhanced magnetic resonance imaging. We reviewed the imaging records, office notes, and surgical records of 112 consecutive “tumors” involving the internal auditory canal treated by the Wilford Hall USAF Medical Center Neurotology Service between July 1991 and July 1994. Two categories of false‐positive magnetic resonance imaging were Identified: (1) surgically confirmed absence of internal auditory canal neoplasm and (2) spontaneous resolution of the internal auditory canal lesions on subsequent, enhanced magnetic resonance images. Overall, eight false‐positive scans were identified. Three were surgically confirmed as false‐positive, and five resolved on subsequent Imaging studies. All cases were smaller than 6 mm and involved the distal internal auditory canal (fundus). The surgically confirmed cases were approached through a middle fossa technique with successful hearing preservation. The overall rate of surgical false‐positive results was 3.5% (3 cases in 86 surgeries). However, the overall false‐positive rate for intracanalicular “tumors” was 32% (8 cases in 25 intracanalicular lesions). Although hearing preservation is more likely in small lesions, the surgeon must consider the possibility that an internal auditory canal lesion smaller than 6 mm may actually represent a nonneoplastic process. Enhancing lesions limited to the internal auditory canal fundus may be treated by reimaging the patient in 6 months after the first image rather than by prompt surgical exploration.
Comparison of tunable dye and ktp lasers in nonsurgical delay of cutaneous flaps
Authors: Odland Rick M. , Rice Reginald D. 
Published: September 2022

PROBLEM: Reproducing the benefits of the delay phenomenon without the risks and cost of a surgical procedure has long been a goal of skin flap physiologists. After the success of the suture‐delay technique and argon tunable dye laser in improving survival in McFarlane skin flaps, important questions remained: (1) will laser delay be effective in dermal flaps, (2) can induction of collateral blood flow be documented, and (3) is the KTP laser, which is generally more available to otolaryngologists, more effective than the argon tunable dye laser.METHODS: The KTP and argon tunable dye lasers were compared by use of the laser‐delay technique, with two outcome measures‐blood flow and survival. The laser‐delay procedure was accomplished with the laser in a noncutting mode in an attempt to coagulate cutaneous vessels at the periphery of a planned skin flap. The objective was to induce collateralization and improve skin flap survival. Patterns of blood flow were tested by use of the base occlusion test. Flap survival of an acute control flap group was compared with that of the laser delay groups.RESULTS: Blood flowing to the distal flap area originated from the base of the flap area after laser delay. Flap survival of the laser delay groups was significantly improved over that of the control group.CONCLUSION: Both lasers were able to effectively induce collateralization and improve flap survival.
Use of intraoperative neuromonitoring to prevent orbital complications in ethmoid sinus surgery
Authors: Keyser Jeffrey S. , Diaz‐Ordaz Ernesto , Samson Michael J. , Kartush Jack M. 
Published: September 2022

Orbital injury is one of the most serious complications in sinus surgery. Although these injuries are generally infrequent, there is a considerable increased risk for orbital complications during procedures in which anatomic landmarks are distorted because of the severity of disease or prior surgery. Currently there are no methods to detect early defects in the lamina papyracea or to prevent continued resection until orbital fat or periorbita is seen. Thirteen New Zealand white rabbits were studied by use of a nerve monitor to identify the periorbita and orbital fat in surgically created lamina defects. Evoked potentials were measured at the medial orbit when the lamina papyracea, periorbita, and orbital fat were stimulated at current intensities ranging from 0.25 to 1.00 mA. Stimulation of the lamina at 0.8 and 1.0 mA resulted in response amplitudes that were significantly lower compared with those of periorbita stimulation (means at 1 mA, 38.26 μV vs. 117.85 μV; p < 0.01). Stimulation of the orbital fat also resulted in higher potentials (mean, 59.47 μV) than those of the lamina papyracea (mean, 38.26 μV) but did not reach statistical significance. The statistically significant difference in response amplitudes between the lamina papyracea and the periorbita indicate that intraoperative monitoring may be useful in identifying early lamina defects, which could in turn reduce the risk of orbital injury during sinus surgery. (OTOLARYNGOL HEAD NECK SURG 1995;113:99‐103.)
Calvarial Bone Repair with Porous D,L‐Polylactide
Authors: Schwartz Ilsa , Robinson Burke P. , Hollinger Jeffrey O. , Szachowicz Edward H. , Brekke John 
Published: September 2022

