FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Holt, JJ AF Holt, James J. TI Posterior sinus of the middle ear SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the Middle Section of the American-Laryngological-Rhinological-and-Otological-Society CY JAN 23, 2005 CL Chicago, IL SP Amer Laryngol Rhinol & Otol Soc, Middle Sect DE cholesteatoma; posterior sinus; posterior tympanum ID RETROFACIAL APPROACH; SURGICAL ANATOMY; TYMPANI AB Objectives: This study defines the anatomy of the posterior sinus of the middle ear and its relationship with the sinus tympani. Methods: Fifty-one temporal bone plugs harvested from human cadavers were studied. The depth and width of the posterior sinus, its relationship to surrounding structures, and the structure that separates it from the sinus tympani were studied. Results: The posterior sinus, positioned just posterior to the oval window, was 1 mm or less in depth, and the width of the opening 1.5 mm or less. A ridge of bone from the floor of the middle ear separated the posterior sinus from the sinus tympani in 82% of specimens. In 10% a sheet of bone separated the two sinuses, and in 8% the sinus tympani and posterior sinus formed one confluent recess. Conclusions: This is the first study that describes the anatomy of the posterior sinus of the middle ear. This sinus is separated from the more inferiorly located sinus tympani by a ridge of bone, not by the ponticulus as was previously thought, and it is no larger than 1 mm in depth and 1.5 mm in width. The results from this study give the otologic surgeon knowledge of middle ear anatomy that he or she can use when removing cholesteatoma, granulation tissue, or retracted epithelium from the posterior tympanum. C1 Marshfield Clin Fdn Med Res & Educ, Dept Otolaryngol Head & Neck Surg, Marshfield, WI 54449 USA. RP Holt, JJ (reprint author), Marshfield Clin Fdn Med Res & Educ, Dept Otolaryngol Head & Neck Surg, 1000 N Oak Ave, Marshfield, WI 54449 USA. CR ALBERA R, 1989, CHOLESTEATOMA MASTOI, P781 [Anonymous], 1988, DORLANDS ILLUSTRATED ANSON BJ, 1967, SURG ANATOMY TEMPORA, P22 DONALDSO.JA, 1970, ARCHIV OTOLARYNGOL, V91, P219 Holt James J, 2004, Ear Nose Throat J, V83, P241 Holt JJ, 2005, OTOL NEUROTOL, V26, P1122, DOI 10.1097/01.mao.0000194887.59270.7d Ozturan O, 1996, ANN OTO RHINOL LARYN, V105, P776 PICKETT BP, 1995, AM J OTOL, V16, P741 PROCTOR B, 1969, ANN OTO RHINOL LARYN, V78, P1026 PROCTOR B, 1989, SURG ANATOMY EAR TEM, P43 SAITO R, 1971, ARCHIV OTOLARYNGOL, V94, P418 Schuknecht H, 1971, J Laryngol Otol, V85, P1238 SPALTEHOLZ W, 1925, HAND ATLAS HUMAN ANA, P835 TOS M, 1995, MASTOID SURG RECONST, V2, P38 NR 14 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2007 VL 116 IS 6 BP 457 EP 461 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 181NW UT WOS:000247444400011 PM 17672249 ER PT J AU Chung, D Tsuji, DH Sennes, LU Imamura, R AF Chung, Daniel Tsuji, Domingos Hiroshi Sennes, Luiz Ubirajara Imamura, Rui TI Upper displacement of the anterior commissure: Experimental study of a new phonosurgical approach to raising vocal pitch SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE fundamental frequency; phonation; thyroid cartilage; vocal fold; voice quality ID TO-FEMALE TRANSSEXUALS; EXCISED HUMAN LARYNGES; CRICOTHYROID APPROXIMATION; LARYNGOPLASTIC PHONOSURGERY; VOICE PRODUCTION; FOLD VIBRATION; SURGERY; THYROPLASTY; VIDEOKYMOGRAPHY; SUBLUXATION AB Objectives: The present study assessed the effects of a unique pitch-raising surgical technique designated upper displacement of the anterior commissure (UDAC), comparing the results with those obtained through cricothyroid approximation (CTA). Methods: Vocal fold vibration was artificially evoked in 20 excised human larynges through tracheal injection of compressed air. Vocal fold length, fundamental frequency, and videokymography parameters were determined preoperatively, post-CTA, and post-UDAC. In UDAC, a bilateral incision was made between the middle and anterior thirds of the thyroid cartilage. The inferiormost portion of the anterior thyroid cartilage (anterior to the cartilaginous incision) was sutured to the superiormost portion of the posterior thyroid cartilage (posterior to the cartilaginous incision). The anterior commissure was thus moved upward and forward, ensuring increased vocal fold tension. Results: The mean vocal fold length was 16.88 mm preoperatively, 20.02 mm post-CTA, and 18.67 mm post-UDAC (p < .05). The mean fundamental frequency was 151.60 Hz preoperatively, 271.10 Hz post-CTA, and 239.30 Hz post-UDAC (p < .05). The post-CTA and post-UDAC vibration amplitudes were significantly lower than the preoperative values (p < .05). Conclusions: Vocal fold length and fundamental frequency increased significantly after UDAC (p < .05), although to a lesser degree than after CTA. C1 Univ Sao Paulo, Dept Clin Otorhinolaryngol, Hosp Clin, BR-01051 Sao Paulo, Brazil. RP Chung, D (reprint author), Abe Irai 210, BR-04082000 Sao Paulo, Brazil. RI Sennes, Luiz/E-6815-2012 CR American Psychiatric Association, 1994, DIAGN STAT MAN MENT, V4th COLTON RH, 1996, COMPREENDENDO PROBLE DONALD PJ, 1982, HEAD NECK SURG, V4, P433, DOI 10.1002/hed.2890040512 FRITZELL B, 1982, FOLIA PHONIATR, V34, P29 Gross M, 1999, J VOICE, V13, P246, DOI 10.1016/S0892-1997(99)80028-9 ISSHIKI N, 1983, J OTOLARYNGOL, V12, P335 ISSHIKI N, 1974, ACTA OTO-LARYNGOL, V78, P451, DOI 10.3109/00016487409126379 ISSHIKI N, 1985, ACTA OTOLARYNGOL S S, V419, P167 Isshiki N, 2000, OTOLARYNG HEAD NECK, V122, P782, DOI 10.1016/S0194-5998(00)70002-7 Isshiki N, 1989, PHONOSURGERY THEORY Kanagalingam J, 2005, LARYNGOSCOPE, V115, P611, DOI 10.1097/01.mlg.0000161357.12826.33 KOUFMAN JA, 1991, OTOLARYNG CLIN N AM, V24, P1151 Kunachak S, 2000, ANN OTO RHINOL LARYN, V109, P1082 LEJEUNE FE, 1987, ANN OTO RHINOL LARYN, V96, P597 LEJEUNE FE, 1983, ANN OTO RHINOL LARYN, V92, P475 Mahieu H F, 1996, Rev Laryngol Otol Rhinol (Bord), V117, P189 Matai V, 2003, OTOLARYNG HEAD NECK, V128, P841, DOI 10.1016/S0194-5998(03)00462-5 NORBART TCJ, 1997, CLIN OTOLARYNGOL ALL, V22, P474 SATALOFF RT, 1992, LARYNGOSCOPE, V102, P90 Schutte HK, 1997, LOG PHON VOCAL, V22, P152 Schutte HK, 1998, LARYNGOSCOPE, V108, P1206, DOI 10.1097/00005537-199808000-00020 Shaw GY, 1995, OTOLARYNG HEAD NECK, V113, P679, DOI 10.1016/S0194-5998(95)70005-6 Su CY, 2005, LARYNGOSCOPE, V115, P528, DOI 10.1097/01.MLG.0000150091.55295.56 Svec JG, 1996, J VOICE, V10, P201, DOI 10.1016/S0892-1997(96)80047-6 TANABE M, 1985, FOLIA PHONIATR, V37, P15 Tsuji DH, 2003, J VOICE, V17, P596, DOI 10.1067/S0892-1997(03)00071-7 TSUJI DH, 1998, ARQ FUND OTORINOLARI, V2, P136 TUCKER HM, 1985, ANN OTO RHINOL LARYN, V94, P547 VILKMAN E, 1987, FOLIA PHONIATR, V39, P169 Wagner I, 2003, LARYNGOSCOPE, V113, P1157, DOI 10.1097/00005537-200307000-00011 Yang CY, 2002, ANN OTO RHINOL LARYN, V111, P477 Zeitels SM, 1999, ANN OTO RHINOL LARYN, V108, P1126 NR 32 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2007 VL 116 IS 6 BP 462 EP 470 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 181NW UT WOS:000247444400012 PM 17672250 ER PT J AU Ling, ZQ Mukaisho, K Hidaka, M Chen, KH Yamamoto, G Hattori, T AF Ling, Zhi-Qiang Mukaisho, Ken-ichi Hidaka, Miyoko Chen, Kuan-Hao Yamamoto, Gaku Hattori, Takanori TI Duodenal contents reflux-induced laryngitis in rats: Possible mechanism of enhancement of the causative factors in laryngeal carcinogenesis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE duodenal reflux; laryngeal cancer; laryngitis; rat; squamous cell carcinoma ID GASTROESOPHAGEAL-REFLUX; RISK-FACTOR; BARRETTS-ESOPHAGUS; CIGARETTE-SMOKING; LARYNGOPHARYNGEAL REFLUX; CELL-PROLIFERATION; BILE-ACID; CANCER; CARCINOMA; ADENOCARCINOMA AB Objectives: The main factors considered responsible for the onset of laryngeal cancer are tobacco smoking and alcohol abuse. Recently, gastroesophageal reflux has also been implicated as a causative factor in several laryngeal disorders, including laryngeal cancer. However, the significance of gastroesophageal reflux in laryngeal cancer is controversial. Methods: We investigated the histologic features of the esophagus and larynx in a rat model of reflux of the duodenal contents. Cell proliferation was also evaluated in laryngeal samples by detection of Ki67 antigen. Results: In this reflux model, laryngitis with infiltration of inflammatory cells and proliferation of small mucous glands was evident from 10 weeks after operation, and basal cell hyperplasia around the epiglottis and hyperplastic changes in the larynx were detected at 30 weeks. No dysplastic or malignant lesions were detected in the laryngeal samples within the duration of the experiment, in spite of detection of malignancy in 31.3% of lesions in esophageal samples at 30 weeks. The Ki67 index at each week was significantly higher than that of the control animals. Conclusions: Previous studies have shown smoking and alcohol abuse to have refluxogenic effects. Reflux of duodenal contents causes laryngitis. Reflux does not appear to be an independent risk factor for laryngeal carcinogenesis, but it may enhance the acknowledged etiologic risk factors, namely, smoking and alcohol abuse, by promoting cell proliferation. C1 Shiga Univ Med Sci, Dept Pathol, Shiga 5202192, Japan. Shiga Univ Med Sci, Dept Oral & Maxillofacial Surg, Shiga 5202192, Japan. RP Mukaisho, K (reprint author), Shiga Univ Med Sci, Dept Pathol, Seta Tsukinowa Cho, Shiga 5202192, Japan. CR Adams J, 2000, ARCH OTOLARYNGOL, V126, P405 Adhami T, 2004, AM J GASTROENTEROL, V99, P2098, DOI 10.1111/j.152-0241.2004.40170.x Balkwill F, 2001, LANCET, V357, P539, DOI 10.1016/S0140-6736(00)04046-0 Cammarota G, 2004, ANN SURG, V240, P817, DOI 10.1097/01.sla.0000143244.76135.ca CANN CI, 1985, OTOLARYNG CLIN N AM, V18, P367 CHAMPION G, 1994, GASTROENTEROLOGY, V107, P747 Cianci R, 2003, ARCH SURG-CHICAGO, V138, P751, DOI 10.1001/archsurg.138.7.751 Coussens LM, 2002, NATURE, V420, P860, DOI 10.1038/nature01322 DENNISH GW, 1971, NEW ENGL J MED, V284, P1136, DOI 10.1056/NEJM197105202842007 El-Serag HB, 2001, AM J GASTROENTEROL, V96, P2013, DOI 10.1016/S0002-9270(01)02497-2 FALK RT, 1989, CANCER RES, V49, P4024 GABRIEL C E, 1960, J Laryngol Otol, V74, P349, DOI 10.1017/S0022215100056693 Galli J, 2002, LARYNGOSCOPE, V112, P1861, DOI 10.1097/00005537-200210000-00030 Galli J, 2003, Acta Otorhinolaryngol Ital, V23, P377 GERDES J, 1991, AM J PATHOL, V138, P867 GLANZ H, 1976, ARCH OTO-RHINO-LARYN, V212, P57, DOI 10.1007/BF00456363 Hanby AM, 1997, AM J PATHOL, V151, P1819 Hanson David G., 2000, American Journal of Medicine, V108, p112S HEDBERG K, 1994, CANCER CAUSE CONTROL, V5, P3, DOI 10.1007/BF01830720 ISOLA JJ, 1990, CANCER, V65, P1180, DOI 10.1002/1097-0142(19900301)65:5<1180::AID-CNCR2820650525>3.0.CO;2-7 KADAKIA SC, 1995, AM J GASTROENTEROL, V90, P1785 KAUFMAN SE, 1978, GUT, V19, P336, DOI 10.1136/gut.19.4.336 Kawabe A, 2004, LIFE SCI, V75, P21, DOI 10.1016/j.lfs.2003.11.022 Klinkenberg-Knol EC, 1998, SCAND J GASTROENTERO, V33, P24, DOI 10.1080/003655298750027173 KOUFMAN JA, 1991, LARYNGOSCOPE S53, V101 Kumagai H, 2004, CARCINOGENESIS, V25, P723, DOI 10.1093/carcin/bgh067 Lagergren J, 1999, NEW ENGL J MED, V340, P825, DOI 10.1056/NEJM199903183401101 LAITAKARI R, 1995, ANN MED, V27, P499, DOI 10.3109/07853899709002459 LANDIS H, 1998, CA CANC J CLIN, V48, P6 Landis SH, 1998, CA-CANCER J CLIN, V48, P192 Ludemann JP, 1998, J OTOLARYNGOL, V27, P127 MIWA K, 1994, BRIT J CANCER, V70, P185, DOI 10.1038/bjc.1994.277 Miwa K, 1996, INT J CANCER, V67, P269, DOI 10.1002/(SICI)1097-0215(19960717)67:2<269::AID-IJC19>3.0.CO;2-6 MOORE C, 1971, J AMER MED ASSOC, V218, P553, DOI 10.1001/jama.218.4.553 Nilsson M, 2005, CANCER EPIDEM BIOMAR, V14, P1194, DOI 10.1158/1055-9965.EPI-04-0697 Ozlugedik S, 2006, EUR ARCH OTO-RHINO-L, V263, P339, DOI 10.1007/s00405-005-1003-5 Qadeer MA, 2006, AM J OTOLARYNG, V27, P119, DOI 10.1016/j.amjoto.2005.07.010 Qadeer MA, 2005, LARYNGOSCOPE, V115, P486, DOI 10.1097/01.mlg.0000157851.24272.41 Romero Y, 1997, GASTROENTEROLOGY, V113, P1449, DOI 10.1053/gast.1997.v113.pm9352846 Sant'Ambrogio FB, 1998, J APPL PHYSIOL, V84, P1299 Sasaki CT, 2005, ANN OTO RHINOL LARYN, V114, P192 Smit CF, 2001, ANN OTO RHINOL LARYN, V110, P190 Sung MW, 2003, LARYNGOSCOPE, V113, P1059, DOI 10.1097/00005537-200306000-00027 VITALE GC, 1987, JAMA-J AM MED ASSOC, V258, P2077, DOI 10.1001/jama.258.15.2077 WARD PH, 1988, LARYNGOSCOPE, V98, P1195 WETMORE RF, 1993, LARYNGOSCOPE, V103, P1242 Wong A, 2005, CLIN GASTROENTEROL H, V3, P1, DOI 10.1053/S1542-3565(04)00602-0 WYNDER EL, 1977, CANCER RES, V37, P4608 Zeka A, 2003, CANCER CAUSE CONTROL, V14, P897, DOI 10.1023/B:CACO.0000003854.34221.a8 NR 49 TC 11 Z9 12 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2007 VL 116 IS 6 BP 471 EP 478 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 181NW UT WOS:000247444400013 PM 17672251 ER PT J AU Deutsch, ES Dixit, D Curry, J Malloy, K Christenson, T Robinson, B Cognetti, D AF Deutsch, Ellen S. Dixit, Divya Curry, Joseph Malloy, Kelly Christenson, Tom Robinson, Barbara Cognetti, David TI Management of aerodigestive tract foreign bodies: Innovative teaching concepts SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE bronchoesophagology; foreign body aspiration; simulation ID MEDICAL-EDUCATION; SIMULATION AB Objectives: We discuss a method to provide medical education in bronchoesophagology by using high-fidelity patient simulation manikins. Methods: A sophisticated, life-sized infant manikin with realistic anatomic, physiologic, and hemodynamic responses to interventions was programmed to simulate endobronchial foreign body lodgment by blocking ventilation of one lung and manifesting audible stridor, asymmetric chest wall motion, and decreased oxygen saturation. Results: Otolaryngology residents participated in simulation exercises incorporating the cognitive and technical skills necessary for successful airway endoscopy, including technical proficiency and teamwork, to learn to coordinate endoscopy and ventilation and manage laryngospasm. Rather than relying on instructor description, the participants responded directly to the manikin. This sense of realism stimulated participants to rehearse to improve provider performance and patient safety. Simulation provided an agenda determined by the needs of the learners, exploration without direct risk to patients, immediate feedback, and objective documentation. Conclusions: Rapidly evolving medical simulation technologies support activated, effective adult learning; they will play an increasing role in medical education. C1 Alfred I Dupont Hosp Children, Div Pediat Otolaryngol, Wilmington, DE 19899 USA. RP Deutsch, ES (reprint author), Alfred I Dupont Hosp Children, Div Pediat Otolaryngol, POB 269, Wilmington, DE 19899 USA. CR Accreditation Council for Graduate Medical Education, 2005, ACGME B DEC, P1 Glick TH, 2005, ACAD MED, V80, P147, DOI 10.1097/00001888-200502000-00008 Kneebone R, 2003, MED EDUC, V37, P267, DOI 10.1046/j.1365-2923.2003.01440.x Whitcomb ME, 2005, ACAD MED, V80, P117, DOI 10.1097/00001888-200502000-00001 Ziv A, 2003, ACAD MED, V78, P783, DOI 10.1097/00001888-200308000-00006 NR 5 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 319 EP 323 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100001 PM 17561758 ER PT J AU Amini, K Frank, DK AF Amini, Kamyar Frank, Douglas K. TI True vocal fold immobility in the setting of well-differentiated thyroid carcinoma: Unusual illustrative cases and recommendations for operative strategy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE thyroid carcinoma; true vocal fold immobility ID RECURRENT LARYNGEAL NERVE; PROGNOSTIC-FACTORS; CORD PARALYSIS; CANCER; MANAGEMENT; DISEASE; SURGERY; PALSY AB Objectives: We present cases of transient true vocal fold (TVF) immobility caused by well-differentiated thyroid carcinoma (WDTC), and review the literature concerning management of WDTC invading the recurrent laryngeal nerve (RLN). Methods: A description of the clinical course of 2 patients with WDTC and transient TVF immobility is presented in the context of a review of the literature concerning locally advanced WDTC with extrathyroidal extension and RLN involvement. Results: Both patients had papillary thyroid carcinoma with ipsilateral TVF paralysis that resolved completely before operation. During the operation, the RLN was found to be grossly involved with disease and inseparable from the tumor, necessitating resection. Review of the literature revealed the following points that should be considered when confronting an RLN invaded by WDTC. 1) Benign disease can mimic invasive WDTC and must be ruled out. 2) RLN invasion does not carry the same prognostic implications as other categories of extrathyroidal extension of WDTC. 3) RLN sacrifice does not increase the overall survival rate. 4) There is no evidence that a paralyzed RLN will regain function when preserved. 5) The majority of RLNs that function before operation can be expected to function after the operation if preserved. Conclusions: Resolution of TVF paralysis should not reduce suspicion of RLN involvement by WDTC. When RLN involvement is discovered during operation, every attempt should be made to preserve a functioning RLN. C1 Beth Israel Deaconess Med Ctr, Dept Otolaryngol Head & Neck Surg, New York, NY 10003 USA. Beth Israel Deaconess Med Ctr, Inst Head & Neck & Thyroid Canc, New York, NY 10003 USA. Albert Einstein Coll Med, Dept Otorhinolaryngol Head & Neck Surg, Bronx, NY 10467 USA. RP Frank, DK (reprint author), Beth Israel Deaconess Med Ctr, Dept Otolaryngol Head & Neck Surg, 10 Union Sq E,Suite 4J, New York, NY 10003 USA. CR Affleck BD, 2003, OTOLARYNG CLIN N AM, V36, P159, DOI 10.1016/S0030-6665(02)00135-4 ANDERSEN PE, 1995, AM J SURG, V170, P467, DOI 10.1016/S0002-9610(99)80331-6 BACOURT F, 1986, BRIT J SURG, V73, P274, DOI 10.1002/bjs.1800730410 Benninger MS, 1998, LARYNGOSCOPE, V108, P1346, DOI 10.1097/00005537-199809000-00016 CADY B, 1979, CANCER, V43, P810, DOI 10.1002/1097-0142(197903)43:3<810::AID-CNCR2820430306>3.0.CO;2-B Chan WF, 2004, WORLD J SURG, V28, P1093, DOI 10.1007/s00268-004-7419-z Cushing SL, 2004, LARYNGOSCOPE, V114, P2110, DOI 10.1097/01.mlg.0000149442.22393.e2 FALK SA, 1995, OTOLARYNG HEAD NECK, V113, P42, DOI 10.1016/S0194-5998(95)70143-5 GODWIN JE, 1991, CHEST, V99, P1029, DOI 10.1378/chest.99.4.1029 HOLLALLE.RT, 1967, ARCHIV OTOLARYNGOL, V 85, P335 Kasperbauer JL, 2004, ANN OTO RHINOL LARYN, V113, P749 Kebebew E, 2003, SURG ONCOL, V12, P91, DOI 10.1016/S0960-7404(03)00032-X Kowalski LP, 2002, HEAD NECK-J SCI SPEC, V24, P340, DOI 10.1002/hed.10058 MCCAFFREY TV, 1994, HEAD NECK-J SCI SPEC, V16, P165, DOI 10.1002/hed.2880160211 McCarty TM, 1997, ANN SURG ONCOL, V4, P403, DOI 10.1007/BF02305553 Nishida T, 1997, ANN SURG, V226, P85, DOI 10.1097/00000658-199707000-00012 Patel Kepal N, 2005, Curr Opin Otolaryngol Head Neck Surg, V13, P112, DOI 10.1097/01.moo.0000156161.82671.43 Randolph GW, 2006, SURGERY, V139, P357, DOI 10.1016/j.surg.2005.08.009 ROWEJONES JM, 1993, ANN ROY COLL SURG, V75, P241 RUEGER RG, 1974, LARYNGOSCOPE, V84, P897, DOI 10.1288/00005537-197406000-00002 SHINDO ML, 1996, OTOLARYNGOL CLIN N A, V29, P625 Wein RO, 2005, AM J OTOLARYNG, V26, P186, DOI 10.1016/j.amjoto.2004.11.012 NR 22 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 324 EP 328 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100002 PM 17561759 ER PT J AU Zoumalan, R Maddalozzo, J Holinger, LD AF Zoumalan, Richard Maddalozzo, John Holinger, Lauren D. TI Etiology of stridor in infants SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE airway obstruction; laryngomalacia; pediatrics; stridor ID LARYNGOMALACIA; AIRWAY AB Objectives: We undertook to identify data that facilitate determination of an accurate diagnosis of the cause of stridor in infants and to develop a framework to conceptualize the problem. Methods: We reviewed medical records of patients less than 1 year of age with the presenting symptom of stridor who were initially evaluated in the outpatient setting of a tertiary children's hospital. Infants with obvious congenital syndromes, cerebral palsy, or hypotonia were excluded. All infants underwent history-taking, physical examination, and when symptoms were mild, office flexible laryngoscopy. With moderate or severe stridor, a more complete endoscopic evaluation was undertaken in the operating room. Results: Of 202 patients, 119 (59%) were boys and 83 (41 %) were girls. Their ages ranged from 3 days to 11 months; 175 (87%) were 6 months of age or younger. Congenital anomalies were diagnosed as the cause of stridor in 170 (84%). Congenital laryngeal anomalies caused stridor in 157 (78%) congenital tracheal abnormalities were the cause in 13 (6%). The most common congenital laryngeal anomaly was laryngomalacia (94%). Forty-two (21 %) of the 202 patients had at least 1 other anomaly that contributed to airway compromise. Half of all patients had laryngopharyngeal reflux, the most common associated condition. Of patients referred with a presumptive diagnosis by non-otolaryngologists, 28 of 94 (30%) were referred with erroneous presumptive diagnoses for which they were being treated, the most common of which was tracheomalacia. Conclusions: A standard, rational approach to the evaluation of stridor in infants facilitates management. A framework for evaluation is presented. C1 Childrens Mem Hosp, Div Pediat Otolaryngol, Chicago, IL 60614 USA. RP Holinger, LD (reprint author), Childrens Mem Hosp, Div Pediat Otolaryngol, 2300 Childrens Plaza,Box 25, Chicago, IL 60614 USA. CR Chandra RK, 2001, INT J PEDIATR OTORHI, V61, P31, DOI 10.1016/S0165-5876(01)00541-9 Froehlich P, 1997, INT J PEDIATR OTORHI, V39, P9, DOI 10.1016/S0165-5876(96)01454-1 HOLINGER LD, 1980, ANN OTO RHINOL LARYN, V89, P397 HOLINGER LD, 1989, LARYNGOSCOPE, V99, P346 Holinger Lauren D., 1997, P41 Matthews BL, 1999, OTOLARYNG HEAD NECK, V120, P860, DOI 10.1016/S0194-5998(99)70327-X MYER CM, 1994, ANN OTO RHINOL LARYN, V103, P319 Parsons DS, 1998, LARYNGOSCOPE, V108, P403, DOI 10.1097/00005537-199803000-00017 Shatz A, 2004, ANN OTO RHINOL LARYN, V113, P483 Smith JL, 2005, ANN OTO RHINOL LARYN, V114, P111 NR 10 TC 27 Z9 31 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 329 EP 334 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100003 PM 17561760 ER PT J AU Ishimaru, T AF Ishimaru, Tadashi TI Optical recording of the intrinsic signal from the human olfactory cleft SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Conference of the European-Chemosensory-Research-Organization CY SEP 07, 2006 CL Granada, SPAIN SP European Chemosensory Res Org DE endoscope; human; intrinsic signal; light-emitting diode; olfaction; olfactory cleft; optical recording ID PERIPHERAL-NERVE STIMULATION; MUCOSAL ACTIVITY PATTERNS; RAT SPINAL-CORD; SOMATOSENSORY CORTEX; NEURONAL-ACTIVITY; RESPONSES; ODOR; BULB; REPRESENTATIONS; ORGANIZATION AB Objectives: Endoscopy of the human olfactory cleft is important for both research in human olfaction and clinical examination with regard to olfactory disorders. However, endoscopy only provides information on the morphology and functional status of the epithelium, and it does not allow discrimination between respiratory and olfactory mucosa. To obtain information on the functional status of the olfactory mucosa, I used endoscopy to investigate the optical intrinsic signal recording from the human olfactory cleft. Methods: A light-emitting diode (617 nm) light source and a cooled charge-coupled device camera were prepared for endoscopy of the olfactory cleft. Subjects were exposed to Various odors presented in front of their nostrils. In addition, blanks were used for control. Results: When normosmic subjects sniffed the odors, the intensity of the signal from the olfactory Mucosa changed, which was not the case when blank Stimuli were presented. Different odors activated different response patterns. A decrease of the oxyhemoglobin level in the activated olfactory epithelium is suspected to be responsible for this observation. Conclusions: The optical intrinsic signals were recorded from the human olfactory cleft with an endoscope. This technique may be applicable to basic research in olfaction and to a clinical lest for the assessment of olfactory disorders. C1 Tech Univ Dresden, Dept Otorhinolaryngol, Smell & Taste Clin, D-8027 Dresden, Germany. Nanto Gen Hosp, Dept Otorhinolaryngol, Nanto, Japan. RP Ishimaru, T (reprint author), Hyotan Machi ENT Clin, Hyotan Machi 2-13, Kanazawa, Ishikawa 9200845, Japan. 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Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 335 EP 341 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100004 PM 17561761 ER PT J AU Kataoka, H Arii, S Ochiai, Y Suzuki, T Hasegawa, K Kitano, H AF Kataoka, Hideyuki Arii, Shiro Ochiai, Yoshitaka Suzuki, Toyohiko Hasegawa, Kensaku Kitano, Hiroya TI Analysis of human glottal velocity using hot-wire anemometry and high-speed imaging SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE glottal velocity; high-speed imaging; hot-wire anemometry ID INVERSE FILTERING TECHNIQUE; AIR-FLOW; WAVEFORM AB Objectives: The aim of this study was to analyze glottal velocity and glottal opening and closure. For this purpose, we developed a miniature, flexible, hot-wire probe that can make truly instantaneous measurements of the human larynx in vivo. Methods: A miniature hot-wire tip was inserted into a flexible transnasal endoscope. Fiberscopic examination was performed transnasally so that we could observe glottal vibration using high-speed imaging. The tip of the hot-wire probe was placed just above the glottis. The position of the probe was carefully monitored and checked with another flexible endoscope. Results: Changes in velocity were recorded periodically. The velocity was higher in close proximity to the vocal folds. High-speed motion pictures were taken at a rate of 2,000 frames per second with an auxiliary light source. Conclusions: Quantitative analysis of glottal velocity is required to improve our understanding of the relationship between laryngeal physiology and acoustics in humans. To solve the problem of synchronization inaccuracy, glottal velocity was captured instantaneously in the high-speed imaging system's processor memory. C1 Tottori Univ, Fac Med, Dept Otolaryngol Head & Neck Surg, Yonago, Tottori 6838504, Japan. Tottori Univ, Fac Engn, Yonago, Tottori 6838504, Japan. RP Kataoka, H (reprint author), Tottori Univ, Fac Med, Dept Otolaryngol Head & Neck Surg, 36-1 Nishimachi, Yonago, Tottori 6838504, Japan. CR Alipour F, 1996, J VOICE, V10, P50, DOI 10.1016/S0892-1997(96)80018-X BERKE GS, 1993, J VOICE, V7, P123, DOI 10.1016/S0892-1997(05)80341-8 Granqvist S, 2003, J VOICE, V17, P319, DOI 10.1067/S0892-1997(03)00070-5 Hertegård Stellan, 2005, Curr Opin Otolaryngol Head Neck Surg, V13, P152, DOI 10.1097/01.moo.0000163451.98079.ba Hirose H, 1988, Acta Otolaryngol Suppl, V458, P151 Imagawa H, 1987, Iyodenshi To Seitai Kogaku, V25, P284 KITAJIMA K, 1985, ANN OTO RHINOL LARYN, V94, P195 KITAJIMA K, 1978, STUDIA PHONOLOGICA, V12, P25 Kobler JB, 1998, ANN OTO RHINOL LARYN, V107, P477 MUSEBECK K, 1983, LARYNG RHINOL OTOL V, V62, P226, DOI 10.1055/s-2007-1008419 Müsebeck K, 1979, Rhinology, V17, P13 ROTHENBE.M, 1973, J ACOUST SOC AM, V53, P1632, DOI 10.1121/1.1913513 ROTHENBERG M, 1977, J ACOUST SOC AM, V61, P1063, DOI 10.1121/1.381392 TEAGER HM, 1980, IEEE T ACOUST SPEECH, V28, P599, DOI 10.1109/TASSP.1980.1163453 Verneuil A, 2003, ANN OTO RHINOL LARYN, V112, P120 WOO P, 1986, OTOLARYNG HEAD NECK, V95, P312 NR 16 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 342 EP 348 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100005 PM 17561762 ER PT J AU Pauw, RJ Huygen, PLM Collin, RWJ Cruysberg, JRM Hoefsloot, LH Kremer, H Cremers, CWRJ AF Pauw, Robert J. Huygen, Patrick L. M. Collin, Rob W. J. Cruysberg, Johannes R. M. Hoefsloot, Lies H. Kremer, Hannie Cremers, Cor W. R. J. TI Phenotype description of a novel DFNA9/COCH mutation, I109T SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE DFNA9; genotype-phenotype; sensorineural hearing impairment ID SENSORINEURAL HEARING-LOSS; TEMPORAL BONE FINDINGS; COCH GENE; COCHLEOVESTIBULAR DYSFUNCTION; VESTIBULAR DYSFUNCTION; MENIERES-DISEASE; LCCL DOMAIN; IMPAIRMENT; FAMILY; DEAFNESS AB Objectives: This is a report of the audiological and vestibular characteristics of a Dutch DFNA9 family with a novel mutation, I109T, in the LCCL domain of COCH. Methods: From the family with the novel I109T COCH Mutation, audiometric data were collected and analyzed longitudinally. Results were compared to those obtained in previously identified P51S, G88E, and G87W COCH mutation carriers. Special attention was also given to a comparison of age-related features such as progressive hearing loss and vestibular impairment. Results: A novel mutation (I109T) in COCH segregates with hearing impairment and vestibular dysfunction in the present family. Pure tone thresholds, phoneme recognition scores, and vestibular responses of the I1109T mutation carriers were essentially similar to those previously established in P51S, G87W, and G88E mutation carriers. Deterioration of hearing in the I109T mutation carriers started at 43 years of age, and vestibular function deteriorated at least 7 years later. Conclusions: The phenotype associated with the novel COCH (I109T) mutation is largely similar to that associated with P51S and G88E mutation carriers. However, subtle differences in terms of onset age and rate of progression seem to exist. C1 Univ Nijmegen, Radboud Med Ctr, Dept Otorhinolaryngol, NL-6500 HB Nijmegen, Netherlands. Univ Nijmegen, Radboud Med Ctr, Dept Ophthalmol, NL-6500 HB Nijmegen, Netherlands. Univ Nijmegen, Radboud Med Ctr, Dept Human Genet, NL-6500 HB Nijmegen, Netherlands. RP Pauw, RJ (reprint author), Univ Nijmegen, Radboud Med Ctr, Dept Otorhinolaryngol, POB 9101, NL-6500 HB Nijmegen, Netherlands. RI Kremer, Hannie/F-5126-2010; Collin, Rob/N-3575-2014 CR BISCHOFF AML, IN PRESS AM J OPHTHA Bischoff AMLC, 2005, OTOL NEUROTOL, V26, P918, DOI 10.1097/01.mao.0000185048.84641.e3 Bom SJH, 1999, LARYNGOSCOPE, V109, P1525, DOI 10.1097/00005537-199909000-00031 Bom SJH, 2001, ARCH OTOLARYNGOL, V127, P1045 Collin RWJ, 2006, AM J MED GENET A, V140A, P1791, DOI 10.1002/ajmg.a.31354 de Kok YJM, 1999, HUM MOL GENET, V8, P361, DOI 10.1093/hmg/8.2.361 De Leenheer EMR, 2002, ANN OTO RHINOL LARYN, V111, P267 Fransen E, 1999, HUM MOL GENET, V8, P1425, DOI 10.1093/hmg/8.8.1425 Huygen PL, 2003, AUDIOL MED, V1, P37 International Standards Organization (ISO), 1984, 7029 ISO Kamarinos M, 2001, Hum Mutat, V17, P351, DOI 10.1002/humu.37 Kamarinos M, 2001, HUM MUTAT, V18, P547, DOI 10.1002/humu.1237 Kemperman MH, 2005, OTOL NEUROTOL, V26, P926, DOI 10.1097/01.mao.0000185062.12458.87 KHETARPAL U, 1991, ARCH OTOLARYNGOL, V117, P1032 KHETARPAL U, 1993, ARCH OTOLARYNGOL, V119, P106 Kunst H, 2000, AM J OTOL, V21, P181, DOI 10.1016/S0196-0709(00)80006-X Lemaire FX, 2003, OTOL NEUROTOL, V24, P743, DOI 10.1097/00129492-200309000-00009 Liepinsh E, 2001, EMBO J, V20, P5347, DOI 10.1093/emboj/20.19.5347 Manolis EN, 1996, HUM MOL GENET, V5, P1047, DOI 10.1093/hmg/5.7.1047 Nagy I, 2004, J MED GENET, V41, DOI 10.1136/jmg.2003.012286 Pauw RJ, 2007, AUDIOL NEURO-OTOL, V12, P77, DOI 10.1159/000097794 ROBERTS BR, 2000, DRUG DISCOVERY TOD S, V1, P10 Robertson NG, 2006, HUM MOL GENET, V15, P1071, DOI 10.1093/hmg/ddl022 Robertson NG, 1998, NAT GENET, V20, P299 Street VA, 2005, AM J MED GENET A, V139A, P86, DOI 10.1002/ajmg.a.30980 THEUNISSEN EJJM, 1986, CLIN OTOLARYNGOL, V11, P161, DOI 10.1111/j.1365-2273.1986.tb00123.x Usami S, 2003, EUR J HUM GENET, V11, P744, DOI 10.1038/sj.ejhg.5201043 VERHAGEN WIM, 1988, ARCH NEUROL-CHICAGO, V45, P766 Verhagen WIM, 2001, CLIN OTOLARYNGOL, V26, P477, DOI 10.1046/j.1365-2273.2001.00505.x NR 29 TC 16 Z9 16 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 349 EP 357 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100006 PM 17561763 ER PT J AU Sulica, L Simpson, CB Branski, R McLaurin, C AF Sulica, Lucian Simpson, C. Blake Branski, Ryan McLaurin, Colby TI Granuloma of the membranous vocal fold: An unusual complication of microlaryngoscopic surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE granulation tissue; granuloma; microlaryngoscopy; vocal fold ID LARYNGEAL GRANULOMAS AB Objectives: We describe the clinical features of granuloma of the membranous vocal fold (as opposed to granuloma of the vocal process, or "contact granuloma"), a poorly recognized sequela of microlaryngoscopic surgery. Membranous vocal fold granuloma may mimic the initial lesion in appearance, and thus be mistaken for recurrence. Methods: We performed a retrospective review of cases from 2 institutions. Results: Fifteen cases of membranous vocal fold granuloma from 2 institutions were identified. In all but 1 case, granuloma developed in the early postoperative period, within 8 weeks. Of the 15 cases, 10 followed laser resection of carcinoma. Five were noted following cold steel resection of benign lesions (2 papillomas, 2 cysts, 1 Reinke's edema). Technical aspects of these cases suggest that membranous vocal fold granulomas result from surgical violation of deep tissue planes and/or epithelial defects. All patients were treated with proton pump inhibitors. In 12 cases, the granulomas proved self-limited, resolving over weeks to months following surgery. Three patients underwent surgical removal of the lesion, which confirmed the diagnosis. One of these cases recurred and was treated nonsurgically. Conclusions: Granuloma should be suspected when a mass lesion appears at the surgical site early in the postoperative course. Surgical excision is generally not necessary and may provoke further growth of granulation tissue. C1 Cornell Univ, Weill Med Coll, Dept Otorhinolaryngol, New York, NY 10021 USA. Mem Sloan Kettering Canc Ctr, Head & Neck Serv, New York, NY 10021 USA. Univ Texas, Hlth Sci Ctr, Dept Otolaryngol Head & Neck Surg, San Antonio, TX 78285 USA. RP Sulica, L (reprint author), Cornell Univ, Weill Med Coll, Dept Otorhinolaryngol, 1305 York Ave,5th Floor, New York, NY 10021 USA. CR Gabbiani G, 2003, J PATHOL, V200, P500, DOI 10.1002/path.1427 Hoffman HT, 2001, HEAD NECK-J SCI SPEC, V23, P1061, DOI 10.1002/hed.10014 Lemos Elza Maria, 2005, Rev. Bras. Otorrinolaringol., V71, P494, DOI 10.1590/S0034-72992005000400016 Martin P, 2005, TRENDS CELL BIOL, V15, P599, DOI 10.1016/j.tcb.2005.09.002 Pham J, 2004, J LARYNGOL OTOL, V118, P781 Pontes PAD, 1999, LARYNGOSCOPE, V109, P289 Scheid Sara C, 2003, Ear Nose Throat J, V82, P244 SHIN T, 1994, EUR ARCH OTO-RHINO-L, V251, P67 NR 8 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 358 EP 362 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100007 PM 17561764 ER PT J AU Brookes, JT Smith, MC Smith, RJH Bauman, NM Manaligod, JM Sandler, AD AF Brookes, James T. Smith, Mark C. Smith, Richard J. H. Bauman, Nancy M. Manaligod, Jose M. Sandler, Anthony D. TI H-type congenital tracheoesophageal fistula: University of Iowa experience 1985 to 2005 SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE H-type fistula; tracheoesophageal fistula ID ESOPHAGEAL ATRESIA; RISK GROUPS; DIAGNOSIS; INFANTS; ADULT; EPIDEMIOLOGY; MANAGEMENT; STENOSIS; NEWBORN AB Objectives: We review the diagnostic workup, associated disorders, surgical technique, and postoperative course of patients who underwent repair of H-type tracheoesophageal fistulas. Methods: We performed a retrospective chart review of patients who received a diagnosis of tracheoesophageal fistula at the University of Iowa. Results: Seven patients with an H-type tracheoesophageal fistula and a single patient with a missed proximal fistula associated with esophageal atresia were identified. Their symptoms included coughing with feeding, recurrent pneumonia, and episodic cyanosis. A delay in diagnosis was seen in 4 patients and ranged from 2.5 months to 5.9 years. In all patients, the diagnosis was made with an esophagogram. The level of the fistulas was between C5 and T3, and all were successfully repaired via a right cervical approach. Conclusions: A high index of suspicion for an H-type tracheoesophageal fistula should be maintained in the presence of neonatal respiratory symptoms, as the condition can be associated with a delay in diagnosis. Repeat esophagograms and bronchoscopy may be required for diagnosis. In the postoperative period, airway obstruction is a potential risk; however, long-term difficulty with swallowing, respiration, and phonation was not observed. C1 Univ Iowa, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. Univ Iowa, Dept Surg, Iowa City, IA 52242 USA. RP Brookes, JT (reprint author), Univ Iowa, Dept Otolaryngol Head & Neck Surg, 200 Hawkins Dr,21201 PFP, Iowa City, IA 52242 USA. 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Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 363 EP 368 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100008 PM 17561765 ER PT J AU Wall, C Kos, MI Guyot, JP AF Wall, Conrad, III Kos, Maria Izabel Guyot, Jean-Philippe TI Eye movements in response to electric stimulation of the human posterior ampullary nerve SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE implant; prosthesis; vestibular system ID SEMICIRCULAR CANAL PROSTHESIS AB Objectives: The concept of a vestibular implant to restore balance, similar to that of a cochlear implant to restore hearing in deaf patients, has been investigated in animal models. It remains to be shown, however, that electric stimulation of the human end organ or its vestibular nerve branches is capable of eliciting a nystagmic eye movement response. Methods: Three subjects were given electric stimulation of their posterior ampullary nerve, which was surgically exposed under local anesthesia, by a procedure developed by Gacek. The stimulus was a multiphasic, charge-balanced train of electric pulses. Results: In all subjects, a pulse repetition rate of 200 pulses per second produced a robust vertical nystagmus without any apparent change in the slow component velocity of the preexisting horizontal nystagmus. Conclusions: We have been able to replicate in humans a finding somewhat similar to that of Suzuki and Cohen in monkeys for electric stimulation of the posterior semicircular canal. The similarity is an eye movement with a large, predominant vertical component. The difference is that we saw no horizontal response component, and were not able to measure a torsional response, because we used 2-dimensional video methods. In addition, we found a robust nystagmus with slow component velocities that are large enough to compensate for vertical head movements. This is an essential step in demonstrating the feasibility of a vestibular prosthesis using electric stimulation. C1 Massachusetts Eye & Ear Infirm, Jenks Vestibular Diagnost Lab, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Otol & Laryngol, Boston, MA 02115 USA. Univ Hosp Geneva, Dept Otorhinolaryngol Head & Neck Surg, Geneva, Switzerland. RP Wall, C (reprint author), Massachusetts Eye & Ear Infirm, Jenks Vestibular Diagnost Lab, 243 Charles St, Boston, MA 02114 USA. CR EPLEY J M, 1980, Otolaryngology - Head and Neck Surgery, V88, P304 GACEK RR, 1974, ANN OTO RHINOL LARYN, V83, P596 Gacek RR, 2002, ORL J OTO-RHINO-LARY, V64, P397, DOI 10.1159/000067572 Gong WS, 2000, ANN BIOMED ENG, V28, P572, DOI 10.1114/1.293 Gong WS, 2002, IEEE T BIO-MED ENG, V49, P175, DOI 10.1109/10.979358 Kos MI, 2006, OTOL NEUROTOL, V27, P542, DOI 10.1097/00129492-200606000-00017 Lewis RF, 2002, J VESTIBUL RES-EQUIL, V12, P87 MONTANDON P, 1992, ORL J OTO-RHINO-LARY, V54, P295 SUZUKI JI, 1964, EXP NEUROL, V10, P393, DOI 10.1016/0014-4886(64)90031-7 Wall C, 2002, J VESTIBUL RES-EQUIL, V12, P95 NR 10 TC 25 Z9 25 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 369 EP 374 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100009 PM 17561766 ER PT J AU Merati, AL Tseng, J Blumin, JH Toohill, RJ Jaradeh, S AF Merati, Albert L. Tseng, Jeffrey Blumin, Joel H. Toohill, Robert J. Jaradeh, Safwan TI Comparative neuromuscular histopathology of cricopharyngeal achalasia patients with and without previous botulinum toxin treatment SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE botox; cricopharyngeal muscle; dysphagia; pathology ID UPPER ESOPHAGEAL SPHINCTER; DYSFUNCTION; MYOTOMY; DYSPHAGIA; INJECTION; EXERCISE; RISK AB Objectives: Botulinum toxin injection (BTX) and cricopharyngeal (CP) myotomy are performed in the treatment of CP achalasia (CA). The objective of this study was to examine the effects of BTX on neuromuscular histopathologic findings and to make direct comparisons between specimens of muscle from CA patients who had received BTX to the upper esophageal sphincter and from CA patients who had no previous exposure to BTX. Methods: We performed a retrospective review (2001 to 2005) of CP muscle specimens from all patients who underwent myotomy for CA. Cases of Zenker's diverticulum were excluded. Patient demographics, clinical course, and neuromuscular pathology findings were noted from the chart. Results: Nineteen patients with CA were identified: 10 male and 9 female, with a mean age of 57 years. Eleven had no prior BTX (6 male and 5 female; mean age, 62 years); 8 had previous treatment with BTX (4 male and 4 female; mean age, 51 years). Eight of the 11 BTX-naive patients revealed predominantly myopathic changes on histology. Those with previous BTX tended to be younger; 6 of the 8 had a clinical benefit from their BTX and ultimately went on to myotomy. The CP muscle specimens featured both mixed and neurogenic pathologic changes in 5 of the 8 patients with BTX. Although these findings suggest some impact of BTX on the CP muscle, the difference between the groups was not statistically significant (p <.20, chi(2) test). Conclusions: Treatment with BTX may have some clinical and histopathologic impact on the upper esophageal sphincter of patients with CA. Although neuropathic changes were noted in the CP muscle of previously injected patients at the time of their CP myotomy, the neuromuscular pathologic findings overall were not significantly different from those of BTX-naive patients. C1 Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Div Laryngol & Profess Voice, Milwaukee, WI 53226 USA. Med Coll Wisconsin, Dept Neurol, Milwaukee, WI 53226 USA. RP Merati, AL (reprint author), 9200 W Wisconsin, Milwaukee, WI 53226 USA. CR Aviv JE, 1997, LARYNGOSCOPE, V107, P1254, DOI 10.1097/00005537-199709000-00018 Chhetri DK, 2003, ANN OTO RHINOL LARYN, V112, P334 Chu LW, 1999, GERONTOLOGY, V45, P220, DOI 10.1159/000022091 Easterling C, 2005, DYSPHAGIA, V20, P133, DOI 10.1007/s00455-005-0004-2 Logemann Jeri A., 1993, Dysphagia, V8, P331, DOI 10.1007/BF01321772 Murry T, 2005, AM J OTOLARYNG, V26, P157, DOI 10.1016/j.amjoto.2004.11.010 Parameswaran MS, 2002, ANN OTO RHINOL LARYN, V111, P871 PROPHET EB, 1992, LAB METHODS HISTOCHE Shaker R, 2002, GASTROENTEROLOGY, V122, P1314, DOI 10.1053/gast.2002.32999 Shaker R, 1997, AM J PHYSIOL-GASTR L, V272, pG1518 Solt J, 2001, GASTROINTEST ENDOSC, V54, P767, DOI 10.1067/mge.2001.118442 Takes RP, 2005, HEAD NECK-J SCI SPEC, V27, P703, DOI 10.1002/hed.20201 Wang AY, 2005, GASTROINTEST ENDOSC, V61, P148, DOI 10.1016/S0016-5107(04)02447-2 Williams RBH, 1999, AM J GASTROENTEROL, V94, P3448 Yip HT, 2006, LARYNGOSCOPE, V116, P93, DOI 10.1097/01.mlg.0000184526.89256.85 NR 15 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 375 EP 380 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100010 PM 17561767 ER PT J AU Hwang, SY Tan, KK AF Hwang, Siew Yoong Tan, Kun Kiaang TI Streptococcus viridans has a leading role in rhinosinusitis complications SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Asian Research for Rhinology Symposium CY DEC 01-03, 2005 CL Kuala Lumpur, MALAYSIA DE pediatric rhinosinusitis; sinusitis complications; Streptococcus viridans ID INTRACRANIAL COMPLICATIONS; MAXILLARY SINUSITIS; CHILDREN; MICROBIOLOGY; MANAGEMENT; ABSCESSES; ADULTS AB Objectives: We sought to determine whether the bacteria in complicated rhinosinusitis were the typical acute rhinosinusitis triad of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. We also compared the difference in yield between infection sites and blood cultures. Methods: We performed a retrospective review of all patients who had required surgical intervention for rhinosinusitis complications over 7 years at a tertiary care pediatric hospital. Results: There were a total of 28 patients during the review period. Twenty-five organisms were isolated from 21 patients, of which Streptococcus viridans formed 44% of the isolates (I I of the 25). The typical triad of bacteria only formed 20% of the isolates (5 of the 25), and none of these 'bacteria were found in the group with intracranial complications. Infection site cultures had a superior yield compared to blood cultures (p <.001). Ninety-six percent of the bacteria were sensitive to a combination of amoxicillin-clavulanate and cloxacillin. Conclusions: In distinction to the typical bacteria of acute rhinosinusitis, S viridans is the leading cause of rhinosinusitis complications. It is not merely a commensal organism of the upper respiratory tract. C1 Changi Gen Hosp, Dept Otolaryngol, Singapore 529889, Singapore. Kandang Kerbau Womens & Childrens Hosp, Dept Otolaryngol, Singapore, Singapore. RP Hwang, SY (reprint author), Changi Gen Hosp, Dept Otolaryngol, 2 Simei St 3, Singapore 529889, Singapore. CR Anon JB, 2004, OTOLARYNG HEAD NECK, V130, P794 ANON JB, 2004, OTOLARYNGOL HEAD N S, V130 Bair-Merritt MH, 2005, PEDIATR INFECT DIS J, V24, P384, DOI 10.1097/01.inf.0000160589.40857.ad Biel MA, 1998, ANN OTO RHINOL LARYN, V107, P942 BLAYNEY AW, 1984, J LARYNGOL OTOL, V98, P895, DOI 10.1017/S0022215100147668 Brook I, 1996, J PERIODONTOL, V67, P608 Cannon Michael L, 2004, Pediatr Crit Care Med, V5, P86, DOI 10.1097/01.PCC.0000102385.95708.3B GAUDREAU C, 1981, CAN MED ASSOC J, V125, P1246 Giannoni CM, 1997, LARYNGOSCOPE, V107, P863, DOI 10.1097/00005537-199707000-00005 Gordts F, 2000, J LARYNGOL OTOL, V114, P184 Jones NS, 2002, LARYNGOSCOPE, V112, P59, DOI 10.1097/00005537-200201000-00011 JONES RL, 1995, J LARYNGOL OTOL, V109, P1061 Lu CH, 2002, QJM-INT J MED, V95, P501, DOI 10.1093/qjmed/95.8.501 MANIGLIA AJ, 1989, ARCH OTOLARYNGOL, V115, P1424 Merino Luis Antonio, 2003, Ear Nose Throat J, V82, P798 Mortimore S, 1998, J LARYNGOL OTOL, V112, P264 OROBELLO PW, 1991, ARCH OTOLARYNGOL, V117, P980 Oxford LE, 2005, OTOLARYNG HEAD NECK, V133, P32, DOI 10.1016/j.otohns.2005.03.020 PATT BS, 1991, OTOLARYNG HEAD NECK, V104, P789 Younis RT, 2001, LARYNGOSCOPE, V111, P1338, DOI 10.1097/00005537-200108000-00006 NR 20 TC 6 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 381 EP 385 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100011 PM 17561768 ER PT J AU Brook, I AF Brook, Itzhak TI Microbiology of acute sinusitis of odontogenic origin presenting with periorbital cellulitis in children SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anaerobic bacteria; odontogenic infection; periorbital cellulitis; sinusitis ID CHRONIC MAXILLARY SINUSITIS; PERIAPICAL ABSCESS AB Objectives: This study was undertaken to evaluate the aerobic and anaerobic microbiology of acute maxillary sinusitis of odontogenic origin presenting with periodontal infection in children. Methods: Aspirates of 18 acutely infected maxillary sinuses that were associated with odontogenic infection in children who presented with periorbital cellulitis were processed for aerobic and anaerobic bacteria. Results: A total of 54 isolates were recovered (3.0 per specimen): 13 aerobic and facultative (0.7 per specimen) and 41 anaerobic (2.3 per specimen). The number of isolates per specimen varied from 1 to 4. Aerobic and facultative organisms alone were recovered in 2 specimens (11%), anaerobes only in 7 (39%), and mixed aerobic and anaerobic bacteria in 9 (50%). The predominant aerobic and facultative organisms were a-hemolytic streptococci (4), microaerophilic streptococci (3), and Streptococcus pyogenes and Staphylococcus aureus (2 each). The predominant anaerobic bacteria were anaerobic gram-negative bacilli (17), Peptostreptococcus spp (11), Fusobacterium spp (8), and Propionibacterium acnes (2). Twelve beta-lactamase-producing bacteria were recovered from 9 specimens (50%). Conclusions: This study demonstrates the unique aerobic and anaerobic microbiological features of acute maxillary sinusitis of odontogenic origin presenting with periorbital cellulitis in children. C1 Georgetown Univ, Sch Med, Dept Pediat, Washington, DC 20057 USA. RP Brook, I (reprint author), 4431 Albermarle St NW, Washington, DC 20016 USA. CR Brook I, 2005, LARYNGOSCOPE, V115, P823, DOI 10.1097/01.MLG.0000157332.17291.FC Brook I, 1996, J PERIODONTOL, V67, P608 Brook I, 2004, OTOLARYNG CLIN N AM, V37, P253, DOI 10.1016/S0030-6665(03)00155-5 Brook Itzhak, 2003, J Clin Pediatr Dent, V28, P13 BROOK I, 1982, ANN OTO RHINOL LARYN, V91, P41 BROOK I, 1991, ORAL MICROBIOL IMMUN, V6, P123, DOI 10.1111/j.1399-302X.1991.tb00464.x BROOK I, 1980, ANTIMICROB AGENTS CH, V18, P164 BROOK I, 1989, ANN OTO RHINOL LARYN, V98, P426 Finegold S. M., 1977, ANAEROBIC BACTERIA H Nash D, 2001, Pediatr Rev, V22, P111, DOI 10.1542/pir.22-4-111 NORD CE, 1995, CLIN INFECT DIS, V20, P1512 NR 11 TC 8 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 386 EP 388 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100012 PM 17561769 ER PT J AU Pena, MT Aujla, PK Zudaire, E Watson, AM Przygodzki, R Zalzal, GH Rose, MC AF Pena, Maria T. Aujla, Pawandeep K. Zudaire, Enrique Watson, Alan M. Przygodzki, Ronald Zalzal, George H. Rose, Mary C. TI Localization and expression pediatric of MUC5B and MUC7 mucins in sintis mucosa SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE chronic rhinosinusitis; goblet cell; MUC5B; MUC7; mucin; submucosal gland ID HUMAN RESPIRATORY-TRACT; CHRONIC RHINOSINUSITIS; SUBMUCOSAL GLANDS; CHRONIC SINUSITIS; UP-REGULATION; GENES; AIRWAYS; CHILDREN; DISEASES; CLONING AB Objectives: The purpose of this study was to analyze the secretory cell population and distribution of MUC5B and MUC7 mucins in the sinus mucosa of pediatric patients with and without chronic rhinosinusitis (CRS). Methods: Sinus mucosal specimens were collected at surgery in a pediatric tertiary care facility. Histologic, immunohistochemical, and morphometric analyses were performed on sinus mucosa of 20 children with CRS and 7 children without CRS. Results: A significant increase in the area of submucosal glands was evident in the sinus mucosa of children with CRS as compared to controls. MUC5B and MUC7 mucins were expressed in the submucosal glands, as well as in goblet cells, in the sinus mucosa of both populations. No differences in MUC5B or MUC7 expression were observed when mucin expression was normalized to glandular area. Conclusions: Children with CRS have an increased number of submucosal glands, indicating that glandular mucins contribute to mucus overproduction in CRS. MUC5B and MUC7 mucins, which have previously been considered only glandular mucins, are also expressed in goblet cells in the sinus mucosa. C1 Childrens Natl Med Ctr, Dept Otolaryngol, Washington, DC 20010 USA. Childrens Natl Med Ctr, Med Genet Res Ctr, Washington, DC 20010 USA. Childrens Natl Med Ctr, Dept Anat Pathol, Washington, DC 20010 USA. NCI, Cell & Canc Biol Branch, NIH, Bethesda, MD 20892 USA. RP Pena, MT (reprint author), Childrens Natl Med Ctr, Dept Otolaryngol, 111 Michigan Ave NW, Washington, DC 20010 USA. 