Bone is a storehouse of biologic factors enabling it to regenerate without scar formation. Recombinant technology has made many of these factors available in significant quantity for therapeutic applications. However, a system to deliver recombinant bone‐regenerating factors is needed. Biodegradable, biocompatible polymers have shown promise for delivering bone regenerative factors, such as bone morphogenetic protein. The polymer we selected to investigate was racemic d l‐polylactide. Our immediate objective was to engineer porous d l‐polylactide to promote bone ingrowth (osteoconduction). We tested the hypothesis that porous d, l‐polylactide implanted in a standard intraosseous calvarial wound would not hinder but would support bone regeneration. Therefore porous polylactide disks (65% void volume) were manufactured with pores ≤ 100 μm, ≤ 200 μm, and ≤ 350 μm; implanted in rabbits’ calvariae, and retrieved 1, 2, 4, and 6 months after insertion. Quantitative histomorphometry revealed a possible relationship in the amount of bone ingrowth with increasing pore size over time. The d l‐polylactide disks ≤350 μm had the greatest quantity of bone ingrowth (≤0.05). However, a disturbing finding was the multinucleated giant cell response associated with all implanted disks. We speculate these cells may have produced an inhospitable environment stifling osteoconduction. Consequently, postsynthesis engineering refinements of d l‐polylactide to eliminate the giant cell response are crucial before loading with bone morphogenetic protein.
Inhibition of Head and Neck Squamous Cell Carcinoma Cell Lines by Transforming Growth Factor‐β
Authors: Briskin Kenneth B. , Fady Catherine , Mickel Robert A. , Wang Marilene , Lichtenstein Alan 
Published: September 2022

Transforming growth factor‐β is known to be a potent autocrine growth inhibitor produced by a wide variety of cells, including cells of the immune system. Other investigators have noted that the growth of nontransformed keratinocytes is inhibited by transforming growth factor‐β, whereas various carcinoma cell lines are resistant to these effects. Head and neck squamous cell carcinoma cells are known to have surface receptors for this cytokine. We thus assessed the effect of transforming growth factor‐β on the growth of head and neck squamous cell carcinoma cell lines. Four head and neck squamous cell carcinoma cell lines were incubated with varying concentrations of transforming growth factor‐β, and cytotoxicity was evaluated with a methylene blue colorimetric assay. After culturing in transforming growth factor‐β for 4 days, inhibition of growth was detected in CAL‐27 (maximal inhibition at 5.0 ng/ml), UMSCC‐1, and UMSCC‐19 (maximal inhibition at 50 ng/ml) cell lines. One other cell line, UMSCC‐8 was found resistant to the inhibitory effects of transforming growth factor‐β. Kinetics analysis experiments revealed minimal inhibition before day 2 of incubation, at which time inhibition increased linearly to day 4. Assessment of double‐stranded DNA fragmentation suggested that DNA fragmentation occurs before significant cytotoxicity. Electron microscopic analysis and gel electrophoresis of extracted DNA revealed morphologic features consistent with apoptotic cell death. Our findings indicate that transforming growth factor‐β significantly inhibits the growth of head and neck squamous cell carcinoma cell lines by inducing apoptotic cell death.
Effects of contralateral white noise stimulation on transitory evoked otoacoustic emissions in patients with acoustic neuroma
Authors: Maurer J. , Hinni M. , Beck A. , Mann W. 
Published: September 2022

Transitory evoked otoacoustic emissions are normal phenomena observed in most persons with hearing levels greater than 35 dB. Further, masking of the contralateral ear produces amplitude reductions in the transitory evoked otoacoustic emissions. We have undertaken a study of transitory evoked otoacoustic emissions in 20 patients with acoustic neuroma. All patients were assessed for transitory evoked otoacoustic emissions bilaterally, with and without contralateral masking with white band noise at 40, 50, and 60 dB. We found that transitory evoked otoacoustic emissions were present in 30% of ears with tumor and that the presence of transitory evoked otoacoustic emissions is associated with improved preoperative hearing levels, but that tumor size is not associated with the presence or absence of transitory evoked otoacoustic emissions. The amplitude of transitory evoked otoacoustic emissions from ears with tumor, when present, is decreased when compared with normal ears of normal patients. Further, with contralateral masking little of the amplitude reduction observed in normal patients is observed in the ears with acoustic neuroma. However, with masking of the contralateral ear, the ear without tumor demonstrated significantly greater amplitude reductions than normal ears from normal patients (p = 0.0006). Pertinent anatomy and possible explanations for these findings are discussed.
Perilesional interleukin‐2 in the VX‐2 carcinoma in rabbits: A preliminary investigation
Authors: Carroll William R. , Bunge Frederick R. , Wolf Gregory T. , Carey Thomas E. , Mcclatchey Kenneth D. , Poore Judy 
Published: September 2022