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Otol. Rhinol. Laryngol. PD MAY PY 2007 VL 116 IS 5 BP 389 EP 397 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 168QM UT WOS:000246539100013 ER PT J AU Skinner, MW Holden, TA Whiting, BR Voie, AH Brunsden, B Neely, JG Saxon, EA Hullar, TE Finley, CC AF Skinner, Margaret W. Holden, Timothy A. Whiting, Bruce R. Voie, Arne H. Brunsden, Barry Neely, J. Gail Saxon, Eugene A. Hullar, Timothy E. Finley, Charles C. TI In vivo estimates of the position of advanced bionics electrode arrays in the human cochlea SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cochlear implant; electrode array; image volume registration; spiral computed tomography; three-dimensional reconstruction; word recognition ID AIDED 3-DIMENSIONAL RECONSTRUCTION; HUMAN TEMPORAL BONES; IMPLANT ELECTRODES; INSERTION TRAUMA; INTRACOCHLEAR POSITION; ACOUSTIC STIMULATION; RESIDUAL HEARING; ELECTRICAL-STIMULATION; MULTISECTION CT; AUDITORY-NERVE AB Objectives: A new technique for determining the position of each electrode in the cochlea is described and applied to spiral computed tomography data from 15 patients implanted with Advanced Bionics HiFocus I, Ij, or Helix arrays. Methods: ANALYZE imaging software was used to register 3-dimensional image volumes from patients' preoperative and postoperative scans and from a single body donor whose unimplanted ears were scanned clinically, with micro computed tomography and with orthogonal-plane fluorescence optical sectioning (OPFOS) microscopy. By use of this registration, we compared the atlas of OPFOS images of soft tissue within the body donor's cochlea with the bone and fluid/tissue boundary available in patient scan data to choose the midmodiolar axis position and judge the electrode position in the scala tympani or scala vestibuli, including the distance to the medial and lateral scalar walls. The angular rotation 0 degrees start point is a line joining the midmodiolar axis and the middle of the cochlear canal entry from the vestibule. Results: The group mean array insertion depth was 477 degrees (range, 286 degrees to 655 degrees). The word scores were negatively correlated (r = -0.59; p = .028) with the number of electrodes in the scala vestibuli. Conclusions: Although the individual variability in all measures was large, repeated patterns of suboptimal electrode placement were observed across subjects, underscoring the applicability of this technique. C1 Washington Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, St Louis, MO 63110 USA. Spencer Technol, Seattle, WA USA. Univ N Carolina, Sch Med, Dept Otolaryngol Head & Neck Surg, Chapel Hill, NC USA. RP Skinner, MW (reprint author), Washington Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, 660 N Euclid Ave,Campus Box 8115, St Louis, MO 63110 USA. 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LARYNGOSCOPE, V116, P1439, DOI 10.1097/01.mlg.0000229826.96593.13 Rebscher SJ, 2001, J ACOUST SOC AM, V109, P2035, DOI 10.1121/1.1365115 Reefhuis J, 2003, NEW ENGL J MED, V349, P435, DOI 10.1056/NEJMoa031101 Robb RA, 2001, IEEE T MED IMAGING, V20, P854, DOI 10.1109/42.952724 Ruegsegger P, 1996, CALCIFIED TISSUE INT, V58, P24, DOI 10.1007/s002239900006 Rydberg J, 2000, RADIOGRAPHICS, V20, P1787 SHEPHERD RK, 1993, HEARING RES, V66, P108, DOI 10.1016/0378-5955(93)90265-3 SHEPHERD RK, 1985, ANN OTO RHINOL LARYN, V94, P55 SHEPHERD RK, 1995, AM J OTOL, V16, P186 Skinner MW, 2002, JARO-J ASSOC RES OTO, V3, P332, DOI 10.1007/s101620020013 Snyder RL, 2004, JARO-J ASSOC RES OTO, V5, P305, DOI 10.1007/s10162-004-4026-5 Sridhar Divya, 2006, Audiol Neurootol, V11 Suppl 1, P16, DOI 10.1159/000095609 Svirsky MA, 2004, ACTA OTO-LARYNGOL, V124, P381, DOI 10.1080/00016480310000593 TAKAGI A, 1989, ANN OTO RHINOL LARYN, V98, P515 Tykocinski M, 2000, AM J OTOL, V21, P205, DOI 10.1016/S0196-0709(00)80010-1 ULEHLOVA L, 1987, HEARING RES, V28, P149, DOI 10.1016/0378-5955(87)90045-1 van der Beek FB, 2005, EAR HEARING, V26, P577, DOI 10.1097/01.aud.0000188116.30954.21 Verbist BM, 2005, AM J NEURORADIOL, V26, P424 VOIE A, 2006, ARO ABSTRACTS, V29, P119 VOIE AH, 1993, J MICROSC-OXFORD, V170, P229 Voie AH, 1995, COMPUT MED IMAG GRAP, V19, P377, DOI 10.1016/0895-6111(95)00034-8 Voie AH, 2003, HEARING RES, V181, P144, DOI 10.1016/S0378-5955(03)00167-9 Voie AH, 2002, HEARING RES, V171, P119, DOI 10.1016/S0378-5955(02)00493-8 von Ilberg C, 1999, ORL J OTO-RHINO-LARY, V61, P334, DOI 10.1159/000027695 Wardrop P, 2005, HEARING RES, V203, P68, DOI 10.1016/j.heares.2004.11.007 Wardrop P, 2005, HEARING RES, V203, P54, DOI 10.1016/j.heares.2004.11.006 WELLING DB, 1993, LARYNGOSCOPE, V103, P995 Whiten D.M., 2007, THESIS MIT Whiting BR, 2001, RADIOLOGY, V221, P543, DOI 10.1148/radiol.2212010275 WRIGHT A, 1987, ACTA OTOLARYNGOL S, V444 Xu J, 2000, AM J OTOL, V21, P49, DOI 10.1016/S0196-0709(00)80112-X Yukawa K, 2004, AUDIOL NEURO-OTOL, V9, P163, DOI 10.1159/000077267 NR 77 TC 33 Z9 33 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 SU 197 BP 2 EP 24 PN 2 PG 23 WC Otorhinolaryngology SC Otorhinolaryngology GA 160FR UT WOS:000245926800001 ER PT J AU Solomon, D Isaacson, G AF Solomon, Don Isaacson, Glenn TI Transoral "adenoidectomy" excision of juvenile nasopharyngeal angiofibromas SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE juvenile nasopharyngeal angiofibroma; minimally invasive technique; transoral excision ID SURGERY AB Objectives: We describe a minimally invasive technique for excision of selected juvenile nasopharyngeal angiofibromas (JNAs) using indirect visualization of the nasopharynx. Methods: An observational case series with follow-up of 9 months to 3 years was performed. The subjects included 4 teenage boys with early-stage nasopharyngeal angiofibromas. The intervention included computed tomography, magnetic resonance imaging, angiography and embolization, tumor excision, pathologic examination, and follow-up. The outcome measures included blood loss, perioperative morbidity, and surgical cure. Results: Four teenage boys underwent excision of early stage JNAs - 3 with preoperative embolization. The JNAs were excised under indirect mirror guidance with an adenoid curette and the nasopharynx packed. Residual tumor was removed endoscopically. The operative time was less than I hour in each case, and blood loss was less than 100 mL. All 4 boys are free of disease. Conclusions: With the advent of refined imaging techniques and relatively safe preoperative embolization, minimally invasive approaches to JNA excision have been advocated. Endoscopic transnasal piecemeal excision is feasible but time-consuming. Transoral avulsion of the tumor mass by adenoidectomy techniques combined with endoscopic removal of tumor remnants from the pterygopalatine fossa allows complete, controlled surgical excision with minimal blood loss. C1 Temple Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Philadelphia, PA 19140 USA. Temple Univ, Childrens Med Ctr, Philadelphia, PA 19122 USA. RP Isaacson, G (reprint author), Temple Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Kresge W 102,3400 N Broad St, Philadelphia, PA 19140 USA. CR CUMMINGS BJ, 1984, LARYNGOSCOPE, V94, P1599 de Mello FV, 2004, AM J OTOLARYNG, V25, P157, DOI 10.1016/j.amjoto.2003.12.001 El-Banhawy OA, 2004, INT J PEDIATR OTORHI, V68, P21, DOI 10.1016/j.ijporl.2003.09.013 Hosseini SMS, 2005, EUR ARCH OTO-RHINO-L, V262, P807, DOI 10.1007/s00405-004-0910-1 Li JR, 1998, EUR ARCH OTO-RHINO-L, V255, P430, DOI 10.1007/s004050050092 Nicolai P, 2003, LARYNGOSCOPE, V113, P775, DOI 10.1097/00005537-200305000-00003 Pryor SG, 2005, LARYNGOSCOPE, V115, P1201, DOI 10.1097/01.MLG.0000162655.96247.66 Radkowski D, 1996, ARCH OTOLARYNGOL, V122, P122 Sivanandan R., 2005, CUMMINGS OTOLARYNGOL, P1669 Ungkanont K, 1996, HEAD NECK-J SCI SPEC, V18, P60, DOI 10.1002/(SICI)1097-0347(199601/02)18:1<60::AID-HED8>3.0.CO;2-X WALDMAN SR, 1981, ARCH OTOLARYNGOL, V107, P677 Wormald PJ, 2003, OTOLARYNG HEAD NECK, V129, P684, DOI 10.1016/S0194-5998(03)01580-8 NR 12 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 243 EP 247 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900002 PM 17491520 ER PT J AU van der Steenstraten, F de Ru, JA Witkamp, TD AF van der Steenstraten, Femke de Ru, J. Alexander Witkamp, Theo D. TI Is microvascular compression of the vestibulocochlear nerve a cause of unilateral hearing loss? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anterior inferior cerebellar artery; imaging; internal auditory canal; microvascular compression syndrome; vestibulocochlear nerve ID DISABLING POSITIONAL VERTIGO; VASCULAR-DECOMPRESSION SURGERY; INFERIOR CEREBELLAR ARTERY; 8TH NERVE; SELECTION CRITERIA; SEVERE TINNITUS; CRANIAL NERVE; SYMPTOMS; TUMORS; LOOPS AB Objectives: We sought to confirm earlier findings it! the literature that microvascular compression of the vestibulocochlear nerve might cause unilateral sensorineural hearing loss. We measured the length and width of the internal auditory canal (IAC) to investigate a possible association between a narrow porus, the presence of an anterior inferior cerebellar artery (AICA) loop, and the development of a microvascular compression syndrome. Methods: We performed a prospective blinded analysis of 167 magnetic resonance imaging scans of the cerebellopontine angle. The presence of an AICA loop was scored. We analyzed these 167 patients for unilateral sensorineural hearing loss, which was defined as an interaural difference of 20 dB at 1 frequency or 10 dB at 2 or more frequencies. Furthermore, the width and length of the IAC on magnetic resonance imaging were measured. Results: An AICA loop was identified in 94% of the 167 patients. There were 196 type I loops, 106 type II loops, and 14 type III loops. Sixty-six patients had unexplained unilateral hearing loss. There was no association between type II and III vascular loops, the width of the IAC, and unilateral hearing loss (p > .05). Conclusions: In this study we found no association between the depth of extension of the AICA loop into the IAC and the presence of unilateral hearing loss. C1 UMC Utrecht, Dept Otorhinolaryngol, NL-3584 CX Utrecht, Netherlands. UMC Utrecht, Dept Radiol, NL-3584 CX Utrecht, Netherlands. RP de Ru, JA (reprint author), UMC Utrecht, Dept Otorhinolaryngol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands. CR APPLEBAUM EL, 1985, AM J OTOL, P110 Brookes GB, 1996, AM J OTOL, V17, P569 Camp JD, 1939, AM J ROENTGENOL RADI, V41, P713 Dandy WE, 1934, AM J SURG, V24, P447, DOI 10.1016/S0002-9610(34)90403-7 Ebenius B, 1934, ACTA RADIOL, V15, P284, DOI 10.3109/00016923409135056 EHNI G, 1945, ARCH NEURO PSYCHIATR, V53, P205 GRAF K, 1952, GESCHWULTSE OHRES HE, P238 HOUSE WF, 1977, NEUROLOGICAL SURG EA, P150 JANNETTA PJ, 1984, NEW ENGL J MED, V310, P1700, DOI 10.1056/NEJM198406283102604 JANNETTA PJ, 1975, SURG FORUM, V26, P467 Kuncz A, 2006, CEPHALALGIA, V26, P266, DOI 10.1111/j.1468-2982.2005.01030.x Lang J, 1984, Adv Otorhinolaryngol, V34, P8 Makins AE, 1998, LARYNGOSCOPE, V108, P1739, DOI 10.1097/00005537-199811000-00027 MARTIN RG, 1980, NEUROSURGERY, V6, P483 MCCABE BF, 1989, AM J OTOL, V10, P117 McDermott AL, 2003, CLIN OTOLARYNGOL, V28, P75, DOI 10.1046/j.1365-2273.2003.00662.x MOLLER AR, 1991, ACTA NEUROCHIR, V113, P18, DOI 10.1007/BF01402109 Moller AR, 1993, NEUROSURGICAL TOPICS, P105 MOLLER MB, 1990, ANN OTO RHINOL LARYN, V99, P724 MOLLER MB, 1993, ACTA NEUROCHIR, V125, P75, DOI 10.1007/BF01401831 MOLLER MB, 1993, LARYNGOSCOPE, V103, P421 Ouaknine G E, 1982, Adv Otorhinolaryngol, V28, P121 PHELPS PD, 1975, BRIT J RADIOL, V48, P973 Ryu H, 1988, Adv Otorhinolaryngol, V42, P280 SASAKI T, 1987, SURG NEUROL, V27, P141 SUNDERLAND S, 1945, BRAIN, V68, P23, DOI 10.1093/brain/68.1.23 Weisenburg TH, 1910, JAMA-J AM MED ASSOC, V54, P1600 NR 27 TC 6 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 248 EP 252 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900003 PM 17491521 ER PT J AU Fitzgerald, DC McGuire, JF AF Fitzgerald, Dennis C. McGuire, John F. TI Intratympanic steroids for idiopathic sudden sensorineural hearing loss SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE idiopathic sudden sensorineural hearing loss; intratympanic steroids ID INNER-EAR; GUINEA-PIG; DEXAMETHASONE; THERAPY; GLUCOCORTICOIDS; CORTICOSTEROIDS; INJECTION AB Objectives: We undertook to evaluate the effectiveness of intratympanic (IT) steroid injections for treating idiopathic sudden sensorineural hearing loss (ISSHL) by performing a retrospective case series study in a private otology practice. Methods: A total of 21 eligible patients with ISSHL were included. We defined ISSHL as a hearing loss of 20 dB or more at at least 3 consecutive audiometric frequencies that develops within 72 hours or less and cannot be attributed to any commonly identifiable cause of sudden hearing loss. Three IT injections of 0.4 mL of 62.5 mg/mL methylprednisolone solution were administered 1 week apart. The end point for the study was a clinically significant change in audiometric values, with a positive response determined to be a 10-dB or greater improvement in the 4-tone pure tone average and/ or a 15% or greater improvement in the word discrimination score. Audiometric data were recorded just before therapy and 1 week after the last IT treatment. The potentially confounding variables recorded included age, sex, "prompt treatment" (defined as treatment within 14 days from onset), concurrent or prior treatment with oral steroids, and severity of hearing loss. Results: The overall response rate to the IT steroid protocol was 67% (14 of 21 patients), with a 95% confidence interval of 43% to 85%. Backward stepwise logistic regression identified "prompt treatment" as the only variable that significantly affected the outcome. The response rate of the "prompt treatment" cohort was 91% (10 of 11 patients), with a 95% confidence interval of 59% to 100%. Conclusions: These findings support the use of IT steroids as an early intervention in the treatment of ISSHL. C1 Washington Hosp Ctr, Dept Otolaryngol, Washington, DC 20010 USA. Georgetown Univ, Sch Med, Dept Otolaryngol, Washington, DC USA. RP Fitzgerald, DC (reprint author), 106 Irving St NW,Suite 4600N, Washington, DC USA. CR Alexiou C, 2001, ARCH OTOLARYNGOL, V127, P253 Balyan FR, 1998, OTOLARYNG HEAD NECK, V118, P261, DOI 10.1016/S0194-5998(98)80028-4 Banerjee A, 2005, OTOL NEUROTOL, V26, P878, DOI 10.1097/01.mao.0000185052.07513.5a Barbara M, 1997, ANN NY ACAD SCI, V830, P243, DOI 10.1111/j.1749-6632.1997.tb51895.x Chandrasekhar SS, 2000, OTOLARYNG HEAD NECK, V122, P521, DOI 10.1016/S0194-5998(00)70094-5 Chandrasekhar SS, 2001, OTOL NEUROTOL, V22, P18, DOI 10.1097/00129492-200101000-00005 Committee on Hearing and Equilibirum, 1995, OTOLARYNGOL HEAD NEC, V113, P181 Erichsen S, 1998, HEARING RES, V124, P146, DOI 10.1016/S0378-5955(98)00117-8 Gacek RR, 1999, AM J OTOL, V20, P553 Gianoli GJ, 2001, OTOLARYNG HEAD NECK, V125, P142, DOI 10.1067/mhn.2001.117162 Himeno C, 2002, HEARING RES, V167, P61, DOI 10.1016/S0378-5955(02)00345-3 Kopke RD, 2001, OTOL NEUROTOL, V22, P475, DOI 10.1097/00129492-200107000-00011 Lee JH, 2002, AUDIOL NEURO-OTOL, V7, P100, DOI 10.1159/000057657 Lefebvre PP, 2002, ACTA OTO-LARYNGOL, V122, P698, DOI 10.1080/003655402/000028037 Nadel D M, 1996, Ear Nose Throat J, V75, P502 PARNES LS, 1999, LARYNGOSCOPE S9, V109 Rarey KE, 1996, OTOLARYNG HEAD NECK, V115, P38, DOI 10.1016/S0194-5998(96)70133-X Ryan AF, 2002, ADV OTO-RHINO-LARYNG, V59, P66 Selivanova OA, 2005, OTOL NEUROTOL, V26, P890, DOI 10.1097/01.mao.0000185050.69394.48 Shirwany NA, 1998, AM J OTOL, V19, P230 Shoji F, 2000, HEARING RES, V146, P134, DOI 10.1016/S0378-5955(00)00106-4 Slattery WH, 2005, OTOLARYNG HEAD NECK, V133, P251, DOI 10.1016/j.otohns.2005.05.015 Uri N, 2003, OTOLARYNG HEAD NECK, V128, P544, DOI 10.1016/mhn.2003.109 WILSON WR, 1980, ARCH OTOLARYNGOL, V106, P772 Yang GSY, 2000, AM J OTOL, V21, P499 Zadeh MH, 2003, OTOLARYNG HEAD NECK, V128, P92, DOI 10.1067/mhn.2003.50 NR 26 TC 22 Z9 27 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 253 EP 256 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900004 PM 17491522 ER PT J AU Arndt, S Veelken, H Schmitt-Graff, A Aschendorff, A Maier, W Richter, B AF Arndt, Susan Veelken, Hendrik Schmitt-Graff, Annette Aschendorff, Antje Maier, Wolfgang Richter, Bernhard TI Multifocal extranodal mucosa-associated lymphoid tissue lymphoma affecting the larynx SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE B-cell lymphoma; larynx; mucosa-associated lymphoid tissue ID B-CELL LYMPHOMA; NON-HODGKINS-LYMPHOMA; MALT-TYPE; CHLAMYDIA-PSITTACI; MALIGNANT-LYMPHOMA; STAGE-I AB Objectives: Extranodal marginal B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) accounts for about 7% to 8% of all B-cell lymphomas and 50% of all gastric lymphomas. Long-term localized growth is typical of MALT lymphoma. Multifocal manifestations are possible in advanced stages. MALT lymphoma of the larynx is a very rare disease; only 15 cases have been reported in the literature. Methods: We report a case of multifocal MALT lymphoma affecting the larynx associated with extraesophageal reflux, chronic laryngitis, and gastric Helicobacter pylori infection. The staging revealed a recurrent tumor of MALT lymphoma in the stomach and an involvement of the right conjunctiva. Results: Following recent reports on successful treatment of MALT lymphoma with antibiotics, initial empirical therapy with doxycycline calcium led to a subjective clinical symptom improvement but no objective response as assessed by laryngoscopy, magnetic resonance imaging of the larynx, and esophagogastroduodenal endoscopy. Because of the advanced stage and multiple extranodal manifestations of the MALT lymphoma, the patient received 3 cycles of chemoimmunotherapy according to the FCR protocol (fludarabine phosphate-cyclophosphamide-rituximab). No evidence of disease was observed after a 6-month follow-up. Conclusions: In the rare diagnosis of MALT lymphoma of the larynx, comprehensive staging is indispensable to exclude multifocal involvement. In contrast to the treatment of primarily localized MALT lymphoma, multifocal disease warrants systemic therapy. C1 Univ Freiburg, Med Ctr, Dept Otorhinolaryngol Head & Neck Surg, D-79106 Freiburg, Germany. Univ Freiburg, Med Ctr, Dept Hematol & Oncol, D-79106 Freiburg, Germany. Univ Freiburg, Med Ctr, Dept Pathol, D-79106 Freiburg, Germany. Univ Freiburg, Med Ctr, Dept Musicians Med, D-79106 Freiburg, Germany. RP Arndt, S (reprint author), Univ Freiburg, Med Ctr, Dept Otorhinolaryngol Head & Neck Surg, Killianstr 5, D-79106 Freiburg, Germany. CR Ahmad A, 2003, AM J GASTROENTEROL, V98, P975, DOI 10.1016/S0002-9270(03)00142-4 Bertoni F, 2005, J CLIN ONCOL, V23, P6415, DOI 10.1200/JCO.2005.05.018 Bhattacharyya N, 1998, ANN OTO RHINOL LARYN, V107, P801 Dallenbach FE, 2000, PATHOLOGE, V21, P162, DOI 10.1007/s002920050383 de Bree R, 1998, EUR ARCH OTO-RHINO-L, V255, P368, DOI 10.1007/s004050050079 Ferreri AJM, 2005, J CLIN ONCOL, V23, P5067, DOI 10.1200/JCO.2005.07.083 Ferreri AJM, 2004, J NATL CANCER I, V96, P586, DOI 10.1093/jnci/djh102 Fung Eric K, 2002, Ann Diagn Pathol, V6, P61, DOI 10.1053/adpa.2002.30611 Harris NL, 1999, ANN ONCOL, V10, P1419, DOI 10.1023/A:1008375931236 ISAACSON P, 1983, CANCER, V52, P1410, DOI 10.1002/1097-0142(19831015)52:8<1410::AID-CNCR2820520813>3.0.CO;2-3 Kuhnt T, 2003, STRAHLENTHER ONKOL, V179, P396, DOI 10.1007/s00066-003-1020-5 Levy M, 2002, AM J GASTROENTEROL, V97, P292 Pak MW, 1999, OTOLARYNG HEAD NECK, V121, P335 Roggero E, 2000, HUM PATHOL, V31, P263, DOI 10.1016/S0046-8177(00)80233-6 Starostik P, 2002, BLOOD, V99, P3, DOI 10.1182/blood.V99.1.3 Thieblemont C, 2000, BLOOD, V95, P802 THIEBLEMONT C, 2000, BLOOD, V95, P2481 Tsang RW, 2001, INT J RADIAT ONCOL, V50, P1258, DOI 10.1016/S0360-3016(01)01549-8 Wohrer S, 2003, ANN ONCOL, V14, P1758, DOI 10.1093/annonc/mdg492 WOTHERSPOON AC, 1991, LANCET, V338, P1175, DOI 10.1016/0140-6736(91)92035-Z Zinzani PL, 1999, J CLIN ONCOL, V17, P1254 Zinzani PL, 2004, CANCER, V100, P2190, DOI 10.1002/cncr.20237 Zucca E, 2000, BLOOD, V96, P410 NR 23 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 257 EP 261 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900005 PM 17491523 ER PT J AU Ayala, MA Patterson, MB Bach, KK AF Ayala, Marco A. Patterson, Matthew B. Bach, Kevin K. TI Late displacement of a Montgomery thyroplasty implant following endotracheal intubation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE airway complication; endotracheal intubation; Montgomery implant; thyroplasty; vocal fold implant ID SURGERY AB Objectives: We document a late displacement of a thyroplasty implant following endotracheal intubation. Methods: A 66-year-old man was referred to our clinic with a chief complaint of breathy dysphonia immediately following an elective inguinal hernia repair under general endotracheal anesthesia. The patient's medical history was significant for a medialization laryngoplasty with a Montgomery implant 14 years earlier. Results: Examination and computed tomographic scanning of the neck confirmed displacement of the implant. The patient underwent revision medialization laryngoplasty with successful restoration of his voice quality. Conclusions: This case report illustrates a potential complication of endotracheal intubation in patients who have previously undergone vocal fold medialization procedures. C1 USN, Med Ctr, Dept Otolaryngol Head & Neck Surg, San Diego, CA 92134 USA. RP Ayala, MA (reprint author), USN, Med Ctr, Clin Invest Dept, 34800 Bob Wilson Dr,Ste 5, San Diego, CA 92134 USA. CR Bielamowicz S, 2004, OTOLARYNG CLIN N AM, V37, P139, DOI 10.1016/S0030-6665(03)00166-X Friedlander P, 1999, ANN OTO RHINOL LARYN, V108, P735 HUNSAKER DH, 1994, LARYNGOSCOPE S65, V104 ISSHIKI N, 1974, ACTA OTO-LARYNGOL, V78, P451, DOI 10.3109/00016487409126379 Tanaka A, 2003, ANESTHESIOLOGY, V99, P252, DOI 10.1097/00000542-200308000-00005 Weinman EC, 2000, LARYNGOSCOPE, V110, P1082, DOI 10.1097/00005537-200007000-00003 1915, DTSCH MED WOCHENSCHR NR 7 TC 3 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 262 EP 264 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900006 PM 17491524 ER PT J AU Ridder, GJ Kayser, G Teszler, CB Pfeiffer, J AF Ridder, Gerd Juergen Kayser, Gian Teszler, Christian Barna Pfeiffer, Jens TI Solitary fibrous tumors in the head and neck: New insights and implications for diagnosis and treatment SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE head and neck tumors; hemangiopericytoma; soft tissue tumor; solitary fibrous tumor; tonsillar neoplasm ID GLAND; PLEURA AB Objectives: The solitary fibrous tumor (SFT) is a potentially malignant spindle cell neoplasm of mesenchymal origin that was originally described as a thoracic lesion originating from pleural tissue. Recently, numerous extrapleural sites of origin have been described, frequently affecting the head and neck region. The purpose of this article is to focus on a formerly underestimated neoplasm and to highlight its appearance in the head and neck region. Methods: The authors present 2 illustrative cases, including what is probably the first reported case of an SFT arising in the human tonsillar fossa, and give a clinical and pathological literature review. Results: The clinical, histologic, and radiologic features are presented, and the surgical treatment is described. The international medical literature concerning SFTs in general and SFTs of the head and neck in particular is reviewed, and the changing concept of SFTs and hemangiopericytomas is discussed on the basis of the updated World Health Organization classification of soft tissue tumors. Conclusions: It is nowadays recognized that the large majority of lesions formerly classified as hemangiopericytomas are, in fact, variants of SFTs. Although still a rare occurrence, SFTs have become increasingly recognized, and clinicians should be aware of their presentation. C1 Univ Freiburg, Sch Med, Dept Otorhinolaryngol Head & Neck Surg, D-79106 Freiburg, Germany. Univ Freiburg, Sch Med, Inst Pathol, D-79106 Freiburg, Germany. Adolfe De Rothschild Fdn, Dept Otolaryngol Head & Neck Surg, Paris, France. RP Ridder, GJ (reprint author), Univ Freiburg, Sch Med, Dept Otorhinolaryngol Head & Neck Surg, Killianstr 5, D-79106 Freiburg, Germany. CR Alawi F, 2001, AM J SURG PATHOL, V25, P900, DOI 10.1097/00000478-200107000-00008 Alobid I, 2005, OTOLARYNG HEAD NECK, V133, P163, DOI 10.1016/j.otohns.2004.09.058 Alobid I, 2003, ACTA OTO-LARYNGOL, V123, P71, DOI 10.1080/003655402/000028052 ENGLAND DM, 1991, AM J SURG PATHOL, V15, P818, DOI 10.1097/00000478-199108000-00022 ENGLAND DM, 1989, AM J SURG PATHOL, V13, P640, DOI 10.1097/00000478-198908000-00003 Fletcher CDM, 2006, HISTOPATHOLOGY, V48, P3, DOI 10.1111/j.1365-2559.2005.02284.x Gengler C, 2006, HISTOPATHOLOGY, V48, P63, DOI 10.1111/j.1365-2559.2005.02290.x Hicks DL, 2004, SKULL BASE-INTERD AP, V14, P203, DOI 10.1055/s-2004-860951 Hofmann T, 2002, EUR ARCH OTO-RHINO-L, V259, P470, DOI 10.1007/s00405-002-0475-9 JHAM BC, IN PRESS BR J ORAL M Munks A, 2003, LARYNGO RHINO OTOL, V82, P655 Mussak EN, 2005, OTOLARYNG HEAD NECK, V133, P805, DOI 10.1016/j.otohns.2004.11.009 Pasquini E, 2003, J LARYNGOL OTOL, V117, P889 Rodriguez F, 2004, AM J SURG PATHOL, V28, P139, DOI 10.1097/00000478-200401000-00017 Sato J, 1998, EUR ARCH OTO-RHINO-L, V255, P18, DOI 10.1007/s004050050015 Schwab R, 2004, CHIRURG, V75, P200, DOI 10.1007/s00104-003-0764-x Shnayder Y, 2003, AM J OTOLARYNG, V24, P246, DOI 10.1016/S0196-0709(03)00007-3 Wilde F, 2005, Mund Kiefer Gesichtschir, V9, P404, DOI 10.1007/s10006-005-0649-x WITKIN GB, 1991, AM J SURG PATHOL, V15, P842, DOI 10.1097/00000478-199109000-00004 NR 19 TC 7 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 265 EP 270 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900007 PM 17491525 ER PT J AU Lin, CC Lee, KS Wang, YP Hsieh, WY Shen, SY Chiu, CH Liaw, SF AF Lin, Ching-Chi Lee, Kuo-Sheng Wang, Ying-Piao Hsieh, Wen-Yeh Shen, Sheng-Yeh Chiu, Chung-Hsin Liaw, Shwu-Fang TI Effect of uvulopalatopharyngoplasty on work of breathing during wakefulness in obstructive sleep apnea syndrome SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE obstructive sleep apnea syndrome; uvulopalatopharyngoplasty; work of breathing ID UPPER AIRWAY; RESISTANCE; ADULTS; CPAP AB Objectives: We evaluated the effects of uvulopalatopharyngoplasty (UPPP) on the work of breathing (WOB) in obstructive sleep apnea syndrome (OSAS). Methods: Fifteen healthy subjects and 30 subjects with OSAS who desired UPPP were prospectively enrolled. All underwent measurement of WOB while awake as well as in a sleep study. These studies were repeated 3 months after UPPP in the patients with OSAS. Results: In OSAS before UPPP, the WOB while supine was increased above that of normal subjects. After UPPP, the WOB while supine remained elevated in those whose OSAS did not respond to surgery, and it returned to normal levels in patients whose OSAS improved after UPPP. Conclusions: Abnormal WOB in patients with OSAS returns to normal if UPPP results in amelioration of OSAS. C1 Mackay Mem Hosp, Dept Internal Med, Chest Div, Taipei, Taiwan. Mackay Mem Hosp, Dept Med Res, Taipei, Taiwan. Mackay Mem Hosp, Dept Otolaryngol, Taipei, Taiwan. Mackay Med Nursing & Management Coll, Taipei, Taiwan. RP Lin, CC (reprint author), Mackay Mem Hosp, Dept Internal Med, Chest Div, 92,Sec 2,Chung Shan N Rd, Taipei, Taiwan. CR AGOSTINI E, 1970, RESPIRATORY MUSCLES, P115 Flemons WW, 1999, SLEEP, V22, P667 American Thoracic Society, 1989, AM REV RESPIR DIS, V139, P559 Amis TC, 1999, J PHYSIOL-LONDON, V515, P293, DOI 10.1111/j.1469-7793.1999.293ad.x Chiumello D, 2001, EUR RESPIR J, V18, P107, DOI 10.1183/09031936.01.00083901 EEG arousals: Scoring rules and examples, 1992, SLEEP, V15, P173 GLEESON K, 1986, AM REV RESPIR DIS, V134, P115 GUILLEMINAULT C, 1977, ARCH INTERN MED, V137, P296, DOI 10.1001/archinte.137.3.296 HE J, 1988, CHEST, V94, P9, DOI 10.1378/chest.94.1.9 HUDGEL DW, 1986, J APPL PHYSIOL, V61, P1403 Kawano K, 1996, Acta Otolaryngol Suppl, V523, P236 KEENAN SP, 1994, CHEST, V105, P155, DOI 10.1378/chest.105.1.155 Lin CC, 2006, EUR ARCH OTO-RHINO-L, V263, P241, DOI 10.1007/S00405-005-0994-2 Lin CC, 2002, METABOLISM, V51, P622, DOI 10.1053/meta.2002.31969 MARTIN SE, 1995, AM J RESP CRIT CARE, V152, P721 MILICEMILI J, 1991, LUNG SCI FDN, P1065 Navajas D, 1998, AM J RESP CRIT CARE, V157, P1526 Pelin Z, 2003, EUR RESPIR J, V21, P688, DOI 10.1183/09031936.03.00293903 PEVERNAGIE DA, 1995, AM J RESP CRIT CARE, V152, P179 Rechtschaffen A, 1968, MANUAL STANDARDIZED SHEPARD JW, 1990, MAYO CLIN PROC, V65, P1260 Sher AE, 1996, SLEEP, V19, P156 SPANN RW, 1971, J APPL PHYSIOL, V31, P708 NR 23 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 271 EP 277 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900008 PM 17491526 ER PT J AU Tanna, N Patel, AA Eisler, LS Goding, G Maisel, R AF Tanna, Neil Patel, Alpen A. Eisler, Lindsay S. Goding, George Maisel, Robert TI Bilobed Zenker's diverticula SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE bilobed Zenker's diverticulum; endoscopic stapling; pharyngeal pouch ID PHARYNGEAL POUCH AB A bilobed Zenker's diverticulum is an uncommon finding. Given the rarity of these bilobed pharyngeal pouches, their management can pose a clinical dilemma. We advocate transoral endoscopic division and stapling of the larger lobe as the management of choice for this clinical finding. We present 2 patients, each with a bilobed Zenker's diverticulum. To our knowledge, these 2 cases represent the first reported bilobed pharyngeal pouches treated successfully with division and stapling of only the larger lobe. C1 Emory Univ, Dept Otolaryngol Head & Neck Surg, Atlanta, GA 30308 USA. George Washington Univ, Div Otolaryngol Head & Neck Surg, Washington, DC USA. Univ Minnesota, Dept Otolaryngol Head & Neck Surg, Minneapolis, MN USA. RP Patel, AA (reprint author), Emory Univ, Dept Otolaryngol Head & Neck Surg, 550 Peachtree St,9th Floor,Suite 4400, Atlanta, GA 30308 USA. CR Chang CY, 2003, LARYNGOSCOPE, V113, P957, DOI 10.1097/00005537-200306000-00009 Izzat AB, 2000, J LARYNGOL OTOL, V114, P802 JESBERG N, 1954, ANN OTO RHINOL LARYN, V63, P39 Ludlow A, 1769, MED OBSERVATIONS INQ, V3, P85 MEEHAN T, 1992, J LARYNGOL OTOL, V106, P1002, DOI 10.1017/S0022215100121607 Philippsen LP, 2000, LARYNGOSCOPE, V110, P1283, DOI 10.1097/00005537-200008000-00011 Sen P, 2004, J LARYNGOL OTOL, V118, P601 STAFFORD N, 1987, ANN OTO RHINOL LARYN, V96, P127 van Overbeek JJM, 2003, ANN OTO RHINOL LARYN, V112, P583 NR 9 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 278 EP 280 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900009 PM 17491527 ER PT J AU Welsh, LW AF Welsh, Louis W. TI Alstrom syndrome: Progressive deafness and blindness SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE Alstrom syndrome; pigmented retinopathy; pr1ogressive sensorineural deafness ID DILATED CARDIOMYOPATHY; COCKAYNE-SYNDROME; REFSUMS-DISEASE; HEARING-LOSS; ALMS1; OBESITY AB Alstrom syndrome is a very rare, genetically transmitted disorder that affects special sense functions, resulting in progressive visual and auditory impairment. The diagnostic criteria for this disorder are presented, and the differential issues between it and other, similar syndromal forms of sensory and multisystem dysfunction are discussed. A report of 2 siblings so involved is summarized. The disability of other organs is considered, namely, the kidney, the heart, and the metabolic and endocrine systems. RP Welsh, LW (reprint author), 2236 Deer Path Rd, Huntingdon Valley, PA 19006 USA. CR ALSTROM CH, 1959, ACTA PSYCHIAT NEUR S, V129 Arenas-Sordo ML, 2006, MED ORAL PATOL ORAL, V11, pE236 Bamiou DE, 2003, CLIN OTOLARYNGOL, V28, P227, DOI 10.1046/j.1365-2273.2003.00694.x Benso C, 2002, GRAEF ARCH CLIN EXP, V240, P622, DOI 10.1007/s00417-002-0479-6 Collin GB, 2002, NAT GENET, V31, P74, DOI 10.1038/ng867 Collin GB, 2005, HUM MOL GENET, V14, P2323, DOI 10.1093/hmg/ddi235 Green GE, 2002, ADV OTO-RHINO-LARYNG, V61, P230 Hearn T, 2002, NAT GENET, V31, P79, DOI 10.1038/ng874 Hearn T, 2005, DIABETES, V54, P1581, DOI 10.2337/diabetes.54.5.1581 Hoffman JD, 2005, AM J MED GENET A, V135A, P96, DOI 10.1002/ajmg.a.30688 Itoh T, 2006, J DERMATOL SCI, V41, P87, DOI 10.1016/j.jdermsci.2005.10.010 Jansen GA, 2004, HUM MUTAT, V23, P209, DOI 10.1002/humu.10315 KUNST D, 2005, GENETICS ENT SPECIAL Maffei Pietro, 2002, Ann Ital Med Int, V17, P221 MARSHALL JD, 2005, ARCH INTERN MED, V165, P673 MCKUSICK VA, 1991, MENDELIAN INHERITANC, V2, P1290 Michaud JL, 1996, J PEDIATR-US, V128, P225, DOI 10.1016/S0022-3476(96)70394-3 Oysu C, 2001, INT J PEDIATR OTORHI, V61, P129, DOI 10.1016/S0165-5876(01)00559-6 Pasquier L, 2006, ARCH DIS CHILD, V91, P178, DOI 10.1136/adc.2005.080473 Russell-Eggitt IM, 1998, OPHTHALMOLOGY, V105, P1274, DOI 10.1016/S0161-6420(98)97033-6 Tseng CJ, 2000, AM J OTOL, V21, P437, DOI 10.1016/S0196-0709(00)80058-7 NR 21 TC 9 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 281 EP 285 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900010 PM 17491528 ER PT J AU Becker, SS Han, JK Nguyen, TA Gross, CW AF Becker, Samuel S. Han, Joseph K. Nguyen, Thuy-Anh Gross, Charles W. TI Initial surgical treatment for chronic frontal sinusitis: A pilot study SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE endoscopic sinus surgery; frontal sinusitis ID NASAL POLYPS; CHRONIC RHINOSINUSITIS; SURGERY; ASTHMA AB Objectives: The initial surgical treatment for chronic frontal sinusitis is not well defined. Our objective was to determine the effectiveness of anterior ethmoidectomy for chronic frontal sinusitis. Methods: Patients with chronic frontal sinusitis who underwent anterior ethmoidectomy as initial surgical treatment were reviewed. Data were collected from computed tomography scans with use of the Lund-Mackay scale. Data on demographics, comorbidities, management, postoperative recovery, and follow-up were collected. Results: Seventy-seven patients representing 121 diseased frontal sinuses met the inclusion criteria. The respiratory comorbidities were asthma alone (8.3%), asthma and polyps (6.6%), aspirin triad (5.8%), and cystic fibrosis (0.8%). Nineteen of 121 frontal sinuses (15.7%) belonged to smokers. Fourteen of 121 frontal sinuses (11.5%) exhibited postoperative evidence of disease. Of these 14 frontal sinuses, 10 (8.3%) underwent revision surgery. Frontal sinuses of patients with aspirin triad, with both nasal polyposis and asthma, or with inter-frontal sinus septal cells were more likely to fail Draf I surgery (p < .05). Conclusions: Anterior ethmoidectomy for drainage of frontal sinuses appears to be effective initial surgical treatment for chronic frontal sinusitis. Patients with aspirin triad, both asthma and polyposis, or inter-frontal sinus septal cells are more likely to fail this procedure. C1 Univ Virginia Hlth Syst, Dept Otolaryngol Head & Neck Surg, Charlottesville, VA USA. RP Han, JK (reprint author), Eastern Virginia Med Sch, Dept Otolaryngol Head & Neck Surg, 825 Fairfax Ave,Suite 510, Virginia Beach, VA 23507 USA. CR Bateman ND, 2004, CLIN OTOLARYNGOL, V29, P677, DOI 10.1111/j.1365-2273.2004.00901.x Batra PS, 2003, LARYNGOSCOPE, V113, P1703, DOI 10.1097/00005537-200310000-00008 Briggs RD, 2004, LARYNGOSCOPE, V114, P126, DOI 10.1097/00005537-200401000-00022 Deal RT, 2004, LARYNGOSCOPE, V114, P1932, DOI 10.1097/01.mlg.147922.12228.1f Draf W., 1991, OPERATIVE TECHNIQUES, V2, P234, DOI DOI 10.1016/S1043-1810(10)80087-9 GOODALE RL, 1958, ARCHIV OTOLARYNGOL, V68, P271 Jacobs JB, 1997, LARYNGOSCOPE, V107, P1, DOI 10.1097/00005537-199711001-00001 Jankowski R, 2002, RHINOLOGY, V40, P173 KENNEDY DW, 1985, ARCH OTOLARYNGOL, V111, P643 Kennedy DW, 1997, LARYNGOSCOPE, V107, P1, DOI 10.1097/00005537-199701000-00002 Lee WT, 2004, OTOLARYNG HEAD NECK, V131, P164, DOI 10.1016/j.otohns.2004.04.012 Lund Valerie J., 1993, Rhinology (Utrecht), V31, P183 Lynch RC, 1921, LARYNGOSCOPE, V31, P1 MAY M, 1995, OPERATIVE TECHNIQUES, V6, P184, DOI 10.1016/S1043-1810(06)80011-4 Pujols L, 2004, J ALLERGY CLIN IMMUN, V114, P814, DOI 10.1016/j.jaci.2004.07.050 NR 15 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 286 EP 289 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900011 PM 17491529 ER PT J AU Hirano, S Nagahara, K Moritani, S Kitamura, M Takagita, SI AF Hirano, Shigeru Nagahara, Kunihiko Moritani, Sueyoshi Kitamura, Morimasa Takagita, Shin-ichi TI Upper mediastinal node dissection for hypopharyngeal and cervical esophageal carcinomas SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cervical esophageal carcinoma; hypopharyngeal carcinoma; mediastinal dissection ID GASTRIC TRANSPOSITION; THORACIC ESOPHAGUS; CANCER; NECK; OMENTUM; PATIENT AB Objectives: Hypopharyngeal cancer (HPC) and cervical esophageal cancer (Ce) are aggressive tumors with a poor prognosis. Multiple lymph node metastases often occur in the upper mediastinum, as well as in the neck, and thus upper mediastinal dissection (MD) is crucial to improving the cure rate. However, excessive MD can increase postoperative morbidity and mortality, making it important to employ the proper technique and appropriate extent of dissection. In the present retrospective study we aimed to determine the proper extent of upper MD according to tumor site and stage. The benefit and risk of upper MD are also discussed. Methods: Chart review was completed for patients who underwent upper MD, including 64 patients with HPC, 21 patients with Ce, and 9 patients with Ce extending to involve the upper thoracic esophagus (Ce/Ut). The incidence and distribution of lymph node metastases in the upper mediastinum were assessed by postoperative histopathologic examination. Postoperative complications of upper MD, as well as the impact on survival and locoregional control, were also reviewed. Results: Upper mediastinal metastases were detected in 7.8% of HPC patients, 33.3% of Ce patients, and 55.6% of Ce/Ut patients. In HPC patients, mediastinal metastases were usually associated with T4 primary tumors (80%), whereas positive nodes in the upper mediastinum were detected regardless of T stage in both Ce and Ce/Ut. Only 1 Ce/Ut patient with a T4 tumor developed late nodal metastasis in the lower mediastinum. The 5-year disease- specific survival and locoregional control rates were 58.6% and 90.2% in HPC, 45.5% and 94.1% in Ce, and 38.9% and 77.7% in Ce/Ut, respectively. Rupture of the greater vessels after MD was observed in 5 cases (5.3%). Conclusions: The present results indicate excellent locoregional control rates following upper MD, while major complications such as arterial breakdown were rare. It is suggested that upper MD may be an essential and adequate procedure for patients with Ce or Ce/Ut tumors, and may also be required for cases of HPC with a T4 primary to improve locoregional control of the disease. C1 Kyoto Univ, Dept Otolaryngol Head & Neck Surg, Grad Sch Med, Sakyo Ku, Kyoto 6068507, Japan. Kyoto Med Ctr, Dept Otolaryngol Bronchoesophagol, Kyoto, Japan. Kusatsu Gen Hosp, Inst Head & Neck Surg, Kusatsu, Japan. RP Hirano, S (reprint author), Kyoto Univ, Dept Otolaryngol Head & Neck Surg, Grad Sch Med, Sakyo Ku, Kyoto 6068507, Japan. CR AKIYAMA H, 1994, ANN SURG, V220, P364, DOI 10.1097/00000658-199409000-00012 AKIYAMA H, 1990, SURG CANC ESOPHAGUS, P143 BABA M, 1994, ANN SURG, V219, P310, DOI 10.1097/00000658-199403000-00012 COLLIN CF, 1984, AM J SURG, V148, P460, DOI 10.1016/0002-9610(84)90370-2 Ferlito A, 2001, ACTA OTO-LARYNGOL, V121, P329, DOI 10.1080/000164801300102671 FUJITA H, 1994, J JPN BRONCHOESOPHAG, V45, P120 HARRISON DFN, 1975, LARYNGOSCOPE, V85, P1208, DOI 10.1288/00005537-197507000-00012 Hoffman HT, 1997, LARYNGOSCOPE, V107, P1005, DOI 10.1097/00005537-199708000-00001 KELLEY DK, 1995, AM J SURG, V170, P427, DOI 10.1016/S0002-9610(99)80322-5 Kuwabara Y, 2001, ANN THORAC SURG, V71, P409, DOI 10.1016/S0003-4975(00)02228-1 Martins AS, 2001, HEAD NECK-J SCI SPEC, V23, P772, DOI 10.1002/hed.1110 Martins AS, 1999, J SURG ONCOL, V70, P181, DOI 10.1002/(SICI)1096-9098(199903)70:3<181::AID-JSO7>3.0.CO;2-E Saito R, 2000, Jpn J Thorac Cardiovasc Surg, V48, P417 SPIRO RH, 1991, AM J SURG, V162, P348, DOI 10.1016/0002-9610(91)90146-5 Urba Susan, 2002, Surg Oncol Clin N Am, V11, P377, DOI 10.1016/S1055-3207(02)00013-3 WEBER RS, 1993, OTOLARYNG HEAD NECK, V108, P11 NR 16 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 290 EP 296 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900012 PM 17491530 ER PT J AU Oikawa, K Furuta, Y Itoh, T Oridate, N Fukuda, S AF Oikawa, Keita Furuta, Yasushi Itoh, Tomoo Oridate, Nobuhiko Fukuda, Satoshi TI Clinical and pathological analysis of recurrent inverted papilloma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE inverted papilloma; malignant transformation; nasal cavity; paranasal sinus; recurrence ID SQUAMOUS-CELL CARCINOMA; SINONASAL PAPILLOMAS; ENDOSCOPIC SURGERY; TREATMENT OUTCOMES; SINUS SURGERY; MANAGEMENT AB Objectives: We analyzed the clinical characteristics, pathological findings, and treatment outcomes of patients with recurrent sinonasal inverted papilloma (IP). Methods: This retrospective study consisted of 13 patients with recurrent IP. Patient data were collected on prior treatment, sites of recurrence, surgical procedures, pathological findings, and postoperative time to recurrence. Results: Eleven of the 13 patients (85%) had recurrence in the ethmoid sinus, particularly at the lamina papyracea (n = 8; 62%). Inverted papilloma with severe dysplasia (SD) was observed in 4 patients, 3 of whom showed malignant transformation of the recurrent tumor. Craniofacial resection was performed in 2 of the 4 patients, resulting in no further recurrence. However, the tumor was not managed in the remaining 2 patients. In the 9 patients without SD, lateral rhinotomy was performed in 6 patients and endoscopic sinus surgery was selected in 3 patients who had a small tumor without scar formation. No further recurrence was observed in the 9 patients. Conclusions: Careful management of IP around the lamina papyracea is essential during initial surgery. Recurrent IP without SD can be successfully managed by lateral rhinotomy in most cases, and by endoscopic sinus surgery in selected cases. However, more aggressive treatment, including craniofacial resection, should be considered in IP with SD, which is associated with a high rate of recurrence and malignant transformation. C1 Hokkaido Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Kita Ku, Sapporo, Hokkaido 0608638, Japan. Hokkaido Univ Hosp, Dept Surg Pathol, Sapporo, Hokkaido 060, Japan. RP Furuta, Y (reprint author), Hokkaido Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Kita Ku, Kita 15,Nishi 7, Sapporo, Hokkaido 0608638, Japan. RI Fukuda, Satoshi/A-8433-2012; Oridate, Nobuhiko/G-5365-2012 CR Buchwald C, 2001, LARYNGOSCOPE, V111, P1104, DOI 10.1097/00005537-200106000-00032 DOLGIN SR, 1992, LARYNGOSCOPE, V102, P231 Han JK, 2001, LARYNGOSCOPE, V111, P1395, DOI 10.1097/00005537-200108000-00015 Homma A, 1999, CLIN CANCER RES, V5, P801 KAUFMAN MR, 2002, LARYNGOSCOPE, V122, P1372 Kraft M, 2003, LARYNGOSCOPE, V113, P1541, DOI 10.1097/00005537-200309000-00025 Krouse JH, 2001, AM J OTOLARYNG, V22, P87, DOI 10.1053/ajot.2001.22563 LAWSON W, 1995, LARYNGOSCOPE, V105, P282, DOI 10.1288/00005537-199503000-00011 Lawson W, 2003, LARYNGOSCOPE, V113, P1548, DOI 10.1097/00005537-200309000-00026 Lee TJ, 2004, LARYNGOSCOPE, V114, P106, DOI 10.1097/00005537-200401000-00019 LESPERANCE MM, 1995, LARYNGOSCOPE, V105, P178, DOI 10.1288/00005537-199502000-00013 MYERS EN, 1990, LARYNGOSCOPE, V100, P481 Schlosser RJ, 2001, OTOLARYNG HEAD NECK, V125, P49, DOI 10.1067/mhn.2001.116789 Tufano RP, 1999, AM J RHINOL, V13, P423, DOI 10.2500/105065899781329665 Von Buchwald C, 2005, OTOLARYNG HEAD NECK, V132, P602, DOI 10.1016/j.otohns.2005.01.016 WAITZ G, 1992, LARYNGOSCOPE, V102, P917, DOI 10.1288/00005537-199208000-00012 Wolfe SG, 2004, OTOLARYNG HEAD NECK, V131, P174, DOI 10.1016/j.otohns.2004.05.011 Yoon JH, 2002, J LARYNGOL OTOL, V116, P699 NR 18 TC 8 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 297 EP 303 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900013 PM 17491531 ER PT J AU Searl, J AF Searl, Jeff TI Bilabial contact pressure and oral air pressure during tracheoesophageal speech SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE articulation; laryngectomy; pressure; tracheoesophageal speech ID CLEAR SPEECH; ESOPHAGEAL; VOICE; LARYNGECTOMY; PERCEPTION; TONGUE AB Objectives: This study compared bilabial contact pressure (CPsp) and oral air pressure (Po) for /p/, /b/, and /m/ produced by tracheoesophageal (TE) versus laryngeal speakers. Nonspeech maximum bilabial contact pressures (CPmax) were measured to calculate the percentage of the range utilized for bilabial phonemes. Methods: Ten TE speakers and 10 laryngeal speakers produced syllables and sentences loaded with bilabial phonemes. The CPsp was measured with a miniature pressure transducer on the lower lip while the Po was simultaneously measured with a catheter in the corner of the mouth coupled to a differential pressure transducer. The speakers completed a non-speech lip-press task with the contact pressure transducer in place. Results: The TE speakers produced bilabial phonemes with significantly higher CPsp and Po than did laryngeal speakers. There was no difference in CPmax between the groups. The percentage of the contact pressure range utilized for bilabial phonemes was significantly higher for TE speakers. Conclusions: The increased CPsp and Po exhibited by TE speakers may reflect an attempt to overexaggerate articulation, although an alternate explanation related to neoglottal and oral aerodynamics must also be considered in future work. Subsequent studies evaluating the relationships between magnitude of articulatory contact pressure, phoneme intelligibility, and speaker's sense of effort should contribute to a better understanding of TE speech demands and may guide novel interventions to facilitate TE speech intelligibility. C1 Bowling Green State Univ, Dept Commun Disorders, Bowling Green, OH 43403 USA. RP Searl, J (reprint author), Univ Kansas, Med Ctr, Hearing & Speech Dept, 3031 Miller Bldg,MS3039, Kansas City, KS 66160 USA. CR AINSWORTH WA, 1992, FOLIA PHONIATR, V44, P297 Brown DH, 2003, WORLD J SURG, V27, P824, DOI 10.1007/s00268-003-7107-4 Cohen J., 1988, STAT POWER ANAL BEHA, V2nd DOYLE PC, 1988, J SPEECH HEAR DISORD, V53, P400 Geraghty JA, 1996, ANN OTO RHINOL LARYN, V105, P501 Gress C., 2005, CONT CONSIDERATIONS, P431 HILLMAN RE, 1998, ANN OTOL RHINOL S172, V107 Hinton VA, 1997, J SPEECH LANG HEAR R, V40, P400 HINTON VA, 1992, J SPEECH HEAR RES, V35, P245 Krause JC, 2004, J ACOUST SOC AM, V115, P362, DOI 10.1121/1.1635842 LINDBLOM B, 1990, SPEECH PRODUCTION SP, P201 Liu S, 2004, J ACOUST SOC AM, V116, P2374, DOI 10.1121/1.1787528 Motta S, 2001, ARCH OTOLARYNGOL, V127, P700 Perkell JS, 2002, J ACOUST SOC AM, V112, P1627, DOI 10.1121/1.1506369 ROBBINS J, 1984, J SPEECH HEAR DISORD, V49, P202 Saito M, 2000, ACTA OTO-LARYNGOL, V120, P771, DOI 10.1080/000164800750000333 SALMON SJ, 2005, CONT CONSIDERATIONS, P59 Searl JP, 2003, J SPEECH LANG HEAR R, V46, P1444, DOI 10.1044/1092-4388(2003/112) Searl JP, 2004, J VOICE, V18, P557, DOI 10.1016/j.jvoice.2003.10.004 Searl JP, 2002, J SPEECH LANG HEAR R, V45, P282, DOI 10.1044/1092-4388(2002/022) SINGER MI, 1980, ANN OTO RHINOL LARYN, V89, P529 Smiljanic R, 2005, J ACOUST SOC AM, V118, P1677, DOI 10.1121/1.2000788 Solomon NP, 2000, J SPEECH LANG HEAR R, V43, P1416 Solomon NP, 2000, J SPEECH LANG HEAR R, V43, P256 THOMPSON EC, 1997, J MED SPEECH-LANG PA, V5, P191 van As CJ, 1999, ARCH OTOLARYNGOL, V125, P891 van As-Brooks CJ, 2005, J VOICE, V19, P360, DOI 10.1016/j.jvoice.2004.07.011 WEINBERG B, 1982, J SPEECH HEAR DISORD, V47, P194 YORKSTON KM, 1984, ASSESSMENT INTELLIGE NR 29 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 304 EP 311 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900014 PM 17491532 ER PT J AU Hekiert, AM Mandel, J Mirza, N AF Hekiert, Adrianna M. Mandel, Jeff Mirza, Natasha TI Laryngoscopies in the obese: Predicting problems and optimizing visualization SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE glottis; laryngoscopy; obesity ID DIFFICULT TRACHEAL INTUBATION AB Objectives: This pilot study was designed to 1) identify predictors of difficult laryngeal exposure in obese patients, 2) develop strategies for efficient intubation and intraoperative visualization of the glottis, and 3) devise perioperative protocols for difficult laryngoscopies. Methods: We undertook a retrospective study over a 1-year period of 14 consecutive patients with a body mass index of more than 30 kg/m(2) who underwent elective direct laryngoscopy under general anesthesia. Measurements of height, weight, neck circumference, Mallampati score, and Cormack-Lehane classification of the airway were recorded. Problems encountered during anesthesia induction and emergence were also noted. The laryngologist recorded on a visual analog scale the degree of difficulty encountered in obtaining a binocular stereoscopic view and magnification, illumination, and suspension. Results: Anatomic challenges during difficult laryngoscopy included decreased neck extension, redundant folds of tissue in the oropharynx and hypopharynx, and upper airway collapsibility. Overall, there was an association between the incidence of difficult laryngeal exposure and the Cormack-Lehane score (r = .57; p = .03), but the Mallampati score was of limited utility to the laryngologist. Neck size in female patients correlated with the Cormack-Lehane score (p = .02). Neither weight nor body mass index were predictive of a difficult laryngeal exposure. Straight blade laryngoscopes with a distal flange allowed greater depth of insertion and provided the best visualization of the glottis. Conclusions: An appropriate clinical examination may help predict a difficult airway. However, further studies are warranted to fully characterize the anatomic predictors of a difficult laryngeal exposure. C1 Univ Penn, Med Ctr, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. Univ Penn, Med Ctr, Dept Anesthesiol, Philadelphia, PA 19104 USA. RP Mirza, N (reprint author), Univ Penn, Med Ctr, Dept Otorhinolaryngol Head & Neck Surg, 3400 Spruce St,5th Floor Ravdin Bldg, Philadelphia, PA 19104 USA. RI Mandel, Jeff/D-1128-2009 OI Mandel, Jeff/0000-0002-8846-4154 CR Arino JJ, 2003, CAN J ANAESTH, V50, P501 Brodsky JB, 2002, ANESTH ANALG, V94, P732, DOI 10.1097/00000539-200203000-00047 CORMACK RS, 1984, ANAESTHESIA, V39, P1105, DOI 10.1111/j.1365-2044.1984.tb08932.x Ezri T, 2003, CAN J ANAESTH, V50, P179 Ezri T, 2003, ANAESTHESIA, V58, P1111, DOI 10.1046/j.1365-2044.2003.03412.x Juvin P, 2003, ANESTH ANALG, V97, P595, DOI 10.1213/01.ANE.0000072547.75928.B0 King GG, 2005, EUR RESPIR J, V25, P896, DOI 10.1183/09031936.05.0014504 MALLAMPATI SR, 1985, CAN ANAESTH SOC J, V32, P429, DOI 10.1007/BF03011357 Roh JL, 2005, ANN OTO RHINOL LARYN, V114, P614 Shore SA, 2005, J ALLERGY CLIN IMMUN, V115, P925, DOI 10.1016/j.jaci.2005.01.064 NR 10 TC 5 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2007 VL 116 IS 4 BP 312 EP 316 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 159CV UT WOS:000245843900015 PM 17491533 ER PT J AU Roy, N Smith, ME Allen, B Merrill, RM AF Roy, Nelson Smith, Marshall E. Allen, Brynn Merrill, Ray M. TI Adductor spasmodic dysphonia versus muscle tension dysphonia: Examining the diagnostic value of recurrent laryngeal nerve lidocaine block SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE adductor spasmodic dysphonia; lidocaine block; muscle tension dysphonia ID SPASTIC DYSPHONIA; DENERVATION-REINNERVATION; FUNCTIONAL DYSPHONIA; SECTION; TERM AB Objectives: Differentiating adductor spasmodic dysphonia (ADSD) from muscle tension dysphonia (MTD) can be difficult. This investigation examined the precision of response to unilateral lidocaine block of the recurrent laryngeal nerve (RLN block) as a potential diagnostic test to discriminate ADSD from MTD. Methods: Patients with ADSD (n = 23) and MTD (n = 20) were audio-recorded before and during RLN block. The patients completed self-ratings of dysphonia severity, vocal effort, and laryngeal tightness, and blinded listeners completed auditory-perceptual ratings of overall severity, breathiness, and strain of voice samples before and during the block. Results: Repeated-measures analysis of variance, with "group" (ADSD/MTD) as the between-subjects variable and "time" (before block/during block) as the within-subjects variable, confirmed significant "time" effects, but no significant "group-by-time" interaction effects, indicating that both disorder groups responded favorably to RLN block, according to patient-and listener-based ratings. Furthermore, low estimates of sensitivity and specificity and weak receiver operating characteristic curves confirmed that a positive response to the RLN block test did not distinguish ADSD from MTD. Conclusions: We conclude that RLN block offers little discriminatory value in the differential diagnosis of ADSD versus MTD, and a positive response to RLN block should not be considered confirmatory of ADSD. C1 Univ Utah, Dept Commun Sci & Disorders, Salt Lake City, UT 84112 USA. Univ Utah, Sch Med, Div Otolaryngol Head & Neck Surg, Salt Lake City, UT 84112 USA. Brigham Young Univ, Dept Hlth Sci, Provo, UT 84602 USA. RP Roy, N (reprint author), Univ Utah, Dept Commun Sci & Disorders, 390 S 1530 E,Room 1219, Salt Lake City, UT 84112 USA. CR Aronson AE, 1990, CLIN VOICE DISORDERS Behrman A, 2003, J VOICE, V17, P403, DOI 10.1067/S0892-1997(03)00018-3 Berke GS, 1999, ANN OTO RHINOL LARYN, V108, P227 Boone DR, 2000, VOICE VOICE THERAPY Cannito MP, 2000, VOICE QUALITY MEASUR, P411 Chhetri DK, 2006, LARYNGOSCOPE, V116, P635, DOI 10.1097/01.MLG.0000201990.97955.E4 DEBO HH, 1980, SPASTIC DYSPHONIA SU DEDO HH, 1976, ANN OTO RHINOL LARYN, V85, P451 Higgins MB, 1999, J SPEECH LANG HEAR R, V42, P101 IZDEBSKI K, 1979, OTOLARYNG HEAD NECK, V87, P428 Koufman J., 2003, DIAGNOSIS TREATMENT, P171 Leonard R, 1999, LARYNGOSCOPE, V109, P295, DOI 10.1097/00005537-199902000-00022 LUDLOW CL, 1984, OTOLARYNG HEAD NECK, V92, P24 Ludlow CL., 1995, DIAGNOSIS TREATMENT, P436 MORRISON MD, 1993, ACTA OTO-LARYNGOL, V113, P428, DOI 10.3109/00016489309135839 ROY N, IN PRESS FOLIA PHONI Roy N, 1997, J VOICE, V11, P321, DOI 10.1016/S0892-1997(97)80011-2 Roy N, 2005, LARYNGOSCOPE, V115, P311, DOI 10.1097/01.mlg.0000154739.48314.ee Roy Nelson, 2003, Curr Opin Otolaryngol Head Neck Surg, V11, P144, DOI 10.1097/00020840-200306000-00002 Sama A, 2001, LARYNGOSCOPE, V111, P458, DOI 10.1097/00005537-200103000-00015 Sapienza CM, 2000, J VOICE, V14, P502, DOI 10.1016/S0892-1997(00)80008-9 Schiratzki H, 1988, Acta Otolaryngol Suppl, V449, P115 Schneider B, 2002, FOLIA PHONIATR LOGO, V54, P44, DOI 10.1159/000048595 Smith ME, 2006, LARYNGOSCOPE, V116, P591, DOI 10.1097/01.MLG.0000205588.04450.AC SMITH ME, 1993, AM J OTOLARYNG, V14, P366, DOI 10.1016/0196-0709(93)90098-R NR 25 TC 4 Z9 5 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 161 EP 168 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400001 PM 17419518 ER PT J AU Stern, Y Felipovich, A Cotton, RT Segal, K AF Stern, Yoram Felipovich, Alexandra Cotton, Robin T. Segal, Karl TI Immunocompetency in children with recurrent respiratory papillomatosis: Prospective study SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE airway; child; immune system; papillomatosis ID JUVENILE LARYNGEAL PAPILLOMATOSIS AB Objectives: We sought to investigate the immunologic status of children with recurrent respiratory papillomatosis and to evaluate possible correlations between the patients' immunocompetency and the clinical course of the disease. Methods: Twenty children with recurrent respiratory papillomatosis underwent immunologic evaluation every 6 months for determination of complete blood count, serum immunoglobulin levels, lymphocyte subpopulations, lymphocyte response to mitogen stimulation, and natural killer cell function. The patients were observed prospectively (42 to 56 months), and their clinical course was recorded. The findings were compared with those in healthy age-matched controls. Results: The CD4/CD8 ratio and the lymphocyte response to mitogen stimulation were significantly reduced in the study children compared to normal controls. A reduction in lymphocyte response to mitogen stimulation was significantly correlated to a high number of papilloma sites and more frequent recurrences. Abnormal natural killer cell function was significantly correlated to more frequent recurrences. Conclusions: A compromised cell-mediated immune response may be associated with repeated or persistent human papillomavirus infections, leading to the development of recurrent respiratory papillomatosis. Patients with an aggressive clinical course may have underlying cell-mediated immunodeficiency. Long-term prospective investigations are needed to establish the role of the host immune system in the pathogenesis of recurrent respiratory papillomatosis in children. C1 Schneider Childrens Med Ctr Israel, Dept Pediat Otolaryngol, IL-49202 Petah Tiqwa, Israel. Rabin Med Ctr, Dept Otolaryngol, Petah Tiqwa, Israel. Childrens Hosp, Med Ctr, Dept Otorhinolaryngol, Cincinnati, OH 45229 USA. Childrens Hosp, Med Ctr, Dept Hematol & Oncol, Cincinnati, OH 45229 USA. RP Stern, Y (reprint author), Schneider Childrens Med Ctr Israel, Dept Pediat Otolaryngol, IL-49202 Petah Tiqwa, Israel. CR Benton C, 1992, PAPILLOMAVIRUS REP, V3, P23 BONAGURA VR, 1994, CLIN DIAGN LAB IMMUN, V1, P357 COLEMAN N, 1994, AM J CLIN PATHOL, V102, P768 HALLDEN C, 1986, J REPROD MED, V31, P804 JAKUBIKOVA J, 1992, INT J PEDIATR OTORHI, V23, P229, DOI 10.1016/0165-5876(92)90104-W KASHIMA HK, 1991, OTOLARYNG HEAD NECK, V104, P191 Knowles G, 1996, J VIROL, V70, P8451 OKABAYASHI M, 1993, AM J PATHOL, V142, P489 PERRICK D, 1990, ANN ALLERGY, V65, P69 SHAH K, 1986, OBSTET GYNECOL, V68, P795 NR 10 TC 17 Z9 17 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 169 EP 171 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400002 PM 17419519 ER PT J AU Svec, JG Sram, F Schutte, HK AF Svec, Jan G. Sram, Frantisek Schutte, Harm K. TI Videokymography in voice disorders: What to look for? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE diagnostics; high-speed imaging; laryngoscopy; videokymography; vocal fold vibration; voice disorders ID VOCAL FOLD VIBRATION; MUCOSAL WAVE; LARYNGEAL VIBRATIONS; GLOTTIC WAVE; KYMOGRAPHY; CORD; GLOTTOGRAPHY; PHONATION AB Objectives: Kymographic imaging through videokymography has been recognized as a convenient, novel way to display laryngeal behavior, yet little systematic research has been done to map the relevant features displayed in such images. Here we have aimed at specification of these features to enable systematic visual characterization and categorization of vocal fold vibratory patterns in voice disorders. Methods: A cross-sectional, descriptive design was used. We selected 45 subjects and extracted 100 videokymographic images from the archive of more than 7,000 videokymographic examinations of subjects with a wide range of voice disorders. The images showed a large variety of vocal fold vibratory behaviors during sustained phonations. We visually identified the prominent features that distinguished the vibration patterns across the images. Results: We divided the findings into 10 feature categories. They included refined traditional features (eg, mucosal waves), as well as additional features that are obscured in strobolaryngoscopy (eg, different types of irregularities, left-right frequency differences, shapes of lateral and medial peaks, cycle aberrations). Conclusions: The variations in the identified features reveal different behavioral origins of voice disorders. The findings open new possibilities for objective documentation and for monitoring vocal fold behavior in clinical practice through kymographic imaging. C1 Univ Groningen, Med Ctr, Groningen Voice Res Lab, Dept Biomed Engn, NL-9713 AB Groningen, Netherlands. Med Healthcom Ltd, Ctr Commun Disorders, Prague, Czech Republic. RP Svec, JG (reprint author), Univ Groningen, Med Ctr, Groningen Voice Res Lab, Dept Biomed Engn, Antonius Deusinglaan 1, NL-9713 AB Groningen, Netherlands. RI Svec, Jan/C-6909-2008 OI Svec, Jan/0000-0001-5095-7415 CR Baken RJ, 2000, CLIN MEASUREMENT SPE BERKE GS, 1993, J VOICE, V7, P123, DOI 10.1016/S0892-1997(05)80341-8 Deliyski DD, 2005, J VOICE, V19, P485, DOI 10.1016/j.jvoice.2004.07.006 Dollinger M, 2002, IEEE T BIO-MED ENG, V49, P773, DOI 10.1109/TBME.2002.800755 Dunker E, 1964, RES POTENTIALS VOICE, P151 Eysholdt U, 2003, EUR ARCH OTO-RHINO-L, V260, P412, DOI 10.1007/s00405-003-0606-y GALL V, 1984, ARCH OTO-RHINO-LARYN, V240, P287 GALL V, 1978, FOLIA PHONIATR, V30, P28 Granqvist S, 2001, J ACOUST SOC AM, V110, P3193, DOI 10.1121/1.1397321 Gross M., 1988, ENDOSKOPISCHE LARYNX Hertegård Stellan, 2005, Curr Opin Otolaryngol Head Neck Surg, V13, P152, DOI 10.1097/01.moo.0000163451.98079.ba Hirano M, 1981, CLIN EXAMINATION VOI Hirano M, 1993, VIDEOSTROBOSCOPIC EX HIRANO M, 1974, FOLIA PHONIATR, V26, P89 Isshiki N, 1998, J VOICE, V12, P125, DOI 10.1016/S0892-1997(98)80031-3 ISSHIKI N, 1977, ANN OTO RHINOL LARYN, V86, P58 Jiang JJ, 2000, LARYNGOSCOPE, V110, P1567, DOI 10.1097/00005537-200009000-00032 Larsson H, 2000, LARYNGOSCOPE, V110, P2117, DOI 10.1097/00005537-200012000-00028 Lindestad Per-Ake, 2004, Logoped Phoniatr Vocol, V29, P162, DOI 10.1080/14015430410020339 MATSUSHITA H, 1975, FOLIA PHONIATR, V27, P7 Mergell P, 1998, J ACOUST SOC AM, V104, P464, DOI 10.1121/1.423250 MOORE P, 1958, FOLIA PHONIATR, V10, P205 Neubauer J, 2001, J ACOUST SOC AM, V110, P3179, DOI 10.1121/1.1406498 Qiu QJ, 2006, LARYNGOSCOPE, V116, P1824, DOI 10.1097/01.mlg.0000233552.58895.d0 Qiu QJ, 2003, FOLIA PHONIATR LOGO, V55, P128, DOI 10.1159/000070724 Schutte HK, 1998, LARYNGOSCOPE, V108, P1206, DOI 10.1097/00005537-199808000-00020 SRAM F, 2000, AKTUELLE PHONIATRISC, V7, P53 Sram F, 1996, SYDNEY '97 - XVI WORLD CONGRESS OF OTORHINOLARYNGOLOGY HEAD AND NECK SURGERY, TOMES 1 AND 2, P1681 Sundberg J, 2001, Logoped Phoniatr Vocol, V26, P26, DOI 10.1080/140154301300109107 Sung MW, 1999, LARYNGOSCOPE, V109, P1859, DOI 10.1097/00005537-199911000-00027 Svec JG, 1996, J VOICE, V10, P201, DOI 10.1016/S0892-1997(96)80047-6 SVEC JG, 1999, OTORINOLARYNGOL PRAG, V48, P155 SVEC JG, 2000, THESIS U GRONINGEN TIMCKE R, 1958, ARCHIV OTOLARYNGOL, V68, P1 TIMCKE R, 1959, ARCHIV OTOLARYNGOL, V69, P438 Titze IR, 2006, J SPEECH LANG HEAR R, V49, P439, DOI 10.1044/1092-4388(2006/034) TITZE IR, 1988, J ACOUST SOC AM, V83, P1536, DOI 10.1121/1.395910 TITZE IR, 1993, ANN OTO RHINOL LARYN, V102, P58 Titze IR, 2000, PRINCIPLES VOICE PRO Verdonck-de Leeuw IM, 2001, J VOICE, V15, P313, DOI 10.1016/S0892-1997(01)00033-9 VON LEDEN H., 1960, ARCH OTOLARYNGOL, V71, P16 Wittenberg T, 1995, MACH VISION APPL, V8, P399, DOI 10.1007/s001380050021 Wittenberg T, 2000, J VOICE, V14, P422, DOI 10.1016/S0892-1997(00)80087-9 WOO P, 1996, LARYNGOSCOPE S79, V106 Yan YL, 2005, J VOICE, V19, P161, DOI 10.1016/j.joice.2004.04.006 YUMOTO E, 1991, J VOICE, V5, P299, DOI 10.1016/S0892-1997(05)80059-1 NR 46 TC 66 Z9 68 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 172 EP 180 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400003 PM 17419520 ER PT J AU Bahmad, F Merchant, SN AF Bahmad, Fayez, Jr. Merchant, Saumil N. TI Histopathology of ossicular grafts and implants in chronic otitis media SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE histopathology; implant; middle ear; ossicular graft ID MIDDLE-EAR; REPLACEMENT PROSTHESIS; HISTOLOGICAL FATE; CARTILAGE; SURGERY; BONE; OSSICULOPLASTY; TYMPANOPLASTY; AUTOGRAFTS; PATHOLOGY AB Objectives: We describe the histopathology of ossicular grafts and implants so as to provide insight into factors that may influence functional results after surgery for chronic otitis media. Methods: Histopathologic observations were made on 56 cases: 50 surgical specimens and 6 temporal bone cases in which the graft was sectioned in situ. Results and Conclusions: Autogenous malleus, incus, and cortical bone grafts behaved in a similar manner and maintained their morphological size, shape, and contour for extended periods of time, at least up to 30 years. These histopathologic observations support the continued use of autograft ossicular and cortical bone grafts for middle ear reconstruction. Cartilage grafts developed chondromalacia with resulting loss of stiffness and showed a tendency to undergo resorption. Synthetic prostheses made of porous plastic (Plastipore, Polycel) elicited foreign body giant cell reactions with various degrees of biodegradation of the implants. Prostheses made of hydroxyapatite and Bioglass were enveloped by a lining of connective tissue and mucosal epithelium. The Bioglass material was broken down into small fragments and partially resorbed by a host response within the middle car. These results warrant caution in the use of prostheses made of porous plastic or Bioglass. C1 Massachusetts Eye & Ear Infirm, Otopathol Lab, Boston, MA 02114 USA. Harvard Univ, Sch Med, Boston, MA 02114 USA. RP Merchant, SN (reprint author), Massachusetts Eye & Ear Infirm, Otopathol Lab, 243 Charles, Boston, MA 02114 USA. CR ALBREKTSSON T, 1980, Scandinavian Journal of Plastic and Reconstructive Surgery, V14, P1 BELAL A, 1981, CLIN OTOLARYNGOL, V6, P231, DOI 10.1111/j.1365-2273.1981.tb01540.x BELAL A, 1984, J LARYNGOL OTOL, V98, P229, DOI 10.1017/S0022215100146481 BELAL A, 1982, J LARYNGOL OTOL, V96, P49, DOI 10.1017/S0022215100092227 BRENNAN G, 1984, CLIN OTOLARYNGOL, V9, P229, DOI 10.1111/j.1365-2273.1984.tb01502.x BURCHARDT H, 1983, CLIN ORTHOP REL 0428 EMMETT JR, 1989, AM J OTOL, V10, P215 GOLDBERG VM, 1987, CLIN ORTHOP REL 1207 Goldenberg RA, 2001, OTOL NEUROTOL, V22, P145, DOI 10.1097/00129492-200103000-00005 HALL A, 1960, Acta Otolaryngol Suppl, V158, P335 Jang CH, 2004, J LARYNGOL OTOL, V118, P840 KERR AG, 1981, CLIN OTOLARYNGOL, V6, P187, DOI 10.1111/j.1365-2273.1981.tb01530.x KERR AG, 1973, J LARYNGOL OTOL, V87, P1193, DOI 10.1017/S0022215100078166 KERR A G, 1971, Journal of Laryngology and Otology, V85, P337, DOI 10.1017/S0022215100073515 KYLEN P, 1987, ACTA OTO-LARYNGOL, V104, P158, DOI 10.3109/00016488709109062 LANG J, 1986, J LARYNGOL OTOL, V100, P741, DOI 10.1017/S0022215100100027 LINTHICU.FH, 1966, LARYNGOSCOPE, V76, P1232 MAKEK M, 1988, ARCH OTOLARYNGOL, V114, P1127 MERCHANT SN, 1994, OTOLARYNG CLIN N AM, V27, P813 Merchant SN, 1998, J LARYNGOL OTOL, V112, P715 MILLS RP, 1995, CLIN OTOLARYNGOL, V20, P365, DOI 10.1111/j.1365-2273.1995.tb00062.x NADOL JB, 2004, SURG EAR TEMPORAL BO PALVA T, 1983, ACTA OTO-LARYNGOL, V95, P139, DOI 10.3109/00016488309130927 PALVA T, 1984, ARCH OTOLARYNGOL, V110, P765 POSTMA D, 1982, ARCH OTOLARYNGOL, V108, P801 ROBIN PE, 1976, CLIN OTOLARYNGOL, V1, P295, DOI 10.1111/j.1365-2273.1976.tb00650.x Schuknecht HF, 1993, PATHOLOGY EAR SCHUKNECHT HF, 1985, LARYNGOSCOPE, V95, P249 SHEA JJ, 1978, ARCH OTOLARYNGOL, V104, P191 SMYTH GDL, 1982, OTOLARYNG HEAD NECK, V90, P343 SMYTH GDL, 1977, OTOLARYNG CLIN N AM, V10, P563 STEINBACH E, 1981, J LARYNGOL OTOL, V95, P1031, DOI 10.1017/S0022215100091787 VANBLITTERSWIJK CA, 1990, ANN OTO RHINOL LARYN, V99, P3 YAMAMOTO E, 1988, OTOLARYNG HEAD NECK, V98, P546 Yung MW, 2003, J LARYNGOL OTOL, V117, P431 NR 35 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 181 EP 191 PG 11 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400004 PM 17419521 ER PT J AU Elmaraghy, CA Tanna, N Wiet, GJ Kang, DR AF Elmaraghy, Charles A. Tanna, Neil Wiet, Gregory J. Kang, D. Richard TI Endoscopic management of blunt pediatric laryngeal trauma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 34th Annual Meeting of the Society-for-Ear-Nose-and-Throat-Advances-in-Children CY NOV 30, 2006 CL San Francisco, MD SP Soc Ear Nose & Throat Advances Children DE blunt trauma; endoscopy; laryngeal trauma; larynx; pediatrics; tracheostomy ID LARYNGOTRACHEAL TRAUMA; INJURIES AB Objectives: Blunt laryngeal trauma in the pediatric population is an uncommon but unique entity that can be potentially life-threatening. Given the infrequency of these events, its management can pose a clinical dilemma. The authors review the evaluation and treatment of blunt pediatric laryngeal trauma. Methods: We present a case report and a review of the literature. Results: We describe the case of a 3-year-old boy who presented with laryngeal injury following blunt trauma. The patient sustained endolaryngeal hematomas and mucosal lacerations with exposed cartilage. After mucosal approximation, the patient was successfully managed in a critical care setting without a tracheostomy. Conclusions: With an appropriate and thorough evaluation of the pediatric patient, endoscopic management without a surgical airway may be considered as a viable alternative for blunt laryngeal trauma. C1 George Washington Univ, Div Otolaryngol Head & Neck Surg, Washington, DC 20036 USA. Columbus Childrens Hosp, Div Pediat Otolaryngol Head & Neck Surg, Columbus, OH USA. RP Tanna, N (reprint author), George Washington Univ, Div Otolaryngol Head & Neck Surg, 2150 Penn Ave NW,Suite 6-301, Washington, DC 20036 USA. CR BENT JP, 1993, OTOLARYNG HEAD NECK, V109, P441 FORD HR, 1995, J PEDIATR SURG, V30, P331, DOI 10.1016/0022-3468(95)90584-7 FUHRMAN GM, 1990, J TRAUMA, V30, P87, DOI 10.1097/00005373-199001000-00014 GUSSACK AS, 1988, J TRAUMA, V28, P1439 HOLINGER PH, 1972, ANN OTO RHINOL LARYN, V81, P538 Lambert G E Jr, 1976, JACEP, V5, P883, DOI 10.1016/S0361-1124(76)80035-4 MACE SE, 1986, ANN EMERG MED, V15, P836, DOI 10.1016/S0196-0644(86)80387-0 MATHISEN DJ, 1987, ANN THORAC SURG, V43, P254 MYER CM, 1987, LARYNGOSCOPE, V97, P1043 SCHAEFER SD, 1982, ANN OTO RHINOL LARYN, V91, P399 STANLEY RB, 1986, ARCH OTOLARYNGOL, V112, P516 NR 11 TC 6 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 192 EP 194 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400005 PM 17419522 ER PT J AU Tringali, S Pouget, JF Bertholon, P Dubreuil, C Martin, C AF Tringali, Stephane Pouget, Jean-Francois Bertholon, Pierre Dubreuil, Christian Martin, Christian TI Value of temporal bone density measurements in otosclerosis patients with normal-appearing computed tomographic scan SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cochlear density; computed tomographic scan; otosclerosis; temporal bone ID SENSORINEURAL HEARING-LOSS; COCHLEAR CAPSULE; CT; DENSITOMETRY AB Objectives: Previous studies demonstrated that otosclerosis diagnosis benefits from temporal bone density measurements. We sought to assess bone density measurements of the fissula ante fenestram (EAF) in normal patients, in patients with otosclerosis, and in patients with cholesteatoma. We discuss the value of temporal bone density measurements in patients with otosclerosis who have a normal-appearing computed tomographic (CT) scan. Methods: This was a prospective case-control study in which 219 temporal bones (123 adults, 18 to 84 years of age) were included between November 1, 2002, and April 30, 2004. All patients underwent a CT scan of the temporal bones. Axial views were obtained with density measurement of the FAR Results: The FAF density was significantly different (p < .0001) in the otosclerosis group (n = 119) compared to the control group (n = 100). There was no significant difference between the otosclerosis group with a normal-appearing CT scan and the control group (p = .64). Conclusions: From our results, it may be suggested that 1) temporal bone density measurements seem not to be strictly comparable between CT scan devices; and 2) temporal bone density measurements of the FAF did not allow the diagnosis of otosclerosis when the CT scan appeared normal. C1 Lyon Sud Hosp, Dept Otorhinolaryngol Head & Neck Surg, Lyon, France. Bellevue Hosp, Dept Radiol, St Etienne, France. Bellevue Hosp, Dept Otorhinolaryngol Head & Neck Surg, St Etienne, France. RP Tringali, S (reprint author), Ctr Hosp Univ Lyon Sud, Serv Otoneurochirurg, F-69495 Pierre Benite, France. CR Grayeli AB, 2004, ACTA OTO-LARYNGOL, V124, P1136, DOI 10.1080/00016480410018188 CHAKERES DW, 1984, AM J NEURORADIOL, V5, P297 CUMMINGS CW, 1993, OTOLARYNGOLOGY HEAD, P2997 DARCHAMBEAU O, 1990, EUR J RADIOL, V11, P22, DOI 10.1016/0720-048X(90)90098-V DEGROOT JAM, 1986, ACTA OTOLARYNGOL S, V434 Guneri EA, 1996, ANN OTO RHINOL LARYN, V105, P659 Harcourt JP, 1997, J LARYNGOL OTOL, V111, P117 HUIZING EH, 1987, ACTA OTO-LARYNGOL, V103, P464 MAFEE MF, 1985, RADIOLOGY, V156, P703 Pekkola J, 2004, RADIOLOGY, V230, P88, DOI 10.1148/radiol.2301021111 ROULLEAU P, 1994, OTOSPONGIOSE OTOSCLE VALVASSORI GE, 1985, AM J NEURORADIOL, V6, P661 VALVASSORI GE, 1993, OTOLARYNG CLIN N AM, V26, P359 VIGNAUD J, 1986, EAR DIAGNOSTIC IMAGI NR 14 TC 7 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 195 EP 198 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400006 PM 17419523 ER PT J AU Lee, JC Song, YJ Chung, YS Lee, BJ Jang, YJ AF Lee, Jong Cheol Song, Yong Jin Chung, Yoo-Sam Lee, Bong-Jae Jang, Yong Ju TI Height and shape of the skull penetration during base as risk factors for skull base endoscopic sinus surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cribriform plate; endoscopic sinus surgery; fovea ethmoidalis; skull base defect ID SCANS AB Objectives: Computed tomography (CT) and magnetic resonance imaging have identified several risk factors for life-threatening complications of skull base penetration during endoscopic sinus surgery (ESS). We compared these risk factors between groups of patients with and without penetration. Methods: We performed a retrospective review of direct coronal paranasal sinus CT scans. Using preoperative CT scans of 100 patients without and 7 patients with penetration, we classified height into 4 groups and contour into 2 groups. The frequencies of shape and height differences of the right and left halves of the skull base were calculated in each group. Results: In 6 of the 7 patients who had skull base penetration, ESS was performed by a resident or junior staff member who had less than 3 years of experience with this technique. Shape asymmetry was seen in 4 of the 7 patients (57%) with penetration, which was a significantly higher rate than in patients without penetration (18 of 100; p = .032). The frequencies of a low skull base and a height difference were 15% and 28%, respectively. Conclusions: The most important risk factor for skull base penetration was the surgeon's inexperience. An asymmetry of shape of the right and left halves of the skull base was significantly related to inadvertent skull base penetration during ESS. C1 Univ Ulsan, Coll Med, Asan Med Ctr, Dept Otolaryngol, Seoul 138736, South Korea. Gangneung Asan Hosp, Dept Otolaryngol, Gangneung, Song, South Africa. RP Jang, YJ (reprint author), Univ Ulsan, Coll Med, Asan Med Ctr, Dept Otolaryngol, 388-1 Pungnap Dong, Seoul 138736, South Korea. CR DESSI P, 1994, J LARYNGOL OTOL, V108, P261 Eggesbo HB, 2001, ACTA RADIOL, V42, P482, DOI 10.1080/028418501127347214 Jones TM, 2002, CLIN OTOLARYNGOL, V27, P101, DOI 10.1046/j.1365-2273.2002.00540.x LAWSON W, 1991, LARYNGOSCOPE, V101, P367 Lebowitz RA, 2001, LARYNGOSCOPE, V111, P2122, DOI 10.1097/00005537-200112000-00007 Meyers RM, 1998, LARYNGOSCOPE, V108, P422, DOI 10.1097/00005537-199803000-00020 RAMADAN HH, 1995, LARYNGOSCOPE, V105, P376, DOI 10.1288/00005537-199504000-00007 Stankiewicz JA, 2004, AM J RHINOL, V18, P35 Stankiewicz James A, 2005, Curr Opin Otolaryngol Head Neck Surg, V13, P19, DOI 10.1097/00020840-200502000-00006 NR 9 TC 3 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 199 EP 205 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400007 PM 17419524 ER PT J AU Edwards, J Tanna, N Bielamowicz, SA AF Edwards, John Tanna, Neil Bielamowicz, Steven A. TI Endoscopic lysis of anterior glottic webs and silicone keel placement SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE endoscope; glottis; keel; larynx; web ID RECURRENT RESPIRATORY PAPILLOMATOSIS; LASER-SURGERY; LARYNGEAL PAPILLOMATOSIS; COMPLICATIONS; REPAIR AB Objectives: Acquired anterior glottic webs occur most commonly after endoscopic resection of laryngeal papilloma involving the anterior vocal folds. Treatment of anterior glottic webs has included a tracheotomy with laryngofissure and placement of a laryngeal stent or keel. We have used an endoscopic technique of web lysis and placement of a laryngeal keel without tracheotomy over the past 7 years. Methods: A retrospective chart review was conducted of all cases of endoscopic web lysis and keel placement performed by the senior author (S.A.B.). Results: Over the past 7 years, 10 patients underwent the procedure, with a mean follow-up of 18 months. The length of the anterior web was up to two thirds of the membranous vocal fold. Outcomes analysis revealed a recurrence in 1 patient and 2 minor complications necessitating treatment. Conclusions: Endoscopic web lysis and keel placement offers superior results with less morbidity compared to open techniques. C1 George Washington Univ, Div Otolaryngol, Washington, DC 20036 USA. George Washington Univ, Voice Treatment Ctr, Washington, DC 20036 USA. RP Bielamowicz, SA (reprint author), George Washington Univ, Div Otolaryngol, 2150 Penn Ave NW,Suite 6-301, Washington, DC 20036 USA. CR BENJAMIN B, 1988, J LARYNGOL OTOL, V102, P1022, DOI 10.1017/S0022215100107169 Bielamowicz S, 2002, LARYNGOSCOPE, V112, P696, DOI 10.1097/00005537-200204000-00019 Casiano RR, 1998, J VOICE, V12, P536, DOI 10.1016/S0892-1997(98)80062-3 CROCKETT DM, 1987, ANN OTO RHINOL LARYN, V96, P639 DEDO HH, 1979, ANN OTO RHINOL LARYN, V88, P467 Holland BW, 2002, LARYNGOSCOPE, V112, P1926, DOI 10.1097/00005537-200211000-00003 JACKSON C, 1930, NOSE THROAT EAR THEI, P755 LICHTENBERGER G, 1994, LARYNGOSCOPE, V104, P771 MCGUIRT WF, 1984, LARYNGOSCOPE, V94, P1176 McNaught RC., 1950, T AM LARYNGOL RHINOL, P232 OSSOFF RH, 1991, LARYNGOSCOPE, V101, P1162 PARKER DA, 1987, J LARYNGOL OTOL, V101, P1055, DOI 10.1017/S0022215100103214 SALEH EM, 1992, J LARYNGOL OTOL, V106, P715, DOI 10.1017/S0022215100120663 Schweinfurth J, 2002, LARYNGOSCOPE, V112, P933, DOI 10.1097/00005537-200205000-00029 STASNEY CR, 1995, J VOICE, V9, P106, DOI 10.1016/S0892-1997(05)80228-0 WETMORE SJ, 1985, LARYNGOSCOPE, V95, P798 NR 16 TC 9 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 211 EP 216 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400009 PM 17419526 ER PT J AU Khosla, S Muruguppan, S Gutmark, E Scherer, R AF Khosla, Sid Muruguppan, Shanmugam Gutmark, Ephraim Scherer, Ronald TI Vortical flow field during phonation in an excised canine larynx model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 127th Annual Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE laryngeal disease; larynx; phonation; voice disorder ID COMPUTATIONAL AEROACOUSTICS; AIR-FLOW; GLOTTIS; FOLDS; JET AB Objectives: To more fully understand the mechanisms of vocal fold vibration and sound production, we studied the velocity flow fields above the folds. Such velocity fields during phonation have not been reported in the literature. Methods: Using the particle image velocimetry method for 3 excised canine larynges, we obtained the velocity fields in the mid-membranous coronal plane during different phases of phonation. The velocity field was determined synchronously with the vocal fold motion recorded by high-speed videography. Results: The results show that vortices occur immediately above the vocal folds and that the location and shape of the vortices depend on the phase of the phonation cycle. Consistent vortical structures found included starting vortices, Kelvin-Helmholtz vortices, entrainment vortices, and vortices directly above the folds during the divergent glottal stage. Conclusions: These vortical structures were consistently found during specific phases of the glottall cycle for 3 canine larynges that significantly varied in size. This consistent behavior suggests that the vortices may be important for both vibration and sound production; however, further study is needed to prove this. The clinical significance of these vortices is discussed. C1 Univ Cincinnati, Med Ctr, Dept Otolaryngol Head & Neck Surg, Cincinnati, OH 45267 USA. Univ Cincinnati, Dept Aerosp Engn & Engn Mech, Cincinnati, OH 45221 USA. RP Khosla, S (reprint author), Univ Cincinnati, Med Ctr, Dept Otolaryngol Head & Neck Surg, 231 Albert B Sabin Way,ML 0528, Cincinnati, OH 45267 USA. CR ALIPOUR F, 1995, J ACOUST SOC AM, V97, P1241, DOI 10.1121/1.412233 Alipour F, 1996, VOCAL FOLD, P17 Barney A, 1999, J ACOUST SOC AM, V105, P444, DOI 10.1121/1.424504 BERKE G S, 1989, Journal of Voice, V3, P306, DOI 10.1016/S0892-1997(89)80052-9 Bielamowicz S, 1999, J VOICE, V13, P153, DOI 10.1016/S0892-1997(99)80019-8 CENGEL YA, 2006, FLUID MECH, P185 Christensen K. T., 2002, Journal of Turbulence, V3, DOI 10.1088/1468-5248/3/1/023 Cossali GE, 2001, AIAA J, V39, P1113, DOI 10.2514/2.1424 GUTMARK E, 1983, PHYS FLUIDS, V26, P2932, DOI 10.1063/1.864058 Liljencrants J., 1991, VOCAL FOLD PHYSL ACO, P99 Lucero JC, 1999, J ACOUST SOC AM, V105, P423, DOI 10.1121/1.424572 MCGOWAN RS, 1988, J ACOUST SOC AM, V83, P696, DOI 10.1121/1.396165 Mueller T.J., 1996, FLUID MECH MEASUREME, P367 PELORSON X, 1994, J ACOUST SOC AM, V96, P3416, DOI 10.1121/1.411449 Shadle C, 1991, VOCAL FOLD PHYSL ACO, P73 Shinwari D, 2003, J ACOUST SOC AM, V113, P487, DOI 10.1121/1.1526468 STEVENS KN, 1998, ACOUSTIC PHONETICS, P75 Zhang C, 2002, J ACOUST SOC AM, V112, P2147, DOI 10.1121/1.1506694 Zhao W, 2002, J ACOUST SOC AM, V112, P2134, DOI 10.1121/1.1506693 NR 19 TC 39 Z9 39 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 217 EP 228 PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400010 PM 17419527 ER PT J AU Altman, KW Waltonen, JD Tarjan, G Radosevich, JA Haines, K AF Altman, Kenneth W. Waltonen, Joshua D. Tarjan, Gabor Radosevich, James A. Haines, Kenneth, III TI Human lung mucous glands manifest evidence of the H+/K+-ATPase proton pump SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE aerodigestive tract; H+/K+-ATPase; lung; mucous gland; mucus; proton pump; secretion ID GASTROESOPHAGEAL-REFLUX DISEASE; ANTIREFLUX THERAPY; SALIVARY-GLANDS; ACID REFLUX; CHRONIC SINUSITIS; CELLS POSSESS; H+-ATPASE; ASTHMATICS; SECRETION; PATHOGENESIS AB Objectives: The H+/K+-ATPase proton pump has been demonstrated in human laryngeal submucosal glands, and is not solely present in the parietal cells of the stomach. Although proton secretion is present in the lung, a variety of mechanisms have been elucidated. The hypothesis of this study is that the H+/K+-ATPase proton pump is one additional pathway of proton secretion in the human lung. Methods: Fourteen surgical lung specimens from 10 subjects were retrospectively obtained after approval from our Human Subjects Committee. Banked human stomach tissue was used for comparative positive and negative controls. Sections were immunostained with 2 monoclonal antibodies selectively reactive with alpha or beta subunits of the H+/K+-ATPase proton pump. Results: In the human lung, consistent staining for both subunits was present in the mucous gland cells and ducts in all specimens in which mucous glands were present (6 specimens from 5 subjects). Overall, weak to strong staining was present in focal areas within the multicellular mucous glands. There was only scant focal staining in the respiratory epithelium in 4 specimens. Stomach parietal cells exhibited strongly positive staining for both subunits of the proton pump. There was no staining in stomach cells that were not morphologically consistent with parietal cells. Conclusions: The H+/K+-ATPase proton pump is present in mucous cells and ducts in the human lung, with some variable expression noted. Proton pump inhibitor pharmacotherapy may have a site of action in the human lung, explaining some of the controversies otherwise attributable to interrelatedness of aerodigestive tract disease. C1 Mt Sinai Sch Med, Dept Otolaryngol Head & Neck Surg, New York, NY 10029 USA. Northwestern Univ, Feinberg Sch Med, Dept Otorhinolaryngol Head & Neck Surg, Evanston, IL 60208 USA. Northwestern Univ, Feinberg Sch Med, Dept Pathol, Evanston, IL 60208 USA. Univ Illinois, Chicago Hlth Care Syst, Dept Pathol, John H Stroger Hosp,Res Serv,Jesse Brown Vet Adm, Chicago, IL 60607 USA. RP Altman, KW (reprint author), Mt Sinai Sch Med, Dept Otolaryngol, 1 Gustave L Levy Pl,Box 1189, New York, NY 10029 USA. CR Altman KW, 2003, LARYNGOSCOPE, V113, P1927, DOI 10.1097/00005537-200311000-00013 Altman KW, 2002, OTOLARYNG HEAD NECK, V127, P501, DOI 10.1067/mhn.2002.127589 Altman KW, 2005, OTOLARYNG HEAD NECK, V133, P718, DOI 10.1016/j.otohns.2005.07.036 Bothwell MR, 1999, OTOLARYNG HEAD NECK, V121, P255, DOI 10.1016/S0194-5998(99)70181-6 Bowrey DJ, 2000, ANN SURG, V231, P161, DOI 10.1097/00000658-200002000-00003 DeCoursey TE, 2000, AM J PHYSIOL-CELL PH, V278, pC1 Field SK, 1999, CHEST, V116, P766, DOI 10.1378/chest.116.3.766 Fischer H, 2002, AM J PHYSIOL-CELL PH, V282, pC736, DOI 10.1152/ajpcell.00369.2001 Galli J, 2002, LARYNGOSCOPE, V112, P1861, DOI 10.1097/00005537-200210000-00030 Ing AJ, 1997, AM J MED, V103, p91S, DOI 10.1016/S0002-9343(97)98981-6 JUST F, 1994, CELL TISSUE RES, V278, P161, DOI 10.1007/BF00305788 Kiljander T, 2001, RESP MED, V95, P387, DOI 10.1053/rmed.2001.1055 KILJANDER TO, 2001, CHEST, V120, P691 Kiljander TO, 1999, CHEST, V116, P1257, DOI 10.1378/chest.116.5.1257 LAYDEN TJ, 1990, GASTROENTEROLOGY, V99, P909 Levin TR, 1998, AM J GASTROENTEROL, V93, P1060 LITTLE FB, 1985, ANN OTO RHINOL LARYN, V94, P516 Maceri DR, 2001, LARYNGOSCOPE, V111, P1976, DOI 10.1097/00005537-200111000-00020 PETERS WHM, 1984, J BIOENERG BIOMEMBR, V16, P223, DOI 10.1007/BF00751051 Poelmans J, 2002, ANN OTO RHINOL LARYN, V111, P933 Roussa E, 1998, J HISTOCHEM CYTOCHEM, V46, P91 Roussa E, 1998, EUR J MORPHOL, V36, P147 SCHROEDER PL, 1995, ANN INTERN MED, V122, P809 Senior BA, 2001, LARYNGOSCOPE, V111, P2144, DOI 10.1097/00005537-200112000-00012 Tandler B, 2001, ANAT RECORD, V264, P121, DOI 10.1002/ar.1108 Tobey NA, 1998, AM J GASTROENTEROL, V93, P2075 Ulualp SO, 1999, OTOLARYNG HEAD NECK, V121, P725, DOI 10.1053/hn.1999.v121.a98010 Ulualp SO, 1999, AM J RHINOL, V13, P197, DOI 10.2500/105065899781389777 Urushidani T, 1997, J MEMBRANE BIOL, V159, P99, DOI 10.1007/s002329900274 Valipour A, 2002, CHEST, V121, P1748, DOI 10.1378/chest.121.6.1748 WETMORE RF, 1993, LARYNGOSCOPE, V103, P1242 NR 31 TC 13 Z9 14 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 229 EP 234 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400011 PM 17419528 ER PT J AU Song, JJ Chae, SW Woo, JS Lee, HM Jung, HH Hwang, SJ AF Song, Jae-Jun Chae, Sung-Won Woo, Jeong-Su Lee, Heung-Man Jung, Hak-Hyun Hwang, Soon-Jae TI Differential expression of human beta defensin 2 and human beta defensin 3 in human middle ear cholesteatoma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE beta defensin; cholesteatoma; middle ear ID BETA-DEFENSIN EXPRESSION; ANTIMICROBIAL PEPTIDES; HUMAN BETA-DEFENSIN-1; INDUCIBLE PEPTIDE; IDENTIFICATION AB Objectives: The purpose of this study was to investigate the differential expressions of human beta defensin (hBD) 2 and hBD-3 in human middle ear cholesteatoma epithelium. Methods: The expressions of hBD-2 and hBD-3 were analyzed by quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR), Western blotting, and immunohistochemical staining. Samples were obtained from 10 patients who underwent middle ear surgery for middle ear cholesteatoma. Results: Real-time RT-PCR and Western blot analysis showed that the messenger RNAs and proteins of hBD-2 and hBD-3 were higher in the cholesteatoma epithelium than in normal external auditory canal skin. In cholesteatoma epithelium, hBD-2 and hBD-3 activities were present in the upper granular layer and in the prickle cell layer, but in the normal skin they were poorly expressed in all layers. Conclusions: Increased expressions of hBD-2 and hBD-3 in cholesteatoma epithelium suggest that cholesteatoma, a chronic inflammatory state of middle ear keratinocytes, may induce an innate immune response. That the induction of hBD-2 was found to be more intense than that of hBD-3 in cholesteatoma epithelium implies that hBD-2 is the major effector in terms of chronic epithelial inflammatory responses. C1 Korea Univ, Dept Otorhinolaryngol Head & Neck Surg, Guro Hosp, Seoul 152050, South Korea. Dongguk Univ, Coll Med, Dept Otolaryngol, Seoul, South Korea. Korea Univ, Coll Med, Dept Otorhinolaryngol Head & Neck Surg, Seoul, South Korea. RP Chae, SW (reprint author), Korea Univ, Dept Otorhinolaryngol Head & Neck Surg, Guro Hosp, 80 Guro Dong, Seoul 152050, South Korea. CR Abiko Y, 2003, J DERMATOL SCI, V31, P225, DOI 10.1016/S0923-1811(03)00007-0 Bals R, 2000, Respir Res, V1, P141, DOI 10.1186/rr25 Dale BA, 2001, J ORAL PATHOL MED, V30, P321, DOI 10.1034/j.1600-0714.2001.300601.x Frye M, 2001, J MOL MED-JMM, V79, P275, DOI 10.1007/s001090100200 GALLO RL, 1994, P NATL ACAD SCI USA, V91, P11035, DOI 10.1073/pnas.91.23.11035 GANZ T, 1994, CURR OPIN IMMUNOL, V6, P584, DOI 10.1016/0952-7915(94)90145-7 GANZ T, 1985, J CLIN INVEST, V76, P1427, DOI 10.1172/JCI112120 Ganz T, 2005, COMB CHEM HIGH T SCR, V8, P209, DOI 10.2174/1386207053764594 Garcia JRC, 2001, CELL TISSUE RES, V306, P257, DOI 10.1007/s004410100433 Garcia JRC, 2001, FASEB J, V15, P1819, DOI 10.1096/fj.00-0865fje Harder J, 2001, J BIOL CHEM, V276, P5707, DOI 10.1074/jbc.M008557200 Harder J, 2000, AM J RESP CELL MOL, V22, P714 Meyer JE, 2006, AURIS NASUS LARYNX, V33, P159, DOI 10.1016/j.anl.2005.11.023 Nishimura Michiko, 2003, Medical Electron Microscopy, V36, P94 Park K, 2003, ACTA OTO-LARYNGOL, V123, P236, DOI 10.1080/0036554021000028102 Schroder JM, 1999, INT J BIOCHEM CELL B, V31, P645, DOI 10.1016/S1357-2725(99)00013-8 SELSTED ME, 1987, INFECT IMMUN, V55, P2281 Sorensen OE, 2005, J IMMUNOL, V174, P4870 Weinberg A, 1998, CRIT REV ORAL BIOL M, V9, P399 Yamaguchi Y, 2002, J IMMUNOL, V169, P2516 NR 20 TC 9 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2007 VL 116 IS 3 BP 235 EP 240 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 147TC UT WOS:000245024400012 PM 17419529 ER PT J AU Cohen, JT Oestreicher-Kedem, Y Fliss, DM DeRowe, A AF Cohen, Jacob T. Oestreicher-Kedem, Yael Fliss, Dan M. DeRowe, Ari TI Glottal Function Index: A predictor of glottal disorders in children SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE Glottal Function Index; hoarseness; vocal cord nodule AB Objectives: Hyperkinetic laryngeal behaviors may be used to achieve glottal closure in the presence of vocal cord disorders. In adults. the Glottal Function Index (GFI) is a validated self-administered survey used to evaluate glottal insufficiency. In children, the relationships between glottal closure and vocal cord lesions have not been examined. We undertook to evaluate the efficacy of the GFI in detecting disorders of the vocal cords in children. Methods: We evaluated 100 consecutive children who underwent flexible fiberoptic laryngoscopy. A 4-item GFI questionnaire was administered to the parents of each study subject on study entry. The videotapes of the examinations were evaluated and scored by 3 investigators in a blinded manner. The GFI scores were compared in subjects with and without vocal cord findings. Results: The final analysis included 100 children 2 to 16 years of age. The mean age of the study group was 7.3 years (+/- 3.9 years). Of the 100 patients, 54 had vocal cord disorders. The most common was vocal cord nodules, in most cases combined with bowing of the vocal cords; the two variables were highly correlated (p << .01). We performed a receiver operating characteristics test between the presence of vocal cord disorders and the GFI score. We found that the "optimal" score. on which the sensitivity and specificity curves cross, was 3. Of the 54 patients who had vocal cord disorders, the index identified 38 patients (70%), whereas the patients' complaints identified only 30 patients (55.6%). This difference was statistically significant (p < .05). Conclusions: The GFI is a reliable 4-item symptom index with excellent correlation to the presence of vocal cord lesions in children. C1 Tel Aviv Univ, Sackler Sch Med, Tel Aviv Sourasky Med Ctr, Voice & Swallowing Disorders Clin, IL-64239 Tel Aviv, Israel. Tel Aviv Univ, Sackler Sch Med, Tel Aviv Sourasky Med Ctr, Div Pediat Otolaryngol, IL-64239 Tel Aviv, Israel. Tel Aviv Univ, Sackler Sch Med, Tel Aviv Sourasky Med Ctr, Dept Otolaryngol Head & Neck Surg, IL-64239 Tel Aviv, Israel. RP Cohen, JT (reprint author), Tel Aviv Univ, Sackler Sch Med, Tel Aviv Sourasky Med Ctr, Voice & Swallowing Disorders Clin, 6 Weizman St, IL-64239 Tel Aviv, Israel. CR Bach KK, 2005, ARCH OTOLARYNGOL, V131, P961, DOI 10.1001/archotol.131.11.961 Belafsky PC, 2002, OTOLARYNG HEAD NECK, V127, P448, DOI 10.1067/mhn.2002.128894 Griner P F, 1981, Ann Intern Med, V94, P557 Kilic MA, 2004, INT J PEDIATR OTORHI, V68, P409, DOI 10.1016/j.ijporl.2003.11.005 Sataloff RT, 1991, PROFESSIONAL VOICE S Wilson D. K., 1987, VOICE PROBLEMS CHILD NR 6 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2007 VL 116 IS 2 BP 81 EP 84 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200001 PM 17388229 ER PT J AU Mendelsohn, AH Sung, MW Berke, GS Chhetri, DK AF Mendelsohn, Abie H. Sung, Myung-Whun Berke, Gerald S. Chhetri, Dinesh K. TI Strobokymographic and videostroboscopic analysis of vocal fold motion in unilateral superior laryngeal nerve paralysis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE kymography; laryngeal electromyography; paralysis; paresis; superior laryngeal nerve ID CRICOTHYROID MUSCLE; VIBRATORY PATTERN; PARESIS AB The clinical diagnosis of superior laryngeal nerve paralysis (SLNp) is infrequently made, because of the heterogeneity of clinical presentations and laryngoscopic findings. Laryngeal electromyography (LEMG) can provide the definitive diagnosis of this abnormality. With increasing use of LEMG in clinical practice, this condition is now more frequently appreciated by otolaryngologists. A characteristic, but infrequently reported, videostroboscopic vocal fold motion termed Gegenschlagen ("dashing-against-each-other") has previously been described to occur in unilateral SLNp. We encountered such motion in a clinical case, which we subsequently verified as unilateral SLNp by means of LEMG. This characteristic glottic motion was then verified in an in vivo canine model of phonation after unilateral SLNp. Videostrobokymography was performed to generate kymograms that illustrated this vocal fold motion clearly. Kymograms of both human and canine subjects with SLNp demonstrated an undulating motion of the horizontally shifting glottic space as the medial edges of the vocal folds chased each other 90 out of phase. As one vocal fold mucosal edge was opening, the other was closing. and this repeated motion appeared as vocal folds chasing or dashing against each other. Although not uniformly seen in all cases. this vocal fold motion appears to be unique to SLNp. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Head & Neck Surg, Los Angeles, CA 90095 USA. Seoul Natl Univ, Dept Head & Neck Surg, Seoul 151, South Korea. RP Mendelsohn, AH (reprint author), Univ Calif Los Angeles, Sch Med, Div Head & Neck Surg, 10833 Le Conte Ave,Room 62-132 CHS, Los Angeles, CA 90095 USA. CR ABELSON TI, 1981, OTOLARYNG HEAD NECK, V89, P463 BERKE GS, 1987, LARYNGOSCOPE, V97, P871 BEVAN K, 1989, J LARYNGOL OTOL, V103, P191, DOI 10.1017/S0022215100108412 DOHNE E, 1941, ARCH SPRACH STIMMHEI, V5, P155 Dursun G, 1996, J VOICE, V10, P206, DOI 10.1016/S0892-1997(96)80048-8 Eckley CA, 1998, J VOICE, V12, P340, DOI 10.1016/S0892-1997(98)80024-6 Gall V, 1973, Folia Phoniatr (Basel), V25, P450 HANSON DG, 1988, LARYNGOSCOPE, V98, P541 Hollinshead WH, 1982, ANATOMY SURG HEAD NE, P423 Kim DY, 2003, ACTA OTO-LARYNGOL, V123, P1102, DOI 10.1080/00016480310001880 Lee JS, 2001, MED BIOL ENG COMPUT, V39, P273, DOI 10.1007/BF02345279 MOORE DM, 1987, LARYNGOSCOPE, V97, P543 Munin MC, 2000, OTOLARYNG CLIN N AM, V33, P759, DOI 10.1016/S0030-6665(05)70242-5 SERCARZ JA, 1992, ANN OTO RHINOL LARYN, V101, P567 Sulica L, 2004, OTOLARYNG CLIN N AM, V37, P183, DOI 10.1016/S0030-6665(03)00175-0 Sung MW, 1999, LARYNGOSCOPE, V109, P1859, DOI 10.1097/00005537-199911000-00027 Svec JG, 1996, J VOICE, V10, P201, DOI 10.1016/S0892-1997(96)80047-6 TANABE M, 1972, ACTA OTO-LARYNGOL, V74, P339, DOI 10.3109/00016487209128460 TANAKA S, 1994, ANN OTO RHINOL LARYN, V103, P93 TRAPP TK, 1988, LARYNGOSCOPE, V98, P486 WARD PH, 1977, T AM ACAD OPHTHALMOL, V84, P78 NR 21 TC 6 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2007 VL 116 IS 2 BP 85 EP 91 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200002 PM 17388230 ER PT J AU Jones, AS Rafferty, M Fenton, JE Jones, TM Husband, DJ AF Jones, Andrew S. Rafferty, Mark Fenton, John E. Jones, Terence M. Husband, David J. TI Treatment of squamous cell carcinoma of the tongue base: Irradiation, surgery, or palliation? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE palliation; radiotherapy; squamous cell carcinoma; surgery; survival rate; tongue base ID EXTERNAL-BEAM IRRADIATION; OROPHARYNGEAL CARCINOMA; SURGICAL-MANAGEMENT; RADIATION-THERAPY; CANCER; BRACHYTHERAPY; CHEMOTHERAPY; HEAD AB Objectives: Squamous cell carcinoma of the tongue base has a poor prognosis, and treatment is accompanied by a number of major problems. In view of this, it is important to recognize which patients will benefit from treatment with curative intent and which treatment method to use. Methods: One hundred sixty-five patients with squamous cell carcinoma of the tongue base were identified on our database. Eighty-two patients were treated by radical irradiation, and 41 by surgery. A further 42 patients were considered unsuitable for curative treatment. Results: The 5-year cause-specific survival rate was 41 % for those treated by irradiation, 58 % for those treated by surgery, and 9 % for untreated patients. There was no difference in the efficacy of treatment methods (p =.5362), but a highly significant difference was seen in survival rate between treated and untreated patients (p =.0028). The decision regarding administration of curative treatment was based on the extent of locoregional involvement at the primary site (p =.0139; odds ratio, 0.43) and in the neck (p =.0078; odds ratio, 0.23). No factors affected the decision to treat by irradiation or surgery. When the observed survival rate was calculated, there was no significant difference in 5-year survival rate between treated and untreated patients (p =.2762). Those with early (T1-2) disease at the primary site had an improved survival rate from 0.5 to 4 years compared with those who were untreated (T3-4; p =.0081; odds ratio, 2.2). In addition, those with early (T1-2) disease had a better survival rate than those with advanced cancers (p =.0139; odds ratio, 2.09). There was, however, no difference in survival rate at 5 years. Those with early disease compared with those with advanced disease were twice as likely to be alive at 2 years; however, all survival advantages had disappeared by 5 years. Conclusions: In terms of observed survival, treating tongue base squamous cell carcinoma that is locally advanced (T3-4) at presentation offers no survival advantage over palliation alone. Treating early disease (T1-2) doubles the survival rate for up to 4 years, but by 5 years this survival advantage is lost. The present study finds radiotherapy and surgery to be equivalent at controlling this disease. C1 Univ Liverpool, Dept Oncol, Head & Neck Oncol Grp, Liverpool L69 3BX, Merseyside, England. Clatterbridge Ctr Oncol, Wirral, Merseyside, England. Univ Limerick, Dept Otolaryngol Head & Neck Surg, Limerick, Ireland. RP Jones, AS (reprint author), Univ Hosp Aintree, Sch Clin Sci, Dept Surg, Head & Neck Oncol Grp, Longmoor Lane, Liverpool L9 7AL, Merseyside, England. CR ARMITAGE P, 1987, STAT METHODS MED RES, P421 BEAHRS OH, 1988, MANUAL STAGING CANC, P9 CALLERY CD, 1984, AM J SURG, V148, P449, DOI 10.1016/0002-9610(84)90368-4 CIVANTOS F, 1994, OTOLARYNG HEAD NECK, V111, P59 COX DR, 1972, J R STAT SOC B, V34, P187 EVANS PHR, 1981, J LARYNGOL OTOL, V95, P809 Gibbs IC, 2003, INT J RADIAT ONCOL, V57, P489, DOI 10.1016/S0360-3016(03)00597-2 HARRISON LB, 1992, RADIOLOGY, V184, P267 Hermanek P, 1992, UICC TNM CLASSIFICAT JAULERRY C, 1991, CANCER, V67, P1532, DOI 10.1002/1097-0142(19910315)67:6<1532::AID-CNCR2820670612>3.0.CO;2-D JONES AS, 1994, CLIN OTOLARYNGOL, V19, P63, DOI 10.1111/j.1365-2273.1994.tb01150.x KALBFLEISCH JD, 1980, STAT ANAL FAILURE TI, P12 Kovacs AF, 2002, J CRANIO MAXILL SURG, V30, P112, DOI 10.1054/jems.2002.0283 KRAUS DH, 1993, AM J SURG, V166, P384, DOI 10.1016/S0002-9610(05)80338-1 Machtay M, 2002, J CLIN ONCOL, V20, P3964, DOI 10.1200/JCO.2002.11.026 MAKKREGAR S, 1992, CLIN OTOLARYNGOL, V17, P107, DOI 10.1111/j.1365-2273.1992.tb01054.x Mantz CA, 2001, CANCER J, V7, P140 MENDENHALL WM, 1988, HEAD NECK-J SCI SPEC, V10, P302 ROLLO J, 1981, CANCER, V47, P333, DOI 10.1002/1097-0142(19810115)47:2<333::AID-CNCR2820470221>3.0.CO;2-9 SAS Institute Inc, 1985, US GUID STAT VERS Sessions DG, 2003, LARYNGOSCOPE, V113, P1252, DOI 10.1097/00005537-200307000-00026 Steiner W, 2003, ARCH OTOLARYNGOL, V129, P36 STELL PM, 1980, HEAD NECK SURG THAWLEY SE, 1983, ANN OTO RHINOL LARYN, V92, P485 VERBIN RS, 1985, SURG PATHOLOGY HEAD, V1, P333 WEBER PC, 1993, EUR ARCH OTO-RHINO-L, V250, P63 ZELEFSKY MJ, 1992, CANCER, V70, P2388, DOI 10.1002/1097-0142(19921115)70:10<2388::AID-CNCR2820701003>3.0.CO;2-M NR 27 TC 8 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2007 VL 116 IS 2 BP 92 EP 99 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200003 PM 17388231 ER PT J AU Savastano, M Aita, M Barlani, F AF Savastano, Marina Aita, Maria Barlani, Federico TI Psychological, neural, endocrine, and immune study of stress in tinnitus patients: Any correlation between psychometric and biochemical measures? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE biochemistry; psychometry; stress; tinnitus ID PSYCHONEUROIMMUNOLOGY; DISTRESS; SUFFERERS; SEVERITY; HEALTH AB Objectives: The present study was carried out in tinnitus patients in order to study the psychological distress and the biochemical measures of this stressful condition. Psychological features were compared to immune and neuroendocrine parameters in order to verify in these subjects the possible presence of psychological and somatic responses to stress. Methods: We studied 85 tinnitus patients who underwent hematochemical immune tests: lymphocyte subpopulations (CD3; CD4; CD3+CD4; CD8; CD19; CD16NK; CD3+CD16+CD56; and CD4/CD8), cortisol, adrenocorticotropic hormone, beta-endorphin, prolactin, and urinary catecholamine. Results: Clinically, significant scores were obtained for hysteria, depression, paranoia, hypochondrias, and social introversion; and high scores were obtained for anxiety, depression, care for health, difficulty of treatment, low self-esteem, family and work difficulties, and social discomfort. There was a low to medium level of self-perception of stress. The less a subject felt stressed, the higher was his or her satisfaction level in the areas of psychological and physical functioning. The scores on the tests and the biochemical measures did not show a significant correlation, but there was a tendency to correlation for the lymphocytes CD19 and CD16NK and for adrenocorticotropic hormone. Conclusions: The comparison between the psychometric and biochemical variables did not reveal any significant correlation among stress perception, daily satisfaction, and the biochemical parameters of stress. C1 Univ Padua, Dept Otolaryngol Head & Neck Surg, I-35100 Padua, Italy. Univ Padua, Dept Psychiat, I-35100 Padua, Italy. RP Savastano, M (reprint author), Dept Med Surg Specialties, Sect Otorhinolaryngol, Via Giustiniana 2, I-35128 Padua, Italy. CR Ader R, 2000, EUR J PHARMACOL, V405, P167, DOI 10.1016/S0014-2999(00)00550-1 Andersson G, 1999, CLIN OTOLARYNGOL, V24, P404, DOI 10.1046/j.1365-2273.1999.00278.x Budd RJ, 1995, J PSYCHOSOM RES, V39, P1015, DOI 10.1016/0022-3999(95)00512-9 D'Amelio R, 2004, HNO, V52, P599, DOI 10.1007/s00106-003-0944-5 DeKeyser Freda, 2003, AACN Clin Issues, V14, P25, DOI 10.1097/00044067-200302000-00004 ERLANDSSON SI, 1992, AUDIOLOGY, V31, P168 ERLANDSSON S I, 1991, British Journal of Audiology, V25, P15, DOI 10.3109/03005369109077860 Fox S, 1999, J Neurosci Nurs, V31, P87 Harter M, 2004, HNO, V52, P125, DOI 10.1007/s00160-003-0889-8 Hiller W, 2004, INT J AUDIOL, V43, P600 Holgers Kajsa-Mia, 2003, Lakartidningen, V100, P3744 Kemeny M E, 1999, Semin Gastrointest Dis, V10, P20 KEMP S, 1992, BRIT J AUDIOL, V26, P381, DOI 10.3109/03005369209076662 Kiecolt-Glaser JK, 2002, PSYCHOSOM MED, V64, P15 Lutgendorf SK, 2003, BRAIN BEHAV IMMUN, V17, P225, DOI 10.1016/S0889-1591(03)00033-3 Lutz Waldemar, 2001, Medycyna Pracy, V52, P203 Mausch K, 2000, Psychiatr Pol, V34, P381 Prolo P, 2002, ANN NY ACAD SCI, V966, P400 Rizzardo R, 1998, J OTOLARYNGOL, V27, P21 Sachanska T, 1999, Int Tinnitus J, V5, P24 Savastano M, 1999, Int Tinnitus J, V5, P121 van Veen ED, 1998, J LARYNGOL OTOL, V112, P258 Vedhara K, 1999, NEUROSCI BIOBEHAV R, V23, P699, DOI 10.1016/S0149-7634(99)00012-3 Weber C, 2002, J PSYCHOSOM RES, V52, P29, DOI 10.1016/S0022-3999(01)00281-1 Whitesman S, 2004, SAMJ S AFR MED J, V94, P259 Yang EV, 2002, INT IMMUNOPHARMACOL, V2, P315, DOI 10.1016/S1567-5769(01)00182-5 NR 26 TC 6 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2007 VL 116 IS 2 BP 100 EP 106 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200004 PM 17388232 ER PT J AU Louizos, AA Hadzilia, SJ Davilis, DI Samanta, EG Georgiou, LG AF Louizos, Antonios A. Hadzilia, Sophie J. Davilis, Dimitrios I. Samanta, Evangelia G. Georgiou, Loucas G. TI Administration of esmolol in microlaryngeal surgery for blunting the hemodynamic response during laryngoscopy and tracheal intubation in cigarette smokers SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cardiovascular system; cigarette smoking; esmolol; laryngoscopy; microlaryngeal surgery; tracheal intubation ID 24 H MEASUREMENTS; ENDOTRACHEAL INTUBATION; BARORECEPTOR FUNCTION; NONSMOKERS; NICARDIPINE; ANESTHESIA; EFFICACY; REFLEXES; SMOKING AB Objectives: Cigarette smokers constitute a group of patients with an increased hemodynamic response to tracheal intubation. We studied the dose-response and side effects of bolus administration of esmolol hydrochloride in cigarette smokers undergoing elective microlaryngeal surgery, when esmolol was used for reducing the intense hemodynamic response to laryngoscopy and tracheal intubation. Methods: We randomly allocated 165 patients (American Society of Anesthesiologists physical status classes I to III) to receive placebo (E-plac) or esmolol 1 mg/kg (E1) or 2 mg/kg (E2). The esmolol was given 2 minutes before laryngoscopy and tracheal intubation. The same anesthetic technique was used in all patients. Cardiovascular parameters were recorded every minute for the first 5 minutes and thereafter every 3 minutes. Bronchospasm, other side effects, and rescue esmolol treatment were noted during anesthesia. Results: In group Eplac, significant increases (p <.05) in arterial blood pressure and heart rate were observed in the first 3 minutes after tracheal intubation. In group Et,significant increases (p <.05) in diastolic blood pressure were observed in the first 2 minutes after intubation. In group E2, no significant fluctuations were recorded in cardiovascular parameters after intubation. During surgery, 17% of the patients in group Eplac showed an increase in blood pressure and tachycardia. Conclusions: We conclude that esmolol administration of 2 mg/kg during induction of anesthesia in smokers provides hemodynamic stability after laryngoscopy and tracheal intubation with no severe side effects. C1 Hippokrateion Hosp, Dept Anesthesiol, Athens, Greece. Hippokrateion Hosp, Dept Otolaryngol, Athens, Greece. RP Louizos, AA (reprint author), Terpsichoris 8A, Athens 19005, Greece. 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PD FEB PY 2007 VL 116 IS 2 BP 107 EP 111 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200005 PM 17388233 ER PT J AU Doshi, J Anari, S AF Doshi, Jayesh Anari, Shahram TI Branchial cyst side predilection: Fact or fiction? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Joint South-African-and-British-Association-of-Otorhinolaryngology-Head-and-Ne ck-Surgeons CY OCT 08-11, 2006 CL Cape Town, SOUTH AFRICA SP S African Assoc Otorhinolaryngol, Head & Neck Surg, British Assoc Otorhinolaryngol, Head & Neck Surg DE branchioma; etiology AB Objectives: It is a common teaching that two thirds of branchial cysts occur on the left side of the neck. We reviewed the evidence behind this statement and assessed whether they actually do present twice as often on the left side. Methods: Our study comprised two parts: 1) a historical review of branchial cysts and 2) a retrospective review of 91 histologically confirmed cases operated on at two British hospitals in the years 1999 to 2005. The side of the branchial cyst was recorded. Results: Early studies on branchial cysts did not always rely upon histologic diagnosis; the definition of a branchial cyst has varied throughout medical history. The statement "two thirds of branchial cysts occur on the left" is based upon these early studies in which the definition was variable. In our study, right-sided branchial cysts were actually more common than left-sided branchial cysts (53.8% versus 45%; chi(2) test, p =.399). One percent were bilateral. Conclusions: Ours is the largest single study in the past 50 years to look at the side predilection of branchial cysts in terms of histologic proof. We propose that branchial cysts may not present more commonly on the left side of the neck; as is commonly taught in medical schools. C1 Sunderland Royal Hosp, Dept Otolaryngol, Sunderland, Durham, England. Freeman Rd Hosp, Dept Otolaryngol, Newcastle Upon Tyne NE7 7DN, Tyne & Wear, England. RP Doshi, J (reprint author), Apt 20 Adderstone Court,17 Adderstone Crescent, Newcastle Upon Tyne NE2 2EA, Tyne & Wear, England. 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PD FEB PY 2007 VL 116 IS 2 BP 112 EP 114 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200006 PM 17388234 ER PT J AU Shiotani, A Saito, K Araki, K Moro, K Watabe, K AF Shiotani, Akihiro Saito, Koichiro Araki, Koji Moro, Kazuhisa Watabe, Kazuhiko TI Gene therapy for laryngeal paralysis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE BDNF; brain-derived neurotrophic factor; functional recovery; GDNF; gene therapy; glial cell line-derived neurotrophic factor; motoneuron loss; nerve conduction velocity ID INDUCED CELL-DEATH; NEUROTROPHIC FACTOR; NUCLEUS AMBIGUUS; MOTONEURON LOSS; MOTOR-NEURONS; ROOT AVULSION; NERVE INJURY; ADULT-RAT; GDNF; MUSCLE AB Objectives: The surgical options for laryngeal paralysis only achieve static changes of vocal fold position. Laryngeal reinnervation procedures have had little impact on the return of dynamic laryngeal function. The development of a new treatment for laryngeal paralysis, aimed at the return of dynamic function and neurologic restoration and regeneration, is necessary. Methods: To assess the possibility of gene therapy for laryngeal paralysis aiming for the return of dynamic laryngeal function. we investigated the therapeutic effects of gene therapy using rat laryngeal paralysis models. Results: In a rat vagal nerve avulsion model, we transferred glial cell line-derived neurotrophic factor (GDNF) gene into the nucleus ambiguus using an adenovirus vector. Two and 4 weeks after the GDNF gene transfer, a significantly larger number of surviving motoneurons was observed. These neuroprotective effects of GDNF gene transfer were enhanced by simultaneous brain-derived neurotrophic factor gene transfer. In a rat recurrent laryngeal nerve crush model, we transferred GDNF gene into recurrent laryngeal nerve fibers after crush injury. Two and 4 weeks after GDNF gene transfer, we observed significantly faster nerve conduction velocity and better vocal fold motion recovery. Conclusions: These results indicate that gene therapy could be a future treatment strategy for laryngeal paralysis. Further studies will be necessary to demonstrate the safety of the vector before clinical application. C1 Natl Def Med Coll, Dept Otolaryngol Head & Neck Surg, Tokorozawa, Saitama 3598513, Japan. Keio Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Tokyo 108, Japan. Tokyo Metropolitan Inst Neurosci, Dept Mol Neuropathol, Tokyo, Japan. RP Shiotani, A (reprint author), Natl Def Med Coll, Dept Otolaryngol Head & Neck Surg, 3-2 Namiki, Tokorozawa, Saitama 3598513, Japan. 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Otol. Rhinol. Laryngol. PD FEB PY 2007 VL 116 IS 2 BP 115 EP 122 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200007 PM 17388235 ER PT J AU Su, WF Hsiao, YC Hung, CC AF Su, Wan-Fu Hsiao, Yu-Che Hung, Chung-Ching TI Features of muscle tension dysphonia before and after correction of unilateral vocal cord paralysis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE glottal closure symptoms; muscle tension dysphonia; unilateral vocal cord paralysis; vocal fatigue ID VOICE DISORDERS; CLASSIFICATION AB Objectives: We performed a retrospective, longitudinal study to compare the prevalence of hyperkinetic laryngeal features before and after successful correction in patients with unilateral vocal cord paralysis (UVCP). Methods: Eighty-six patients with UVCP who had a successful surgical correction were enrolled. Preoperative and postoperative videolaryngostroboscopy images were analyzed, and the muscle tension patterns (MTPs) were rated according to the Morrison-Rammage classification. A 4-item glottal closure index was used for each patient on study entry and for 40 normal subjects as the control group. Results: There was no significant difference in MTP prevalence before (57%) and after (55%) surgical correction for UVCP. Although the glottal closure symptoms were tremendously improved through surgical medialization for UVCP, they persisted and were more prevalent than those in normal individuals. Conclusions: Persistence of MTPs after correction of UVCP may be due to intractable vocal habits or psychogenic factors. C1 Natl Def Med Ctr, Tri Serv Gen Hosp, Dept Otolaryngol Head & Neck Surg, Taipei 11490, Taiwan. RP Su, WF (reprint author), Natl Def Med Ctr, Tri Serv Gen Hosp, Dept Otolaryngol Head & Neck Surg, 325 Chen Kung Rd,Sec 2, Taipei 11490, Taiwan. CR Belafsky PC, 2002, OTOLARYNG HEAD NECK, V127, P448, DOI 10.1067/mhn.2002.128894 Crumley RL, 2000, ANN OTO RHINOL LARYN, V109, P365 CRUMLEY RL, 1991, LARYNGOSCOPE, V101, P384 Hsiung MW, 2004, ORL J OTO-RHINO-LARY, V66, P246, DOI 10.1159/000081121 KOUFMAN JA, 1982, ANN OTO RHINOL LARYN, V91, P372 LINVILLE SE, 1992, J SPEECH HEAR RES, V35, P1209 MORRISON MD, 1993, ACTA OTO-LARYNGOL, V113, P428, DOI 10.3109/00016489309135839 Sama A, 2001, LARYNGOSCOPE, V111, P458, DOI 10.1097/00005537-200103000-00015 NR 8 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2007 VL 116 IS 2 BP 123 EP 127 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200008 PM 17388236 ER PT J AU Deguchi, S Matsuzaki, Y Ikeda, T AF Deguchi, Shinji Matsuzaki, Yuji Ikeda, Tadashige TI Numerical analysis of effects of transglottal pressure change on fundamental frequency of phonation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE fundamental frequency of phonation; numerical analysis; phonation threshold pressure; self-excited oscillation; transglottal pressure; vocal fold stiffness ID VOCAL FOLDS; MODEL AB Objectives: In humans, a decrease in transglottal pressure (P-t) causes an increase in the fundamental frequency of phonation (F0) only at a specific voice pitch within the modal register, the mechanism of which remains unclear. Methods: In the present study, numerical analyses were performed to investigate the mechanism of the voice pitch-dependent positive change of F0 due to Pt decrease. The airflow and the airway, including the vocal folds, were modeled in terms of mechanics of fluid and structure. Results: Simulations of phonation using the numerical model indicated that Pt affects both the average position and the average amplitude magnitude of vocal fold self-excited oscillation in a non-monotonous manner. This effect results in voice pitch-dependent responses of F0 to Pt decreases, including the positive response of F0 as actually observed in humans. Conclusions: The findings of the present study highlight the importance of considering self-excited oscillation of the vocal folds in elucidation of the phonation mechanism. C1 Okayama Univ, Grad Sch Nat Sci & Technol, Okayama 7008530, Japan. Nagoya Univ, Grad Sch Nat Sci & Technol, Nagoya, Aichi, Japan. Nagoya Univ, Grad Sch Engn, Dept Aerosp Engn, Nagoya, Aichi, Japan. RP Deguchi, S (reprint author), Okayama Univ, Grad Sch Nat Sci & Technol, 3-1-1 Tsushimanaka, Okayama 7008530, Japan. 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Otol. Rhinol. Laryngol. PD FEB PY 2007 VL 116 IS 2 BP 128 EP 134 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200009 PM 17388237 ER PT J AU Alipour, F Jaiswal, S Finnegan, E AF Alipour, Fariborz Jaiswal, Sanyukta Finnegan, Eileen TI Aerodynamic and acoustic effects of false vocal folds and epiglottis in excised larynx models SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE canine larynx; false vocal fold; fundamental frequency; glottal resistance; medial compression; sound intensity ID PHONATION; FLOW AB Objectives: The purpose of this study was to examine the aerodynamic and acoustic effects of the false vocal folds and the epiglottis on excised larynx phonation. Methods: Several canine larynges were prepared and mounted over a tapered tube that supplied pressurized, heated, and humidified air. Glottal adduction was accomplished either by using two-pronged probes to press the arytenoids together or by passing a suture to simulate lateral cricoarytenoid muscle activation. First, the excised larynx with false vocal folds and epiglottis intact was subjected to a series of pressure-flow experiments with longitudinal tension and adduction as major control parameters. Then, the epiglottis and finally the false vocal folds were removed and the experiment was repeated. The subglottal pressure and the electroglottographic, flow rate, audio, and sound pressure signals were recorded during each experiment. Glottal flow resistance was calculated from the pressure and flow signals. The electroglottographic signal was used to extract the fundamental frequency. Results: It was found that the false vocal folds and the epiglottis offer a positive contribution to the glottal resistance and sound intensity of the larynx. Also, vocal fold elongation and glottal medial compression caused an increase in glottal resistance. The pressure-flow relationships were approximately linear regardless of the structure. Conclusions: The addition of the supraglottic laryngeal structures has a significant impact on both aerodynamic and acoustic characteristics of excised larynges. C1 Univ Iowa, Dept Speech Pathol & Audiol, Iowa City, IA 52242 USA. RP Alipour, F (reprint author), Univ Iowa, Dept Speech Pathol & Audiol, 334 WJSHC, Iowa City, IA 52242 USA. 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TI Artificial voice modulation in dogs by recurrent laryngeal nerve stimulation: Electrophysiological confirmation of anatomic data SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE agonist-antagonist coupling; artificial voice manipulation; intrinsic laryngeal muscle motor unit; orderly recruitment; recurrent laryngeal nerve ID ELECTRICAL-STIMULATION; FUNDAMENTAL-FREQUENCY; MOTOR UNITS; MUSCLE; CANINE; RECRUITMENT; SIZE; EXCITATION; FIBERS AB Objectives: We hypothesized that voice may be artificially manipulated to ameliorate dystonias considered to be a failure in dynamic integration between competing neuromuscular systems. Methods: Orderly intrinsic laryngeal muscle recruitment by anodal block via the recurrent laryngeal and vagus nerves has allowed us to define specific values based on differential excitabilities, but has precluded voice fluency because of focused breaks during stimulation and the need to treat several neural conduits. Such problems may be obviated by a circuit capable of stimulating some axons while simultaneously blocking others in the recurrent laryngeal nerve, which carries innervation to all intrinsic laryngeal muscles, including the arguably intrinsic cricothyroideus. In 5 dogs, both recurrent laryngeal nerves received 40-Hz quasi-trapezoidal pulses (0 to 2,000 mu A, 0 to 2,000 mu s, 0 to 500 mu s decay) via tripolar electrodes. Electromyograms were matched with audio intensities and fundamental frequencies recorded under a constant flow of humidified air. Data were digitized and evaluated for potential correlations. Results: Orderly recruitment of the thyroarytenoideus, posterior cricoarytenoideus, and cricothyroideus was correlated with stimulating intensities (p <.001), and posterior cricoarytenoideus opposition to the thyroarytenoideus and cricothyroideus was instrumental in manipulating audio intensities and fundamental frequencies. Conclusions: Manipulation of canine voice parameters appears feasible via the sole recurrent laryngeal nerve within appropriate stimulation envelopes, and offers promise in human laryngeal dystonias. C1 Case Western Reserve Univ, Univ Hosp Hlth Syst, St Vincent Char Hosp, Dept Surg Otolaryngol Head & Neck Surg, Cleveland, OH 44106 USA. Case Western Reserve Univ, Cleveland Clin Fdn, Dept Gen Surg, Dept Otolaryngol Head & Neck Surg, Cleveland, OH 44106 USA. Case Western Reserve Univ, Cleveland Clin, Lerner Coll Med, Dept Surg, Cleveland, OH 44106 USA. Case Western Reserve Univ, Dept Biomed Engn, Cleveland, OH 44106 USA. 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TI Immuno-scanning electron microscopy of collagen types I and III in human vocal fold lamina propria SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE collagen type I; collagen type III; human vocal fold; immuno-scanning electron microscopy ID RETICULAR FIBERS AB Objectives: This study was undertaken to identify the types of collagen fibrils in the extracellular matrix of the human vocal fold lamina propria. Methods: Human vocal folds were obtained from 3 autopsy cases less than 65 years of age. The vocal fold specimens were labeled by primary antibodies of anti-type I and anti-type III collagens, and then by secondary antibody conjugated with 15 nm colloidal gold. The specimens were observed with a scanning electron microscope. Secondary electron imaging and backscatter electron imaging of high-resolution field emission scanning electron microscopy were used to detect gold particles indicating immunolabeling. Results: Type III collagen-labeling gold particles were abundant on the fibrils constructing collagenous fibers, whereas type I collagen-labeling gold particles were sparsely present on fibrils in collagenous fibers. A few reticular fibers were labeled by both collagen type I and collagen type III. Conclusions: The results suggest that collagen type I coexists with collagen type III in fibrils of both collagenous fibers and reticular fibers. C1 Univ Wisconsin, Div Otolaryngol Head & Neck Surg, Madison, WI 53706 USA. RP Tateya, T (reprint author), Kyoto Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Sakyo Ku, Kawaharacho 54, Kyoto 6068507, Japan. CR FLEISCHMAJER R, 1990, J STRUCT BIOL, V105, P162, DOI 10.1016/1047-8477(90)90110-X FLEISCHMAJER R, 1990, ANN NY ACAD SCI, V580, P161, DOI 10.1111/j.1749-6632.1990.tb17927.x FLEISCHMAJER R, 1980, J INVEST DERMATOL, V75, P189, DOI 10.1111/1523-1747.ep12522644 Sato K, 1998, ANN OTO RHINOL LARYN, V107, P1023 Schmitt FO, 1942, J CELL COMPAR PHYSL, V20, P11, DOI 10.1002/jcp.1030200103 Tateya T, 2006, ANN OTO RHINOL LARYN, V115, P469 Ushiki T, 2002, ARCH HISTOL CYTOL, V65, P109, DOI 10.1679/aohc.65.109 NR 7 TC 11 Z9 12 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2007 VL 116 IS 2 BP 156 EP 159 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 139JD UT WOS:000244427200012 PM 17388240 ER PT J AU Amin, M Rosen, CA Simpson, CB Postma, GN AF Amin, Milan Rosen, Clark A. Simpson, C. Blake Postma, Gregory N. TI Hands-on training methods for vocal fold injection education SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE education; simulation; training; vocal fold injection ID SIMULATOR; SURGERY; PERFORMANCE AB Objectives: Vocal fold injection (VFI) in the office setting and in the operating room is becoming increasingly popular. Most training programs fail to educate residents in performing these injections. In this report, we describe novel and effective teaching tools that provide real-life simulation of VFI for the education of residents and otolaryngologists in practice. Methods: Equipment was developed to allow the use of excised fresh cadaver larynges to simulate peroral VFI in a life-sized model of the human head and neck. A separate setup was also developed for use of a laryngoscope holder and cadaver larynges to simulate nucrolaryngoscopy VFI. Each of these VFI training setups allows the student to perform and practice VFI in a simulated setting with physical and anatomic constraints and laryngeal anatomy similar to those of real-life VFI.The use of fresh cadaver larynges allows the user to have a realistic feel of actual injection. A visual analog scale was used to measure the participants' comfort levels with the peroral and microlaryngoscopic injection techniques before and after the workshop. Results: Pre-workshop and post-workshop surveys were collected from 22 of the VFI Course participants. The mean comfort levels for VFI prior to the workshop were 22 for peroral VFI and 69 for microlaryngoscopy VFI (0 = not comfortable at all and 100 = very comfortable). The post-workshop comfort levels were 52 for peroral VFI and 85 for microlaryngoscopy VFI. The differences in the pre- and post-workshop comfort level scores for each VFI technique were significant (microlaryngoscopy, p =.001 peroral, p <.0001). Conclusions: The use of VFI Simulations appears to improve surgeon comfort level with injection techniques. The described training simulations may be useful for allowing residents and practicing otolaryngologists to learn VFI before attempting these techniques oil actual patients. C1 Univ Pittsburgh, Voice Ctr, Dept Otolaryngol Head & Neck Surg, Pittsburgh, PA 15215 USA. NYU, Sch Med, Voice Ctr, Dept Otolaryngol Head & Neck Surg, New York, NY USA. Univ Texas, Hlth Sci Ctr, Dept Otolaryngol Head & Neck Surg, San Antonio, TX USA. Med Coll Georgia, Dept Otolaryngol, Augusta, GA 30912 USA. RP Rosen, CA (reprint author), Univ Pittsburgh, Voice Ctr, Dept Otolaryngol Head & Neck Surg, Eye & Ear Inst Bldg,Suite 500,200 Lothrop St, Pittsburgh, PA 15215 USA. CR Blyth P, 2006, J SURG RES, V131, P133, DOI 10.1016/j.jss.2005.08.027 Caversaccio M, 2003, AM J RHINOL, V17, P283 Dailey SH, 2004, LARYNGOSCOPE, V114, P878, DOI 10.1097/00005537-200405000-00017 Deering S, 2006, OBSTET GYNECOL, V107, P86, DOI 10.1097/01.AOG.0000192168.48738.77 Goldmann Kai, 2005, Best Pract Res Clin Anaesthesiol, V19, P717, DOI 10.1016/j.bpa.2005.07.007 Gunther Stephen B, 2002, Acad Med, V77, P753, DOI 10.1097/00001888-200207000-00045 Hamilton EC, 2001, AM J SURG, V182, P725, DOI 10.1016/S0002-9610(01)00800-5 Haque S, 2006, IEEE T INF TECHNOL B, V10, P51, DOI 10.1109/TITB.2005.855529 Korndorffer JR, 2005, SURG ENDOSC, V19, P161, DOI 10.1007/s00464-004-8901-2 Mohamed AS, 2004, LARYNGOSCOPE, V114, P1128, DOI 10.1097/00005537-200406000-00032 Murray David, 2005, Curr Opin Anaesthesiol, V18, P645, DOI 10.1097/01.aco.0000188419.77140.1a Sedlack RE, 2004, CLIN GASTROENTEROL H, V2, P348, DOI 10.1053/S1542-3565(04)00067-9 Tabas JA, 2005, ACAD EMERG MED, V12, P782, DOI 10.1197/j.aem.2005.04.004 NR 13 TC 8 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 1 EP 6 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100001 PM 17305270 ER PT J AU Segal, N Shkolnik, M Kochba, A Segal, A Kraus, M AF Segal, Nili Shkolnik, Mark Kochba, Anat Segal, Avichai Kraus, Mordechai TI Asymmetric hearing loss in a random population of patients with mild to moderate sensorineural hearing loss SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE asymmetric hearing loss; hearing threshold; noise exposure ID PERFORMANCES; EARS AB Objectives: We evaluated the correlation of asymmetric hearing loss, in a random population of patients with mild to moderate sensorineural hearing loss, to several clinical factors such as age, sex, handedness, and noise exposure. Methods: We randomly selected, frorn 8 hearing institutes in Israel, 429 patients with sensorineural hearing loss of at least 30 dB at one frequency and a speech reception threshold not exceeding 30 d13. Patients with middle ear disease or retrocochlear disorders were excluded. The results of audiometric examinations were compared binaurally and in relation to the selected factors. Results: The left ear's hearing threshold level was significantly higher than that of the right ear at all frequencies except 1.0 kHz (p <.05). One hundred fifty patients (35%) had asymmetric hearing loss (more than 10 dB difference between ears). In most of the patients (85%) the binaural difference in hearing threshold level, at any frequency, was less than 20 dB.. Conclusions: Age, handedness, and sex were not found to be correlated to asymmetric hearing loss. Noise exposure was found to be correlated to asymmetric hearing loss. C1 Ben Gurion Univ Negev, Dept Otolaryngol Head & Neck Surg, Soroka Univ Med Ctr, IL-84101 Beer Sheva, Israel. Ben Gurion Univ Negev, Dept Ophthalmol, Soroka Univ Med Ctr, IL-84101 Beer Sheva, Israel. RP Kraus, M (reprint author), Ben Gurion Univ Negev, Dept Otolaryngol Head & Neck Surg, Soroka Univ Med Ctr, Box 151, IL-84101 Beer Sheva, Israel. CR AXELSSON A, 1981, SCAND AUDIOL, V10, P91, DOI 10.3109/01050398109076167 BURKE KA, 1994, NEUROPSYCHOLOGIA, V32, P1409, DOI 10.1016/0028-3932(94)00074-3 CHUNG DY, 1983, AUDIOLOGY, V22, P199 Hazell J. W., 1981, J LAR OTOL S, V4, P39 Job A, 1998, HEARING RES, V122, P119, DOI 10.1016/S0378-5955(98)00104-X KANNAN PM, 1974, J ACOUST SOC AM, V55, P1092, DOI 10.1121/1.1914657 Khalfa S, 1997, ACTA OTO-LARYNGOL, V117, P192, DOI 10.3109/00016489709117767 PIRILA T, 1991, SCAND AUDIOL, V20, P223, DOI 10.3109/01050399109045967 ROBERTS J, 1967, VITAL HLTH STAT, V11, P26 ROBERTS J, 1968, VITAL HLTH STAT, V11, P31 SCHLAUCH RS, 1995, J SPEECH HEAR RES, V38, P1168 NR 11 TC 5 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 7 EP 10 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100002 PM 17305271 ER PT J AU Su, CY Chuang, HC Tsai, SS Chiu, JF AF Su, Chih-Ying Chuang, Hui-Ching Tsai, Shang-Shyue Chiu, Jeng-Fen TI Transoral approach to laser thyroarytenoid myoneurectomy for treatment of adductor spasmodic dysphonia: Short-term results SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 18th World Congress of the International-Federation-of-Oto-Rhino-Laryngological-Societies CY JUN 25-30, 2005 CL Rome, ITALY SP Int Federat Oto Rhino Laryngol Soc DE adductor spasmodic dysphonia; recurrent laryngeal nerve; thyroarytenoid muscle; transoral laser myoneurectomy; ventricular fold hyperfunction ID SPASTIC DYSPHONIA; NEUROMUSCULAR-JUNCTIONS; MUSCLE; RECONSTRUCTION; THYROPLASTY; INNERVATION; MYECTOMY; SECTION AB Objectives: The surgical technique for the resection of the recurrent laryngeal nerve for adductor spasmodic dysphonia (ASD) has high late failure rates. During the past decade, botulinum toxin has emerged as the treatment of choice for ASD. Although effective, it also has significant disadvantages, including a temporary effect and an unpredictable dose-response relationship. In this study we investigated the effectiveness of a new transoral approach to laser thyroarytenoid myoneurectomy for treatment of ASD. Methods: Fourteen patients with ASD underwent transoral laser myoneurectomy of bilateral thyroarytenoid muscles. Under general anesthesia, an operating microscope and a carbon dioxide laser were used to perform myectomy of the mid-posterior belly of bilateral thyroarytenoid muscles together with neurectomy of the terminal nerve fibers among the deep muscle bundles. Care was taken not to damage the vocalis ligaments, arytenoid cartilages, and lateral cricoarytenoid muscles. Preoperative and postoperative videolaryngostroboscopy and vocal assessments were studied. Results: The 13 patients who completed more than 6 months follow-up were enrolled in this study. Moderate and marked vocal improvement was achieved in 92% of the patients (12 of 13) after laser surgery during an average follow-up period of 17 months (range, 6 to 31 months). No vocal fold atrophy or paralysis was observed in any patient. None of the patients had a recurrence during the follow-up period. Conclusions: Transoral laser myoneurectomy of bilateral thyroarytenoid muscles is a relatively simple, effective, and valuable technique for the treatment of ASD. The durability of outcome achieved with this procedure is encouraging. C1 Chang Gung Univ, Dept Otolaryngol, Kaohsiung Med Ctr, Chang Gung Mem Hosp,Coll Med, Kaohsiung, Taiwan. Chang Gung Univ, Voice Ctr, Kaohsiung Med Ctr, Chang Gung Mem Hosp,Coll Med, Kaohsiung, Taiwan. Foo Yin Inst Technol, Dept Med Technol, Kaohsiung, Taiwan. I Shou Univ, Dept Hlth Care Adm, Kaohsiung, Taiwan. RP Su, CY (reprint author), Chang Gung Univ, Dept Otolaryngol, Kaohsiung Med Ctr, Chang Gung Mem Hosp,Coll Med, 123 Tapei Rd, Kaohsiung, Taiwan. CR ARONSON AE, 1983, LARYNGOSCOPE, V93, P1 BENDIKSEN FS, 1981, ACTA OTO-LARYNGOL, V91, P391, DOI 10.3109/00016488109138520 Blitzer A, 1998, LARYNGOSCOPE, V108, P1435, DOI 10.1097/00005537-199810000-00003 Chan SW, 2004, LARYNGOSCOPE, V114, P1604, DOI 10.1097/00005537-200409000-00019 DEDO HH, 1983, LARYNGOSCOPE, V93, P268 DEDO HH, 1976, ANN OTO RHINOL LARYN, V85, P451 GENACK SH, 1993, OTOLARYNG HEAD NECK, V108, P256 Isshiki N, 2000, ANN OTO RHINOL LARYN, V109, P187 Koufman JA, 2006, ANN OTO RHINOL LARYN, V115, P97 ROSEN M, 1983, ANN OTO RHINOL LARYN, V92, P424 ROSSI G, 1965, Acta Otolaryngol, V59, P575, DOI 10.3109/00016486509124588 SANDERS I, 1993, ARCH OTOLARYNGOL, V119, P934 Schonweiler R, 1998, LARYNGOSCOPE, V108, P55 Sheppert AD, 2003, LARYNGOSCOPE, V113, P1973, DOI 10.1097/00005537-200311000-00022 SU CY, 2002, LARYNGOSCOPE, V11, P342 Su CY, 2004, LARYNGOSCOPE, V114, P1106, DOI 10.1097/00005537-200406000-00028 Su CY, 2005, LARYNGOSCOPE, V115, P1752, DOI 10.1097/01.mlg.0000172203.28583.63 Sulica Lucian, 2004, Curr Opin Otolaryngol Head Neck Surg, V12, P543, DOI 10.1097/01.moo.0000145959.50513.5e WOO P, 1990, LASER SURG MED, V10, P438, DOI 10.1002/lsm.1900100507 NR 19 TC 2 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 11 EP 18 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100003 PM 17305272 ER PT J AU Weinstein, GS O'Malley, BW Snyder, W Hockstein, NG AF Weinstein, Gregory S. O'Malley, Bert W., Jr. Snyder, Wendy Hockstein, Neil G. TI Transoral robotic surgery: Supraglottic partial laryngectomy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE da Vinci Surgical Robot; minimally invasive surgery; robotics; supraglottic cancer; supraglottic surgery; transoral robotic surgery ID RADICAL PROSTATECTOMY; CANINE MODEL; CARCINOMA AB Objectives: We assessed the feasibility of performing transoral supraglottic partial laryngectomy with robotic instrumentation. Methods: Transoral robotic surgery JORS) was performed on 3 human patients with supraglottic carcinoma in a prospective human trial. The study was approved by our institutional review board and involved the da Vinci Surgical Robot (Intuitive Surgical, Inc, Sunnyvale, California). Results: All procedures were completed robotically. The median overall operation time to perform the robotic procedure was 120 minutes (range, 1:32:48 to 2:58:18), including 18 minutes (range, 00:6:07 to 00:30:39) for exposure and robotic positioning. There were no intraoperative or postoperative complications or surgical mortality. Conclusions: The preliminary results of our series suggest that application of the da Vinci robotic surgical system for TORS to supraglottic partial laryngectomy is technically feasible and relatively safe. Furthermore, TORS provides excellent surgical exposure that allows complete tumor resection. Most importantly, TORS provides an alternative to open approaches and "conventional" transoral supraglottic partial laryngectomy. C1 Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. RP Weinstein, GS (reprint author), Univ Penn Hlth Syst, Dept Otorhinolaryngol Head & Neck Surg, 3400 Spruce St,5 Ravdin, Philadelphia, PA 19104 USA. CR Advincula AP, 2004, OBSTET GYN CLIN N AM, V31, P599, DOI 10.1016/j.ogc.2004.05.004 Ahlering TE, 2003, J UROLOGY, V170, P1738, DOI 10.1097/01.ju.0000092881.24608.5e Binder J, 2004, BJU INT, V94, P1183, DOI 10.1111/j.1464-410X.2004.05130.x Boehm Dieter H, 2003, Semin Thorac Cardiovasc Surg, V15, P112, DOI 10.1016/S1043-0679(03)70019-7 Hockstein NG, 2005, LARYNGOSCOPE, V115, P1003, DOI 10.1212/01.WNL.0000164714.90354.7D Hockstein NG, 2005, LARYNGOSCOPE, V115, P780, DOI 10.1097/01.MLG.0000159202.04941.67 Jacobsen G, 2003, J LAPAROENDOSC ADV A, V13, P279, DOI 10.1089/109264203322333610 Kitagawa M, 2005, J THORAC CARDIOV SUR, V129, P151, DOI 10.1016/j.jtcvs.2004.05.029 Meier AH, 2001, J AM COLL SURGEONS, V192, P372, DOI 10.1016/S1072-7515(01)00769-4 Menon M, 2004, BJU INT, V93, P715, DOI 10.1111/j.1464-410X.2004.04748.x O'Malley BW, 2006, J VOICE, V20, P263, DOI 10.1016/j.jvoice.2005.10.004 Rudert HH, 1999, ANN OTO RHINOL LARYN, V108, P819 Vilaseca-Gonzalez I, 2003, HEAD NECK-J SCI SPEC, V25, P382, DOI 10.1002/hed.10207 Weinstein GS, 2005, LARYNGOSCOPE, V115, P1315, DOI 10.1097/01.MLG.0000170848.76045.47 NR 14 TC 137 Z9 144 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 19 EP 23 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100004 PM 17305273 ER PT J AU Karkos, PD Yates, PD Carding, PN Wilson, JA AF Karkos, Petros D. Yates, Philip D. Carding, Paul N. Wilson, Janet A. TI Is laryngopharyngeal reflux related to functional dysphonia? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE dysphonia; hoarseness; laryngopharyngeal reflux ID AMBULATORY ESOPHAGEAL; NONORGANIC DYSPHONIA; VOICE THERAPY; HOARSENESS; DISORDERS; DIAGNOSIS AB Objectives: Laryngopharyngeal reflux (LPR) may be a contributing factor in chronic hoarseness. The association of LPR with functional dysphonia (FD), the most common voice clinic diagnosis, is unknown. We attempted to determine whether patients with FD have a higher rate of laryngeal exposure to acidic stomach contents than do healthy volunteers. Methods: We recruited through the voice clinic 23 patients who had had persistent dysphonia for 3 months. Pregnancy, major structural laryngeal abnormality, and vocal fold paralysis were exclusion criteria. Eight healthy volunteers were recruited. The subjects gave informed consent to enter the study, which had the approval of our hospital ethics committee. The patients and control subjects underwent 24-hour dual-probe pH-metry. Results: Twenty-two patients and 6 control subjects completed the study. Overall, there seemed to be no statistical differences between patients and controls on all but 2 channel 1 pH-metry parameters. These were the longest reflux episode (seconds) in a supine position, and the fraction of time the pH was less than 4 in a supine position. Both of these time periods were longer in patients than in the controls (p <.05). Conclusions: Our study demonstrated an association between LPR and FD for 2 pH parameters. Larger studies are required to assess the potential relationship between nonorganic dysphonias and reflux. Furthermore, the presence of a multifactorial causation of FD, including "medical" and psychological causes, should be addressed in future studies. C1 Freeman Rd Hosp, Dept Otolaryngol, Newcastle Upon Tyne NE7 7DN, Tyne & Wear, England. Freeman Rd Hosp, Dept Speech Therapy, Newcastle Upon Tyne NE7 7DN, Tyne & Wear, England. RP Karkos, PD (reprint author), AFRCSI, 36 Hopkinsons Court,Walls Ave, Chester CH1 4LN, Cheshire, England. CR CARDING PN, 1992, EUR J DISORDER COMM, V27, P137 Carding PN, 1999, J VOICE, V13, P72, DOI 10.1016/S0892-1997(99)80063-0 Goldberg D. P., 1988, USERS GUIDE GEN HLTH Karkos PD, 2006, LARYNGOSCOPE, V116, P144, DOI 10.1097/01.mlg.0000191463.67692.36 KATZ PO, 1990, AM J GASTROENTEROL, V85, P38 KOUFMAN JA, 1991, LARYNGOSCOPE S53, V101 Koufman JA, 2000, OTOLARYNG HEAD NECK, V123, P385, DOI 10.1067/mhn.2000.109935 Koufman JA, 2002, OTOLARYNG HEAD NECK, V127, P32, DOI 10.1067/mhn.2002.125760 Koufman James A, 2002, Ear Nose Throat J, V81, P7 KOUFMAN JA, 2001, OTOLARYNGOL HEAD NEC, V124, P104 Maldonado A, 2003, LARYNGOSCOPE, V113, P349, DOI 10.1097/00005537-200302000-00027 Postma Gregory N, 2002, Ear Nose Throat J, V81, P14 Postma GN, 2000, ANN OTO RHINOL LARYN, V109, P10 Richter JE, 1997, AM J MED, V103, p130S, DOI 10.1016/S0002-9343(97)00338-0 Roy Nelson, 2003, Curr Opin Otolaryngol Head Neck Surg, V11, P144, DOI 10.1097/00020840-200306000-00002 SCHALEN L, 1992, CLIN OTOLARYNGOL, V17, P225, DOI 10.1111/j.1365-2273.1992.tb01832.x Scott S, 1997, CLIN OTOLARYNGOL, V22, P37, DOI 10.1046/j.1365-2273.1997.00855.x SHAKER R, 1995, GASTROENTEROLOGY, V109, P1575, DOI 10.1016/0016-5085(95)90646-0 Smit CF, 1998, LARYNGOSCOPE, V108, P299, DOI 10.1097/00005537-199802000-00027 Tasker A, 2002, LARYNGOSCOPE, V112, P1930, DOI 10.1097/00005537-200211000-00004 Ulualp SO, 2000, OTOLARYNG CLIN N AM, V33, P785, DOI 10.1016/S0030-6665(05)70244-9 Vaezi MF, 1997, AM J GASTROENTEROL, V92, P825 WIENER GJ, 1989, AM J GASTROENTEROL, V84, P1503 WILSON JA, 1995, BRIT MED J, V311, P1039 Yates PD, 2001, CLIN OTOLARYNGOL, V26, P113, DOI 10.1046/j.1365-2273.2001.00451.x NR 25 TC 8 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 24 EP 29 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100005 PM 17305274 ER PT J AU Sanchez, TG Lima, AD Brandao, AL Lorenzi, MC Bento, RF AF Sanchez, Tanit Ganz Lima, Adriana da Silva Brandao, Ana Laura Lorenzi, Maria Cecilia Bento, Ricardo Ferreira TI Somatic modulation of tinnitus: Test reliability and results after repetitive muscle contraction training SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE auditory connection; rehabilitation; somatic modulation; somatosensory system; tinnitus ID COCHLEAR NUCLEUS; AUDITORY-PERCEPTION; CAT AB Objectives: We sought to study the reliability of tinnitus modulation by muscle contractions and to observe the effect of their prolonged repetition. Methods: Thirty-eight patients with tinnitus underwent 9 maneuvers of muscle contractions in test and retest situations. After a 2-month training period of repeating the maneuvers, tinnitus modulation and daily perception were evaluated. Results: There was no difference between the occurrence of tinnitus modulation in test (57.9%) and retest (63.2%) situations. After 2 months, the occurrence of modulation during the maneuvers was similar (55.3%), but a new pattern showed an increase in tinnitus improvement and a decrease in tinnitus worsening. The daily perception of tinnitus was unchanged. Conclusions: Maneuvers of head and neck muscle contractions evoked tinnitus modulation in a frequent and reliable manner. Also, the repetition of such maneuvers for 2 months altered the pattern of modulation. C1 Univ Sao Paulo, Sch Med, Dept Otolaryngol, Sao Paulo, Brazil. RP Sanchez, TG (reprint author), Rua Tenente Negrao,140 CJ 91, BR-04530030 Sao Paulo, Brazil. CR Abel MD, 2004, CRANIO, V22, P181 Cacace AT, 2003, HEARING RES, V175, P112, DOI 10.1016/S0378-5955(02)00717-7 HOTTA T, 1963, EXP NEUROL, V8, P1, DOI 10.1016/0014-4886(63)90003-7 JASTREBOFF PJ, 1990, NEUROSCI RES, V8, P221, DOI 10.1016/0168-0102(90)90031-9 Jastreboff P J, 2000, J Am Acad Audiol, V11, P162 JASTREBOFF PJ, 2002, BALLENGERS OTORHINOL, P456 KANDEL ER, 2000, PRINCIPLES NEURAL SC, P18 Levine RA, 1999, AM J OTOLARYNG, V20, P351, DOI 10.1016/S0196-0709(99)90074-1 Levine RA, 1999, P 6 INT TINN SEM CAM, P193 Lockwood AH, 1998, NEUROLOGY, V50, P114 MOLLER AR, 1992, LARYNGOSCOPE, V102, P187 Sanchez T, 1997, ARQ FUND OTORRINOLAR, V1, P2 Sanchez TG, 1997, REV BRAS OTORRINOLAR, V63, P229 Sanchez TG, 2002, AUDIOL NEURO-OTOL, V7, P370, DOI 10.1159/000066155 Shore SE, 2003, NEUROSCIENCE, V119, P1085, DOI 10.1016/S0306-4522(03)00207-0 THOMPSON RF, 1963, J NEUROPHYSIOL, V26, P365 Wright DD, 1996, J COMP NEUROL, V365, P159, DOI 10.1002/(SICI)1096-9861(19960129)365:1<159::AID-CNE12>3.0.CO;2-L NR 17 TC 17 Z9 20 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 30 EP 35 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100006 PM 17305275 ER PT J AU Shaw, GY Sechtem, PR Searl, J Keller, K Rawi, TA Dowdy, E AF Shaw, Gary Y. Sechtem, Phillip R. Searl, Jeff Keller, Kristina Rawi, Taib A. Dowdy, Emily TI Transcutaneous neuromuscular electrical stimulation (VitalStim) curative therapy for severe dysphagia: Myth or reality? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE aspiration; dysphagia; neuromuscular electrical stimulation; VitalStim therapy ID UPPER ESOPHAGEAL SPHINCTER; SWALLOWING DISORDERS; STROKE AB Objectives: VitalStim therapy was approved by the US Food and Drug Administration in 2001 for the treatment of dysphagia through the application of neuromuscular electrical stimulation to cervical swallowing muscles. This approval was based upon submission of data on more than 800 patients who received this therapy collected by the principal developer and patent-holder of the device. The therapy is marketed as successful in restoring long-term swallowing function in 97.5% of dysphagic patients past the point of requiring a feeding tube and as significantly better than existing therapies. More than 2,500 speech-language pathologists have taken the certification course, and thousands of devices have been sold. To date, however, aside from the developer's own studies, there are no peer-reviewed publications supporting these claims. We sought to evaluate the effectiveness of VitalStim therapy in a heterogeneous group of dysphagic patients. Methods: We performed a retrospective analysis of 18 patients who received this therapy at an urban tertiary referral center. All patients underwent pretherapy evaluation by speech-language pathologists, including modified barium swallow and/or functional endoscopic evaluation of swallowing and clinical evaluation of swallowing that included assessment of laryngeal elevation, diet tolerance, and swallowing delay, and were then assigned an overall dysphagia severity score. After therapy, all patients underwent the same assessments. Twelve of the 18 also underwent a functional swallowing telephone survey months (range, I to 21 months) after their therapy to assess whether the improvement was worthwhile and sustained. Results: Eleven of the 18 patients (61%) demonstrated some improvement in their swallowing. Six of the 18 patients (33%) were improved enough to no longer require a feeding tube. However, of the 5 patients categorized as having "severe dysphagia" before therapy, only 2 showed any improvement, and these patients still required a feeding tube for adequate nutrition. Telephone surveys did confirm that those who improved with their therapy seemed to maintain their progress and that most patients were satisfied with their therapy. Conclusions: VitalStim therapy seems to help those with mild to moderate dysphagia. However, the patients with the most severe dysphagia in our study did not gain independence from their feeding tubes. The authors conclude that VitalStim therapy clearly has a place in the management of dysphagia, but that the most severely afflicted are unlikely to gain dramatic improvement. C1 Kansas City Univ Med & Biosci, Dept Surg, Kansas City, MO USA. Med Res Ctr, Voice & Swallowing Care Ctr, Kansas City, MO USA. Univ Kansas, Med Ctr, Dept Speech & Hearing Sci, Kansas City, KS 66103 USA. RP Shaw, GY (reprint author), Lees Summit ENT Ctr, 296 Tudor Rd, Lees Summit, MO 64086 USA. CR *ASHA NOMS, 1998, AD SPEECH LANG PATH, P23 Baredes S, 1997, AM J OTOLARYNG, V18, P185, DOI 10.1016/S0196-0709(97)90080-6 Burnett TA, 2003, J APPL PHYSIOL, V94, P128, DOI 10.1152/japplphysiol.00406.2002 Freed M, 1996, DYSPHAGIA, V11, P159 FREED M, 2004, CIAO SEM GULF BREEZ Freed M L, 2001, Respir Care, V46, P466 Handa Y, 1998, NEUROL MED-CHIR, V38, P784, DOI 10.2176/nmc.38.784 JACOB P, 1989, GASTROENTEROLOGY, V97, P1469 Kagaya H, 1996, PARAPLEGIA, V34, P24 Korfage JAM, 2001, ARCH ORAL BIOL, V46, P821, DOI 10.1016/S0003-9969(01)00042-5 LANGMORE SE, 1994, ARCH PHYS MED REHAB, V75, P1154, DOI 10.1016/0003-9993(94)90094-9 Langmore S E, 1988, Dysphagia, V2, P216, DOI 10.1007/BF02414429 Lazzara G, 1986, DYSPHAGIA, Vl, P73 Leelamanit V, 2002, LARYNGOSCOPE, V112, P2204, DOI 10.1097/00005537-200212000-00015 LEESE G, 1986, ACTA ANAT, V127, P77 LOGEMANN J, 1983, EVALUATION TREATMENT, P134 Lundy DS, 1999, OTOLARYNG HEAD NECK, V120, P474, DOI 10.1053/hn.1999.v120.a91765 Mann G, 2000, CEREBROVASC DIS, V10, P380, DOI 10.1159/000016094 MILNERBROWN HS, 1988, ARCH PHYS MED REHAB, V69, P20 NEUMANN S, 1995, DYSPHAGIA, V10, P1, DOI 10.1007/BF00261272 OTT DJ, 1993, AM J ROENTGENOL, V161, P507 Park CL, 1997, DYSPHAGIA, V12, P161, DOI 10.1007/PL00009531 ROSENBEK JC, 1991, J SPEECH HEAR RES, V34, P1257 STAL P, 1994, SWED DENT J S, P98 *US DEP HHS, 1999, AHCPR PUBL Yokoyama M, 2000, LARYNGOSCOPE, V110, P434, DOI 10.1097/00005537-200003000-00021 NR 26 TC 31 Z9 41 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 36 EP 44 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100007 PM 17305276 ER PT J AU Rees, CJ Postma, GN Koufman, JA AF Rees, Catherine J. Postma, Gregory N. Koufman, Jamie A. TI Cost savings of unsedated office-based laser surgery for laryngeal papillomas SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE cost; pulsed dye laser; recurrent respiratory papillomatosis; unsedated office-based laryngeal laser surgery ID PULSED DYE-LASER; GLOTTAL DYSPLASIA AB Objectives: Unsedated office-based laryngeal laser surgery (UOLS) is now an effective alternative to traditional operating room-based suspension microdirect laryngoscopy under general anesthesia. This procedure includes pulsed dye laser (PDL) treatment of recurrent respiratory papillomas, granulomas, leukoplakia, and polypoid degeneration. The objective of this study was to determine the magnitude of the cost savings derived by moving these types of procedures from the operating room to the office setting. Methods: Retrospective cost-identification analysis was performed by comparing the billing records of patients who underwent surgical laser treatment for recurrent respiratory papillomatosis in the operating room to the costs and charges for patients who underwent similar procedures with the in-office PDL. Results: fit performing surgery with the PDL in the office, the average cost savings was more than $5,000 per case. Current reimbursement rates do not cover the cost of performing UOLS. Conclusions: The potential cost savings of UOLS are tremendous; however. at present significant financial disincentives prevent proliferation of this technology. C1 Wake Forest Univ, Sch Med, Dept Otolaryngol, Winston Salem, NC 27109 USA. RP Koufman, JA (reprint author), Voice Inst New York, 9 W 67th St, New York, NY 10023 USA. CR ANDERSON R R, 1983, Lasers in Surgery and Medicine, V3, P211 Anderson R R, 1981, Lasers Surg Med, V1, P263 Clyne SB, 2005, ANN OTO RHINOL LARYN, V114, P198 EISENBERG JM, 1989, JAMA-J AM MED ASSOC, V262, P2879, DOI 10.1001/jama.262.20.2879 Franco RA, 2003, ANN OTO RHINOL LARYN, V112, P751 Franco RA, 2002, ANN OTO RHINOL LARYN, V111, P486 McMillan K, 1998, LARYNGOSCOPE, V108, P968, DOI 10.1097/00005537-199807000-00003 Rees CJ, 2006, OTOLARYNG HEAD NECK, V134, P1023, DOI 10.1016/j.otohns.2006.01.019 *US DEP LAB BUR LA, NOV 2004 STAT OCC EM Utley DS, 1997, LARYNGOSCOPE, V107, P726, DOI 10.1097/00005537-199706000-00005 Valdez TA, 2001, OTOLARYNG HEAD NECK, V124, P421, DOI 10.1067/mhn.2001.113944 Zeitels SM, 2004, ANN OTO RHINOL LARYN, V113, P265 NR 12 TC 24 Z9 24 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 45 EP 48 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100008 PM 17305277 ER PT J AU Munoz, AA Shapiro, J Cuddy, LD Misono, S Bhattacharyya, N AF Munoz, Amanda A. Shapiro, Jo Downey Cuddy, Lorraine Misono, Stephanie Bhattacharyya, Neil TI Videofluoroscopic findings in dysphagic patients with cricopharyngeal dysfunction: Before and after open cricopharyngeal myotomy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE dysphagia; fluoroscopy; oropharyngeal dysphagia; swallowing disorder; Zenker's diverticulum ID ZENKERS DIVERTICULUM; PHARYNGEAL DYSPHAGIA; MUSCLE; PATHOGENESIS AB Objectives: Functional outcomes after open cricopharyngeal myotomy (CPM) for Zenker's diverticulum (ZD) and cricopharyngeal dysfunction without diverticulum (CPD) have not been uniformly measured by videofluorographic swallow study (VFSS). Here we characterize preoperative VFSS findings in these groups and evaluate the effect of CPM on swallowing via postoperative VFSS. Methods: We performed a retrospective review of paired preoperative and postoperative VFSS results from 50 patients (36 with ZD and 14 with CPD) over 6 years. Serniquantitative scales were used to assess 1) degree of stasis in the pharyngeal recesses; 2) degree of narrowing at the pharyngoesophageal sphincter (PES); 3) aspiration; and 4) diverticular size. Findings were compared between the groups and across subjects. Results: Pharyngeal stasis was more severe in Subjects with CPD than in subjects with ZD, both before and after CPM (p =.02 and p =.0002, respectively). The CPM improved PES narrowing in both groups (p =.03; p =.06) and reduced diverticular size in the ZD group (p <.001), but it did not significantly reduce the stasis severity or the proportion of patients with aspiration. Conclusions: According to VFSS, CPM opens LIP the PES and decreases diverticular size. More severe stasis in CPD suggests that diffuse pharyngeal weakness may play a role in this disease, and may partially explain the variable post-CPM outcomes that have been observed in CPD. C1 Brigham & Womens Hosp, Div Otolaryngol, Boston, MA 02115 USA. Brigham & Womens Hosp, Speech & Swallow Dept, Boston, MA 02115 USA. Harvard Univ, Sch Med, Dept Otol & Laryngol, Boston, MA 02115 USA. RP Bhattacharyya, N (reprint author), Div Otolaryngol, 45 Francis St, Boston, MA 02115 USA. CR Ali GN, 1997, DYSPHAGIA, V12, P133, DOI 10.1007/PL00009527 BROWNLOW H, 1989, J ANAT, V166, P67 Colombo-Benkmann M, 2003, J AM COLL SURGEONS, V196, P370, DOI 10.1016/S1072-7515(02)01903-8 COOK IJ, 1992, GASTROENTEROLOGY, V103, P1229 ELLIS FH, 1996, J CARDIOTHORAC SURG, V10, P1033 Kelly JH, 2000, AM J MED S4A, V108S, P43, DOI 10.1016/S0002-9343(99)00334-4 LAURIKAINEN E, 1992, EUR ARCH OTO-RHINO-L, V249, P216 LERUT T, 1990, ACTA GASTRO-ENT BELG, V53, P330 Mason RJ, 1998, ANN SURG, V228, P598, DOI 10.1097/00000658-199810000-00016 RIMINTON DS, 1993, NEUROLOGY, V43, P1241 Shapiro J, 1996, ANN OTO RHINOL LARYN, V105, P331 SHAPIRO J, 1996, LARYNX MULTIDISCIPLI, P293 STGUILY JL, 1995, ANN OTO RHINOL LARYN, V104, P603 Sydow BD, 2001, AM J ROENTGENOL, V177, P1067 van Overbeek JJM, 2003, ANN OTO RHINOL LARYN, V112, P583 VENCOVSKY J, 1988, J RHEUMATOL, V15, P1016 WOUTERS B, 1990, ACTA GASTRO-ENT BELG, V53, P323 NR 17 TC 9 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 49 EP 56 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100009 PM 17305278 ER PT J AU Woodson, GE AF Woodson, Gayle E. TI Spontaneous laryngeal reinnervation after recurrent laryngeal or vagus nerve injury SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE electromyography; recurrent laryngeal nerve; reinnervation; vagus nerve ID CRICOTHYROID MUSCLE-CONTRACTION; VOCAL FOLD; PARALYSIS; ELECTROMYOGRAPHY; DOGS AB Objectives: The status of innervation in patients with laryngeal paralysis is somewhat controversial. Electromyographic activity has been frequently documented in the laryngeal muscles of patients with laryngeal paralysis, and animal experiments report a strong propensity for reinnervation after laryngeal nerve injury. However, a study of intraoperative electromyography performed in patients during reinnervation surgery failed to document activity with stimulation of the recurrent laryngeal nerve (RLN). Noting the long-observed differences in the symptoms of patients with vagus nerve injury and those with RLN injury, I hypothesized that reinnervation is influenced by the site of nerve injury. Methods: Cats were sacrificed at various intervals after resection of I cm of either the RLN or the vagus nerve, without any attempt to repair the nerve. Results: Four months after RLN resection, distal nerve biopsy revealed unmyelinated axons scattered through fibrous tissue. By 6 months, myelinated axons were organized, and electromyographic and histologic examination showed preferential reinnervation of the thyroarytenoid muscle. After vagotomy, the RLN was fibrotic and no axons were present. Both the thyroarytenoid and posterior cricoarytenoid muscles were fibrotic and had no electromyographic activity. Conclusions: The results confirm the strong propensity for laryngeal reinnervation after RLN injury, but not after vagus nerve injury. Preferential reinnervation of adductor Muscles may account for a medial position of the paralyzed vocal fold. C1 So Illinois Univ, Div Otolaryngol, Springfield, IL 62794 USA. RP Woodson, GE (reprint author), So Illinois Univ, Div Otolaryngol, POB 19662, Springfield, IL 62794 USA. CR AMIS TC, 1992, J APPL PHYSIOL, V72, P2329 Baker SE, 2003, J VOICE, V17, P384, DOI 10.1067/S0892-1997(03)00066-3 Crumley RL, 2000, ANN OTO RHINOL LARYN, V109, P365 Damrose EJ, 2001, ANN OTO RHINOL LARYN, V110, P815 DEDO HH, 1970, LARYNGOSCOPE, V80, P1455, DOI 10.1288/00005537-197010000-00001 FLINT PW, 1991, ANN OTO RHINOL LARYN, V100, P797 Gordon T, 2003, J PERIPHER NERV SYST, V8, P236, DOI 10.1111/j.1085-9489.2003.03029.x Grossmann M, 1906, ARCH LARYNGOL RHINOL, V18, P463 Hirano M, 1987, NEUROLARYNGOLOGY REC, P232 KIRCHNER JA, 1977, ACTA OTO-LARYNGOL, V83, P163, DOI 10.3109/00016487709128828 KOUFMAN JA, 1995, LARYNGOSCOPE, V105, P368, DOI 10.1288/00005537-199504000-00005 KUNA ST, 1988, J APPL PHYSIOL, V65, P1332 LEWIS WS, 1991, LARYNGOSCOPE, V101, P1259 NETTERVILLE JL, 1991, ANN OTO RHINOL LARYN, V100, P10 SHINDO ML, 1992, LARYNGOSCOPE, V102, P663, DOI 10.1288/00005537-199206000-00012 Woodson GE, 1997, ANN OTO RHINOL LARYN, V106, P552 WOODSON GE, 1989, ANN OTO RHINOL LARYN, V98, P119 WOODSON GE, 1993, LARYNGOSCOPE, V103, P1235 NR 18 TC 40 Z9 41 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 57 EP 65 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100010 PM 17305279 ER PT J AU Zhai, LJ Sun, YQ Tang, LH Liu, H AF Zhai, Lijie Sun, Yiqing Tang, Linghao Liu, Hui TI Polymorphism between loci for human leukocyte antigens DR and DQ in patients with nasal polyps SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE gene; human leukocyte antigen; nasal polyp; pathogenesis ID HLA AB Objectives: We explored a potential association between nasal polyps (NPs) and polymorphism at loci for human leukocyte antigen (HLA) DR and HLA-DQ. Methods: Polymorphism at loci HLA-DR and HLA-DQ were examined in 30 patients with NPs and in 81 healthy subjects by use of the polymerase chain reaction-sequence specific primer method. Results: HLA-DR16, HLA-DQ8, and HLA-DQ9 were found to be significantly associated with NPs. HLA-DR16, HLADQ8. and HLA-DQ9 specificities were found at higher frequencies in patients with NPs than in control subjects (5% versus 0.62%, RR = 8.9, p =.03; 10% versus 2.47%, RR = 4.8 1, p =.01- and 20% versus 6.18%. RR = 4.73%, p =.001; respectively). In contrast, HLA-DQ7 was found at lower frequencies in patients with NPs than in controls (10% versus 20.37%, RR = 0.36, p =.04). Conclusions: We conclude that HLA-DR16, HLA-DQ8, and HLA-DQ9 represent potential susceptibility determinants and that HLA-DQ7 might confer resistance in nasal polyps. C1 Dalian Med Univ, Dept Clin Immunol, Dalian 116027, Peoples R China. Dalian Med Univ, Dept Otolaryngol, Hosp 1, Dalian 116027, Peoples R China. RP Liu, H (reprint author), Dalian Med Univ, Dept Clin Immunol, Dalian 116027, Peoples R China. CR CAUNA N, 1972, ANN OTO RHINOL LARYN, V81, P41 DRAKELEE AB, 1984, J LARYNGOL OTOL, V98, P783, DOI 10.1017/S0022215100147462 Ediger D, 2005, CLIN EXP ALLERGY, V35, P319, DOI 10.1111/j.1365-2222.2005.02194.x Leprini A., 1993, Bollettino Societa Italiana Biologia Sperimentale, V69, P395 Liu Tian-yi, 2003, Zhonghua Er Bi Yan Hou Ke Za Zhi, V38, P183 Molnar-Gabor E, 2000, LARYNGOSCOPE, V110, P422, DOI 10.1097/00005537-200003000-00017 SARFARAZI M, 1995, GENOMICS, V30, P171, DOI 10.1006/geno.1995.9888 SVEJGAAR.A, 1974, TISSUE ANTIGENS, V4, P95 SVEJGAARD A, 1976, LANCET, V2, P547 TOS M, 1977, Rhinology (Utrecht), V15, P87 Wang D, 1997, CLIN EXP ALLERGY, V27, P306 WATANABE K, 1980, ANN OTO RHINOL LARYN, V89, P377 NR 12 TC 8 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 66 EP 68 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100011 PM 17305280 ER PT J AU Doyle, WJ Yuksel, S Banks, J Alper, CM AF Doyle, William J. Yuksel, Sancak Banks, Juliane Alper, Cuneyt M. TI Directional asymmetry in the measured nitrous oxide time constant for middle ear transmucosal gas exchange SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE animal experiment; gas exchange; middle ear; modeling ID MASS-SPECTROMETRY; PRESSURE; MONKEYS; VENTILATION; ATELECTASIS; MUCOSA AB Objectives: Simple, 2-compartment mathematical models of middle ear (ME) transmucosal gas exchange reproduce observed ME pressure behavior. These models require input of an experimentally determined, lumped-parameter exchange constant for each represented gas species. Previous model applications assumed directional asymmetry for those parameters, which has not been experimentally validated. Methods: As a surrogate for the inert gas nitrogen (N-2), for which exchange is too slow to be measurable, the nitrous oxide (N2O) transmucosal exchange constant for 16 cars of 8 monkeys was measured for positive and negative ME blood N2O gradients. Results: The paired exchange constants for each ear were highly correlated, but the ME-blood/blood-ME exchange constant ratio was approximately 13. Modeling shows this asymmetry to depend on the value of the arterial-venous/arterial-ME ratio, a variable in the exchange constant for perfusion-limited gases. Conclusions: These results support an asymmetric rate of transmucosal N2O and, by extension, N-2 exchange for the ME. Because the primary controlling parameter for ME pressure behavior in the absence of eustachian tube opening is the rate of transmucosal N-2 exchange, this effect needs to be incorporated into the simple 2-compartment exchange models for predictive accuracy. The gradient ratio dependence Suggests that parameter-free modeling may require treating the ME mucosa as having a distributed gradient for certain gas species. C1 Childrens Hosp Pittsburgh, Div Pediat Otolaryngol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Otolaryngol, Pittsburgh, PA USA. RP Alper, CM (reprint author), Childrens Hosp Pittsburgh, Div Pediat Otolaryngol, 3705 5th Ave,DeSoto St, Pittsburgh, PA 15213 USA. CR ALPER CM, 1996, P 6 INT S REC ADV OT, P116 Doyle WJ, 2000, FUNCTION AND MECHANICS OF NORMAL, DISEASED AND RECONSTRUCTED MIDDLE EARS, P3 Doyle W J, 1999, Auris Nasus Larynx, V26, P5, DOI 10.1016/S0385-8146(98)00060-1 Doyle WJ, 1997, ACTA OTO-LARYNGOL, V117, P708, DOI 10.3109/00016489709113464 DOYLE WJ, 1994, ANN OTO RHINOL LARYN, V103, P636 DOYLE WJ, 1996, P 6 INT S REC ADV OT, P102 Doyle WJ, 2003, J APPL PHYSIOL, V94, P199, DOI 10.1152/japplphysiol.00634.2002 DOYLE WJ, 1995, ARCH OTOLARYNGOL, V121, P887 Fink N, 2003, ACTA PHYSIOL SCAND, V177, P493, DOI 10.1046/j.1365-201X.2003.01096.x HERGILS L, 1990, ACTA OTO-LARYNGOL, V110, P92, DOI 10.3109/00016489009122520 Hergils L, 1997, ANN OTO RHINOL LARYN, V106, P743 HERGILS L, 1985, ARCH OTOLARYNGOL, V111, P86 HERGILS L, 1996, P 6 INT S REC ADV OT, P106 HERGILS L, 1988, ARCH OTOLARYNGOL, V114, P1442 Loring SH, 2011, HDB PHYSL 3, V4, P283 Miura M, 1998, LARYNGOSCOPE, V108, P683, DOI 10.1097/00005537-199805000-00011 MOVERLEV H, 1988, ANN OTO RHINOL LARYN, V107, P194 OSTFELD EJ, 1991, ARCH OTOLARYNGOL, V117, P1390 OSTFELD EJ, 1992, ANN OTO RHINOL LARYN, V101, P445 RANADE A, 1980, ACTA OTOLARYNGOL S S, V371 SADE J, 1992, EUR ARCH OTO-RHINO-L, V249, P301 NR 21 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 69 EP 75 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100012 PM 17305281 ER PT J AU Kim, SW Jeon, YK Won, TB Dhong, HJ Min, JY Shim, WS Min, YG AF Kim, Si Whan Jeon, Yoon Kyung Won, Tae Bin Dhong, Hun-Jong Min, Jin-Young Shim, Woo Sub Min, Yang-Gi TI Effects of corticosteroids on expression of interleukin-18 in the airway mucosa of a mouse model of allergic rhinitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE allergic rhinitis; glucocorticoid; interleukin-18; nasal secretion; respiratory mucosa ID IFN-GAMMA; PROINFLAMMATORY CYTOKINES; ATOPIC-DERMATITIS; UP-REGULATION; SERUM IGE; IN-VITRO; T-CELLS; IL-18; ASTHMA; SENSITIZATION AB Objectives: In this study, we aimed to investigate the release and response of interleukin (IL)-18 to steroid treatment in a mouse model of allergic rhinitis. Methods: BALB/c mice were sensitized systemically by intraperitoneal injection of ovalbumin and locally by ovalbumin inhalation. Dexamethasone sodium phosphate was given by intraperitoneal injection in the steroid treatment group. Symptom scores, eosinophil counts, and IL-18 concentrations in the nasal and lung lavage fluids were analyzed. Results: The symptom scores and eosinophil counts of the negative control and steroid treatment groups were significantly lower than those of the positive control group (p <.01). The mean IL-18 concentrations in the nasal lavage fluid were not significantly different among the three groups (56.68 +/- 9.57, 63.39 +/- 8.93, and 64.47 +/- 6.83 pg/mL, respectively). The IL-18 concentrations in the lung lavage fluid were significantly different between the positive control group and the steroid treatment group (430.75 +/- 154.54 and 69.94 +/- 14.26 pg/mL, respectively, p =.028). Conclusions: The IL-18 concentration was found to be increased in the lung lavage fluid. but not in the nasal lavage fluid, in a mouse model of allergic rhinitis. Increased IL-18 concentrations returned toward the previous concentrations after steroid treatment. These results suggest that the roles of IL-18 may be different in the pathogenesis of allergic rhinitis and the pathogenesis of asthma. C1 Seoul Natl Univ, Coll Med, Dept Otorhinolaryngol Head & Neck Surg, Seoul 110744, South Korea. Seoul Natl Univ, Coll Med, Dept Pathol, Seoul 110744, South Korea. Sungkyunkwan Univ, Dept Otorhinolaryngol Head & Neck Surg, Sch Med, Seoul, South Korea. RP Min, YG (reprint author), Seoul Natl Univ, Coll Med, Dept Otorhinolaryngol Head & Neck Surg, 28 Yongon Dong, Seoul 110744, South Korea. RI Seoul National University, Pathology/B-6702-2012 CR Bachert C, 1995, EUR ARCH OTORHINO S1, V252, P44 Baraniuk J. N., 1997, J ALLERGY CLIN IMMUN, V99, P763 BENTLEY AM, 1992, J ALLERGY CLIN IMMUN, V89, P877, DOI 10.1016/0091-6749(92)90444-7 Bousquet J, 2001, J ALLERGY CLIN IMMUN, V108, P147, DOI DOI 10.1067/MAI.2001.118891 Chang JT, 2000, EUR J IMMUNOL, V30, P1113, DOI 10.1002/(SICI)1521-4141(200004)30:4<1113::AID-IMMU1113>3.0.CO;2-P El-Mezzein REH, 2001, CLIN EXP IMMUNOL, V126, P193, DOI 10.1046/j.1365-2249.2001.01664.x Fantuzzi G, 1999, J CLIN IMMUNOL, V19, P1, DOI 10.1023/A:1020506300324 Ho LP, 2002, CHEST, V121, P1421, DOI 10.1378/chest.121.5.1421 Hofstra CL, 1998, J IMMUNOL, V161, P5054 Holt PG, 2000, AM J RESP CRIT CARE, V162, pS91 Hoshino T, 1999, J IMMUNOL, V162, P5070 Johansson S. G. O., 2001, Allergy (Copenhagen), V56, P1229 Johansson SGO, 2001, ALLERGY, V56, P813, DOI 10.1034/j.1398-9995.2001.t01-1-00001.x Nakanishi K, 2001, ANNU REV IMMUNOL, V19, P423, DOI 10.1146/annurev.immunol.19.1.423 Netea MG, 2000, EUR J IMMUNOL, V30, P3057, DOI 10.1002/1521-4141(200010)30:10<3057::AID-IMMU3057>3.0.CO;2-P Okamura H, 1998, ADV IMMUNOL, V70, P281, DOI 10.1016/S0065-2776(08)60389-2 Okamura H, 1998, CURR OPIN IMMUNOL, V10, P259, DOI 10.1016/S0952-7915(98)80163-5 Rudack C, 2000, ALLERGY, V55, P363, DOI 10.1034/j.1398-9995.2000.00404.x Tanaka H, 2001, J ALLERGY CLIN IMMUN, V107, P331, DOI 10.1067/mai.2001.112275 Verhaeghe B, 2002, ALLERGY, V57, P825, DOI 10.1034/j.1398-9995.2002.23539.x WANG DY, 1995, INT ARCH ALLERGY IMM, V106, P278 Wild JS, 2000, J IMMUNOL, V164, P2701 Wong CK, 2001, CLIN EXP IMMUNOL, V125, P177, DOI 10.1046/j.1365-2249.2001.01602.x Xu DM, 2000, EUR J IMMUNOL, V30, P3147, DOI 10.1002/1521-4141(200011)30:11<3147::AID-IMMU3147>3.0.CO;2-J Yoshizawa Y, 2002, CLIN EXP DERMATOL, V27, P225, DOI 10.1046/j.1365-2230.2002.00987.x NR 25 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2007 VL 116 IS 1 BP 76 EP 80 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 130ET UT WOS:000243783100013 PM 17305282 ER PT J AU Albera, R Ferrero, V Lacilla, M Canale, A AF Albera, Roberto Ferrero, Vittorio Lacilla, Michelangelo Canale, Andrea TI Tympanic reperforation in myringoplasty: Evaluation of prognostic factors SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE myringoplasty; prognostic factor; tympanic reperforation ID TYMPANOPLASTY; CHILDREN; EXPERIENCE AB Objectives: The most frequent failure in myringoplasty is reperforation. This complication appears at a rate of 7% to 27%. The aim of this study was to evaluate the importance of the principal prognostic factors to the risk of reperforation. Methods: This is a study of prognosis based on an inception cohort. The prognostic factors considered in the study refer to clinical and surgical aspects; follow-up ranged from 5 to 7 years (mean, 68 months). The study was performed on 212 patients with or without otorrhea who underwent operation for tympanic perforation. All subjects underwent myringoplasty by means of an underlay or overlay technique depending on the size and site of the perforation. Results: Healing of the tympanic perforation was obtained in 182 cases (86%). Age, otorrhea, status of the contralateral ear, and conductive hearing loss did not significantly affect the outcome of surgery. On the other hand, time from surgery, the site of perforation, the type of anesthesia, the approach, the surgical technique, and the type of graft were significantly related to the outcome. Conclusions: In the analysis of our results, the surgical approach proved to be the principal prognostic factor in the anatomic outcome of myringoplasty. The results obtained suggest that the principal factors influencing the outcome of myringoplasty are technical and not clinical. C1 Univ Turin, Dept Otorhinolaryngol, Div Clin Physiopathol, Turin, Italy. RP Canale, A (reprint author), Via G Servais 134H, I-10146 Turin, Italy. CR Albu S, 1998, AM J OTOL, V19, P136 Berger G, 1997, J LARYNGOL OTOL, V111, P517 Bhat NA, 2000, J OTOLARYNGOL, V29, P229 CHANDRASEKHAR SS, 1995, ARCH OTOLARYNGOL, V121, P873 Denoyelle F, 1999, LARYNGOSCOPE, V109, P47, DOI 10.1097/00005537-199901000-00010 GLASSCOC.ME, 1973, LARYNGOSCOPE, V83, P754, DOI 10.1288/00005537-197305000-00011 KOCH WM, 1990, ARCH OTOLARYNGOL, V116, P35 LAU T, 1986, AM J OTOL, V7, P55 Lee P, 2002, CLIN OTOLARYNGOL, V27, P331, DOI 10.1046/j.1365-2273.2002.00590.x OPHIR D, 1987, ARCH OTOLARYNGOL, V113, P1288 PAPPAS DG, 1992, LARYNGOSCOPE, V102, P1192, DOI 10.1288/00005537-199210000-00018 Podoshin L, 1996, AM J OTOL, V17, P293 RAINE CH, 1983, J LARYNGOL OTOL, V97, P217, DOI 10.1017/S0022215100094032 SADE J, 1981, J LARYNGOL OTOL, V95, P653, DOI 10.1017/S0022215100091246 VARTIAINEN E, 1993, AM J OTOL, V14, P301 NR 15 TC 25 Z9 28 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2006 VL 115 IS 12 BP 875 EP 879 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400002 PM 17214259 ER PT J AU Somers, T Vercruysse, JP Zarowski, A Verstreken, M Offeciers, E AF Somers, Thomas Vercruysse, Jean-Philippe Zarowski, Andrzej Verstreken, Margriet Offeciers, Erwin TI Stapedotomy with microdrill or carbon dioxide laser: Influence on inner ear function SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE laser; middle ear surgery; otosclerosis; stapedotomy; stapes surgery ID STAPES SURGERY; HEARING THRESHOLDS; OTOSCLEROSIS AB Objectives: A prospective randomized audiological analysis of 336 otosclerosis operations was conducted to compare the evolution of bone conduction thresholds after primary stapedotomy with two different techniques to open the footplate: microdrill and carbon dioxide laser stapedotomy. Methods: To monitor the inner ear function, we compared the preoperative bone conduction thresholds with the postoperative levels at day 2, week 2, week 6, and month 6. Evolution of the bone conduction was compared for the two studied groups (laser versus microdrill). Results: An average bone conduction loss of 1.8 dB was measured at day 2 for the middle frequencies (0.5, 1, and 2 kHz). At 4 kHz, a bone conduction loss of 7 dB was found. The bone conduction thresholds measured in the first and second months after surgery showed a gradual recovery with overclosure as the end result. Conclusions: Our results confirm the transient depression of inner ear function in the immediate postoperative period, with recovery within the first weeks after surgery. In the studied population, no statistically significant difference was found between the two techniques that were used to make the calibrated hole (laser versus microdrill). These results demonstrate that both techniques possess the same early effect regarding inner ear function. The authors hypothesize that an early inflammatory reaction could be the cause of the transient bone conduction shift. C1 Univ ENT Dept, St Augustinus Hosp, Dept Otorhinolaryngol, Antwerp, Antwerp, Belgium. RP Somers, T (reprint author), Univ ENT Dept, St Augustinus Hosp, Dept Otorhinolaryngol, Oosterveldlaan 24, Antwerp, Antwerp, Belgium. CR Antonelli PJ, 1998, AM J OTOL, V19, P443 COLLETTI V, 1985, NEW DIMENSIONS OTORH, V2, P18 Hausler R, 1999, ACTA OTO-LARYNGOL, V119, P207 Hausler R, 2000, LARYNGO RHINO OTOL, V79, P95 Keck T, 2002, OTOL NEUROTOL, V23, P21, DOI 10.1097/00129492-200201000-00006 LESINSKI S, 1989, LARYNGOSCOPE S46, V99 MARQUET J, 1965, SOC FR ORL CR SCI C, P151 Riechelmann H, 2000, AM J OTOL, V21, P809 ROBINSON M, 1977, ARCH OTOLARYNGOL, V103, P238 SCHUKNECHT H, 1993, PATHOLOGY EAR, P560 SHAMBAUGH GE, 1955, ACTA OTOLARYNGOL S S, V123 Shea JJ, 1998, AM J OTOL, V19, P52 SHEA J J Jr, 1958, Ann Otol Rhinol Laryngol, V67, P932 SOMERS T, 1994, ANN OTO RHINOL LARYN, V103, P945 NR 14 TC 14 Z9 16 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2006 VL 115 IS 12 BP 880 EP 885 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400003 PM 17214260 ER PT J AU Kim, YH Baek, SJ AF Kim, Young-Ho Baek, Seung Jae TI Outcome of endoscopic management of extensive laryngotracheal stenosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE endotracheal intubation; laryngotracheal stenosis; tracheotomy ID ENDOTRACHEAL INTUBATION; SUBGLOTTIC STENOSIS; SEQUELAE AB Objectives: When performing endotracheal intubation or tracheotomy in unconscious patients in emergent situations, one should consider the possibility of the later complication of laryngotracheal stenosis, which can result in difficulties with decannulation. We analyzed the clinical features of laryngotracheal stenosis to search for its possible etiologic factors and its proper preventive methods. Methods: The medical records of 249 cases of laryngotracheal stenosis out of 2,208 patients who underwent tracheotomy in our hospital during the past 12 years were retrospectively reviewed regarding several parameters, such as the duration of endotracheal intubation, site of tracheostoma, site of stenosis, treatment method, and so forth. Results: Non-otolaryngologists had a tendency to place the tracheostoma at a higher level of the trachea. We identified technical precautions that should be taken into consideration in performing an emergency tracheotomy. Bronchoscopic evaluation and tracheal stent insertion was the most commonly used treatment method. Successful decannulation was achieved in about 70%, and was especially frequent in patients whose endotracheal intubation was less than 20 days. Conclusions: It is desirable that the duration of endotracheal intubation be limited to less than 20 days. A database of patients who undergo tracheotomy should be submitted to careful follow-up to diagnose early development of laryngotracheal stenosis and to prevent long-term complications. C1 Yonsei Univ, Coll Med, Dept Otorhinolaryngol, Seoul 120749, South Korea. RP Kim, YH (reprint author), Yonsei Univ, Coll Med, Dept Otorhinolaryngol, CPO Box 8044, Seoul 120749, South Korea. CR AHN HY, 1985, KOREAN J OTOLARYNGOL, V28, P556 BRADBEER TL, 1976, ANAESTHESIA, V31, P504, DOI 10.1111/j.1365-2044.1976.tb12355.x Brown MT, 1996, ANN OTO RHINOL LARYN, V105, P624 CHANG EY, 1988, KOREAN J OTOLARYNGOL, V31, P1006 CHO JS, 1996, KOREAN J BRONCHOESOP, V1, P13 CHUNG JJ, 1980, KOREAN J OTOLARYNGOL, V23, P342 DEDO HH, 1990, SURG LARYNX TRACHEA, P81 DEDO HH, 1990, SURG LARYNX TRACHEA, P141 GAYNOR EB, 1985, LARYNGOSCOPE, V95, P1461 KIM KH, 1991, KOREAN J OTOLARYNGOL, V34, P324 KIM KM, 1989, KOREAN J OTOLARYNGOL, V32, P904 MONTGOMERY WW, 1989, SURG UPPER RESP SYST, P445 SASAKI CT, 1979, LARYNGOSCOPE, V89, P857 STAUFFER JL, 1981, AM J MED, V70, P65, DOI 10.1016/0002-9343(81)90413-7 SUPANCE JS, 1982, ARCH OTOLARYNGOL, V108, P727 WHITED RE, 1984, LARYNGOSCOPE, V94, P367 NR 16 TC 1 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2006 VL 115 IS 12 BP 887 EP 890 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400005 PM 17214261 ER PT J AU Zeitels, SM Burns, JA Akst, LM Hillman, RE Broadhurst, MS Anderson, RR AF Zeitels, Steven M. Burns, James A. Akst, Lee M. Hillman, Robert E. Broadhurst, Matthew S. Anderson, R. Rox TI Office-based and microlaryngeal applications of a fiber-based thulium laser SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cancer; glottis; laryngoscopy; larynx; papillomatosis; thulium laser; vocal cord; vocal fold ID VOCAL CORDS; SURGERY; CO2-LASER; PAPILLOMATOSIS; CARCINOMA AB Objectives: The carbon dioxide (CO2) laser is the premier dissecting instrument for hemostatic cutting and ablation during endolaryngeal surgery. However, microlaryngeal tangential dissection and office-based photoablation have been limited by the lack of a fiber-based delivery system. To address this limitation, a new laser was designed, which is a diode-pumped solid-state laser with a thulium-doped yttrium-aluminum-garnet laser rod. It produces a continuous-wave beam with a wavelength of 2,013 nm and a target chromophore of water. This new laser functions similarly to a CO2 laser with the benefit of being delivered through a small glass fiber (0.365 to 0.550 mm). Methods: A prospective pilot trial was done in 74 cases to explore applications of the new thulium laser. Thirty-two procedures were done with the laser used as an ablating instrument and topical anesthesia through a flexible laryngoscope (papillomatosis, 20; microinvasive carcinoma, 6; benign supraglottic lesions, 3; edema, 2; granuloma, 1). Forty-two procedures were done with the laser used as a cutting or ablating instrument for microlaryngeal dissection and general anesthesia. These included 27 partial laryngeal resections (supraglottis, 15; glottis, 10; subglottis, 2) and 8 posterior glottic laryngoplasties. The laser was also used as an ablative instrument during microlaryngoscopy in 7 cases. Results: The thulium laser was used effectively in all cases, under both local and general anesthesia. In microlaryngeal dissection, electrocautery was not needed to control bleeding, even during cutting in the highly vascular paraglottic space. No complications related to the use of the thulium laser were experienced in any case. Conclusions: Because of the fiber-based delivery system, the 2,013-nm continuous-wave thulium laser shows substantial promise for tangential dissection during microlaryngoscopy and soft tissue photoablation during office-based flexible laryngoscopy. Hemostasis was judged to be superior to experiences with the CO2 laser. In this pilot study, performing en bloc laryngeal cancer resection procedures was facilitated by use of the thulium laser. C1 Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Boston, MA 02114 USA. Massachusetts Gen Hosp, Wellman Labs Photomed, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Surg, Boston, MA 02115 USA. Harvard Univ, Sch Med, Dept Dermatol, Boston, MA 02115 USA. RP Zeitels, SM (reprint author), Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, 1 Bowdoin Sq,11th Floor, Boston, MA 02114 USA. CR DAVIS RK, 1983, LARYNGOSCOPE, V93, P429 DESANTO LW, 1976, WORKSH CENT C LAR CA, P146 ELSBERG L, 1866, LARYNGOSCOPAL SURG I Fraenkel B, 1886, ARCH KLIN CHIR, V12, P283 JAKO GJ, 1972, LARYNGOSCOPE, V82, P2204, DOI 10.1288/00005537-197212000-00009 JELINEK E, 1884, WIEN MED WOCHENSCHR, V34, P1334 KAY SL, 1992, OTOLARYNG HEAD NECK, V107, P438 Killian G, 1912, ARCH LARYNGOLOGIE RH, V26, P277 KIRSTEIN A, 1897, AUTOSCOPY LARYNX TRA, P47 Kirstein A, 1895, ARCH LARYNGOL RHINOL, V3, P156 KOLLER K, 1884, WIEN MED WOCHENSCHR, V43, P1276 LEWIN G, 1861, ALLGEMEINE MED CENTR, V30, P654 Lynch RC, 1920, T AM LARYNGOL ASS, V40, P119 MACKENZIE M, 1865, USE LARYNGOSCOPE DIS SHAPSHAY SM, 1990, OTOLARYNG HEAD NECK, V102, P251 Steiner W, 1988, Adv Otorhinolaryngol, V39, P135 STEINER W, 1984, TRANSORAL MICROSURGI, P121 STRONG MS, 1976, ANN OTO RHINOL LARYN, V85, P508 STRONG MS, 1975, LARYNGOSCOPE, V85, P1286, DOI 10.1288/00005537-197508000-00003 TREAT MR, 1988, LASER SURG MED, V8, P322, DOI 10.1002/lsm.1900080316 TUCKER GF, 1971, HUMAN LARYNX CORONOL VAUGHAN CW, 1978, LARYNGOSCOPE, V88, P1399 VAUGHAN CW, 1978, AM J SURG, V136, P490, DOI 10.1016/0002-9610(78)90267-2 ZEITELS SM, 1999, ANN OTOL RHINOL S179, V108 ZEITELS SM, 1990, OTOLARYNG HEAD NECK, V103, P337 Zeitels SM, 2006, ANN OTO RHINOL LARYN, V115, P535 Zeitels SM, 2004, ANN OTO RHINOL LARYN, V113, P265 Zeitels SM, 2001, ATLAS PHONOMICROSURG Zeitels SM, 1996, LARYNGOSCOPE, V106, P545, DOI 10.1097/00005537-199605000-00006 NR 29 TC 34 Z9 36 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2006 VL 115 IS 12 BP 891 EP 896 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400006 PM 17214262 ER PT J AU Leonard, R Belafsky, PC Rees, CJ AF Leonard, Rebecca Belafsky, Peter C. Rees, Catherine J. TI Relationship between fluoroscopic and manometric measures of pharyngeal constriction: The pharyngeal constriction ratio SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE pharyngeal constriction; pharyngeal pressure ID STRUCTURAL DISPLACEMENTS AB Objectives: The gold standard objective measure of pharyngeal strength is pharyngeal manometry. We have developed an objective fluoroscopic measure of pharyngeal strength, the pharyngeal constriction ratio (PCR). A high PCR indicates poor pharyngeal constriction. The objective of the current study was to evaluate the correlation between the PCR and peak pressures on pharyngeal manometry. Methods: The charts of 20 consecutive individuals who underwent a dynamic fluoroscopic swallow evaluation and pharyngeal manometry at the Center for Voice and Swallowing of the University of California, Davis, were retrospectively reviewed. Information regarding patient demographics, diagnoses, PCR, and manometric pharyngeal peak pressures was abstracted. The correlation between the PCR and pharyngeal pressure was determined with the Pearson correlation coefficient. Results: The mean (+/- SD) age of the cohort was 63 +/- 11 years. Fourteen of the 20 patients (70%) were male. The most common diagnoses were reflux (7 of 20) and cerebrovascular accident (4 of 20). The mean PCR was 0.26 +/- 0.31. The mean pharyngeal pressure was 83 +/- 43 mm Hg. The correlation between the PCR and pharyngeal pressure was -0.70 (p < .01). Conclusions: There was a high inverse correlation between the PCR and the peak pharyngeal pressure on manometry (-0.70). The PCR appears to be a valid objective surrogate measure of pharyngeal strength. C1 Univ Calif Davis, Dept Otorhinolaryngol Head & Neck Surg, Ctr Voice & Swallowing, Sacramento, CA 95817 USA. RP Leonard, R (reprint author), Univ Calif Davis, Dept Otorhinolaryngol Head & Neck Surg, Ctr Voice & Swallowing, 2521 Stockton Blvd,Suite 7200, Sacramento, CA 95817 USA. CR Ali GN, 1997, DYSPHAGIA, V12, P133, DOI 10.1007/PL00009527 BRASSEUR J G, 1991, Dysphagia, V6, P100, DOI 10.1007/BF02493487 Castell J. 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TI Thyroidectomy for Graves' disease: A case-control study SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE Graves' disease; thyroidectomy ID HUNGRY BONE SYNDROME; SUBTOTAL THYROIDECTOMY; SURGICAL-TREATMENT; ANTITHYROID DRUGS; THYROTOXICOSIS; IODINE; HYPERTHYROIDISM; HYPOTHYROIDISM; HYPOCALCEMIA; MANAGEMENT AB Objectives: The most common treatment for Graves' disease in the United States is radioactive iodine. Surgery is performed rarely. The surgery for Graves' disease is usually considered technically difficult. Our goal was to assess the differences in outcomes in patients with Graves' disease who underwent thyroidectomy and in patients without Graves' disease who underwent the same procedures. Methods: A retrospective chart review was performed of patients who underwent surgery for Graves' disease between 1997 and 2005. A control group of age-matched and thyroid size-matched patients who underwent thyroidectomy for a diagnosis other than Graves' disease was identified. The groups were statistically compared with respect to length of hospital stay, operative time, and estimated blood loss. Comparison with the published literature was also performed. Results: Eleven patients underwent thyroidectomy for a diagnosis of Graves' disease. The operative time, estimated blood loss, and length of hospitalization did not differ significantly from those of the control patients. Three of the 4 complications that occurred, however, were in the 3 patients with persistent hyperthyroidism despite medical therapy at the time of surgery. Conclusions: Thyroidectomy may be performed relatively safely for selected euthyroid patients with Graves' disease. In those with persistent hyperthyroidism at surgery, there were more complications. C1 Temple Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Philadelphia, PA 19140 USA. Temple Univ, Sch Med, Dept Biostat, Philadelphia, PA 19140 USA. RP Soliman, AMS (reprint author), Temple Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, 3400 N Broad St,Kresge W 102, Philadelphia, PA 19140 USA. CR Abe Y, 1998, WORLD J SURG, V22, P714 Aizawa Y, 1997, CLIN ENDOCRINOL, V46, P1, DOI 10.1046/j.1365-2265.1997.d01-1737.x BELFIORE A, 1990, J CLIN ENDOCR METAB, V70, P830 BRADLEY EL, 1983, SURGERY, V94, P955 Cantalamessa L, 1999, ARCH INTERN MED, V159, P1705, DOI 10.1001/archinte.159.15.1705 CATZ B, 1969, AM J SURG, V118, P434, DOI 10.1016/0002-9610(69)90151-2 COYLE PJ, 1982, ANN ROY COLL SURG, V64, P334 Dabon-Almirante CLM, 1998, ENDOCRIN METAB CLIN, V27, P25, DOI 10.1016/S0889-8529(05)70295-4 DAVENPORT M, 1989, ANN ROY COLL SURG, V71, P87 DEMBINSKI TC, 1994, CLIN BIOCHEM, V27, P69, DOI 10.1016/0009-9120(94)90014-0 Friguglietti CUM, 2003, LARYNGOSCOPE, V113, P1820, DOI 10.1097/00005537-200310000-00030 Grieff M, 2003, ANN INTERN MED, V139, P706 KAUFMAN DW, 1988, BRIT MED J, V297, P262 Kaplan MM, 1998, ENDOCRIN METAB CLIN, V27, P205, DOI 10.1016/S0889-8529(05)70307-8 KASUGA Y, 1990, SURG GYNECOL OBSTET, V170, P327 KAUR S, 1988, ANN ROY COLL SURG, V70, P123 Liu Q, 1998, SURGERY, V123, P2, DOI 10.1016/S0039-6060(98)70221-1 MARIGOLD JH, 1985, BRIT J SURG, V72, P45, DOI 10.1002/bjs.1800720118 Miccoli P, 1996, SURGERY, V120, P1020, DOI 10.1016/S0039-6060(96)80049-3 Mittendorf EA, 2001, ARCH OTOLARYNGOL, V127, P61 Palit TK, 2000, J SURG RES, V90, P161, DOI 10.1006/jsre.2000.5875 PATWARDHAN NA, 1993, SURGERY, V114, P1108 PERZIK SL, 1976, AM J SURG, V131, P284, DOI 10.1016/0002-9610(76)90117-3 Razack MS, 1997, HEAD NECK-J SCI SPEC, V19, P378, DOI 10.1002/(SICI)1097-0347(199708)19:5<378::AID-HED3>3.0.CO;2-X See ACH, 1997, BRIT J SURG, V84, P95, DOI 10.1002/bjs.1800840136 Sniezek JC, 2003, OTOLARYNG CLIN N AM, V36, P55, DOI 10.1016/S0030-6665(02)00133-0 SUGINO K, 1995, WORLD J SURG, V19, P648 Torre G, 1998, EUR J SURG, V164, P495, DOI 10.1080/110241598750005831 Weetman AP, 2000, NEW ENGL J MED, V343, P1236, DOI 10.1056/NEJM200010263431707 Wheeler MH, 1998, LANCET, V351, P1526, DOI 10.1016/S0140-6736(05)61116-6 Williams KV, 1997, J CLIN ENDOCR METAB, V82, P1727, DOI 10.1210/jc.82.6.1727 Witte J, 2000, WORLD J SURG, V24, P1303 NR 32 TC 0 Z9 0 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2006 VL 115 IS 12 BP 902 EP 907 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400008 PM 17214264 ER PT J AU Gouveris, H Victor, A Mann, W AF Gouveris, Haralampos Victor, Anja Mann, Wolf TI Transient evoked otoacoustic emissions in vestibular neuritis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE neuritis; otoacoustic emission; outer hair cell; vestibular nerve ID EFFERENT SYSTEM DEGENERATION; TINNITUS AB Objectives: Partial or total degeneration of the vestibulocochlear anastomosis at its takeoff from the saccular ganglion and regenerating efferent neural buds under the cochlear outer hair cells (OHCs) have been found in the temporal bones of human patients with a history of vestibular neuritis (VN). We sought to test whether VN has any functional impact on the ipsilateral OHCs by means of transient evoked otoacoustic emission (TEOAE) testing. Methods: We retrospectively analyzed prospectively collected TEOAE data of 28 patients (19 female, 9 male; age range, 21 to 60 years; median age, 42.5 years). The pure tone air conduction hearing thresholds at each standard audiometric frequency (0.125 to 8 kHz) and the amplitudes of the TEOAEs at the 1-, 2-, 3-, and 4-kHz frequency bands were compared between the lesional and contralateral sides by use of the nonparametric sign test for 2 paired samples. Results: No significant difference was found in the pure tone air conduction hearing thresholds between the lesional and contralateral ears at any of the 11 standard tested frequencies. No significant difference was found between the TEOAE amplitudes of the lesional and contralateral sides. Conclusions: Subclinical OHC functional impairment is not present in VN. Moreover, no apparent significant changes in medial olivocochlear bundle resting activity accompany VN. C1 Univ Mainz, Dept Otolaryngol Head & Neck Surg, Sch Med, D-6500 Mainz, Germany. Univ Mainz, Inst Med Biometry Epidemiol & Bioinformat, D-6500 Mainz, Germany. RP Gouveris, H (reprint author), Univ HNO Klin Mainz, Langenbeckstr 1, D-55131 Mainz, Germany. 