Immune system amplification by perilesional injection of interleukin‐2 is a promising adjuvant approach for treating squamous cell carcinoma of the head and neck. A pilot study was designed to develop an animal model bearing squamous cell carcinoma in which to test the efficacy of perilesional interleukin‐2. Rabbits were inoculated intramuscularly with the papilloma virus‐induced squamous carcinoma VX‐2 cell line. Tumor regression and host lymphatic response after perilesional interleukin‐2 were measured. Variable responses were found. Growth of tumor cells implanted from cell culture was rapid in most animals. Tumor growth was prevented in animals receiving 10,000 units of interleukin‐2 per injection initiated 9 days after tumor inoculation. This inhibition approached statistical significance when compared with growth of saline controls. Histologic responses consisted primarily of plasma cell and eosinophil infiltration. The intensity of the inflammatory response did not correlate with interleukin‐2 dose. A trend toward enhanced tumor growth was seen with lower doses of interleukin‐2 and when inferleukin‐2 therapy was initiated simultaneously with tumor inoculation. These findings suggest that high‐dose recombinant interleukin‐2 can prevent tumor growth if initiated after tumor inoculation. Whether this effect was caused by direct tumor cytotoxicity or mediated by the immune system is unclear. These preliminary results underscore the importance of understanding the effects of dose and schedule in the design of immunotherapy models before Clinical use.
Thermal Imaging of the Temporal Bone in CO2 Laser Surgery: An Experimental Model
Authors: Wong Brian J. F. , Lee Jon , Hashisaki George T. , Berns Michael W. , Neev Joseph 
Published: September 2022

The unique properties of lasers create an enormous potential for specific treatment of chronic ear disease. Despite the widespread acceptance and use of the laser, however, a complete understanding of the time‐ and space‐dependent temperature distribution in otic capsule bone immediately after pulsed laser exposure has not been elucidated. Using a liquid nitrogen‐cooled mercury‐cadmium telluride infrared detector, the temperature distribution in human cadaveric otic capsule bone was determined immediately after pulsed (100 msec) carbon dioxide laser exposure (0.3 to 4.0 W; 200 urn spot diameter). The time‐ and space‐dependent temperature increases and thermal diffusion were determined as a function of the laser power density and were found to vary linearly.
A comparison of ibuprofen versus acetaminophen with codeine in the young tonsillectomy patient
Authors: St. Charles Christopher S. , Matt Bruce H. , Hamilton Mark M. , Katz Barry P. 
Published: September 2022

OBJECTIVETo compare the use of ibuprofen with the use of acetaminophen with codeine for posttonsillectomy management.BACKGROUNDWe were not satisfied with our traditional pain‐management practice for tonsillectomy patients. We hoped to find a new approach for improved patient comfort and avoid scheduled, abusable drugs such as codeine.DESIGNIntervention, prospective, randomized control trial. Follow‐up was 1 month.SETTINGUniversity referral center; institutional pediatric practice, ambulatory.PATIENTS110 children undergoing tonsillectomy with or without other procedures. Consecutive patients were offered participation. Enrollees were randomly assigned to one of two classes and analyzed with the initial assignment. No patients withdrew for adverse effects, although 12 in group 2 used codeine and 5 of those used acetaminophen, whereas 2 in group 1 received ibuprofen.INTERVENTIONSPatients received either acetaminophen with codeine (group 1) or ibuprofen (group 2) for postoperative pain control.MAIN OUTCOME MEASURESThe main outcomes, determined before initiation of the study, were assessment of (1) postoperative bleeding, (2) pain, (3) efficacy of relief of pain by drug, (4) nausea, (5) emesis, (6) readmission to hospital, (7) average temperature, and (8) highest temperature after surgery.RESULTSThe only statistically significant difference is less nausea in patients receiving ibuprofen (p = 0.0049). Of note, no difference existed in postoperative bleeding, pain, or temperature control.CONCLUSIONSIbuprofen is at least as effective as acetaminophen with codeine for postoperative pain control in children after tonsillectomy. (Otolaryngol Head Neck Surg 1997;117:76–82.)
Posterior Cervical Rhytidectomy: A Valuable Adjunct in Facial Rejuvenation Surgery
Authors: Campbell Jeffrey P. , McCollough E. Gaylon , Metzinger Stephen E. 
Published: September 2022