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Rhinol. Laryngol. PD DEC PY 2006 VL 115 IS 12 BP 908 EP 911 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400009 PM 17214265 ER PT J AU Jacob, A Morris, TJ Welling, DB AF Jacob, Abraham Morris, Targhee J. Welling, D. Bradley TI Leaving a lasting impression: Ear mold impressions as middle ear foreign bodies SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE ear mold; ear mold impression; hearing aid ID HEARING-AID COMPLICATION AB Objectives: We describe a series of otologic complications from impression material used to make hearing aid molds. Methods: We examined a retrospective case series of patients presenting to a tertiary care academic medical center. Results: The presentation, clinical course, and treatment outcomes of 6 patients with complications related to ear molds are discussed. These patients had preexisting abnormalities in their aural anatomy, including tympanic membrane perforations, retraction pockets, and mastoidectomy cavities. Conclusions: Although the majority of patients who have ear canal impressions taken experience no adverse outcomes, hearing aid dispensers should perform a thorough history-taking and physical examination to discern those with abnormal anatomy at risk for complications. These patients may benefit from evaluation in conjunction with an otolaryngologist. C1 Ohio State Univ, Dept Otorhinolaryngol Head & Neck Surg, Columbus, OH 43210 USA. RP Jacob, A (reprint author), Ohio State Univ, Dept Otorhinolaryngol Head & Neck Surg, 456 W 10th Ave,Suite 4A, Columbus, OH 43210 USA. 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PD DEC PY 2006 VL 115 IS 12 BP 912 EP 916 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400010 PM 17214266 ER PT J AU Brook, I AF Brook, Itzhak TI Microbiology of intracranial abscesses associated with sinusitis of odontogenic origin SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anaerobe; brain abscess; Fusobacterium; odontogenic infection; Prevotella; sinusitis ID CHRONIC MAXILLARY SINUSITIS; BRAIN-ABSCESS; PERIAPICAL ABSCESS; CHILDREN; COMPLICATIONS; INFECTIONS AB Objectives: The unique microbiology of sinusitis of dental origin that is associated with intracranial abscesses (IAs) and the correlation between the organisms at the two sites has not been reported before. This report describes the author's experience during a 30-year period in studying the microbiology of 8 IAs and their corresponding sinusitis of dental origin. Methods: Aspirates of pus from 8 infected sinuses associated with odontogenic infections and their corresponding IAs were studied for aerobic and anaerobic bacteria. Polymicrobial flora was found in all 8 sinuses and 7 lAs, and the number of isolates varied from 1 to 5. Results: Anaerobic bacteria were isolated from all sinuses and IAs. A total of 28 isolates (3.5 isolates per site; 25 strict anaerobic, I aerobic or facultative, and 2 microaerophilic) were recovered from the sinuses, and 20 isolates (2.5 isolates per site; 16 strict anaerobic, I aerobic or facultative, and 3 microaerophilic) were found in the IAs. The bacterial isolates were Fusobacterium spp (14), Prevotella spp (11), Peptostreptococcus spp (13), microaerophilic streptococci (5), Veillonella parvula (3), and beta-hemolytic streptococci group F (2). Concordance in the microbiological findings between the sinus and the IA was found in all instances; however, certain organisms were only present at one site. Conclusions: These data illustrate the concordance in the organisms recovered from sinusitis of dental origin and their associated lAs and confirm the importance of anaerobic bacteria in sinusitis and IAs of dental origin. C1 Georgetown Univ, Sch Med, Dept Pediat, Washington, DC 20007 USA. RP Brook, I (reprint author), 4431 Albemarle St NW, Washington, DC 20016 USA. 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Otol. Rhinol. Laryngol. PD DEC PY 2006 VL 115 IS 12 BP 917 EP 920 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400011 PM 17214267 ER PT J AU Lim, XH Tateya, L Tateya, T Munoz-Del-Rio, A Bless, DM AF Lim, Xinhong Tateya, Lchiro Tateya, Tomoko Munoz-Del-Rio, Alejandro Bless, Diane M. TI Immediate inflammatory response and scar formation in wounded vocal folds SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cytokine; extracellular matrix; inflammation; inflammatory factor; scarless wound healing; vocal fold scarring ID GROWTH-FACTOR-BETA; NECROSIS-FACTOR-ALPHA; HYALURONAN SYNTHESIS; SKIN FIBROBLASTS; LUNG FIBROBLASTS; ORAL MUCOSAL; TGF-BETA; FETAL; MODEL; EXPRESSION AB Objectives: Vocal fold scarring is the major cause of voice disorders after voice surgery or laryngeal trauma. The role of inflammatory factors in vocal fold wound healing and fibrosis has not been adequately investigated. Scarless wound healing has been associated with decreased inflammatory responses. To understand scar formation and develop reliable treatments, it is necessary to control extracellular matrix production and inflammation. Thus, we examined the inflammation profile and extracellular matrix production in wounded vocal folds in the acute phase of wound healing. Methods: Vocal fold stripping was performed on 30 Sprague-Dawley rats. Vocal fold tissue was collected at 5 time points (4, 8, 16, 24, and 72 hours). We examined the in vivo messenger RNA expression profile of inflammatory factors interleukin 1 beta, interferon gamma, tumor necrosis factor alpha, nuclear factor kappa beta, transforming growth factor beta, and cyclooxygenase 2, as well as hyaluronic acid synthases 1 and 2, procollagen subtypes I and III, and elastin synthase in scarred vocal folds after injury, compared to normal vocal folds, using real-time reverse transcription-polymerase chain reaction. Results: The inflammatory factors showed a time-dependent sequence of expression peaks, starting with interleukin 1 beta nuclear factor 0, tumor necrosis factor a (4 and 8 hours), and transforming growth factor 0 (72 hours). Interferon gamma decreased at 24 hours. Correspondingly, hyaluronic acid synthase 1 expression peaked first (4 and 8 hours), whereas hyaluronic acid synthase 2 expression peaked at 16 hours and again at 72 hours. Procollagen I expression peaked at 72 hours, whereas procollagen III decreased from 8 to 16 hours but peaked at 72 hours. Cyclooxygenase 2 expression was elevated, whereas elastin expression remained constant. Conclusions: The results show a clear profile of vocal fold inflammation with corresponding changes in extracellular matrix production. C1 Univ Wisconsin, Div Otolaryngol Head & Neck Surg, Madison, WI USA. RP Bless, DM (reprint author), K4-789 CSC,600 Highland Ave, Madison, WI 53792 USA. 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Otol. Rhinol. Laryngol. PD DEC PY 2006 VL 115 IS 12 BP 921 EP 929 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400012 PM 17214268 ER PT J AU Yian, C Moon, SK Jin, SJ Webster, P Rhim, JS Andalibi, A Lim, DJ AF Yian, Christopher Moon, Sung K. Jin, Sunji Webster, Paul Rhim, Johng S. Andalibi, Ali Lim, David J. TI Characterization of rat spiral ligament cell line immortalized by adenovirus 12-simian virus 40 hybrid virus SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE adenovirus 12-simian virus 40 hybrid virus; cell line; spiral ligament fibrocyte ID EAR EPITHELIAL-CELLS; JUNCTION PROTEIN CONNEXIN43; INNER-EAR; MIDDLE-EAR; NEOPLASTIC TRANSFORMATION; CREATINE-PHOSPHOKINASE; IMMUNOHISTOCHEMICAL LOCALIZATION; SARCOPLASMIC-RETICULUM; MOUSE COCHLEA; EXPRESSION AB Objectives: Spiral ligament fibrocytes play an important role in inner ear ion homeostasis and are classified into several subtypes according to expression of specific enzymes such as Na+,K+-ATPase, Ca++-ATPase, and carbonic anhydrase. Although our understanding of the cell and molecular biology of spiral ligament fibrocytes has increased over time, access to these cells still remains a significant hurdle hindering future studies. In this study, we aimed to establish a rat spiral ligament cell line with minimal disruption of the original characteristics. Methods: The primary spiral ligament fibrocytes were exposed to adenovirus 12-simian virus 40 hybrid virus for immortalization. Karyotypic analysis was performed after stabilization of the infected cells, and the population doubling time was compared to that of the primary cell. The cell line was characterized by immunolabeling and electron microscopy. Results: We describe the establishment and characterization of a line of type I spiral ligament fibrocytes immortalized with an adenovirus 12-simian virus 40 hybrid virus. Conclusions: This cell line can be a useful research tool for investigating the role of spiral ligament fibrocytes in homeostasis and inflammation of the inner ear. C1 Univ So Calif, Gonda Dept Cell & Mol Biol, House Ear Inst, Keck Sch Med, Los Angeles, CA 90057 USA. Univ So Calif, Ctr Adv Electon Microscopy, House Ear Inst, Keck Sch Med, Los Angeles, CA 90057 USA. Univ So Calif, Keck Sch Med, Dept Otolaryngol, Los Angeles, CA 90057 USA. Univ So Calif, Keck Sch Med, Det Cell & Neurobiol, Los Angeles, CA 90057 USA. Uniformed Serv Univ Hlth Sci, Cell Biol Lab, Natl Inst Deafness & Other Commun Disorders, NIH, Bethesda, MD 20814 USA. Uniformed Serv Univ Hlth Sci, Ctr Prostate Dis Res, Dept Surg, Bethesda, MD 20814 USA. RP Lim, DJ (reprint author), Univ So Calif, Gonda Dept Cell & Mol Biol, House Ear Inst, Keck Sch Med, 2100 W 3rd St, Los Angeles, CA 90057 USA. 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Otol. Rhinol. Laryngol. PD DEC PY 2006 VL 115 IS 12 BP 930 EP 938 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 120LE UT WOS:000243085400013 PM 17214269 ER PT J AU Hillman, RE Heaton, JT Masaki, A Zeitels, SM Cheyne, HA AF Hillman, Robert E. Heaton, James T. Masaki, Asa Zeitels, Steven M. Cheyne, Harold A. TI Ambulatory monitoring of disordered voices SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE ambulatory monitoring; phonation; voice disorder ID SPEAKING TIME; ACCUMULATOR; SPEECH; VIBRATION AB Objectives: Recently developed systems for ambulatory monitoring of voice use employ miniature accelerometers placed at the base of the anterior neck to sense phonation. As it is hoped that such systems will help improve the clinical assessment and management of voice disorders, this study was undertaken to determine the impact of dysphonia severity on the accuracy of accelerometer-based estimates of vocal function. Methods: Simultaneous recordings were made of oral acoustic (microphone) and neck skin acceleration signals for 6 normal speakers and 18 patients with voice disorders (mild to severe dysphonia) as they performed several speech tasks. Measures of phonation time, fundamental frequency, and sound pressure level were extracted from the two types of signals and compared. Results: It was generally demonstrated that accelerometer-based measures closely approximated corresponding measurements obtained from a microphone signal across all levels of dysphonia severity. Furthermore, there was evidence that in some cases the accelerometer may actually represent a more robust approach for estimating phonation parameters in disordered voices. Conclusions: The results generally support the recent application of accelerometers as phonation sensors in ambulatory voice monitoring systems that can be used in the clinical assessment and management of voice disorders. C1 Harvard Univ, Sch Med, Ctr Laryngeal Surg & Voice Rehabil,Dept Surg, Massachusetts Gen Hosp, Cambridge, MA 02138 USA. Harvard Mit Div Hlth Sci & Technol, Speech & Hearing Biosci & Technol Program, Boston, MA USA. RP Hillman, RE (reprint author), Ctr Laryngeal Surg & Voice Rehabil, 1 Bowdoin Sq,11th Floor, Boston, MA 02114 USA. CR Airo E, 2000, FOLIA PHONIATR LOGO, V52, P275, DOI 10.1159/000021545 BUEKERS R, 1995, FOLIA PHONIATR LOGO, V47, P252 Cheyne HA, 2003, J SPEECH LANG HEAR R, V46, P1457, DOI 10.1044/1092-4388(2003/113) Fairbanks G., 1960, VOICE ARTICULATION D, P127 MASUDA T, 1993, ACTA OTO-LARYNGOL, V113, P547, DOI 10.3109/00016489309135861 OHLSSON AC, 1989, J SPEECH HEAR RES, V32, P451 Popolo PS, 2005, J SPEECH LANG HEAR R, V48, P780, DOI 10.1044/1092-4388(2005/054) RYU S, 1983, ORL J OTO-RHINO-LARY, V45, P108 Svec Jan G, 2003, Logoped Phoniatr Vocol, V28, P181 Svec JG, 2005, J ACOUST SOC AM, V117, P1386, DOI 10.1121/1.1850074 Titze I. R., 1994, WORKSH ACOUSTIC VOIC Titze IR, 2003, J SPEECH LANG HEAR R, V46, P919, DOI 10.1044/1092-4388(2003/072) WATANABE H, 1984, Agressologie, V25, P1035 WATANABE H, 1987, FOLIA PHONIATR, V39, P65 NR 14 TC 36 Z9 36 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 795 EP 801 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200001 PM 17165660 ER PT J AU Michaelson, PG Allan, P Chaney, J Mair, EA AF Michaelson, Peter G. Allan, Patrick Chaney, John Mair, Eric A. TI Validations of a portable home sleep study with twelve-lead polysomnography: Comparisons and insights into a variable gold standard SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE obstructive sleep apnea; polysomnography; SNAP ID POSITIVE AIRWAY PRESSURE; APNEA SYNDROME; APNOEA/HYPOPNOEA SYNDROME; ADULTS; DISORDERS; UVULOPALATOPLASTY; DISTURBANCES; HYPERTENSION; VARIABILITY; DIAGNOSIS AB Objectives: Accurate and timely diagnosis for patients with obstructive sleep apnea (OSA) is imperative. Unfortunately, growing interest in this diagnosis has resulted in increased requests and waiting times for polysomnography (PSG), as well as a potential delay in diagnosis and treatment. This study evaluated the accuracy and viability of utilizing SNAP (SNAP Laboratories, LLC, Wheeling, Illinois), a portable home sleep test, as an alternative to traditional PSG in diagnosing OSA. Methods: This prospective clinical trial included 59 patients evaluated at our institution's sleep laboratory. Concurrent PSG and SNAP testing was performed for I night on each patient. Independent, blinded readers at our institution and at an outside-accredited institution read the PSG data, and 2 independent, blinded readers interpreted the SNAP data at SNAP laboratories. The apnea-hypopnea index (AHI) was used to compare the 2 testing modalities. The correlation coefficient, receiver operating characteristic curve analysis, and the Bland-Altman curves, as well as sensitivity, specificity, inter-reader variability, positive predictive value, and negative predictive value, were used to compare SNAP and PSG. Results: There is a definitive, statistically sound correlation between the AHIs determined from both PSG and SNAP. This relationship holds true for all measures of comparison, while displaying a concerning, weaker correlation between the different PSG interpretations. Conclusions: There is a convincing correlation between the study-determined AHIs of both PSG and SNAP. This finding supports SNAP as a suitable alternative to PSG in identifying OSA, while accentuating the inherent variation present in a PSG-derived AHI This test expands the diagnostic and therapeutic prowess of the practicing otolaryngologist by offering an alternative OSA testing modality that is associated with not only less expense, decreased waiting time, and increased convenience, but also statistically proven accuracy. C1 Wilford Hall USAF Med Ctr, Dept Otolaryngol Head & Neck Surg, San Antonio, TX 78236 USA. Wilford Hall USAF Med Ctr, Dept Pulm Med, San Antonio, TX 78236 USA. RP Mair, EA (reprint author), Charlotte EENT Assoc, 6035 Fairview Rd, Charlotte, NC 28210 USA. EM emair@ceenta.com CR Akashiba T, 2002, CHEST, V122, P861, DOI 10.1378/chest.122.3.861 Flemons WW, 1999, SLEEP, V22, P667 Collop NA, 2002, SLEEP MED, V3, P43, DOI 10.1016/S1389-9457(01)00115-0 Cracowski C, 2001, AM J RESP CRIT CARE, V164, P944 Dingli K, 2003, EUR RESPIR J, V21, P253, DOI 10.1183/09031936.03.00298103 DOUGLAS NJ, 1992, LANCET, V339, P347, DOI 10.1016/0140-6736(92)91660-Z Drinnan MJ, 1998, AM J RESP CRIT CARE, V158, P358 Flemons WW, 2003, CHEST, V124, P1535, DOI 10.1378/chest.124.4.1535 Gibson GJ, 2004, THORAX, V59, P361, DOI 10.1136/thx.2003.020040 HIDA W, 1988, Tohoku Journal of Experimental Medicine, V156, P137 Liesching TN, 2004, CHEST, V125, P886, DOI 10.1378/chest.125.3.886 Masa JF, 2004, AM J RESP CRIT CARE, V170, P1218, DOI 10.1164/rccm.200312-178OC Meoli AL, 2001, SLEEP, V24, P469 MILJETEIG H, 1993, AM REV RESPIR DIS, V147, P1526 MOSKO SS, 1988, SLEEP, V11, P340 Parish JM, 2004, MAYO CLIN PROC, V79, P1036 Parra O, 1997, EUR RESPIR J, V10, P1720, DOI 10.1183/09031936.97.10081720 Peppard PE, 2000, NEW ENGL J MED, V342, P1378, DOI 10.1056/NEJM200005113421901 Chesson AL, 1997, SLEEP, V20, P406 Portier F, 2000, AM J RESP CRIT CARE, V162, P814 Redline S, 1997, SLEEP, V20, P1209 Redline S, 2000, AM J RESP CRIT CARE, V161, P369 REDLINE S, 1991, CHEST, V100, P1281, DOI 10.1378/chest.100.5.1281 SHEPARD JW, 1992, CLIN CHEST MED, V13, P437 Su S, 2004, OTOLARYNG HEAD NECK, V131, P844, DOI 10.1016/j.otohns.2004.07.014 Weaver TE, 1997, SLEEP, V20, P835 WEINGARTEN C, 1995, LARYNGOSCOPE, V105, P1033, DOI 10.1288/00005537-199510000-00004 WEINGARTEN CZ, 1995, J OTOLARYNGOL, V24, P352 YOUNG T, 1993, NEW ENGL J MED, V328, P1230, DOI 10.1056/NEJM199304293281704 NR 29 TC 12 Z9 12 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 802 EP 809 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200002 PM 17165661 ER PT J AU Cantarella, G Fasano, V Maraschi, B Mazzola, RF Sambataro, G AF Cantarella, Giovanna Fasano, Valter Maraschi, Barbara Mazzola, Riccardo F. Sambataro, Giuseppe TI Airway resistance and airflow dynamics after fat injection into vocal folds SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE airway resistance; plethysmography; spirometry; upper airway patency; vocal fold fat augmentation ID LARYNGEAL HEMIPLEGIA; CORD PARALYSIS; TEFLON INJECTION; VOLUME LOOP; AUGMENTATION; THYROPLASTY; OBSTRUCTION AB Objectives: The aim of this prospective study was to verify whether vocal fold fat augmentation (VFFA) modifies upper airway patency. To the best of our knowledge, this is the first study analyzing the impact of VFFA on laryngeal resistance to airflow. Methods: Twenty-one consecutive patients 16 to 74 years of age underwent 24 VFFA operations because of glottic incompetence due to laryngeal hemiplegia (13 patients) or vocal fold tissue defects (8 patients). Flow-volume loop spirometry and body plethysmography were performed before and I to 6 months after surgery. Results: There were no significant differences between preoperative and postoperative pulmonary volumes (FVC and FEV1), expiratory flows (PEF, FEF50), or inspiratory flows (PIF, FIF50), although a slight increase in inspiratory flows meant that FEF50/FIF50 slightly decreased. Specific airway resistance (sRaw) increased after VFFA, but not in a statistically significant manner (p =.078). None of the patients experienced postoperative stridor. One obese woman with laryngeal hemiplegia had postoperative effort dyspnea; her respiratory studies showed a reduction in inspiratory flows and an increase in sRaw, and demonstrated progressive improvement. Conclusions: Flow-volume loop spirometry showed that VFFA does not significantly modify respiratory airflows, although a slight increase of inspiratory airflows suggested an improvement in variable extrathoracic obstruction. Body plethysmography proved to be a sensitive procedure that highlighted the subtle increase in upper airway resistance. Hence, VFFA can be considered a relatively safe procedure for achieving vocal fold medialization. and spirometry and plethysmography can be useful for preoperative assessment and postoperative follow-up. C1 Fdn IRCCS, Osped Maggiore Policlin, Dept Otolaryngol, I-20122 Milan, Italy. Fdn IRCCS, Osped Maggiore Policlin, Dept Resp Dis, I-20122 Milan, Italy. Univ Milan, Dept Otolaryngol & Ophthalmol Sci, Milan, Italy. RP Cantarella, G (reprint author), Fdn IRCCS, Osped Maggiore Policlin, Dept Otolaryngol, Via Commenda 10, I-20122 Milan, Italy. CR BASS H, 1973, CHEST, V63, P171, DOI 10.1378/chest.63.2.171 Cantarella G, 2005, ANN OTO RHINOL LARYN, V114, P434 Cantarella G, 2003, ANN OTO RHINOL LARYN, V112, P1014 Cantarella G, 2005, OTOLARYNG HEAD NECK, V132, P239, DOI 10.1016/j.otohns.2004.09.022 Chan RW, 1998, LARYNGOSCOPE, V108, P725, DOI 10.1097/00005537-199805000-00019 CORMIER Y, 1978, THORAX, V33, P57, DOI 10.1136/thx.33.1.57 Fasano V, 2001, EUR RESPIR J, V18, P1003, DOI 10.1183/09031936.01.00061501 Janas JD, 1999, ANN OTO RHINOL LARYN, V108, P286 KASHIMA HK, 1984, LARYNGOSCOPE, V94, P923 Quanjer P H, 1993, Eur Respir J Suppl, V16, P5 Saarinen A, 2000, ANN OTO RHINOL LARYN, V109, P563 Schneider B, 2003, ACTA OTO-LARYNGOL, V123, P883, DOI 10.1080/00016480310015957 Shaw GY, 1997, LARYNGOSCOPE, V107, P177, DOI 10.1097/00005537-199702000-00008 TATTERSFIELD AE, 1979, BRIT J CLIN PHARMACO, V8, P307 WOO JKS, 1992, CLIN OTOLARYNGOL, V17, P497 NR 15 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 810 EP 815 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200003 PM 17165662 ER PT J AU Sato, K Nakashima, T AF Sato, Kiminori Nakashima, Tadashi TI Histopathologic changes in laryngeal mucosa of extremely low-birth weight infants after endotracheal intubation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE extremely low-birth weight infant; histopathology; infant; intubation; very low-birth weight infant ID PROLONGED INTUBATION; CHILDREN; COMPLICATIONS AB Objectives: Advances in medicine have improved the survival of infants with increasingly lower birth weights. The histopathologic changes of intubation-related laryngeal injury in extremely low-birth weight infants (less than 1,000 g) have not been well known. We examined histopathologic changes in infant larynges, including extremely low-birth weight infants, after endotracheal intubation. Methods: Forty-four infants, including 21 extremely low-birth weight infants, who had been intubated for periods ranging from 10 minutes to 138 days, were examined in a whole organ serial section study. Results: As the duration of intubation increased, the ulceration was found to be larger and deeper. The injury at the subglottis and posterior glottis was greater than that at other portions. The perichondrium of the cartilage was exposed in many cases intubated longer than 8 days. Repaired epithelium that was composed of squamous epithelium was present in 6 of 7 larynges that had been intubated more than 20 days, indicating that not only injury but also the healing process occurred during long intubation. There were no obvious relationships between the degree of intubation injury and the birth weight of the infants. Conclusions: Prolonged intubation is better tolerated by infants than adults. The intubation-related laryngeal injuries of extremely low-birth weight infants were histopathologically the same as those of infants of other birth weights. C1 Kurume Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Kurume, Fukuoka 8300011, Japan. RP Sato, K (reprint author), Kurume Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, 67 Asahi Machi, Kurume, Fukuoka 8300011, Japan. CR ALLEN TH, 1965, BRIT J ANAESTH, V37, P566, DOI 10.1093/bja/37.8.566 BENJAMIN B, 1993, ANN OTOL RHINOL S160, V102 DANKLE SK, 1987, ARCH OTOLARYNGOL, V113, P841 DANKLE SK, 1986, ANN OTO RHINOL LARYN, V95, P626 DONNELLY WH, 1969, ARCH PATHOL, V88, P511 FEARON B, 1966, ANN OTO RHINOL LARYN, V75, P975 FREEMAN GR, 1972, LARYNGOSCOPE, V82, P1385, DOI 10.1288/00005537-197208000-00001 HAWKINS DB, 1978, LARYNGOSCOPE, V88, P201, DOI 10.1288/00005537-197802000-00001 HIRANO M, 1986, ANN OTO RHINOL LARYN, V95, P576 HIRANO M, 1993, HISTOLOGICAL COLOR A LINDHOLM CE, 1969, ACTA ANAESTHESIO S33, V33 RASCHE RFH, 1972, PEDIATRICS, V50, P632 SATO K, 1987, Otologia Fukuoka, V33, P153 Sato K, 1990, JPN ANAESTH J, V4, P103 STRONG RM, 1977, ARCH OTOLARYNGOL, V103, P329 NR 15 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 816 EP 823 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200004 PM 17165663 ER PT J AU Aydin, O Iseri, M Ozturk, M AF Aydin, Omer Iseri, Mete Ozturk, Murat TI Radiofrequency ablation in the treatment of idiopathic bilateral palatal myoclonus: A new indication SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE palatal myoclonus; radiofrequency ablation; tinnitus AB Objectives: We tested the effect of radiofrequency ablation in the treatment of palatal myoclonus refractory to other therapeutic regimens. Methods: A 20-year-old patient who presented with palatal myoclonus and annoying rhythmic objective clicking noise was treated with a radiofrequency generator with topical and local anesthesia in an outpatient setting. Results: The clicking noise was abolished within 3 to 4 days of the radiofrequency ablation. The rhythmic, jerky movements of the soft palate were confirmed to be absent 2 weeks later with electromyographic studies. The patient has been symptom-free for 6 months, and no side effects have occurred. Conclusions: As a new indication, radiofrequency ablation may effectively abolish abnormal movements of the soft palate and relieve associated tinnitus. C1 Kocaeli Univ, Fac Med, Dept Otolaryngol, Kocael, Turkey. RP Ozturk, M (reprint author), Kocaeli Univ, Tip Fak, Kulak Burun Bogaz Anabilim Dali, TR-41380 Kocaeli, Turkey. CR Brown SR, 2004, ANN OTO RHINOL LARYN, V113, P418 Deuschl G, 2002, MOVEMENT DISORD, V17, pS63, DOI 10.1002/mds.10062 DEUSCHL G, 1990, BRAIN, V113, P1645, DOI 10.1093/brain/113.6.1645 FITZGERALD DC, 1984, LARYNGOSCOPE, V94, P217, DOI 10.1288/00005537-198402000-00014 Le Pajolec C, 1990, Ann Otolaryngol Chir Cervicofac, V107, P363 POLITZER A, 2002, DIS EAR TXB DIS EAR Powell NB, 1998, CHEST, V113, P1163, DOI 10.1378/chest.113.5.1163 NR 7 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 824 EP 826 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200005 PM 17165664 ER PT J AU Peretti, G Piazza, C Cattaneo, A De Benedetto, L Martin, E Nicolai, P AF Peretti, Giorgio Piazza, Cesare Cattaneo, Augusto De Benedetto, Luigi Martin, Eva Nicolai, Piero TI Comparison of functional outcomes after endoscopic versus open-neck supraglottic laryngectomies SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE carbon dioxide laser; endoscopic supraglottic laryngectomy; open-neck supraglottic laryngectomy; supraglottic cancer; swallowing; vocal outcome ID CARBON-DIOXIDE LASER; LARYNGEAL CARCINOMAS; RESECTION; MICROSURGERY; ASPIRATION; SURGERY; CANCER; HYPOPHARYNX; CO2-LASER AB Objectives: Endoscopic supraglottic laryngectomy (ESL) by carbon dioxide laser for selected T1-T3 supraglottic squamous cell carcinomas is a sound procedure with oncological results comparable to those obtained by open-neck supraglottic laryngectomy (ONSL). The aim of this study was to retrospectively evaluate functional outcomes after ESL in comparison with ONSL. Methods: We performed perceptual voice evaluation by GRBAS (grade, roughness, breathiness, asthenicity, strain), subjective analysis by Voice Handicap Index, objective analysis with the Multidimensional Voice Program, swallowing evaluation with the M. D. Anderson Dysphagia Inventory, video nasal endoscopic examination of swallowing, videofluoroscopy, and analysis of hospitalization time, need for and duration of feeding tube and tracheotomy, and complication and aspiration pneumonia rates in a group of 14 patients treated with ESL. These results were compared to those obtained in a historical group of 14 patients matched for T category who were treated with ONSL at the same institution. Statistical analysis was performed with the Mann-Whitney U and Pearson chi(2) tests. Results: Comparison of comprehensive voice analysis, M. D. Anderson Dysphagia Inventory, and complication and aspiration rates showed no statistically significant differences between the two groups. However, significant differences were found for video nasal endoscopic examination of swallowing (p =.03), videofluoroscopy (p =.03), hospitalization (p =.0001), feeding tube duration (p =.0001), and tracheotomy duration (p =.0001). Conclusions: Endoscopic supraglottic laryngectomy had a significantly lower functional impact on swallowing than ONSL, even though it was not subjectively perceived by patients, and was associated with less morbidity and a shorter hospitalization time. C1 Univ Brescia, Dept Otolaryngol, I-25123 Brescia, Italy. Univ Brescia, Dept Radiol, I-25123 Brescia, Italy. RP Peretti, G (reprint author), Univ Brescia, Dept Otolaryngol, Piazza Spedali Civili 1, I-25123 Brescia, Italy. CR Ambrosch P, 1998, ANN OTO RHINOL LARYN, V107, P680 Bernal-Sprekelsen M, 2004, HEAD NECK-J SCI SPEC, V26, P103, DOI 10.1002/hed.10363 Cabanillas R, 2004, HEAD NECK-J SCI SPEC, V26, P653, DOI 10.1002/hed.20063 Chen AY, 2001, ARCH OTOLARYNGOL, V127, P870 Davis RK, 2004, ANN OTO RHINOL LARYN, V113, P132 Dejonckere PH, 2001, EUR ARCH OTO-RHINO-L, V258, P77, DOI 10.1007/s004050000299 Donzelli J, 2003, ANN OTO RHINOL LARYN, V112, P469 Eckel HE, 1997, OTOLARYNG HEAD NECK, V117, P681, DOI 10.1016/S0194-5998(97)70052-4 Greene FL, 2002, AJCC CANC STAGING HD, V6th Hirano M, 1981, DISORDERS HUMAN COMM, V5, P81 Iro H, 1998, ARCH OTOLARYNGOL, V124, P1245 Jacobson BH, 1997, AM J SPEECH-LANG PAT, V6, P66 KOLLISCH M, 1995, ADV OTO-RHINO-LARYNG, V49, P237 Kreuzer SH, 2000, CLIN RADIOL, V55, P775, DOI 10.1053/crad.2000.0517 LANGMORE SE, 1991, ANN OTO RHINOL LARYN, V100, P678 Langmore S E, 1988, Dysphagia, V2, P216, DOI 10.1007/BF02414429 Moreau PR, 2000, LARYNGOSCOPE, V110, P1000, DOI 10.1097/00005537-200006000-00022 Myers EN, 1996, LARYNGOSCOPE, V106, P559, DOI 10.1097/00005537-199605000-00008 Oeken J, 2001, EUR ARCH OTO-RHINO-L, V258, P250, DOI 10.1007/s004050100353 Prgomet D, 2002, EUR ARCH OTO-RHINO-L, V259, P399, DOI 10.1007/s00405-002-0485-7 Rassekh CH, 1998, LARYNGOSCOPE, V108, P445, DOI 10.1097/00005537-199803000-00025 RUDERT HH, 1995, EUR ARCH OTO-RHINO-L, V252, P146 Rudert HH, 1999, ANN OTO RHINOL LARYN, V108, P819 Sasaki CT, 2006, ANN OTO RHINOL LARYN, V115, P93 STEINER W, 1993, AM J OTOLARYNG, V14, P116, DOI 10.1016/0196-0709(93)90050-H ZEITELS SM, 1994, LARYNGOSCOPE, V104, P71 NR 26 TC 24 Z9 24 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 827 EP 832 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200006 PM 17165665 ER PT J AU Rotenberg, BW Berkowitz, RG AF Rotenberg, Brian W. Berkowitz, Robert G. TI Changing trends in the success rate of anterior cricoid split SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE anterior cricoid split; laryngotracheal stenosis; neonatal intensive care; subglottic stenosis ID ACQUIRED SUBGLOTTIC STENOSIS; EXPERIENCE; EXTUBATION; MANAGEMENT; INFANTS; TRACHEOTOMY AB Objectives: We determined the historical trends at our institution in the extubation success rate, defined as avoiding tracheostomy, for infants with acquired laryngotracheal stenosis (LTS) who undergo anterior cricoid split (ACS) as primary treatment. Methods: We performed a retrospective chart review of all neonates with acquired LTS treated with ACS between 1989 and 2005. Successful extubation rates were assessed over the study's time period. Student's t-test was used to compare identified subgroups. Results: Thirty-one neonates (14 male, 17 female) were identified, with an average gestational age of 27.6 weeks. During 1989 to 1995, a successful cumulative extubation rate of 71.4% was achieved in 14 children. By 2005, though, following a further 17 children, the successful cumulative extubation rate had dropped to 54.8%. The extubation rate in the time period 1996 to 2005 specifically was only 41.2%. The factor identified that most significantly correlated with this change was the difference in average duration of preoperative intubation. Relatively higher numbers of significant neurologic, respiratory, and cardiac comorbidities were identified both in the 1996 to 2005 grouping and in the ACS failure grouping. Conclusions: The success rate of ACS as a means of avoiding neonatal tracheostomy appears to have declined over the past 10 years at our institution. A prolonged period of preoperative intubation, as well as associated increasingly significant comorbidities, may be explanatory for this change. Revising the accepted selection criteria for ACS, or broadening the indications for alternative techniques, may be warranted. C1 Royal Childrens Hosp, Dept Otolaryngol, Melbourne, Vic, Australia. RP Berkowitz, RG (reprint author), Royal Childrens Hosp, Dept Otolaryngol, Flemington Rd, Parkville, Vic 3052, Australia. CR ANDERSON GJ, 1988, INT J PEDIATR OTORHI, V16, P31, DOI 10.1016/0165-5876(88)90097-3 BERKOWITZ RG, 1994, J PAEDIATR CHILD H, V30, P345, DOI 10.1111/j.1440-1754.1994.tb00660.x Choi SS, 2000, OTOLARYNG HEAD NECK, V122, P61, DOI 10.1016/S0194-5998(00)70145-8 COTTON RT, 1980, ANN OTO RHINOL LARYN, V89, P508 COTTON RT, 1988, ARCH OTOLARYNGOL, V114, P1300 DANKLE SK, 1986, ANN OTO RHINOL LARYN, V95, P626 Eze NN, 2005, INT J PEDIATR OTORHI, V69, P843, DOI 10.1016/j.ijporl.2005.01.023 FRANKEL LR, 1984, CRIT CARE MED, V12, P395, DOI 10.1097/00003246-198404000-00012 HAWKINS DB, 1987, ANN OTO RHINOL LARYN, V96, P116 HOLINGER LD, 1987, LARYNGOSCOPE, V97, P19 MILLER RH, 1986, ARCH OTOLARYNGOL, V112, P972 PARK AH, 2001, OPER TECHN OTOLARYNG, V12, P232, DOI 10.1016/S1043-1810(01)80028-2 SEID AB, 1985, J PEDIATR SURG, V20, P388, DOI 10.1016/S0022-3468(85)80224-4 SILVER FM, 1991, AM J OTOLARYNG, V12, P343, DOI 10.1016/0196-0709(91)90030-J TAVIN E, 1994, ARCH OTOLARYNGOL, V120, P823 NR 15 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 833 EP 836 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200007 PM 17165666 ER PT J AU Conoyer, JM Netterville, JL Chen, A Vos, JD AF Conoyer, J. Matthew Netterville, James L. Chen, Anton Vos, Jeremy D. TI Pedicled fat flap reconstruction of the atrophic or "empty" paraglottic space following resection of Teflon granuloma or oversized implant SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE glottal incompetence; Gore-Tex; granuloma; laryngotomy; medialization laryngoplasty; paraglottic space; paralysis; Teflon ID VOCAL FOLD; LATERAL LARYNGOTOMY; MEDIALIZATION; MANAGEMENT; INJECTION; REMOVAL; CORD AB Objectives: Loss of functional and supporting architecture in the paraglottic space (PGS) necessitates augmentation to restore phonation and prevent aspiration. Our previous PGS reconstructions using an inferiorly based sternohyoid muscle flap have shown a propensity to fibrose over time, tethering the vocal fold inferolaterally. Poor voice outcomes have led us to explore other reconstructive options such as the laterally based vascularized fat flap described below. Our objectives in the present study were 1) to discuss phonosurgical options for reestablishing PGS volume after removal of an oversized implant or after definitive resection of Teflon granuloma; and 2) to understand the surgical technique, indications, and functional prognosis of the laterally based fat flap used for augmenting the "empty" PGS. Methods: Fourteen cases of PGS reconstruction with a laterally based subplatysmal fat flap were retrospectively investigated for indications, functional outcome, and the need for subsequent phonosurgical procedures. Preoperative and postoperative voice and videostroboscopic findings were analyzed. Results: Fat flap augmentation helped achieve subjective vocal improvement in patients with an empty PGS. A subset of our patients demonstrated fat flap atrophy within 12 months, prompting revision laryngoplasty. Viable flaps were encountered in each revision, facilitating future medialization attempts. Conclusions: Fat flap reconstruction of the PGS is a versatile, beneficial adjunct for revision medialization in select cases. C1 Vanderbilt Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Nashville, TN USA. RP Netterville, JL (reprint author), 7204 Med Ctr E,S Tower,1215 21st Ave S, Nashville, TN 37232 USA. CR ARNOLD GE, 1962, ARCHIV OTOLARYNGOL, V76, P76 Billante CR, 2001, ORL J OTO-RHINO-LARY, V63, P302, DOI 10.1159/000055763 Hogikyan ND, 2000, J VOICE, V14, P378, DOI 10.1016/S0892-1997(00)80083-1 HORN KL, 1980, LARYNGOSCOPE, V90, P281 KASPERBAUER JL, 1993, ANN OTO RHINOL LARYN, V102, P748 NAKAYAMA M, 1993, OTOLARYNG HEAD NECK, V109, P493 Netterville JL, 1998, ANN OTO RHINOL LARYN, V107, P735 NETTERVILLE JL, 1993, ANN OTO RHINOL LARYN, V102, P413 OSSOFF RH, 1993, ANN OTO RHINOL LARYN, V102, P405 RUBIN HJ, 1975, ARCH OTOLARYNGOL, V101, P114 Spector BC, 2001, OTOLARYNG HEAD NECK, V125, P176, DOI 10.1067/mhn.2001.117714 TOOMEY JM, 1967, LARYNGOSCOPE, V77, P110, DOI 10.1288/00005537-196701000-00010 VARVARES MA, 1995, ANN OTO RHINOL LARYN, V104, P511 Zeitels SM, 2003, ANN OTO RHINOL LARYN, V112, P180 NR 14 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 837 EP 845 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200008 PM 17165667 ER PT J AU Simental, AA Duvvuri, U Johnson, JT Myers, EN AF Simental, Alfred A., Jr. Duvvuri, Umamaheswar Johnson, Jonas T. Myers, Eugene N. TI Selective neck dissection in patients with upper aerodigestive tract cancer with clinically positive nodal disease SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 6th International Conference on Head and Neck Cancer CY AUG 07-11, 2004 CL Washington, DC SP Amer Head & Neck Soc DE cancer; neck dissection; nodal disease ID SQUAMOUS-CELL CARCINOMA; QUALITY-OF-LIFE; NEGATIVE NECK; MANAGEMENT; METASTASES; DISABILITY; EVOLUTION; EFFICACY; IMPACT AB Objectives: We evaluated the efficacy of the application of selective neck dissection to cases of clinically node-positive disease. Methods: We performed a retrospective review at the University of Pittsburgh Head and Neck Cancer Database. A database of 65 patients was followed for an average of 36 months (range, 2 to 128 months) after they underwent selective neck dissection for clinically node-positive regional disease. Results: Regional failure occurred in 8 patients (12.3%). In-field failure was experienced in 4 patients (6.1%), and failures outside the field of dissection occurred in 4 patients (6.1%). The overall incidence of extracapsular spread was 33.8% (22 of 65). Only 2 of 8 regional recurrences were associated with extracapsular spread at the initial neck dissection; however, both recurrences were in the contralateral, undissected side of the neck. Four regional failures were salvaged with surgery, with eventual overall regional control in the neck of 93.9%. Only 1 of 4 ipsilateral recurrences (25%) was successfully salvaged. In contrast, 3 of 4 contralateral failures (75%) were successfully salvaged. In our study population, 21 of 65 cases (32%) that were initially staged as clinically node-positive had no evidence of nodal metastases on pathologic examination. Conclusions: The application of selective neck dissection and postoperative irradiation in patients with clinically NI and limited N2 clinical disease appears to be oncologically efficacious. Clinical overstaging occurred frequently in this sample, and may put patients at risk for more morbid surgical procedures. C1 Loma Linda Univ, Sch Med, Dept Surg, Loma Linda, CA USA. Univ Pittsburgh, Sch Med, Dept Otolaryngol, Pittsburgh, PA USA. RP Simental, AA (reprint author), 11234 Anderson St,2584, Loma Linda, CA 92350 USA. CR Ambrosch P, 2001, OTOLARYNG HEAD NECK, V124, P180, DOI 10.1067/mhn.2001.111598 Andersen PE, 2002, ARCH OTOLARYNGOL, V128, P1180 Byers RM, 1999, HEAD NECK-J SCI SPEC, V21, P499, DOI 10.1002/(SICI)1097-0347(199909)21:6<499::AID-HED1>3.0.CO;2-A Cappiello J, 2005, LARYNGOSCOPE, V115, P259, DOI 10.1097/01.mlg.0000154729.31281.da Chepeha DB, 2002, LARYNGOSCOPE, V112, P434, DOI 10.1097/00005537-200203000-00005 Chepeha DB, 2002, HEAD NECK-J SCI SPEC, V24, P432, DOI 10.1002/hed.10067 Doweck I, 2003, HEAD NECK-J SCI SPEC, V25, P960, DOI 10.1002/hed.10315 Hosal AS, 2000, LARYNGOSCOPE, V110, P2037 Kuntz AL, 1999, LARYNGOSCOPE, V109, P1334, DOI 10.1097/00005537-199908000-00030 Laverick S, 2004, ARCH OTOLARYNGOL, V130, P149, DOI 10.1001/archotol.130.2.149 LEONE M, 2000, ANN FR ANESTH, V1, P23 Lohuis PJFM, 2004, AM J SURG, V187, P295, DOI 10.1016/j.amjsurg.2003.11.015 MCGUIRT WF, 1995, ARCH OTOLARYNGOL, V121, P278 Mira E, 2002, OTOLARYNG HEAD NECK, V127, P279, DOI 10.1067/mhn.2002.128601 Muzaffar K, 2003, LARYNGOSCOPE, V113, P1460, DOI 10.1097/00005537-200309000-00005 Myers EN, 2003, ARCH OTOLARYNGOL, V129, P14 Pellitteri PK, 1997, HEAD NECK-J SCI SPEC, V19, P260, DOI 10.1002/(SICI)1097-0347(199707)19:4<260::AID-HED3>3.0.CO;2-Z de Zinis LOR, 2002, HEAD NECK-J SCI SPEC, V24, P913, DOI 10.1002/hed.10152 Salerno G, 2002, LARYNGOSCOPE, V112, P1299, DOI 10.1097/00005537-200207000-00029 Samant S, 2003, WORLD J SURG, V27, P805, DOI 10.1007/s00268-003-7113-6 Shah S, 2001, HEAD NECK-J SCI SPEC, V23, P954, DOI 10.1002/hed.1138 van Wilgen CP, 2003, BRIT J ORAL MAX SURG, V41, P7, DOI 10.1016/S0266-4356(02)00288-7 van Wilgen CP, 2003, J CRANIO MAXILL SURG, V31, P183, DOI 10.1016/S1010-5182(03)00030-1 NR 23 TC 13 Z9 13 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 846 EP 849 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200009 PM 17165668 ER PT J AU Perkins, JA Inglis, AF Sie, KCY Manning, SC AF Perkins, Jonathan A. Inglis, Andrew F. Sie, Kathleen C. Y. Manning, Scott C. TI Recurrent thyroglossal duct cysts: A 23-year experience and a new method for management SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 20th Annual Meeting of the American-Society-of-Pediatric-Otolaryngology CY MAY 27-30, 2005 CL Las Vegas, NV SP Amer Soc Pediat Otolaryngol DE complication; recurrence; surgery; thyroglossal duct cyst ID SISTRUNK PROCEDURE; CORE-OUT; REMNANTS; CHILDREN; OPERATION; TRACT AB Objectives: We present an experience in the management of primary and recurrent thyroglossal duct cysts (TGDCs) and describe a novel method for recurrent TGDC removal. Methods: We performed a retrospective review of TGDC surgery at Children's Hospital in Seattle from 1980 to 2003. The surgical techniques for primary and recurrent TGDCs and the factors associated with TGDC recurrence were evaluated and analyzed. Results: During the study period, 231 patients underwent 296 TGDC surgeries. Thirty-four of the 231 patients (15%) underwent a total of 88 procedures for recurrent TGDCs. Successful procedures used for secondary TGDC management included central neck dissection with directed base of tongue (BOT) excision in 6 of 9 patients (67%), secondary Sistrunk operation with limited BOT resection in 12 of 27 patients (44%), revision Sistrunk operation with BOT dissection in 7 of 11 patients (64%), and suture-guided transhyoid pharyngotomy in 8 of 8 patients (100%). Ten of the 231 patients (4%) had initial TGDC incision and drainage and then underwent a total of 21 procedures, excluding the incision and drainage. The factors associated with TGDC recurrence were inaccurate initial diagnosis (17 of 34 or 50%), infection (5 of 34 or 15%), unusual TGDC presentation (5 of 34 or 15%), and lack of BOT musculature removal (7 of 34 or 20%). The level of surgeon training affected the surgical outcome. Conclusions: Successful TGDC treatment requires consideration of factors associated with recurrence. Recurrent TGDCs can be treated by several methods, including suture-guided transhyoid pharyngotomy. C1 Childrens Hosp & Med Ctr, Div Pediat Otolaryngol, Seattle, WA 98105 USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. RP Perkins, JA (reprint author), Childrens Hosp & Med Ctr, Div Pediat Otolaryngol, 4800 Sand Point Way NE,6E-1, Seattle, WA 98105 USA. CR ATHOW AC, 1989, BRIT J SURG, V76, P811, DOI 10.1002/bjs.1800760815 Ducic Y, 1998, INT J PEDIATR OTORHI, V44, P47, DOI 10.1016/S0165-5876(98)00041-X EIN SH, 1984, J PEDIATR SURG, V19, P437, DOI 10.1016/S0022-3468(84)80270-5 HOFFMAN MA, 1988, ANN OTO RHINOL LARYN, V97, P483 HORISAWA M, 1992, J PEDIATR SURG, V27, P710, DOI 10.1016/S0022-3468(05)80097-1 HORISAWA M, 1991, J PEDIATR SURG, V26, P766, DOI 10.1016/0022-3468(91)90134-F Horisawa M, 1999, J PEDIATR SURG, V34, P1589, DOI 10.1016/S0022-3468(99)90622-X Kim MK, 1999, OTOLARYNG HEAD NECK, V121, P543, DOI 10.1016/S0194-5998(99)70054-9 Lubben B, 2001, OTOLARYNG HEAD NECK, V125, P426, DOI 10.1067/mhn.2001.117168 Maddalozzo J, 2001, LARYNGOSCOPE, V111, P119, DOI 10.1097/00005537-200101000-00021 Marianowski R, 2003, INT J PEDIATR OTORHI, V67, P19, DOI 10.1016/S0165-5876(02)00287-2 MICKEL RA, 1983, ARCH OTOLARYNGOL, V109, P34 NOYEK AM, 1981, OTOLARYNG CLIN N AM, V14, P187 PELAUSA EO, 1989, J OTOLARYNGOL, V18, P325 SADE J, 1968, ANN OTO RHINOL LARYN, V77, P139 Sistrunk WE, 1920, ANN SURG, V71, P121, DOI 10.1097/00000658-192002000-00002 SOUCY P, 1984, J PEDIATR SURG, V19, P506, DOI 10.1016/S0022-3468(84)80091-3 Waddell A, 2000, J LARYNGOL OTOL, V114, P128 NR 18 TC 21 Z9 22 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 850 EP 856 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200010 PM 17165669 ER PT J AU Licup, AT Arkia, H Mabel, A Cohen-Kerem, R Forte, V AF Licup, Ana Teresa Arkia, Homan Mabel, Anita Cohen-Kerem, Raanan Forte, Vito TI Partial neurolysis of the hypoglossal nerve for selective lingual atrophy in a porcine model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE hypoglossal nerve; hypoglossal neurectomy; lingual mapping; lingual muscle; tongue atrophy; tongue prolapse ID OBSTRUCTIVE SLEEP-APNEA; SURGICAL-MANAGEMENT; AIRWAY-OBSTRUCTION; TONGUE; STIMULATION; CHILDREN; MACROGLOSSIA; REDUCTION; BRANCHES; CANINE AB Objectives: Obstructive sleep apnea in children is most commonly treated with adenotonsillectomy; however, in cases of significant tongue base prolapse, this may prove inadequate. Surgical procedures used to increase the retroglossal airway have significant morbidities and low patient acceptability. We theorized that effective reduction of the tongue base can be achieved through partial denervation of the hypoglossal nerve, which is easily accessed in the submandibular space with minimal morbidity. Methods: We performed a prospective, experimental study in which topographic innervation maps of porcine tongue were generated by stimulating the hypoglossal main trunk and peripheral branches. The effects of complete unilateral nerve sectioning on tongue base volume and linear dimensions were measured and compared to the contralateral control side. In the final stage, only the peripheral nerve that was determined as the main supply to the tongue base was sectioned, and the results were compared to those in the matched controls. Results: A medial branch of the hypoglossal nerve was consistently identified as the main motor supply to the tongue base. Complete denervation resulted in a measurable decrease in the volume of the tongue base as compared to that of controls. Partial neurolysis produced inconsistent changes in 2 subjects, with decreases in linear dimensions that were not proportional to the decrease in volume. Histologically, complete denervation was followed by a significantly greater replacement of muscle with fat and connective tissue as compared with partial neurolysis. Conclusions: There were inconsistent changes in volume and linear dimensions of the tongue base following partial neurolysis of the hypoglossal nerve over the 3-month experimental period. C1 Univ Toronto, Hosp Sick Children, Dept Otolaryngol Head & Neck Surg, Toronto, ON M5G 1X8, Canada. Univ Toronto, Hosp Sick Children, Dept Neurosci, Toronto, ON M5G 1X8, Canada. Univ Toronto, Hosp Sick Children, Auditory Sci Lab, Brain & Behav Div, Toronto, ON M5G 1X8, Canada. RP Licup, AT (reprint author), Univ Toronto, Hosp Sick Children, Dept Otolaryngol Head & Neck Surg, 555 Univ Ave, Toronto, ON M5G 1X8, Canada. CR BASSLER R, 1987, PATHOL RES PRACT, V182, P87 Brennick MJ, 2001, J APPL PHYSIOL, V90, P1373 DONALDSON JD, 1988, J OTOLARYNGOL, V17, P398 Eisele DW, 2003, OTOLARYNG CLIN N AM, V36, P501, DOI 10.1016/S0030-6665(02)00178-0 GISLASON T, 1995, CHEST, V107, P963, DOI 10.1378/chest.107.4.963 Goding GS, 1998, LARYNGOSCOPE, V108, P162, DOI 10.1097/00005537-199802000-00003 Kalantarian B, 1998, J RECONSTR MICROSURG, V14, P459, DOI 10.1055/s-2007-1000208 Mann EA, 2002, LARYNGOSCOPE, V112, P351, DOI 10.1097/00005537-200202000-00027 MAY M, 1991, OTOLARYNG HEAD NECK, V104, P818 MIXTER RC, 1993, PLAST RECONSTR SURG, V91, P1159, DOI 10.1097/00006534-199305000-00031 Morgan WE, 1996, ARCH OTOLARYNGOL, V122, P326 Murakami R, 1998, AM J NEURORADIOL, V19, P515 POTSIC WP, 1990, OTOLARYNG CLIN N AM, V23, P651 Powell NB, 1997, CHEST, V111, P1348, DOI 10.1378/chest.111.5.1348 Salame K, 2006, CLIN ANAT, V19, P37, DOI 10.1002/ca.20141 Schwartz AR, 1996, J APPL PHYSIOL, V81, P643 STROME M, 1986, LARYNGOSCOPE, V96, P1340 Terris DJ, 2002, J LARYNGOL OTOL, V116, P716 UEMURA M, 1979, NEUROSCI LETT, V13, P99, DOI 10.1016/0304-3940(79)90024-7 UEMURASUMI M, 1981, NEUROSCI LETT, V22, P31, DOI 10.1016/0304-3940(81)90280-9 WOODSON BT, 1992, OTOLARYNG HEAD NECK, V107, P40 Yoo PB, 2005, J APPL PHYSIOL, V99, P937, DOI 10.1152/jappiphysiol.00652.2004 NR 22 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 857 EP 863 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200011 PM 17165670 ER PT J AU Kim, SM McCulloch, TM Bae, H Kim, SJ AF Kim, Sung Min McCulloch, Timothy M. Bae, Hasuk Kim, Sung Jae TI Biomechanical model for muscular dysfunction of the human pharynx using finite element analysis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE dysphagia; finite element method; muscular dysfunction; pharynx ID SWALLOW; STROKE AB Objectives: The oropharynx functions to transport food from the oral cavity to the esophagus, as well as to maintain an air passage from the nose to the lungs. By combining data from prior material property experimentation, a 3-dimensional finite element method reconstruction of the pharynx, and the utilization of a optimization process based on an inverse dynamic approach, we can estimate the pressures and associated consecutive pressure gradients created internally when the pharynx functions during swallowing. Methods: In this study, pharyngeal muscular dysfunction was modeled under 3 scenarios of increasing tissue stiffness. This was done by modifications in the stress-strain relationship material property within the finite element method nodes. This mechanical property was used as a surrogate for clinical changes in muscle function complicating neuromuscular disorders, such as stroke and amyotrophic lateral sclerosis. The pharyngeal tissue and deformation of the cross-sectional area of the pharynx were analyzed while increasing the mechanical stiffness by 25%, 50%, and 75%. Results: Increases in stiffness resulted in modified pressure-area curves predicting diminished movement, primarily in stiffened regions. Conclusions: These simulation results may act as a clinical index illustrating the association between tissue dysfunction and pharyngeal pressure and movement dysfunction. This type of modeling has the potential to act as an investigational tool, as well as a predictive tool, regarding disease progression, cancer treatment, and perhaps even the effects of aging on swallowing function. C1 Univ Washington, Harborview Med Ctr, Dept Otolaryngol Head & Neck Surg, Coll Med, Seattle, WA 98104 USA. Konkuk Univ, Coll Med, Dept Biomed Engn, Chungju, South Korea. Ewha Womans Univ, Coll Med, Dept Rehabil, Seoul, South Korea. RP McCulloch, TM (reprint author), Univ Washington, Harborview Med Ctr, Dept Otolaryngol Head & Neck Surg, Coll Med, Box 359894,325 9Th Ave, Seattle, WA 98104 USA. CR BRASSEUR J G, 1991, Dysphagia, V6, P100, DOI 10.1007/BF02493487 Castell D O, 1987, Dysphagia, V2, P65, DOI 10.1007/BF02408136 ELLIOTT JL, 1988, GERIATRICS, V43, P95 Elliott JL, 1988, GERIATRICS, V43, P113 Elliott JL, 1988, GERIATRICS, V43, P104 FINESTONE HM, 1995, ARCH PHYS MED REHAB, V76, P310, DOI 10.1016/S0003-9993(95)80655-5 Fung Y. C., 1972, BIOMECHANICS ITS FDN, P181 GORDON C, 1987, BRIT MED J, V295, P411 KAHRILAS PJ, 1995, RADIOLOGY, V194, P575 Kahrilas PJ, 1996, GASTROENTEROLOGY, V111, P297, DOI 10.1053/gast.1996.v111.pm8690194 KAHRILAS P J, 1992, Dysphagia, V7, P155, DOI 10.1007/BF02493449 Kern M, 1999, ANN OTO RHINOL LARYN, V108, P982 Kim SM, 1998, TISSUE ENG, V4, P389, DOI 10.1089/ten.1998.4.389 Kim SM, 2000, ANN OTO RHINOL LARYN, V109, P585 MCCONNEL FMS, 1988, LARYNGOSCOPE, V98, P71 Perlman AL, 1993, J MED SPEECH-LANG PA, V11, P223 NR 16 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2006 VL 115 IS 11 BP 864 EP 870 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 106NS UT WOS:000242108200012 PM 17165671 ER PT J AU Guillermo, LQ Gal, TJ Mair, EA AF Guillermo, Louis Q. Gal, Thomas J. Mair, Eric A. TI Does obstructive sleep apnea affect aerobic fitness? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE aerobic fitness; cycle ergometry; obstructive sleep apnea ID EXERCISE; DEPRIVATION; PERFORMANCE AB Objectives: We sought to determine whether patients with obstructive sleep apnea (OSA) had an objective change in aerobic fitness during cycle ergometry compared to a normal population. The most accurate test of aerobic fitness is measurement of maximum oxygen consumption (V) over dot O2max with cycle ergometry. Methods: We performed a retrospective cohort analysis (247 patients with OSA) of (V) over dot O2max from annual cycle ergometry tests compared to a large control group (normative data from 1.4 million US Air Force tests) in a tertiary care setting. Results: Overall, individuals with OSA had increased (V) over dot O2max when compared to the normalized US Air Force data (p <.001). Patients with an apnea-hypopnea index of greater than 20 demonstrated a decreased (V) over dot O2max as compared to normalized values (p <.001). No differences in (V)over dot O2max were observed after either medical or surgical therapy for OSA. Conclusions: Overall, in a US Air Force population, OSA does not predict a decrease in aerobic fitness as measured by cycle ergometry. However, patients with an apnea-hypopnea index of greater than 20 have a statistically significant decrease in aerobic fitness compared to the normal population. This study demonstrates the effects of OSA on aerobic fitness. Further correlation of fitness testing results with OSA severity and treatment is needed. C1 Wilford Hall USAF Med Ctr, Dept Otolaryngol Head & Neck Surg, San Antonio, TX 78236 USA. RP Mair, EA (reprint author), Charlotte EENT Associates, 6035 Fairview Rd, Charlotte, NC 28210 USA. EM emair@ceenta.com CR ASTRAND PO, 1954, J APPL PHYSIOL, V7, P218 BOND V, 1986, J SPORT MED PHYS FIT, V26, P169 DeVries H A, 1965, J Sports Med Phys Fitness, V5, P207 *DIR CSDACT, 1993, US GUID AIR FORC CYC George CFP, 2003, NEW ENGL J MED, V348, P367, DOI 10.1056/NEJM200301233480422 HEDNER J, 1995, EUR RESPIR J, V8, P222, DOI 10.1183/09031936.95.08020222 KASCH F. W., 1984, PHYSICIAN SPORTSMED, V12, P47 Konermann M, 1996, Wien Med Wochenschr, V146, P340 KRIBBS NB, 1993, AM REV RESPIR DIS, V147, P887 Lin CC, 2005, OTOLARYNG HEAD NECK, V133, P55, DOI 10.1016/j.otohns.2005.03.025 MARTIN BJ, 1981, MED SCI SPORT EXER, V13, P220, DOI 10.1249/00005768-198104000-00002 MONTOYE HJ, 1986, RES Q EXERCISE SPORT, V57, P250 PARTINEN M, 1990, CHEST, V97, P27, DOI 10.1378/chest.97.1.27 PLYLEY MJ, 1987, EUR J APPL PHYSIOL O, V56, P338, DOI 10.1007/BF00690902 SAJKOV D, 1994, AM J RESP CRIT CARE, V149, P416 SHIFFLETT ED, 2001, SLEEP MED, V2, P145 SHIOMI T, 1991, CHEST, V100, P894, DOI 10.1378/chest.100.4.894 Taguchi O, 1997, TOHOKU J EXP MED, V183, P45, DOI 10.1620/tjem.183.45 WILLICH SN, 1993, NEW ENGL J MED, V329, P1684, DOI 10.1056/NEJM199312023292302 YOUNG T, 1993, NEW ENGL J MED, V328, P1230, DOI 10.1056/NEJM199304293281704 NR 20 TC 6 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 715 EP 720 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300001 PM 17076091 ER PT J AU Tsikoudas, A Eason, D Kara, N Brunton, JN Mountain, RE AF Tsikoudas, Alexandros Eason, David Kara, Naveed Brunton, John N. Mountain, Rodney E. TI Correlation of radiologic findings and clinical outcome in pharyngeal pouch stapling SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE correlation; outcome; pharyngeal pouch; radiology ID ZENKERS DIVERTICULUM; CRICOPHARYNGEAL MYOTOMY; COMPLICATIONS; PATHOGENESIS; PERFORATION; MANAGEMENT AB Objectives: We undertook to identify any correlation between radiologic findings and clinical outcome in pharyngeal pouch surgery. Methods: We performed a retrospective case control study in a teaching hospital in Dundee, Scotland. The subjects were 21 patients who underwent pharyngeal pouch stapling. We used a novel method to measure the characteristics of each pouch by focusing on a triangular area in the neck of the pouch. Results: A correlation was found between the radiologic preoperative findings and the clinical outcome. A short triangle was more likely to result in postoperative complications, whereas a long one was more likely to require revision surgery. Conclusions: It is possible to predict the surgical outcome from the radiologic characteristics of the diverticulum. We believe that our findings may have important clinical implications. C1 Ninewells Hosp, Dept Otolaryngol, Dundee DD1 9SY, Scotland. Ninewells Hosp, Dept Radiol, Dundee DD1 9SY, Scotland. RP Tsikoudas, A (reprint author), Ninewells Hosp, Dept Otolaryngol, Dundee DD1 9SY, Scotland. CR Chang CY, 2003, LARYNGOSCOPE, V113, P957, DOI 10.1097/00005537-200306000-00009 Feeley MA, 1999, LARYNGOSCOPE, V109, P858, DOI 10.1097/00005537-199906000-00003 Hilton M, 2000, J LARYNGOL OTOL, V114, P549 Hoffman M, 2003, ANN OTO RHINOL LARYN, V112, P202 LAHEY FH, 1954, SURG GYNECOL OBSTET, V98, P1 Mirza S, 2003, J LARYNGOL OTOL, V117, P93 MORTON RP, 1993, HEAD NECK-J SCI SPEC, V15, P253, DOI 10.1002/hed.2880150315 Narne S, 1999, ANN OTO RHINOL LARYN, V108, P810 Ong CC, 1999, J LARYNGOL OTOL, V113, P233 PONETTE E, 1992, HEPATO-GASTROENTEROL, V39, P115 Siddiq MA, 2004, ANN ROY COLL SURG, V86, P247, DOI 10.1308/147870804524 Sydow BD, 2001, AM J ROENTGENOL, V177, P1067 VANOVERBEEK JJM, 1994, ANN OTO RHINOL LARYN, V103, P178 van Eeden S, 1999, J LARYNGOL OTOL, V113, P237 van Overbeek JJM, 2003, ANN OTO RHINOL LARYN, V112, P583 Veenker Elizabeth, 2003, Curr Opin Otolaryngol Head Neck Surg, V11, P160, DOI 10.1097/00020840-200306000-00006 WITTERICK IJ, 1995, HEAD NECK-J SCI SPEC, V17, P382, DOI 10.1002/hed.2880170504 NR 17 TC 6 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 721 EP 726 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300002 PM 17076092 ER PT J AU Nomiya, T Nemoto, K Wada, H Takai, Y Yamada, S AF Nomiya, Takuma Nemoto, Kenji Wada, Hitoshi Takai, Yoshihiro Yamada, Shogo TI Advantage of accelerated fractionation regimens in definitive radiotherapy for stage II glottic carcinoma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE accelerated fractionation; glottic carcinoma; overall treatment time; radiotherapy; T2 cancer; total dose ID LOCAL-CONTROL; RADIATION-THERAPY; TREATMENT TIME; PROGNOSTIC-FACTORS; SIZE; LARYNX; CANCER; T2 AB Objectives: We evaluated the prognostic factors for local control of T2 glottic cancer and verified the efficacy of accelerated fractionation regimens such as hyperfractionation and accelerated hyperfractionation. Methods: A total of 86 patients with T2 NO MO glottic squamous cell carcinoma, who were treated with definitive radiotherapy, were analyzed retrospectively by multivariate analysis. Results: Overall treatment time of radiotherapy (p =.0003) and total dose (p = .0036) were the significant prognostic factors for local control on multivariate analysis. The group with a higher total dose (>= 67 Gy versus < 67 Gy) showed a favorable prognosis (5-year local control rate of 91 % versus 60%, respectively; p = .0013, log-rank test). Likewise, the group with a shorter overall treatment time of radiotherapy (<= 54 days versus > 54 days) showed a favorable prognosis (5-year local control rate of 87% versus 71 %, respectively; p = .023). Conclusions: A radiotherapy total dose of >= 67 Gy delivered for a shorter period is required for T2 glottic cancer. The fractionation regimens of hyperfractionation and accelerated hyperfractionation are more effective than conventional fractionation in terms of shortening overall treatment time and delivering a high total dose with acceptable toxicity. C1 Tohoku Univ, Sch Med, Dept Radiat Oncol, Aoba Ku, Sendai, Miyagi 9808574, Japan. RP Nomiya, T (reprint author), Tohoku Univ, Sch Med, Dept Radiol, Aoba Ku, 1-1 Seiryo Machi, Sendai, Miyagi 9808574, Japan. CR [Anonymous], 1999, COMM TOX CRIT VERS 2 Chatani Masashi, 1993, Strahlentherapie und Onkologie, V169, P102 Fein DA, 1996, INT J RADIAT ONCOL, V34, P823, DOI 10.1016/0360-3016(95)02205-8 HARWOOD AR, 1980, CANCER, V45, P991, DOI 10.1002/1097-0142(19800301)45:5<991::AID-CNCR2820450526>3.0.CO;2-D KAPLAN MJ, 1984, CANCER, V53, P2641, DOI 10.1002/1097-0142(19840615)53:12<2641::AID-CNCR2820531212>3.0.CO;2-H Kitano Masashi, 2002, Nippon Acta Radiologica, V62, P366 Krawczyk J, 1991, Clin Oncol (R Coll Radiol), V3, P330, DOI 10.1016/S0936-6555(05)81278-6 Le QTX, 1997, INT J RADIAT ONCOL, V39, P115, DOI 10.1016/S0360-3016(97)00284-8 MENDENHALL WM, 1988, INT J RADIAT ONCOL, V15, P1267 Nishimura Y, 1996, RADIOTHER ONCOL, V40, P225, DOI 10.1016/0167-8140(96)01796-3 RICCIARDELLI EJ, 1994, ARCH OTOLARYNGOL, V120, P737 SAKATA KI, 1994, INT J RADIAT ONCOL, V30, P1059 SLEVIN NJ, 1992, RADIOTHER ONCOL, V25, P227 SLEVIN NJ, 1992, RADIOTHER ONCOL, V24, P215, DOI 10.1016/0167-8140(92)90226-K Smee R, 2000, Australas Radiol, V44, P53, DOI 10.1046/j.1440-1673.2000.00772.x Sobin LH, 1997, TNM CLASSIFICATION M NR 16 TC 5 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 727 EP 732 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300003 PM 17076093 ER PT J AU Kobler, JB Rosen, DI Burns, JA Akst, LM Broadhurst, MS Zeitels, SM Hillman, RE AF Kobler, James B. Rosen, David I. Burns, James A. Akst, Lee M. Broadhurst, Matthew S. Zeitels, Steven M. Hillman, Robert E. TI Comparison of a flexible laryngoscope with calibrated sizing function to intraoperative measurements SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE calibration; endoscope; laryngology; laryngoscopy; optics; videostroboscopy; vocal fold AB Objectives: The objectives were to assess the clinical performance and accuracy of a prototype fiberoptic transnasal laryngeal endoscope with an auxiliary optical system that allows images to be spatially calibrated. Methods: A novel fiberoptic endoscope was developed that projects green laser beams across the field of view from a separate optical channel. According to the location of the spots in the field of view, the images can be calibrated with a software routine. To assess its performance, we compared measurements of 14 lesions imaged with the calibrated endoscope and during microlaryngoscopy, where a calibration instrument was placed next to the lesions. Four clinicians measured lesion length, width, and area from the collected images. Results: The calibrated endoscope performed as well as current flexible fiberoptic laryngoscopes in terms of image quality and patient comfort. For lesions with well-defined borders, the error ranged from 14% to 23% for length, from 20% to 30% for width, and from 33% to 50% for area across observers. Factors contributing to larger errors in some subjects were identified. Conclusions: The calibrated endoscope is capable of providing useful sizing information for laryngeal structures, and these measures correspond quite well to more direct measurements in the operating room. Objective sizing of laryngeal lesions is complicated by subjective judgments of lesion boundaries, which can be indistinct in many cases. C1 Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Surg, Boston, MA 02115 USA. Phys Sci Inc, Andover, MA USA. RP Kobler, JB (reprint author), Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, 1 Bowdoin Sq 11th Floor, Boston, MA 02114 USA. CR HERTEGARD S, 1995, J SPEECH HEAR RES, V38, P85 Kobler JB, 1998, ANN OTO RHINOL LARYN, V107, P477 Larsson Hans, 2004, Logoped Phoniatr Vocol, V29, P154, DOI 10.1080/14015430410024353 ROSEN D, 2003, P 6 INT WORKSH ADV Q Schade G, 2004, LASER SURG MED, V34, P363, DOI 10.1002/lsm.20065 Schuberth S, 2002, LARYNGOSCOPE, V112, P1043, DOI 10.1097/00005537-200206000-00020 Truitt TO, 2000, ANN OTO RHINOL LARYN, V109, P128 WENOKUR R, 1993, J ACOUST SOC AM, V93, P2295, DOI 10.1121/1.406499 NR 8 TC 8 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 733 EP 740 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300004 PM 17076094 ER PT J AU Sato, K Sakamoto, K Nakashima, T AF Sato, Kiminori Sakamoto, Kikuo Nakashima, Tadashi TI Expression and distribution of CD44 and hyaluronic acid in human vocal fold mucosa SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE CD44; glycosaminoglycan; hyaluronic acid; larynx; macula flava; stellate cell; vocal fold ID AGE-RELATED-CHANGES; STORING STELLATE CELLS; MACULA FLAVA; HUMAN NEWBORN; VITAMIN; FIBERS; BIOMECHANICS; FIBROBLASTS; TISSUE AB Objectives: Expression of CD44 (a cell surface receptor for hyaluronic acid) and the distribution of hyaluronic acid were examined in the human vocal fold mucosa. Methods: Light microscopic investigation was carried out on 10 normal larynges of newborn, infant, younger adult, and older adults with Alcian blue staining, a hyaluronidase digestion study, and immunohistochemistry for CD44. Results: Before the appearance of hyaluronic acid in the newborn vocal fold mucosa, CD44 was expressed on the stellate cells in the macula flava and on the fibroblasts in Reinke's space. During infancy, hyaluronic acid appeared and was distributed in the vocal fold mucosa. Many more stellate cells in the macula flava showed CD44 expression, and a large amount of hyaluronic acid was present around the infant stellate cells; however, the fibroblasts in Reinke's space expressed little CD44. During adulthood, hyaluronic acid was distributed in the vocal fold mucosa. Almost all of the stellate cells in the macula flava showed CD44 expression, and much hyaluronic acid existed around the stellate cells in the adult macula flava. However, fibroblasts in the adult Reinke's space expressed little CD44, and hyaluronic acid density in that space was lower than that in the macula flava. Conclusions: Stellate cells in the macula flava and CD44 cooperatively play important roles in maintaining hyaluronic acid in the human vocal fold mucosa as a vibrating tissue. C1 Kurume Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Kurume, Fukuoka 8300011, Japan. RP Sato, K (reprint author), Kurume Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, 67 Asahi Machi, Kurume, Fukuoka 8300011, Japan. CR ARUFFO A, 1990, CELL, V61, P1303, DOI 10.1016/0092-8674(90)90694-A Chan RW, 2001, OTOLARYNG HEAD NECK, V124, P607, DOI 10.1067/mhn.2001.115906 DELUCA L, 1968, ARCH BIOCHEM BIOPHYS, V123, P1, DOI 10.1016/0003-9861(68)90097-0 Gray SD, 1999, LARYNGOSCOPE, V109, P845, DOI 10.1097/00005537-199906000-00001 Hirano M., 1975, OTOLOGIA FUKUOKA S1, V21, P239 Hirano M, 2000, ACTA OTO-LARYNGOL, V120, P336 Hirano M, 1999, ACTA OTO-LARYNGOL, V119, P271 HIRANO M, 1993, HISTOLOGICAL COLOR A HIRANO M, 1989, ACTA OTO-LARYNGOL, V107, P428, DOI 10.3109/00016488909127535 Hirano M., 1983, VOCAL FOLD PHYSL CON, P22 LEVI AS, 1968, BIOCHEM J, V109, P69 MATSUO K, 1984, Practica Otologica Kyoto, V77, P817 Sato K, 1997, ANN OTO RHINOL LARYN, V106, P44 SATO K, 2003, PRACT OTOL KYOTO, V96, P567 Sato K, 2003, ACTA OTO-LARYNGOL, V123, P106, DOI 10.1080/0036554021000028077 Sato K, 2004, ANN OTO RHINOL LARYN, V113, P108 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P138 Sato K, 2002, ANN OTO RHINOL LARYN, V111, P15 Sato K, 2003, DIAGNOSIS TREATMENT, P41 Sato K, 2001, ANN OTO RHINOL LARYN, V110, P319 Sato K, 1998, ANN OTO RHINOL LARYN, V107, P1023 Sato K, 1992, LARYNX JPN, V4, P84 Sato K, 2005, ANN OTO RHINOL LARYN, V114, P517 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P556 Sato K, 2003, ACTA OTO-LARYNGOL, V123, P269, DOI 10.1080/00016480310001123 Sato K, 2000, ANN OTO RHINOL LARYN, V109, P136 Sato K, 2001, ANN OTO RHINOL LARYN, V110, P417 Sato K, 1997, Nihon Jibiinkoka Gakkai Kaiho, V100, P479 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P839 SUNDARES.PR, 1966, BIOCHIM BIOPHYS ACTA, V113, P95 NR 30 TC 14 Z9 15 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 741 EP 748 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300005 PM 17076095 ER PT J AU Ushio, M Takeuchi, N Kaga, K AF Ushio, Munetaka Takeuchi, Naonobu Kaga, Kimitaka TI Evaluation of recovery from transient facial palsy following canalplasty and tympanoplasty for the treatment of congenital aural atresia SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE canalplasty; congenital aural atresia; electroneurography; facial palsy; House-Brackmann grading system ID GRADING SYSTEM; BELLS-PALSY; NERVE; SURGERY; INJURY; BONE; CT AB Objectives: Canalplasty is a surgical procedure of the external auditory canal. In this study we examined anatomic risk factors for facial nerve injury in aural atresia surgery, in addition to facial nerve outcomes and the time course of recovery in patients with facial nerve palsy following atresia surgery. Methods: Transient facial palsy was observed immediately after surgery in 6 of 99 ears (6 of 87 patients) after canalplasty and tympanoplasty for the treatment of congenital aural atresia. We assessed the course of recovery and mean scores using Jahrsdoerfer's grading system. Results: The rate of absence of the stapes and the rate of presence of positional anomalies of the facial nerve were significantly higher among cases with facial palsy, and Jahrsdoerfer total scores were significantly lower among cases with facial palsy. The mean recovery time in 5 cases with a minimum electroneurography value of 0% was 16.2 weeks (range, 14 to 18 weeks). No trends during recovery were detected for the nerve excitability test and R1 components of the blink reflex. Conclusions: The anatomic conditions that cause a predisposition to transient facial palsy include absence of the stapes and the presence of positional anomalies of the facial nerve. Although some patients displayed transient facial palsy after surgery, all patients fully recovered. Mechanisms of facial nerve injury are proposed. C1 Univ Tokyo, Dept Otolaryngol, Bunkyo Ku, Tokyo 1138655, Japan. RP Ushio, M (reprint author), Univ Tokyo, Dept Otolaryngol, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1138655, Japan. 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Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 749 EP 753 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300006 PM 17076096 ER PT J AU Murry, T Tabaee, A Owczarzak, V Aviv, JE AF Murry, Thomas Tabaee, Abtin Owczarzak, Vicki Aviv, Jonathan E. TI Respiratory retraining therapy and management of laryngopharyngeal reflux in the treatment of patients with cough and paradoxical vocal fold movement disorder SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE acid reflux; cough; paradoxical vocal fold motion; respiratory retraining therapy ID CORD MOTION; GASTROESOPHAGEAL-REFLUX; DYSFUNCTION; STRIDOR; ASTHMA AB Objectives: We describe the outcome of patients with cough and paradoxical vocal fold movement disorder (PVFMD) treated with respiratory retraining therapy and management of laryngopharyngeal reflux (LPR). Methods: Twenty patients with the complaint of cough were given a diagnosis of PVFMD and treated with proton pump inhibitors for a minimum of 6 months followed by 3 to 5 sessions of respiratory retraining therapy. Pulmonary function testing (PFT) and subjective rating of cough and reflux (reflux symptom index; RSI) were performed. Also, PFT and rating of cough were performed on a group of 10 healthy volunteers with no complaint of cough. Results: The study group comprised 13 women and 7 men. The baseline cough rating and ratio of forced inspiratory volume at 0.5 second to forced inspiratory vital capacity (FIV0.5/FIVC) on PFT were significantly worse in the treatment group than in the control group. After therapy, 20 patients (100%) experienced improvement in cough, 19 patients (95%) experienced improvement on PFT, and 17 patients (85%) experienced improvement in the RSI score. The differences were statistically significant. Conclusions: Respiratory retraining therapy combined with management of LPR is an effective treatment for patients with cough and PVFMD when a single-modality treatment is not sufficient. C1 New York Presbyterian Hosp, Dept Otolaryngol Head & Neck Surg, New York, NY 10032 USA. Columbia Univ, Coll Phys & Surg, New York, NY 10027 USA. RP Murry, T (reprint author), New York Presbyterian Hosp, Dept Otolaryngol Head & Neck Surg, HP 8th Floor,180 Ft Washington Ave, New York, NY 10032 USA. CR Altman KW, 2002, OTOLARYNG HEAD NECK, V127, P501, DOI 10.1067/mhn.2002.127589 Andrianopoulos MV, 2000, J VOICE, V14, P607, DOI 10.1016/S0892-1997(00)80016-8 Belafsky PC, 2002, J VOICE, V16, P274, DOI 10.1016/S0892-1997(02)00097-8 BLAGER FB, 1995, AM SPEECH HEARING AS, V5, P8 CHRISTOPHER KL, 1983, NEW ENGL J MED, V308, P1566, DOI 10.1056/NEJM198306303082605 Harding SM, 1997, CHEST, V111, P1389, DOI 10.1378/chest.111.5.1389 ING AJ, 1994, AM J RESP CRIT CARE, V149, P160 Irwin RS, 2000, NEW ENGL J MED, V343, P1715, DOI 10.1056/NEJM200012073432308 Loughlin CJ, 1996, LARYNGOSCOPE, V106, P1506, DOI 10.1097/00005537-199612000-00012 MARTIN RJ, 1987, SEMIN RESPIR MED, V8, P332, DOI 10.1055/s-2007-1012672 Maschka DA, 1997, LARYNGOSCOPE, V107, P1429, DOI 10.1097/00005537-199711000-00002 Murry T, 2004, LARYNGOSCOPE, V114, P1341, DOI 10.1097/00005537-200408000-00005 Murry Thomas, 1998, Seminars in Speech and Language, V19, P83, DOI 10.1055/s-2008-1064038 NEWMAN KB, 1995, AM J RESP CRIT CARE, V152, P1382 OCONNELL MA, 1995, ANN ALLERG ASTHMA IM, V74, P341 Patel NJ, 2004, OTOLARYNG HEAD NECK, V130, P686, DOI 10.1016/j.otohns.2004.01.003 PATTERSO.R, 1974, CLIN ALLERGY, V4, P307, DOI 10.1111/j.1365-2222.1974.tb01390.x ROGERS JH, 1978, J LARYNGOL OTOL, V92, P157, DOI 10.1017/S0022215100085169 ROSEN DC, 1997, PSYCHOL VOICE DISORD, P151 Treole K, 1999, J VOICE, V13, P143, DOI 10.1016/S0892-1997(99)80068-X NR 20 TC 17 Z9 19 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 754 EP 758 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300007 PM 17076097 ER PT J AU Sasaki, CT Yu, ZW Xu, JJ Hundal, J Rosenblatt, W AF Sasaki, Clarence T. Yu, Ziwei Xu, Jiajun Hundal, Jagdeep Rosenblatt, William TI Effects of altered consciousness on the protective glottic closure reflex SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE altered consciousness; glottic closure reflex; larynx ID SUPERIOR LARYNGEAL NERVE; ASPIRATION; SLEEP AB Objectives: The sphincteric function of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal folds. We hypothesize that central facilitation is an essential component of a bilateral brain stem-mediated adductor reflex and that its disturbance by altered consciousness or physiologic sleep could result in weakened sphincteric closure. Methods: In 10 adult pigs the glottic closure response was evaluated under light and deep isoflurane anesthesia. The internal branch of the left superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes, and recording electrodes were positioned in the ipsilateral and contralateral thyroarytenoid muscles. The force of evoked glottic closure was measured with a pressure transducer positioned between the vocal folds. Results: Consistent threshold responses (> 90%) were obtained ipsilaterally from 0.5 to 2.0 minimal alveolar concentration (MAC) anesthesia. However, the contralateral reflex responses declined to 6.4% in successive trials as anesthetic levels approached 1.5 to 2.0 MAC. Furthermore, glottic closing force closely reflected these electromyographic changes, declining from 383 mm Hg at 0.5 to 1.0 MAC to 114 mm Hg at 1.5 to 2.0 MAC. Conclusions: Alteration of central facilitation by progressively deeper loss of consciousness abolishes a lower brain stem-mediated crossed adductor reflex, predisposing the subject to a weakened glottic closure response. C1 Yale Univ, Sch Med, Otolaryngol Sect, New Haven, CT 06520 USA. RP Sasaki, CT (reprint author), Yale Univ, Sch Med, Otolaryngol Sect, 333 Cedar St,POB 208041, New Haven, CT 06520 USA. CR BLITT CD, 1990, MONITORING ANESTHESI, P450 Drummond J, 2000, ANESTHESIA, P695 GODING GS, 1987, OTOLARYNG HEAD NECK, V97, P28 Hunter JD, 1998, RESP PHYSIOL, V112, P71, DOI 10.1016/S0034-5687(98)00018-8 HUXLEY EJ, 1978, AM J MED, V64, P564, DOI 10.1016/0002-9343(78)90574-0 Kim YH, 2001, ACTA OTO-LARYNGOL, V121, P310 LEAR C. S. C., 1965, ARCH ORAL BIOL, V10, P83, DOI 10.1016/0003-9969(65)90060-9 LERMAN J, 1990, ANESTHESIOLOGY, V73, P717, DOI 10.1097/00000542-199010000-00018 LUDLOW CL, 1992, ANN OTO RHINOL LARYN, V101, P127 Medda BK, 2003, AM J PHYSIOL-GASTR L, V284, pG933, DOI 10.1152/ajpgi.00395.2002 NUNEZ A, 1992, NEUROSCIENCE, V51, P269, DOI 10.1016/0306-4522(92)90314-R Orr WC, 2001, SLEEP MED REV, V5, P91, DOI 10.1053/smrv.2000.0149 PASRICHA PJ, 2003, AM J MED S3A, V115, pA114 ROY TM, 1989, CHEST, V96, P852, DOI 10.1378/chest.96.4.852 SASAKI CT, 2001, ANN OTOLRHINOLLARYNG, V100, P401 SASAKI CT, 1976, ARCH OTOLARYNGOL, V102, P400 Shifrin RY, 1996, RADIOL CLIN N AM, V34, P83 Sleigh JW, 1999, ANESTH ANALG, V88, P659, DOI 10.1097/00000539-199903000-00035 Steriade M, 1996, J NEUROSCI, V16, P2788 SUZUKI M, 1977, ANN OTO RHINOL LARYN, V86, P30 VINCENT MT, 1994, AM FAM PHYSICIAN, V49, P1815 NR 21 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 759 EP 763 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300008 PM 17076098 ER PT J AU Cobell, W Duflo, SM Magrufov, A Thibeault, SL AF Cobell, Will Duflo, Suzy M. Magrufov, Akhmar Thibeault, Susan L. TI Fine needle aspiration of the vocal fold lamina propria in an animal model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE biomechanical properties; collagen; elastin; fine needle aspiration; scar; vocal fold ID RABBIT MODEL; BIOPSY; LESIONS AB Objectives: The development of a minimally invasive fine needle aspiration (FNA) technique for vocal fold (VF) biopsy would have far-reaching implications and applicability in laryngology. The objective of this study was to determine whether FNA of the VF lamina propria is feasible and whether it causes injury to the VF. Methods: Unilateral VF FNA was performed with a 26-gauge needle on 20 rabbits. The INA cell collection of the lamina propria was confirmed by cytology. Four weeks after the FNA, the rabbits were painlessly sacrificed and the larynges were harvested. Histologic analysis of the VF lamina propria included Masson's trichrome and elastin-van Gieson stains. The linear viscoelastic shear properties, elastic modulus, and viscous modulus of the tissue were measured. Results: Compared to the contralateral normal VFs, those VFs that underwent FNA demonstrated no significant differences in levels of collagen (p = .17) and elastin (p = .94). Rheologically, the elastic shear modulus and viscous modulus did not significantly differ between the normal and FNA VFs (p = .9380 and p = .9359, respectively). Conclusions: Fine needle aspiration of the VF lamina propria is feasible without injury and offers a potentially promising, less invasive alternative to be developed for future diagnostic and therapeutic management of VF lesions. C1 Univ Utah, Sch Med, Dept Surg, Div Otolaryngol Head & Neck Surg, Salt Lake City, UT 84112 USA. RP Thibeault, SL (reprint author), Univ Wisconsin, Sch Med & Publ Hlth, Div Otolaryngol Head & Neck Surg, Madison, WI 53792 USA. CR Amedee RG, 2001, LARYNGOSCOPE, V111, P1551, DOI 10.1097/00005537-200109000-00011 Behrman A, 2004, LARYNGOSCOPE, V114, P1693, DOI 10.1097/00005537-200410000-00004 BOTTLES K, 1986, AM J MED, V81, P525, DOI 10.1016/0002-9343(86)90309-8 Cannon CR, 2000, OTOLARYNG HEAD NECK, V123, P563, DOI 10.1067/mhn.2000.110615 Courey MS, 1997, LARYNGOSCOPE, V107, P340, DOI 10.1097/00005537-199703000-00012 DUFLO S, IN PRESS TISSUE ENG FRABLE WJ, 1983, HUM PATHOL, V14, P9, DOI 10.1016/S0046-8177(83)80042-2 Hansen JK, 2005, ANN OTO RHINOL LARYN, V114, P662 KAMINSKY DB, 1984, ACTA CYTOL, V28, P333 Klemuk SA, 2004, LARYNGOSCOPE, V114, P1597, DOI 10.1097/00005537-200409000-00018 LAYFIELD LJ, 1993, CANCER, V72, P1642, DOI 10.1002/1097-0142(19930901)72:5<1642::AID-CNCR2820720525>3.0.CO;2-8 OERTEL YC, 1993, SOUTHERN MED J, V86, P282 ORELL SR, 1982, PATHOLOGY, V14, P113 Rimm DL, 1997, CANCER CYTOPATHOL, V81, P51, DOI 10.1002/(SICI)1097-0142(19970225)81:1<51::AID-CNCR11>3.0.CO;2-B Rousseau B, 2004, J VOICE, V18, P116, DOI 10.1016/j.jvoice.2003.06.001 Roy N, 2004, J SPEECH LANG HEAR R, V47, P358, DOI 10.1044/1092-4388(2004/029) Thibeault SL, 2002, J VOICE, V16, P96, DOI 10.1016/S0892-1997(02)00078-4 Vargas Hernan I, 2003, Breast J, V9 Suppl 2, pS81, DOI 10.1046/j.1524-4741.9.s2.8.x NR 18 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 764 EP 768 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300009 PM 17076099 ER PT J AU Hashimoto, K Seki, M Miyasaka, H Watanabe, K AF Hashimoto, Kazuya Seki, Morihiro Miyasaka, Hiroe Watanabe, Kensuke TI Effect of steroids on increased permeability of blood vessels of the stria vascularis after auditory ossicle vibration by a drill in otologic surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE ear drill; steroids; stria vascularis; vascular permeability ID CHRONIC EAR SURGERY; SENSORINEURAL HEARING-LOSS; HORSERADISH-PEROXIDASE; CAPILLARY-PERMEABILITY; HEAD-INJURY; RADICALS AB Objectives: The vibration caused by drills used for middle ear surgery is considered one of the causes of postoperative sensorineural deafness. Seki et al reported that when drill-induced damage was created in the auditory ossicles of guinea pigs, permeability across the capillary vessels in the stria vascularis increased significantly with the duration of drill-induced vibration. The present study was undertaken to examine changes in permeability across the stria vascularis capillaries following vibration in experimental animals pretreated with steroids, with the goal of developing a method of preventing a vibration-induced increase in permeability across these capillaries. Methods: After an intravenous dose of hydrocortisone and horseradish peroxidase, the auditory ossicles of guinea pigs were vibrated with a drill for 60 seconds. Results: Intravenous steroid administration before vibration reduced the leakage of horseradish peroxidase from the stria vascularis capillaries after vibration. Conclusions: The findings suggested that steroids suppress the increase in permeability across the stria vascularis capillaries that results from drill-induced vibration. C1 Dokkyo Univ, Sch Med, Koshigaya Hosp, Dept Otorhinolaryngol, Koshigaya, Saitama 3438555, Japan. RP Watanabe, K (reprint author), Dokkyo Univ, Sch Med, Koshigaya Hosp, Dept Otorhinolaryngol, 2-1-50 Minami Kosigaya, Koshigaya, Saitama 3438555, Japan. CR BLOMSTRAND C, 1975, ACTA NEUROL SCAND, V52, P331 COPLEY AL, 1964, LIFE SCI, V3, P65, DOI 10.1016/0024-3205(64)90181-X COTRAN RS, 1967, P SOC EXP BIOL MED, V126, P557 EISENBERG HM, 1976, ARCH NEUROL-CHICAGO, V23, P18 GIROTTI AW, 1984, J BIOL CHEM, V259, P1744 HALL ED, 1993, J NEUROCHEM, V60, P588, DOI 10.1111/j.1471-4159.1993.tb03189.x HALL ED, 1992, J NEUROTRAUMA, V9, P425 HALLIWELL B, 1992, J NEUROCHEM, V59, P1609, DOI 10.1111/j.1471-4159.1992.tb10990.x HUKEE MJ, 1985, ANN OTO RHINOL LARYN, V94, P297 JESBERGER JA, 1991, INT J NEUROSCI, V57, P1, DOI 10.3109/00207459109150342 LANGFITT TW, 1982, CLIN NEUR, V29, P353 Miyasaka H, 1999, Nihon Jibiinkoka Gakkai Kaiho, V102, P1249 PALVA T, 1973, ARCH OTOLARYNGOL, V98, P176 RIZVI SS, 1980, ARCH OTOLARYNGOL, V106, P751 Seki M, 2001, ANN OTO RHINOL LARYN, V110, P122 SMYTH GDL, 1977, ANN OTO RHINOL LARYN, V86, P3 TOS M, 1984, ANN OTO RHINOL LARYN, V93, P403 WATANABE K, 1990, ANN OTO RHINOL LARYN, V99, P660 Watanabe K, 1997, ANN OTO RHINOL LARYN, V106, P394 WATANABE K, 1986, ANN OTO RHINOL LARYN, V95, P427 XU RD, 1994, ORL J OTO-RHINO-LARY, V56, P183 NR 21 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 769 EP 774 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300010 PM 17076100 ER PT J AU Ylitalo, R Thibeault, SL AF Ylitalo, Riitta Thibeault, Susan L. TI Relationship between time of exposure of laryngopharyngeal reflux and gene expression in laryngeal fibroblasts SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE cell culture; decorin; extraesophageal reflux; gene expression; growth factor; matrix metalloproteinase; pepsin ID GASTROESOPHAGEAL-REFLUX; HEALTHY-VOLUNTEERS; GROWTH-FACTOR; PH 5; ACID; DISEASE; SYMPTOMS; PEPSIN; INJURY; PSEUDOSULCUS AB Objectives: Acid reflux is damaging to the laryngeal mucosa; however, the significance of the duration of reflux episodes has not been evaluated. The purpose of this study was to determine whether varying the exposure times at low pH with or without pepsin alters gene expression in laryngeal fibroblasts. Methods: Human false vocal fold and postcricoidal cultures were exposed to pH 4 or pH 5 media with and without pepsin for 10, 30, 60, and 240 seconds. Using a real-time polymerase chain reaction, we determined the messenger RNA expression of TGf beta-1, VEGF, FGF-2, EGR-1, ATF-3, CTGF, MMP-1, MMP-2, and decorin. Results: Molecular responses were initiated at pH 5. Postcricoidal fibroblasts were more sensitive than false vocal fold fibroblasts to the presence of pepsin. Changes in transcript levels were dependent on acid exposure time, and the most significant changes were measured during the first 60 seconds after exposure. Conclusions: Time of exposure to acid and pepsin needs to be taken into consideration when determining limit of pathology in pharyngeal reflux. Genes are identified that are induced by low pH and that may be of potential importance in the pathogenesis of reflux laryngitis. C1 Karolinska Inst, Dept Otolaryngol Head & Neck Surg, S-10401 Stockholm, Sweden. Umea Univ, Dept Clin Sci Otolaryngol, S-90187 Umea, Sweden. Univ Utah, Dept Surg, Div Otolaryngol Head & Neck Surg, Salt Lake City, UT 84112 USA. RP Ylitalo, R (reprint author), Karolinska Univ Hosp, Dept Otolaryngol Head & Neck Surg, S-14186 Huddinge, Sweden. 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Otol. Rhinol. Laryngol. PD OCT PY 2006 VL 115 IS 10 BP 775 EP 783 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300011 PM 17076101 ER PT J AU Boseley, ME Hartnick, CJ AF Boseley, Mark E. Hartnick, Christopher J. TI Development of the human true vocal fold: Depth of cell layers and quantifying cell types within the lamina propria SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE development; lamina propria; larynx; phonosurgery ID HUMAN NEWBORN AB Objectives: We sought to further describe the development of the 3-layered human vocal fold in children and to quantify macrophage and myofibroblast concentrations in each layer. Methods: We used an optical analysis software package to examine 8 longitudinally sectioned human vocal folds that had been fixed in formalin (ages 2 days to 14 years). Results: The 2-day-old vocal fold contained only a monolayer of cells. This became a bilayer by 5 months, and a trilayer began to become evident by 7 years. The percent of total depth represented by the superficial layer of the lamina propria (SLP) gradually decreased with age. The SLP made up 22% of the total lamina propria by age 7 years; this percentage approximates that in the adult vocal fold. Macrophages and myofibroblasts were predominately found in the SLP, and began to be apparent by 11 months of age. Conclusions: These results help describe the development of human voice and may have implications as to when phonosurgical therapy can be considered for children. C1 Massachusetts Eye & Ear Infirm, Dept Otol & Laryngol, Boston, MA 02115 USA. RP Hartnick, CJ (reprint author), 325 Cambridge St, Boston, MA 02115 USA. 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PD OCT PY 2006 VL 115 IS 10 BP 784 EP 788 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 095XJ UT WOS:000241341300012 PM 17076102 ER PT J AU Kennedy, DW AF Kennedy, David W. TI Technical innovations and the evolution of endoscopic sinus surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE endoscopy; microdebrider; robotics; sinuplasty; transnasal approach ID FRONTAL-SINUS; HEAD; EXPERIENCE; HOLMIUM AB Since the introduction of endoscopic sinus surgery, a number of significant technological advances, as well as an improved understanding of disease pathogenesis and management, have enabled major evolutions in surgical techniques. Modifications to surgical instruments, imaging, the development of the microdebrider, and other newer instrumentation have all contributed to the current level of patient success associated with endoscopic intranasal techniques. At the same time, it has become evident that anatomic variations are less important in the pathogenesis of chronic rhinosinusitis than was previously thought, and that ventilation alone is insufficient to resolve well-established disease. This paper reviews the changes that have occurred in endoscopic sinus surgery over the past 20 years since the techniques were first introduced into the United States, and the technologies that have enabled these changes and the development of extended endoscopic techniques. Continuing developments of interactive computer-guided surgery, endoscopic 3-dimensional imagery, robotics, and improved adjunctive therapies will further extend the role of endoscopic transnasal approaches to an expanded number of skull base and intracranial lesions. C1 Univ Penn, Med Ctr, Div Rhinol, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. RP Kennedy, DW (reprint author), Univ Penn, Med Ctr, Div Rhinol, Dept Otorhinolaryngol Head & Neck Surg, 5 Silverstein Ravdin,3400 Spruce St, Philadelphia, PA 19104 USA. CR Anon JB, 1997, OTOLARYNG CLIN N AM, V30, P389 Bale RJ, 1997, LARYNGOSCOPE, V107, P373, DOI 10.1097/00005537-199703000-00018 Berci G, 1996, SURG ENDOSC-ULTRAS, V10, P1123, DOI 10.1007/s004649900261 BOLGER W, 2005, ANN M AM RHIN SOC LO Brown CL, 2006, ANN OTO RHINOL LARYN, V115, P293 Chandra RK, 2004, LARYNGOSCOPE, V114, P188, DOI 10.1097/00005537-200402000-00002 Cohen Noam A, 2005, Curr Opin Otolaryngol Head Neck Surg, V13, P32, DOI 10.1097/00020840-200502000-00009 Hilding A, 1933, ARCHIV OTOLARYNGOL, V17, P760 Hosemann W, 2000, THORAX, V55, pS87, DOI 10.1136/thorax.55.suppl_2.S87 JACOBS IB, 1997, LARYNGOSCOPE S83, V107 Jennings CR, 1998, ARCH OTOLARYNGOL, V124, P1042 KENNEDY DW, 1989, ANN OTO RHINOL LARYN, V98, P901 KENNEDY DW, 2000, DIS SINUSES DIAGNOSI, P197 Knappe V, 2004, PHOTOMED LASER SURG, V22, P411, DOI 10.1089/1549541042555668 Krouse J H, 1996, Ear Nose Throat J, V75, P42 MCCLAY J, 2006, PEDIAT SINUSITIS SUR Messerklinger W, 1978, ENDOSCOPY NOSE Messerklinger W, 1994, Ear Nose Throat J, V73, P449 Moharir VM, 1998, LARYNGOSCOPE, V108, P1592, DOI 10.1097/00005537-199811000-00002 Moriyama H, 1996, AM J RHINOL, V10, P61, DOI 10.2500/105065896781795067 Palmer JN, 2005, OTOLARYNG CLIN N AM, V38, P419, DOI 10.1016/j.otc.2004.10.023 Parsons DS, 1996, OTOLARYNG CLIN N AM, V29, P105 Pownell PH, 1997, PLAST RECONSTR SURG, V99, P1451, DOI 10.1097/00006534-199704001-00042 Romashko AA, 2005, OTOLARYNG HEAD NECK, V132, P407, DOI 10.1016/j.otohns.2004.10.002 Schaefer SD, 1998, LARYNGOSCOPE, V108, P1628, DOI 10.1097/00005537-199811000-00008 Schuman D M, 1994, J Clin Laser Med Surg, V12, P333 Setliff R C 3rd, 1996, Otolaryngol Clin North Am, V29, P95 SHAPSHAY SM, 1992, LARYNGOSCOPE, V102, P1177, DOI 10.1288/00005537-199210000-00014 SHAPSHAY SM, 1991, LARYNGOSCOPE, V101, P142 Slack R, 1998, AM FAM PHYSICIAN, V58, P707 Weber AL, 2001, RADIOLOGY, V218, P15 Woodham Jeremy, 1995, P3 NR 32 TC 11 Z9 12 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 SU 196 BP 3 EP 12 PN 2 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 088IB UT WOS:000240804300002 ER PT J AU Chiu, AG AF Chiu, Alexander G. TI Frontal sinus surgery: Its evolution, present standard of care, and recommendations for current use SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE chronic rhinitis; chronic sinusitis; frontal sinus ID FOLLOW-UP; OBLITERATION; EXPERIENCE; MANAGEMENT; OPERATIONS; RATIONALE; LOTHROP; RECESS AB From a historical perspective, frontal sinus surgery has evolved from radical, highly invasive, disfiguring approaches to function-preserving, minimally invasive, and non-disfiguring intranasal procedures. Most sinus surgeons would agree that a sound surgical procedure is one that relieves patients' symptoms and provides a safe sinus in which future intracranial and orbital complications will not occur. For the future, sinus surgeons are searching for the ideal procedure, ie, one that is minimally invasive, reversible, and ensures the patient a safe frontal sinus for the long term. The ideal surgery will also leave minimal morbidity, will leave no cosmetic defect, and will allow for easy postoperative surveillance. To achieve this new standard in frontal sinus surgery, continuous refinements are required in the medical management and understanding of the disease processes that undermine long-term surgical success. Further advancements in instrumentation and visualization techniques are also necessary to enhance surgical precision, spare mucosa, and prevent the scarring and neo-osteogenesis that may cause surgical failures. Perhaps the most important development may be in the selection criteria for appropriate candidates who will benefit most from frontal sinus surgery. C1 Univ Penn, Div Rhinol, Dept Otorhinolaryngol Head & Neck Surg, Med Ctr, Philadelphia, PA 19104 USA. RP Chiu, AG (reprint author), Univ Penn, Div Rhinol, Dept Otorhinolaryngol Head & Neck Surg, Med Ctr, 5 Silverstein Ravdin,3400 Spruce St, Philadelphia, PA 19104 USA. 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Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 SU 196 BP 13 EP 19 PN 2 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 088IB UT WOS:000240804300003 ER PT J AU Cohen, NA AF Cohen, Noam A. TI Sinonasal mucociliary clearance in health and disease SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cilia; mucociliary clearance ID CILIARY-BEAT FREQUENCY; ENDOSCOPIC SINUS SURGERY; MAMMALIAN RESPIRATORY-TRACT; EPITHELIAL-CELLS; HUMAN NASAL; EXTRACELLULAR ATP; PURINERGIC STIMULATION; INTRACELLULAR CALCIUM; AIRWAY EPITHELIA; MAXILLARY SINUS AB Although much has been elucidated in the past 170 years concerning the precise mechanism of ciliary function in the healthy or diseased human respiratory system, significant questions remain. The first description of ciliary action is credited to Sharpey in 1835. However, the importance of mucosal function was not apparent until Hilding's investigations of the postsurgical canine sinus demonstrated scar formation and disruption of mucociliary clearance. Subsequently, several techniques for mucosal coverage of exposed bone, most notably by Sewall and Boyden, were reported. The underlying physiology explaining the importance of the mucosa and the concept of mucosal preservation became apparent with the description of the sinonasal mucociliary flow patterns by Messerklinger; and thus the restoration of natural sinus physiology, ie, mucociliary clearance, became the goal of both medical and surgical treatment of sinonasal inflammatory disease. Clearance of benign and pathological substances in the mucus is governed by the propulsive force of the beating cilia and the physical characteristics of the overlying mucus. The respiratory cilia continually beat in a coordinated fashion, and in times of stress (eg, exercise, infection, or fever) ciliary beat frequency increases to accelerate mucus clearance. Thus, upper airway ciliary motility is under dynamic modulation. Multiple investigations incontrovertibly demonstrate a marked decrease in sinonasal mucociliary clearance in patients with chronic rhinosinusitis. Possible explanations for this finding are 1) a reduced basal ciliary beat frequency, 2) an alteration of the viscoelastic properties of airway secretions, and/or 3) a blunted dynamic response of sinonasal cilia to environmental stimuli. Studies of the first two explanations yield conflicting results, and to date, the third possibility remains uninvestigated. A review of the current understanding of the cellular regulation of respiratory ciliary activity and its contribution to chronic rhinosinusitis is presented. C1 Univ Penn, Div Rhinol, Dept Otorhinolaryngol Head & Neck Surg, Med Ctr, Philadelphia, PA 19104 USA. RP Cohen, NA (reprint author), Univ Penn, Div Rhinol, Dept Otorhinolaryngol Head & Neck Surg, Med Ctr, 5 Silverstein Ravdin,3400 Spruce St, Philadelphia, PA 19104 USA. 