OBJECTIVE: To describe the aesthetic indications and operative technique of posterior cervical rhytidectomy as a staged procedure after extended cervical‐facial rhytidectomy.DESIGN: The senior author's series of patients requiring posterior cervical rhytidectomy is reviewed, including preoperative and postoperative aesthetic results.SETTING: A private practice plastic surgery clinic.PATIENTS: Eleven patients who underwent staged posterior cervical rhytidectomy after extensive cervical‐facial rhytidectomy are presented, with follow‐up ranging from 3 months to 8 years. During this same duration, 941 primary and 256 secondary cervical‐facial rhytidectomies were performed.INTERVENTIONS: The preoperative and postoperative results are presented along with a description of the pertinent anatomy and the senior author's operative technique. Potential complications are reviewed. A discussion is included on ways to minimize these untoward sequelae.OUTCOME MEASURE: The aesthetic postoperative results are reviewed, and representative clinical photographs are presented.RESULTS: Staged posterior cervical rhytidectomy is a safe and effective means of improving certain stigmata of previous cervical‐facial rhytidectomy in patients requiring extensive facial rejuvenation.CONCLUSIONS: Posterior cervical rhytidectomy is a valuable surgical adjunct in selective patients who demonstrate redundant skin and soft tissue in the posterior cervical region.
Historical Ties Between Otolaryngology‐Head and Neck Surgery and Aviation and Space Medicine
Authors: Alford Bobby R. , Atkins James H. 
Published: September 2022

Otolaryngology‐head and neck surgeons have been involved in the development of aviation and space medicine since the beginning of this century. More than 75 years ago, otolaryngologists revised the physical examination for pilots, organized “boards of medical examiners” to test pilot applicants, coined the term “flight surgeon,” and helped organize the first medical research laboratories at Hazelhurst Field in New York. These laboratories were transformed in 1922 into the School of Aviation Medicine at Brooks Field, Texas, which in turn subsequently was relocated to Randolph Field, Texas. During World War II the Director of Research at the school was Colonel Paul A. Campbell, MD, an otolaryngologist. In 1959, the school moved back to Brooks Air Force Base and was renamed the Aerospace Medical Center. Since manned space flight began in the 1960s there have been many joint research efforts between principal investigators in otolaryngology‐head and neck surgery and NASA. Several otolaryngology‐head and neck surgeons have served or currently serve as consultants and advisors to many of NASA's standing committees. The space environment offers a new frontier for development and research in the specialty and for better understanding of vestibular function and related disorders. (Otolaryngol Head Neck Surg 1998;118:S2‐S4.)
Spaceflight Influences on Ocular Counterrolling and Other Neurovestibular Reactions
Authors: Young Laurence R. , Sinha Prashant 
Published: September 2022

Exposure to extended periods of weightlessness in orbital flight has profound effects on the neurovestibular system and influences head and eye movements, postural control, and spatial orientation. The associated space motion sickness is among the earliest of the signs of adaptation to this new environment. This report both reviews the prominent neurovestibular phenomena associated with going into space and returning to earth and relates the issues to vestibular compensation and rehabilitation. New results from the Spacelab SLS‐2 mission are included, showing significant reductions in postflight ocular counterrolling and changes in ocular counterrolling left/right asymmetries after 2 weeks in space. (Otolaryngol Head Neck Surg 1998;118:S31‐S34.)
User and stakeholder perspective taking in novice design teams
Authors: Surma-aho Antti , Björklund Tua , Hölttä-Otto Katja 
Published: September 2022

Abstract
Taking the perspective of users and stakeholders can help designers incorporate human-centricity in their practice. However, we know relatively little of the dynamics of perspective taking – a cognitive facet of empathy – in design processes as a situated cognitive and behavioural activity, rather than as an overall orientation. To illuminate how perspective taking is used in design, we carried out a longitudinal multiple case study of 49-month-long graduate-level product and service design projects, exploring differences between high and midscale performance in different design phases. Through thematic analysis of review session discussions, we find that perspective taking in high-performing sessions involves three aggregate dimensions: gathering data to form perspectives, scoping and making sense of perspectives and using perspectives in creative processing. We identify phase-dependent characteristics for the scope and emphasis of perspective taking in concept development, system design and detailed design. We also describe different ways in which novice teams struggled to create and apply user perspectives. As a result, the current study sheds light on perspective taking and the changing nature of effective perspective taking across the design process.