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Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 SU 196 BP 20 EP 26 PN 2 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 088IB UT WOS:000240804300004 ER PT J AU Lanza, DC Dhong, HJ Tantilipikorn, P Tanabodee, J Nadel, DM Kennedy, DW AF Lanza, Donald C. Dhong, Hun-Jong Tantilipikorn, Pongsakorn Tanabodee, Jirayu Nadel, Douglas M. Kennedy, David W. TI Fungus and chronic rhinosinusitis: From bench to clinical understanding SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE Alternaria; antifungal therapy; antimycotic therapy; Aspergillus; Dematiaceae; Dematium; eosinophilia; fungal rhinosinusitis; fungal sinusitis ID ALLERGIC ASPERGILLUS SINUSITIS; IN-SITU HYBRIDIZATION; NASAL POLYPOSIS; AMPHOTERICIN-B; DOUBLE-BLIND; DIAGNOSIS; EOSINOPHILIA; IMMUNOTHERAPY; SINUSES; ENTITY AB Although fungus-related sinusitis has been described for at least 2 centuries, a more detailed pathologic description of the problem as it relates to eosinophilic disease was not detailed until 1983, when "allergic fungal sinusitis" was described histopathologically. Until then, most fungal sinus disease was perceived to occur in immunosuppressed diabetic patients with invasive fungus. It is now acknowledged that depending upon the immune status of the host, fungus-related sinus disease can take several forms. Interest in this subject matter was intensified in 1999, when it was suggested that fungi might be an important cause of most cases of chronic rhinosinusitis. This hypothesis remains controversial, and there is mounting evidence to support the multifactorial nature of chronic rhinosinusitis, which may include fungus. In fact, etiologic factors for all forms of fungus-related sinus disease are still poorly understood. The prevalence of the disease and the dominant fungal pathogen appear to vary in different geographic regions and probably are related to individual host conditions. Immunoglobulin E-mediated allergic reactions to mold appear to be associated with disease in some patients, but not in all. Although antifungal therapy is known to be lifesaving for invasive disease, its role in extramucosal disease is less well defined. Preliminary trials suggest that some systemic and topical antifungal agents are of clinical benefit in extramucosal disease. Since sinus fungi are rarely invasive in immunocompetent individuals, it is not clear whether the effects of the antifungal treatments are a result of the antifungal action itself, or due to additional properties these drugs possess. This review summarizes the available data and presents some Of Our clinical and experimental findings as to the role of fungus in chronic rhinosinusitis. C1 Univ Penn, Med Ctr, Dept Otorhinolaryngol Head & Neck Surg, Div Rhinol, Philadelphia, PA 19104 USA. RP Lanza, DC (reprint author), Sinus & Nasal Inst Florida, Carillon Outpatient Ctr, Suite 200,900 Carillon Pkwy, St Petersburg, FL 33716 USA. 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Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 SU 196 BP 27 EP 34 PN 2 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 088IB UT WOS:000240804300005 ER PT J AU Palmer, J AF Palmer, James TI Bacterial biofilms in chronic rhinosinusitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE biofilm; chronic sinusitis; human; Pseudomonas; rabbit ID PSEUDOMONAS-AERUGINOSA; SINUSITIS; MODEL AB Chronic sinusitis is a prevalent, debilitating condition, and a subpopulation of patients fails to respond to either medical or surgical intervention. Bacterial biofilms are 3-dimensional aggregates of bacteria that have special properties due to their group structure, including increased resistance to antibiotics in some forms. They have been shown to play a major role in many chronic infections, including cystic fibrosis, endocarditis, and otitis media. Evidence now suggests that they may play an important role in chronic sinusitis. Our laboratory has identified the presence of biofilms in sinonasal mucosa isolated from human patients and on stents removed after frontal sinus surgery. In addition, biofilms have been found on the sinus epithelium of rabbits infected with Pseudomonas aeruginosa, but not in rabbits infected with non-biofilm-forming P aeruginosa mutants. This animal model can provide opportunities to address the functional significance of biofilm production in the sinus cavities. A further understanding of the role of bacterial biofilms may lead to the development of more appropriate therapies for the treatment and prevention of chronic sinusitis. C1 Univ Penn, Div Rhinol, Dept Otolaryngol Head & Neck Surg, Med Ctr, Philadelphia, PA 19104 USA. RP Palmer, J (reprint author), Univ Penn, Div Rhinol, Dept Otolaryngol Head & Neck Surg, Med Ctr, 3400 Spruce St, Philadelphia, PA 19104 USA. 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PD SEP PY 2006 VL 115 IS 9 SU 196 BP 35 EP 39 PN 2 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 088IB UT WOS:000240804300006 ER PT J AU Schlosser, RJ AF Schlosser, Rodney J. TI Surfactant and its role in chronic sinusitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE lamellar body; phospholipid; surfactant; surfactant protein ID PROTEIN-D; SP-A; CYSTIC-FIBROSIS; ASPERGILLUS-FUMIGATUS; MUCOSAL SURFACES; LIPOPOLYSACCHARIDE; LOCALIZATION; INFLAMMATION; ASTHMA; SP-A2 AB Although numerous studies have focused on the nature and defensive role of surfactant in the lower airways, relatively little is known about its role in the upper airways. Decreased levels of the main component of surfactant-phospholipids-have been implicated in atrophic rhinitis. The lamellar body arrangement of phospholipids has now been demonstrated in both normal and diseased sinus tissue, resulting in the implication that these structures may play a crucial role in mucociliary clearance against inhaled pathogens, as well as in the regulation of mucous viscosity. Furthermore, they may be secreted from sinonasal ciliated epithelium. Surfactant proteins (SPs) make up a relatively smaller proportion of surfactant, but appear to have an important role in innate immunity. Altered levels of SPs have been observed in a number of respiratory tract diseases. These SPs may prove to play a significant role in chronic sinusitis. Demonstrated expression of SP-A and SP-D in diseased and normal sinus tissue may mean that these SPs are excreted into the airway-lining fluid of the sinuses. Additionally, initial contact and interaction between pathogens and SP-A and SP-D may occur relatively early after inhalation and deposition into the mucus of the respiratory tract. These findings may lead to potential therapeutic options for difficult-to-treat sinus disease in the future. C1 Med Univ S Carolina, Dept Otolaryngol Head & Neck Surg, Div Rhinol & Sinus Surg, Charleston, SC 29425 USA. RP Schlosser, RJ (reprint author), Med Univ S Carolina, Dept Otolaryngol Head & Neck Surg, Div Rhinol & Sinus Surg, 135 Rutledge Ave,Suite 1130,POB 250550, Charleston, SC 29425 USA. 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Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 SU 196 BP 40 EP 44 PN 2 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 088IB UT WOS:000240804300007 ER PT J AU Stamm, AM AF Stamm, Aldo M. TI Transnasal endoscopy-assisted skull base surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE endoscopy; sinus; surgery AB Skull base surgery (SBS), which originated in the 19th century, became refined in the 20th century in parallel with technological advancements and is now in the midst of further refinements largely driven by advances in endoscopic sinus surgery. With the development of modern SBS, lesions that were once inoperable and potentially fatal can now be eradicated successfully by means of endoscopy-assisted procedures that reduce or completely eliminate intracranial trauma, minimize postsurgical morbidity, and make full recovery possible. It is absolutely mandatory to have the appropriate instrumentation for endoscopy-assisted SBS. Among the new technologies available are advanced endoscopes, high-speed suction irrigation drills, digital video cameras, computed tomography and magnetic resonance imaging, and systems for 3-dimensional computer-assisted image-guided surgical navigation. An experienced endoscopic surgeon working with multidisciplinary teams, and using new instrumentation and techniques, can bring SBS to new levels of success in the 21st century. C1 Univ Fed Sao Paulo, Sao Paulo Otolaryngol Ctr, Sao Paulo, Brazil. RP Stamm, AM (reprint author), Sao Paulo ENT Ctr, Rua Afonso Braz,525-CJ13, BR-04511011 Sao Paulo, Brazil. 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PD SEP PY 2006 VL 115 IS 9 SU 196 BP 45 EP 53 PN 2 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 088IB UT WOS:000240804300008 ER PT J AU Vining, EM AF Vining, Eugenia M. TI Evolution of medical management of chronic rhinosinusitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE antibiotics; chronic rhinosinusitis; corticosteroids; macrolides ID ALLERGIC FUNGAL SINUSITIS; CYSTIC-FIBROSIS; INTRAVENOUS ANTIBIOTICS; CONTROLLED-TRIAL; MAXILLARY SINUS; ETHMOID BONE; QT INTERVAL; THERAPY; CULTURES AB Chronic rhinosinusitis (CRS) is a surprisingly common, poorly defined, and notoriously difficult-to-treat disease. It has a complex pathophysiology that often, but not always, involves nasal or paranasal sinus infection. Anatomic variations that predispose the sinuses to obstruction may play a role, but are unusual sole causes of chronic disease. Other possible causative factors include allergic or nonallergic inflammation, mucociliary dysfunction, aspirin intolerance (Samter's triad), immunodeficiency, and cystic fibrosis. Although a majority of patients achieve long-term relief from CRS after successful endoscopic sinus surgery, a significant proportion do not, and are likely to benefit from sustained postsurgical medical therapy. Medical therapy for CRS may include treatment with corticosteroids, antibiotics, antifungal agents, antihistamines, leukotriene modifiers, nasal decongestants, mucolytics, and nasal irrigations. The selection of appropriate medical therapy is based on endoscopic evaluation, sinus cultures, and symptoms. Computed tomography, the imaging standard for evaluation of the sinuses, provides information about the extent and distribution of mucosal disease beyond what is visible endoscopically. Because it fails to provide information on the origin of the mucosal changes, computed tomography provides limited information to guide medical therapy. C1 Yale Univ, Otolaryngol Sect, Dept Surg, Sch Med, New Haven, CT USA. Univ Hosp St Rafael, Otolaryngol Sect, New Haven, CT USA. RP Vining, EM (reprint author), Ear Nose & Throat med & Surg Grp LLC, 46 Prince St,Suite 601, New Haven, CT 06519 USA. 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Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 SU 196 BP 54 EP 60 PN 2 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 088IB UT WOS:000240804300009 ER PT J AU Zinreich, SJ AF Zinreich, S. James TI Progress in sinonasal imaging SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE computed tomography; imaging; sinonasal structures ID ENDOSCOPIC SINUS SURGERY; COMPUTED-TOMOGRAPHY; CT AB Imaging of sinonasal structures has evolved from standard radiographs to the much more complicated and informative techniques used today. The plain radiograph was useful when the surgical techniques practiced were primarily aimed at the maxillary and frontal sinuses. With a better understanding of the mucociliary clearance of the nasal cavity and the paranasal sinuses, the surgical technique was shifted to the ethmoid sinuses and became more focal, thus needing a better understanding and display of the intricate morphology of the nasal cavity and paranasal sinuses. Polytomography was a step above plain radiographs and was first used in the display of the regional anatomy for the development of functional endoscopic sinus surgery. Polytomography was quickly replaced by computed tomography, as this imaging technique provides a much more detailed view of the sinonasal architecture than does polytomography. Magnetic resonance imaging has also shown usefulness in imaging this morphological area, as it provides better soft tissue resolution, but it does not allow good visualization of bony structures. Newer computer systems with software capable of reconstructing the digitized information into a 3-dimensional display further enhance our understanding of the regional morphology and afford an improved means of correlating the imaging and endoscopic information. Furthermore, stereotactic navigation systems allow surgeons the ability to visualize the endoscope-instrument tip position, as instruments are actively being used during surgery, on the computed tomographic and/or magnetic resonance images. There is a persistent trend toward reducing the size of the imaging equipment to render it more mobile (computed tomography) and adapt it for operating room use. C1 Johns Hopkins Med Inst, Dept Radiol, Baltimore, MD 21287 USA. RP Zinreich, SJ (reprint author), Johns Hopkins Med Inst, Dept Radiol, 600 N Wolfe St,Phipps,B100, Baltimore, MD 21287 USA. CR DAVIDSON TM, 1989, HEAD NECK-J SCI SPEC, V11, P405, DOI 10.1002/hed.2880110505 Frush DP, 2003, PEDIATRICS, V112, P951, DOI 10.1542/peds.112.4.951 Ishii M, 2003, ACAD RADIOL, V10, P373, DOI 10.1016/S1076-6332(03)80025-9 KENNEDY DW, 1985, ARCH OTOLARYNGOL, V111, P576 Lund Valerie J., 1993, Rhinology (Utrecht), V31, P183 Melhem ER, 1996, AM J NEURORADIOL, V17, P181 Messerklinger W, 1978, ENDOSCOPY NOSE Okuyemi KS, 2002, AM FAM PHYSICIAN, V66, P1882 Slovis TL, 2003, PEDIATRICS, V112, P971, DOI 10.1542/peds.112.4.971 Vining E M, 1994, Ear Nose Throat J, V73, P456 ZINREICH SJ, 1988, RADIOLOGY, V169, P439 ZINREICH SJ, 1987, RADIOLOGY, V163, P769 NR 12 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 SU 196 BP 61 EP 65 PN 2 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 088IB UT WOS:000240804300010 ER PT J AU Cable, BB Mair, EA AF Cable, Benjamin B. Mair, Eric A. TI Pediatric functional endoscopic sinus surgery: Frequently asked questions SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE paranasal sinus; pediatric endoscopic sinus surgery; sinusitis ID FACIAL GROWTH; RETROSPECTIVE ANALYSIS; SURGICAL-MANAGEMENT; ANTIBIOTIC-THERAPY; CONTROLLED-TRIAL; CHILDREN; ADENOIDECTOMY; RHINOSINUSITIS; EFFICACY; DISEASE AB Pediatric endoscopic sinus surgery is a controversial procedure that has evolved considerably over the past 2 decades. We present a current review of the literature regarding the treatment of children with refractory sinusitis with a focus on the use of endoscopic sinus surgery. Preoperative evaluation, surgical technique, postoperative care, and unusual applications are discussed. C1 Tripler Army Med Ctr, Dept Pediat Otolaryngol, Honolulu, HI 96859 USA. Charlotte EENT Associates, Div Pediat Otolaryngol, Charlotte, NC USA. RP Cable, BB (reprint author), Tripler Army Med Ctr, Dept Pediat Otolaryngol, 1 Jarrett White Rd, Honolulu, HI 96859 USA. 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Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 BP 643 EP 657 PG 15 WC Otorhinolaryngology SC Otorhinolaryngology GA 086KH UT WOS:000240671700001 PM 17044535 ER PT J AU Roberts, RA Gans, RE Johnson, EL Chisolm, T AF Roberts, Richard A. Gans, Richard E. Johnson, Erika L. Hnath Chisolm, Theresa TI Computerized dynamic visual acuity with volitional head movement in patients with vestibular dysfunction SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE bilateral vestibular dysfunction; dynamic visual acuity; oscillopsia; unilateral vestibular dysfunction; vestibulo-ocular reflex ID ILLEGIBLE E-TEST; VESTIBULOOCULAR REFLEX; OSCILLOPSIA; LOCOMOTION AB Objectives: Patients with uncompensated vestibular dysfunction frequently report blurred vision during head movement, a symptom termed oscillopsia. One way to measure the functional deficit associated with an impaired vestibulo-ocular reflex is by comparing visual acuity from a baseline condition in which there is no head movement to visual acuity obtained during a dynamic condition with head movement. A previously described test incorporated a treadmill upon which patients walked during assessment of visual acuity. The objective of the current investigation was to evaluate an alternative method of assessing dynamic visual acuity that uses volitional head movement instead of walking on a treadmill. Methods: Fifteen participants with normal vestibular function and 16 participants with impaired vestibular function were enrolled. All participants performed the visual acuity task under baseline conditions with no movement and also under dynamic conditions that included 1) walking on a treadmill and 2) volitionally moving their head in the vertical plane. Results: No difference in performance was observed between the treadmill task and the volitional head movement task. Participants with impaired vestibular function performed more poorly under the dynamic conditions than did participants with normal vestibular function. Conclusions: The results suggest that the volitional head movement paradigm may be useful in identification of patients with functional deficits of the vestibulo-ocular reflex. C1 Amer Inst Balance, Seminole, FL USA. Univ S Florida, Dept Commun Sci & Disorders, Tampa, FL USA. St Vincents Hosp, Dept Rehabil Med, New York, NY USA. RP Roberts, RA (reprint author), 11290 Pk Blvd, Seminole, FL 33772 USA. CR BHANSALI SA, 1993, OTOLARYNG HEAD NECK, V109, P120 Brickner RM, 1936, ARCH NEURO PSYCHIATR, V36, P586 Dannenbaum E, 2005, J OTOLARYNGOL, V34, P13, DOI 10.2310/7070.2005.03105 DEMER JL, 1994, AM J OTOL, V15, P340 Demer J L, 1993, J Vestib Res, V3, P101 Furman JM, 1999, J VESTIBUL RES-EQUIL, V9, P189 GROSSMAN GE, 1988, EXP BRAIN RES, V70, P470 GROSSMAN GE, 1990, ANN NEUROL, V27, P528, DOI 10.1002/ana.410270512 Herdman SJ, 1998, AM J OTOL, V19, P790 Herdman SJ, 2001, ARCH OTOLARYNGOL, V127, P1205 Hillman EJ, 1999, J VESTIBUL RES-EQUIL, V9, P49 Jacobson GP, 1997, HDB BALANCE FUNCTION, P193 LEIGH RJ, 2000, VESTIBULAR REHABILIT, P237 LONGRIDGE NS, 1987, ACTA OTO-LARYNGOL, V103, P273, DOI 10.3109/00016488709107794 LONGRIDGE NS, 1984, OTOLARYNG HEAD NECK, V92, P671 LONGRIDGE NS, 1987, J OTOLARYNGOL, V16, P97 OLEARY D, 2002, SEMIN HEAR, V23, P121, DOI 10.1055/s-2002-33003 Schubert MC, 2002, OTOL NEUROTOL, V23, P372, DOI 10.1097/00129492-200205000-00025 NR 18 TC 6 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 BP 658 EP 666 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 086KH UT WOS:000240671700002 PM 17044536 ER PT J AU Naiman, AN Ayari, S Nicollas, R Landry, G Colombeau, B Froehlich, P AF Naiman, Ana Nusa Ayari, Sonia Nicollas, Richard Landry, Guillaume Colombeau, Bruno Froehlich, Patrick TI Intermediate-term and long-term results after treatment by cidofovir and excision in juvenile laryngeal papillomatosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cidofovir; endoscopy; larynx; microdebrider; papillomatosis; surgical excision ID RECURRENT RESPIRATORY PAPILLOMATOSIS; INTRALESIONAL CIDOFOVIR; THERAPY; INJECTIONS; CHILDREN; PROTOCOL AB Objectives: We assessed the intermediate-term and long-term efficacy of intralesional injection of cidofovir used with surgical excision in juvenile-onset recurrent respiratory papillomatosis. Methods: The protocol was revised during the study, from endoscopy at 4-week intervals with intralesional injection of cidofovir at 5 mg/mL, to a 2-week interval and a 7.5-mg/mL dosage. Partial surgical excision of hypertrophic papillomas was performed before the initiation of injection. Further injections at 4-week (or 2-week) intervals were performed until complete remission. Results: Sixteen patients received a mean 8.9 injections. Complete remission was obtained in 12 patients (75%) after a mean 7.2 endoscopic treatments. Remission was stable at a mean 33.6 months' follow-up. Five of these 12 patients received 5.2 injections and remained disease-free at a mean 39.3 months' follow-up. Seven of the 12 had 1 relapse; they needed complementary treatment to become disease-free, and remained so thereafter over a mean 27.3 months' follow-up. The other 4 of the 16 patients (25%) continued to present active disease. Conclusions: Active endoscopic treatment until complete remission led to a higher-than-expected complete remission rate on intermediate-term to long-term follow-up, with or without relapse. Transient relapse was associated with a long delay in initiating cidofovir treatment. C1 Hop Edouard Herriot, Dept Otolaryngol, F-69437 Lyon 03, France. RP Froehlich, P (reprint author), Royal Hobart Hosp, Dept Otolaryngol, Hobart, Tas, Australia. CR Akst LM, 2003, ARCH OTOLARYNGOL, V129, P841, DOI 10.1001/archotol.129.8.841 Andrei G, 2001, ONCOL RES, V12, P397 Bielamowicz S, 2002, LARYNGOSCOPE, V112, P696, DOI 10.1097/00005537-200204000-00019 Chhetri DK, 2003, ARCH OTOLARYNGOL, V129, P1081, DOI 10.1001/archotol.129.10.1081 Dedo HH, 2001, LARYNGOSCOPE, V111, P1639, DOI 10.1097/00005537-200109000-00028 Derkay C, 2005, INT J PEDIATR OTORHI, V69, P1465, DOI 10.1016/j.ijporl.2005.08.007 Derkay CS, 1998, LARYNGOSCOPE, V108, P935, DOI 10.1097/00005537-199806000-00026 Derkay CS, 2005, ANN OTO RHINOL LARYN, V114, P730 Go C, 2003, ANN OTO RHINOL LARYN, V112, P298 Inglis AF, 2005, ANN OTO RHINOL LARYN, V114, P834 Milczuk HA, 2003, OTOLARYNG HEAD NECK, V128, P788, DOI 10.1016/S0194-5998(03)00259-6 Naiman AN, 2003, LARYNGOSCOPE, V113, P2174, DOI 10.1097/00005537-200312000-00024 Naiman AN, 2006, ANN OTO RHINOL LARYN, V115, P175 Neumann K, 2003, LARYNGO RHINO OTOL, V82, P700 Pransky SM, 2000, ARCH OTOLARYNGOL, V126, P1239 Pransky SM, 2003, LARYNGOSCOPE, V113, P1583, DOI 10.1097/00005537-200309000-00032 Schraff S, 2004, ARCH OTOLARYNGOL, V130, P1039, DOI 10.1001/archotol.130.9.1039 Shirley WP, 2004, INT J PEDIATR OTORHI, V68, P413, DOI 10.1016/j.ijporl.2003.11.007 Snoeck R, 1998, J MED VIROL, V54, P219, DOI 10.1002/(SICI)1096-9071(199803)54:3<219::AID-JMV13>3.0.CO;2-C Wemer RD, 2005, ANN OTO RHINOL LARYN, V114, P836 NR 20 TC 23 Z9 23 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 BP 667 EP 672 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 086KH UT WOS:000240671700003 PM 17044537 ER PT J AU Kim, ST Gang, IG Cha, HE Ha, JS Chung, YS AF Kim, Seon-Tae Gang, Il-Gyu Cha, Heung-Eog Ha, Jong-Su Chung, Yoo-Sam TI Effect of mitomycin C on the size of antrostomy after endoscopic sinus surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE antrostomy; mitomycin C ID CHRONIC MAXILLARY SINUSITIS; MIDDLE MEATUS; DACRYOCYSTORHINOSTOMY; STENOSIS; PREVENTION; SYNECHIA; PATENCY; STENTS AB Objectives: Mitomycin C (MMC) is an antibiotic-antineoplastic agent that decreases fibroblast proliferation and scar formation. We aimed to evaluate the effect of MMC on the size of antrostomy and the mucociliary clearance rate. Methods: We selected 20 patients with chronic sinusitis on both sides. After middle meatal antrostomy, we selected one side, and a piece of Merocel soaked with 1.5 mL of MMC (0.4 mg/mL) was applied for 5 minutes. On the other side, normal saline solution was applied for a control. The size of the antrostomy was measured serially after surgery with a ruler. Mucociliary clearance was assessed by the saccharin test. Results: The effect of MMC in maintaining the size of the antrostomy was only significant during the first month. The relative size (the ratio of the remaining antrostomy area compared to the area in the immediate postoperative period) in the first month was significantly greater on the MMC-treated side than on the control side. The results of the saccharin test were not different between the two sides. Conclusions: Topical MMC application may have a short-term effect in maintaining the patency of the antrostomy site. However, it does not seem to improve the relative size over an extended period of time. C1 Asan Med Ctr, Dept Otolaryngol, Coll Med, Seoul 138736, South Korea. Gachon Med Sch, Gil Med Ctr, Dept Otolaryngol, Inchon, South Korea. RP Chung, YS (reprint author), Asan Med Ctr, Dept Otolaryngol, Coll Med, 388-1 Pungnap 2dong, Seoul 138736, South Korea. CR Albu S, 2004, OTOLARYNG HEAD NECK, V131, P542, DOI 10.1016/j.otohns.2004.02.045 Anand VK, 2004, AM J RHINOL, V18, P311 Asai K, 2000, LARYNGOSCOPE, V110, P117, DOI 10.1097/00005537-200001000-00021 Camara JG, 2000, OPHTHALMIC PLAST REC, V16, P114, DOI 10.1097/00002341-200003000-00005 Catalano PJ, 2003, OTOLARYNG HEAD NECK, V128, P875, DOI 10.1016/S0194-5998(03)00469-8 Chambers DW, 1997, LARYNGOSCOPE, V107, P504, DOI 10.1097/00005537-199704000-00014 Chung JH, 2002, OTOLARYNG HEAD NECK, V126, P468, DOI 10.1067/mhn.2002.124705 DAVIS WE, 1991, LARYNGOSCOPE, V101, P416 Elwany S, 2002, J LARYNGOL OTOL, V116, P112 Gall RM, 2004, J OTOLARYNGOL, V33, P47, DOI 10.2310/7070.2004.02084 Hu D, 2000, OPHTHALMIC PLAST REC, V16, P119, DOI 10.1097/00002341-200003000-00006 Ingrams DR, 1998, LARYNGOSCOPE, V108, P883, DOI 10.1097/00005537-199806000-00017 Kao SCS, 1997, OPHTHALMOLOGY, V104, P86 Kountakis SE, 2003, AM J RHINOL, V17, P215 Lund Valerie J., 1993, Rhinology (Utrecht), V31, P183 Malki D, 1999, J LARYNGOL OTOL, V113, P725 McMains KC, 2005, AM J RHINOL, V19, P344 Musy PY, 2004, AM J OTOLARYNG, V25, P418, DOI 10.1016/j.amjoto.2004.06.002 Nayak DR, 1998, INT J PEDIATR OTORHI, V46, P171, DOI 10.1016/S0165-5876(98)00124-4 Nouraei SAR, 2005, LARYNGOSCOPE, V115, P889, DOI 10.1097/01.MLG.0000161450.81557.6D Rahbar R, 2001, ANN OTO RHINOL LARYN, V110, P1 Ramadan HH, 1999, LARYNGOSCOPE, V109, P27, DOI 10.1097/00005537-199901000-00006 SALAM MA, 1993, CLIN OTOLARYNGOL, V18, P135, DOI 10.1111/j.1365-2273.1993.tb00545.x Selig YK, 2000, AM J RHINOL, V14, P205, DOI 10.2500/105065800782102672 Tom LWC, 1997, AM J RHINOL, V11, P229, DOI 10.2500/105065897781751884 Ugurbas SH, 1997, OPHTHALMIC SURG LAS, V28, P300 Yanagisawa E, 1999, Ear Nose Throat J, V78, P530 Yeatts RP, 1999, OPHTHALMIC PLAST REC, V15, P19, DOI 10.1097/00002341-199901000-00005 You YA, 2001, OPHTHALMIC PLAST REC, V17, P115, DOI 10.1097/00002341-200103000-00007 NR 29 TC 14 Z9 14 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 BP 673 EP 678 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 086KH UT WOS:000240671700004 PM 17044538 ER PT J AU Zeitels, SM Akst, LM Burns, JA Hillman, RE Broadhurst, MS Anderson, RR AF Zeitels, Steven M. Akst, Lee M. Burns, James A. Hillman, Robert E. Broadhurst, Matthew S. Anderson, R. Rox TI Office-based 532-nm pulsed KTP laser treatment of glottal papillomatosis and dysplasia SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE dysphonia; dysplasia; glottis; hoarseness; keratosis; KTP laser; laryngoscopy; papillomatosis; vocal cord; vocal fold ID DYE-LASER AB Objectives: Treatment of glottal papillomatosis and dysplasia was mirror-guided and done in surgeons' offices in the 19th century. It migrated to the operating room in the 20th century to accommodate direct laryngoscopic surgery, which required assistants to administer anesthesia and procedural support. The primary treatment goals, which are disease regression and voice restoration and/or maintenance, are tempered by the morbidity of general anesthesia and potential treatment-induced vocal deterioration. To obviate general anesthesia, office-based laser laryngeal surgery was first done in 2001 with the 585-nm pulsed dye laser (PDL), because it employs a fiber delivery system and its energy is selectively absorbed by oxyhemoglobin. Since then, this new angiolytic laser treatment paradigm has become a mainstay of management for many surgeons; however, there are a number of shortcomings of the PDL. To further develop this concept and address the limitations of the PDL, we used a 532-nm pulsed potassium titanyl phosphate (KTP) laser. Methods: A prospective assessment was performed on 48 patients in 72 cases of recurrent glottal dysplasia (36) or papillomatosis (36). All individuals had previously undergone microlaryngoscopic management with histopathologic evaluation. Results: Two dysplasia patients did not tolerate the procedure. Of the treatable dysplasia cases, there was follow-up in 29 of 34. Disease regression was at least 75% in 18 of 29 cases (62%), 50% to 75% in 7 of 29 (24%), and 25% to 50% in the remaining 4 of 29 (14%). Papilloma patients returned for treatment when symptoms recurred, so disease regression could not be assessed accurately. Similar to data obtained with the PDL, these data confirmed that dysplastic mucosa could normalize without resection. Conclusions: Our observations revealed that the 532-nm pulsed KTP laser provided enhanced performance over the PDL laser in a number of ways. The ability to use smaller glass fibers precluded mechanical trauma to the channels of the flexible laryngoscopes and allowed for improved suctioning of secretions. Oxyhemoglobin absorbs energy better at 532 nm than at 585 nm, and the KTP laser can be delivered through a longer pulse width. These factors provide enhanced hemostasis and improved intralesional energy absorbance. Finally, unlike the PDL, the KTP laser is a solid-state laser and is not prone to mechanical failure. C1 Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Surg, Boston, MA 02115 USA. Harvard Univ, Sch Med, Dept Dermatol, Wellman Ctr Photomed,Massachusetts Gen Hosp, Boston, MA 02115 USA. RP Zeitels, SM (reprint author), Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, 1 Bowdoin Sq,11th Floor, Boston, MA 02114 USA. CR Clyne SB, 2005, ANN OTO RHINOL LARYN, V114, P198 ELSBERG L, 1864, LARYNGOSCOPAL MED LO Franco RA, 2003, ANN OTO RHINOL LARYN, V112, P751 Franco RA, 2002, ANN OTO RHINOL LARYN, V111, P486 JACKSON C, 1915, PERORAL ENDOSCOPY LA KIRSTEIN A, 1897, AUTOSCOPY LARYNX TRA, P47 Kirstein A, 1895, ARCH LARYNGOL RHINOL, V3, P156 LEWIN G, 1861, MED CENTRAL ZEITUNG, V30, P654 MACKENZIE M, 1865, LARYNGOSCOPE DIS THR, P121 Suthamjariya K, 2004, J INVEST DERMATOL, V122, P518, DOI 10.1046/j.0022-202X.2004.22241.x Zeitels SM, 2001, ATLAS PHONOMICROSURG, P119 Zeitels SM, 2004, ANN OTO RHINOL LARYN, V113, P265 Zeitels SM, 2006, ANN OTO RHINOL LARYN, V115, P571 NR 13 TC 54 Z9 56 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 BP 679 EP 685 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 086KH UT WOS:000240671700005 PM 17044539 ER PT J AU Sigari, F Blair, E Redleaf, M AF Sigari, Farhad Blair, Elizabeth Redleaf, Miriam TI Headache with unilateral pulsatile tinnitus in women can signal dural sinus thrombosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cerebral venous thrombosis; dural sinus thrombosis; pulsatile tinnitus; sigmoid sinus; women's health ID CEREBRAL VENOUS THROMBOSIS AB Objectives: Dural sinus thrombosis commonly presents with headache, and rarely with tinnitus. These thromboses can progress to neurologic impairment and death. We are sharing recent clinical experiences with these thromboses as they present to the otologist. Methods: We report the presentation, physical examination, and imaging studies of 4 patients. Results: Four women had thrombotic occlusion of the sigmoid sinus. Their only symptoms were focal headache in all 4 patients, and unilateral pulsatile tinnitus in 2 of them. Imaging studies had to be repeated or alternative testing performed in order to conclusively identify the problem. Conclusions: It is important to be vigilant for the possibility of sigmoid sinus thrombosis in women who complain of unilateral head pain or unilateral pulsatile tinnitus. Appropriate imaging must be performed. C1 Univ Chicago Hosp, Sec OHNS, Chicago, IL 60637 USA. RP Redleaf, M (reprint author), Univ Chicago Hosp, Sec OHNS, 5841 S Maryland Ave,MC 1035, Chicago, IL 60637 USA. CR Bergui M, 2003, CEREBROVASC DIS, V16, P211, DOI 10.1159/000071118 CAMARGO EC, 2005, ETHNIC DIFFERENCES C, V19, P147 CANHAO P, PREDISPOSING CONDITI CANHAO P, INT STUDY CEREBRAL V Cumurciuc R, 2005, J NEUROL NEUROSUR PS, V76, P1084, DOI 10.1136/jnnp.2004.056275 Diener HC, 2005, J NEUROL NEUROSUR PS, V76, P1043, DOI 10.1136/jnnp.2004.061879 FERRO JM, PROGNOSIS ACUTE CERE Finelli PF, 2005, NEW ENGL J MED, V353, P315 Grover M, 2004, J AM BOARD FAM PRACT, V17, P295 Sanna G, 2005, ANN NY ACAD SCI, V1051, P465, DOI 10.1196/annals.1361.088 Sengstaken E A, 1996, J Am Board Fam Pract, V9, P282 Stam J, 2005, NEW ENGL J MED, V352, P1791, DOI 10.1056/NEJMra042354 VANGIJN J, 2004, CEREBROVASC DIS, V18, P377 NR 13 TC 5 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 BP 686 EP 689 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 086KH UT WOS:000240671700006 PM 17044540 ER PT J AU Lavasani, L Zapanta, PE Tanna, N Sadeghi, N AF Lavasani, Leela Zapanta, Philip E. Tanna, Neil Sadeghi, Nader TI Metastasis of prostatic adenocarcinoma to the sphenoid sinus SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the Southern Section of the Triological-Society CY JAN 12-14, 2006 CL Naples, FL SP Triol Soc, SE Sect DE prostate cancer; sphenoid sinus ID PARANASAL SINUSES; CANCER; CARCINOMA; NOSE AB The presentation, diagnosis, and management of prostatic adenocarcinoma metastatic to the sphenoid sinus are reviewed. We present a case report with a review of the literature. A 67-year-old man with a history of prostatic adenocarcinoma presented with gradual left visual loss. Magnetic resonance imaging revealed a lesion of the left orbital apex with extension into the ipsilateral sphenoid sinus. Operative biopsy of the lesion was significant for adenocarcinoma of the prostate. When an otolaryngologist encounters a mass in the sphenoid sinus, he or she needs to consider a diverse differential diagnosis. In evaluating possible causes, a history of malignancies should be elicited. Furthermore, the pathophysiology and potential routes of metastatic disease should be assessed for these primary neoplasms. Having a high level of suspicion for metastatic disease from specific primary sites will help guide the pathological evaluation. As in this clinical scenario of a patient with a history of prostatic adenocarcinoma, appropriate analysis would entail sending specimens for immunohistochemical staining, such as prostate-specific antigen and prostate-specific acid phosphatase. Correct diagnosis is crucial, as these patients may achieve remission and prolonged survival with irradiation and/or hormonal therapy. C1 George Washington Univ, Div Otolaryngol Head & Neck Surg, Med Ctr, Washington, DC USA. RP Zapanta, PE (reprint author), Voice Treatment Ctr, Div Otolaryngol, Suite 6-301,2150 Penn Ave NW, Washington, DC 20037 USA. CR BARRS DM, 1979, LARYNGOSCOPE, V89, P1229 BERNSTEI.JM, 1966, LARYNGOSCOPE, V76, P621 Hunt JL, 2004, HEAD NECK-J SCI SPEC, V26, P171, DOI 10.1002/hed.10353 LEDUC D, 1986, REV MED INTERNE, V7, P70, DOI 10.1016/S0248-8663(86)80086-8 Maschka DA, 1996, ANN OTO RHINOL LARYN, V105, P70 MATSUMOTO I, 1986, ACTA PATHOL JAPON, V36, P1753 MCCLATCHEY KD, 1985, ARCH OTO-RHINO-LARYN, V241, P219, DOI 10.1007/BF00453691 MICKEL RA, 1990, OTOLARYNG HEAD NECK, V102, P709 SALEH HA, 1993, J LARYNGOL OTOL, V107, P629, DOI 10.1017/S0022215100123928 Telera S, 2001, NEUROCHIRURGIE, V47, P61 NR 10 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 BP 690 EP 693 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 086KH UT WOS:000240671700007 PM 17044541 ER PT J AU Lassaletta, L Alfonso, C Del Rio, L Roda, JM Gavilan, J AF Lassaletta, Luis Alfonso, Carolina Del Rio, Laura Roda, Jose Maria Gavilan, Javier TI Impact of facial dysfunction on quality of life after vestibular schwannoma surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE facial paralysis; outcome; quality of life; vestibular schwannoma ID ACOUSTIC NEUROMA SURGERY; NERVE FUNCTION; MICROSURGERY; RADIOSURGERY; ASSOCIATION; MANAGEMENT; PARALYSIS; OUTCOMES; COHORT; TUMORS AB Objectives: This study was performed to evaluate the impact of facial dysfunction on quality of life in patients who underwent surgery for vestibular schwannoma. Other factors with a possible impact on quality of life were also assessed. Methods: We performed a retrospective review of 95 patients who underwent removal of a unilateral vestibular schwannoma. The Glasgow Benefit Inventory, an open-ended questionnaire, and a pain scale were sent to each patient. The questions were answered by 70 respondents (74%). After a minimum 1-year follow-up, the overall House-Brackmann postoperative facial function was grade I-II in 61% of patients, grade III-IV in 36%, and grade V-VI in 3%. Results: The open-ended questionnaire showed that 33% of patients stated a complaint related to facial dysfunction; it was the main complaint for 13% of patients. No significant difference was found in terms of Glasgow Benefit Inventory scores between patients with and without facial dysfunction, nor between those with different House-Brackmann grades. The most frequent complaint after surgery was hearing loss (46%). Postoperative pain was significantly associated with a worse postoperative quality of life. Conclusions: An overestimation of the effect of facial paralysis after vestibular schwannoma resection may exist on the surgeon's part. Detailed information about the possibility of hearing loss, vestibular problems, and pain must be given to all patients. C1 Univ Madrid, Hosp La Paz, Dept Neurosurg, Madrid 3, Spain. Univ Madrid, Hosp La Paz, Dept Otolaryngol, Madrid 3, Spain. RP Lassaletta, L (reprint author), Hosp La Paz, Serv ORL, Po Castellana 261, Madrid 28046, Spain. CR Committee on Hearing and Equilibrium, 1995, OTOLARYNGOL HEAD NEC, V113, P179 Cross T, 2000, LARYNGOSCOPE, V110, P1539, DOI 10.1097/00005537-200009000-00024 da Cruz MJ, 2000, LARYNGOSCOPE, V110, P151, DOI 10.1097/00005537-200001000-00027 Darrouzet V, 2004, LARYNGOSCOPE, V114, P681, DOI 10.1097/00005537-200404000-00016 HOUSE JW, 1985, OTOLARYNG HEAD NECK, V93, P146 Kelleher MO, 2002, BRIT J NEUROSURG, V16, P16, DOI 10.1080/02688690120114183 Mamikoglu B, 2003, ARCH OTOLARYNGOL, V129, P429, DOI 10.1001/archotol.129.4.429 Martin HC, 2001, J NEUROSURG, V94, P211, DOI 10.3171/jns.2001.94.2.0211 Myrseth E, 2005, NEUROSURGERY, V56, P927, DOI 10.1227/01.NEU.0000158315.64079.0A Nikolopoulos TP, 1998, LARYNGOSCOPE, V108, P1382, DOI 10.1097/00005537-199809000-00024 Robinson K, 1996, ANN OTO RHINOL LARYN, V105, P415 Ryzenman JM, 2005, LARYNGOSCOPE, V115, P703, DOI 10.1097/01.mlg.0000161331.83224.c5 Ryzenman JM, 2004, LARYNGOSCOPE, V114, P814, DOI 10.1097/00005537-200405000-00005 Ryzenman JM, 2005, OTOL NEUROTOL, V26, P516, DOI 10.1097/01.mao.0000169786.22707.12 Sandooram D, 2004, CLIN OTOLARYNGOL, V29, P621, DOI 10.1111/j.1365-2273.2004.00881.x vanLeeuwen JPPM, 1996, ANN OTO RHINOL LARYN, V105, P423 Yen TL, 2003, OTOL NEUROTOL, V24, P118, DOI 10.1097/00129492-200301000-00023 NR 17 TC 19 Z9 19 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 BP 694 EP 698 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 086KH UT WOS:000240671700008 PM 17044542 ER PT J AU Amin, MR AF Amin, Milan R. TI Thyrohyoid approach for vocal fold augmentation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 86th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Broncho Esophagol Assoc DE thyrohyoid approach; vocal fold augmentation; vocal fold paralysis ID INJECTION AB Objectives: I performed a retrospective chart review to evaluate the patient tolerance and clinical results of a new technique for office-based vocal fold augmentation. Methods: Ten patients undergoing the thyrohyoid approach for vocal fold augmentation were asked to rate their tolerance of the procedure using a 10-point rating scale (1 = "no problem" and 10 = "very uncomfortable"). The patients also filled out a quality-of-life survey (Voice Handicap Index-10) immediately before and 1 month after the procedure. I reviewed the preprocedure and postprocedure stroboscopic findings. The findings analyzed included changes in wave symmetry and glottal closure, and evidence of implant migration. Results: All patients successfully underwent the procedure. The mean patient tolerance score was found to be 2.1. The average score on the Voice Handicap Index-10 improved from 21.3 before the procedure (SD, 9.23) to 7.5 after the procedure (SD, 5.77). These values were compared by use of a paired t-test, and the difference was found to be significant, with a p value of .01. The analysis of stroboscopic results revealed "improvement" or "no change" in the wave symmetry, "improvement" in glottal closure, and "no evidence of migration" after the procedure in all cases. Conclusions: The study findings demonstrate that the thyrohyoid approach can be used successfully in patients who need vocal fold augmentation, and that it is generally well tolerated. C1 NYU, Voice Ctr, New York, NY 10016 USA. NYU, Sch Med, Div Laryngol, Dept Otolaryngol, New York, NY 10016 USA. RP Amin, MR (reprint author), NYU, Sch Med, Dept Otolaryngol, 550 1st Ave,NBV 5 East 5, New York, NY 10016 USA. 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Schade, Goetz Hess, Markus M. TI Differential gene expression profiling of vocal fold polyps and Reinke's edema by complementary DNA microarray SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE complementary DNA microarray; gene expression; polyp; reflux; Reinke's edema; voice disorder ID GLUTATHIONE-S-TRANSFERASE; EXTRACELLULAR-MATRIX; OXIDATIVE STRESS; PHOSPHOINOSITIDE 3-KINASE; MOLECULAR CLASSIFICATION; BENIGN LESIONS; CELLS; SPARC; APOPTOSIS; PREDICTION AB Objectives: Our purpose was to determine whether complementary DNA (cDNA) microarray analysis (MA) can establish distinct gene expression profiles for 2 phenotypically similar vocal fold lesions: Reinke's edema (RE) and polyps. Established transcript profiles can provide insight into the molecular and cellular processes involved in these diseases. Methods: Eleven RE specimens and 17 polyps were analyzed with MA for 8,745 genes. Further MA profiling was attempted within each lesion group to identify molecular markers for reflux exposure and smoking. Prediction analysis was used to predict lesion classification for 2 unclassified samples. A real-time polymerase chain reaction was performed to corroborate MA transcript levels for selected significant genes. Results: Sixty-five genes were found to differentiate RE and polyps (p =.0088). For RE, 19 genes were differentiated for reflux exposure (p =.016). No genes were found to differentiate smokers from nonsmokers. For polyps, no genes were found to differentiate for reflux (p =.16) and smoking (p =.565). Categorization of unclassified lesions was possible with a minimum of 13 genes. Conclusions: We demonstrate the feasibility of benign lesion classification based on MA. Microarray analysis is useful not only for improving diagnosis and classification of such lesions, but also for potentially generating prognostic indicators and targets for therapy. C1 Univ Utah, Div Otolaryngol Head & Neck Surg, Dept Surg, Sch Med, Salt Lake City, UT 84112 USA. Univ Bonn, Dept Phoniatr & Pediat Audiol, Clin Otrhinolaryngol Head & Neck Surg, D-5300 Bonn, Germany. Univ Hamburg Eppendorf, Med Ctr, Dept Voice Speech & Hearing Disorders, Hamburg, Germany. RP Thibeault, SL (reprint author), Univ Wisconsin, Sch Med & Publ Hlth, Div Otolaryngol Head Neck Surg, Madison, WI 53792 USA. 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Otol. Rhinol. Laryngol. PD SEP PY 2006 VL 115 IS 9 BP 703 EP 714 PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 086KH UT WOS:000240671700010 PM 17044544 ER PT J AU Anandasabapathy, S Jaffin, BW AF Anandasabapathy, Sharmila Jaffin, Barry W. TI Multichannel intraluminal impedance in the evaluation of patients with persistent globus on proton pump inhibitor therapy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE gastroesophageal reflux disease; globus; multichannel intraluminal impedance; pH testing ID GASTROESOPHAGEAL-REFLUX DISEASE; SYMPTOM INDEX; PH DATA; ACID; LARYNGITIS; REPRODUCIBILITY; HYSTERICUS; PHARYNGEUS; OMEPRAZOLE; RELEVANCE AB Objectives: Studies suggest an association between globus sensation ("globus") and gastroesophageal reflux. Although globus often persists despite proton pump inhibitor (PPI) therapy, the role of nonacid reflux has never been determined. Our goal was to use 24-hour multichannel intraluminal impedance (pH/MII) to determine 1) reflux characteristics in patients with globus despite PPI therapy; 2) whether there are differences in reflux patterns between patients with globus and patients with heartburn alone; and 3) whether there are differences in the number of positive symptom indices when standard pH testing is compared to pH/MII. Methods: Twenty-one adult patients with globus and 12 with heartburn symptoms alone underwent 24-hour pH/MII on PPI therapy. Reflux frequencies and characteristics were compared in both groups. For patients with globus, the symptom index and symptom sensitivity index were calculated. Logistic regression was performed to determine which reflux characteristics correlated with symptoms. Results: With pH/MII, we detected 1,160 reflux episodes; 64.7% were nonacid, and 55% reached the proximal sensor. In identifying patients with positive symptom indices, pH/MII increased the yield of standard pH testing by 27.8%. Proximal reflux was a significant predictor of globus symptoms (p = .04). Nonacid reflux approached significance in predicting globus (p = .08). Compared to patients with heartburn alone, those with globus had a higher mean frequency of proximal reflux (27.76% versus 15.63%; p = .04). Conclusions: In adults on PPI therapy with refractory globus, acid reflux does not predict globus symptoms. Through detection of nonacid reflux, pH/MII increased the yield of standard pH testing in identifying positive symptom indices. Additionally, pH/MII provided important information regarding reflux-symptom correlation. Proximal reflux may be predictive of globus symptoms. C1 CUNY, Mt Sinai Med Ctr, Div Gastroenterol, New York, NY 10029 USA. RP Jaffin, BW (reprint author), CUNY, Mt Sinai Med Ctr, Div Gastroenterol, Box 1069,1 Gustave Levy Pl, New York, NY 10029 USA. 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Rox TI Pulsed angiolytic laser treatment of ectasias and varices in singers SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE dysphonia; ectasia; glottis; hoarseness; laryngoscopy; laser; singer; varix; vocal cord; vocal fold; voice ID VOCAL FOLD; DYE-LASER; CLINICAL EXPERIENCE; GLOTTAL DYSPLASIA; SURGERY; PAPILLOMATOSIS; MANAGEMENT; CO2-LASER; LARYNX; CORDS AB Objectives: Varices and ectasias in singers are typically the result of phonotraumatic shearing stresses and/or collision forces on the microcirculation within the superficial lamina propria. These lesions can be debilitating in performing vocalists because of the effect of recurrent hemorrhage and/or as a contributing factor to the morbidity of other mass lesions such as polyps, nodules, and cysts. Phonomicrosurgical treatment of performers is understandably approached with great trepidation, as the vocal liability of surgically disturbing the superficial lamina propria and epithelium must be balanced with the inherent detrimental vocal effect(s) of the lesion(s). Pulsed angiolytic lasers that emit radiation at high absorbance peaks of oxyhemoglobin were examined to determine whether they were an efficacious treatment approach for ectasias and varices based on these lasers' mechanisms of action and prior experience in phonomicrosurgery. Methods: A prospective trial was done in 39 patients (40 procedures in 54 vocal folds) without complication to evaluate the effectiveness of a 585-nm pulsed dye laser (PDL; 25 cases) and a 532-nm pulsed KTP laser (15 cases) in a noncontact mode to treat 65 varices and 43 ectasias. Twenty-nine of 39 patients had varices and ectasias associated with other phonotraumatic mass lesions that required resection. Results: All patients have resumed full vocal activities, and no patient has had a subsequent hemorrhage or vocal deterioration. Conclusions: Both the 585-nm PDL and the 532-nm pulsed KTP laser were found to be efficacious and relatively safe treatment modalities for vascular abnormalities of the vocal folds in singers. Noncontact selective photoangiolysis of the aberrant vessels prevented future bleeding without substantial photothermal trauma to the overlying epithelium and surrounding delicate superficial lamina propria, thereby allowing for optimal postoperative mucosal pliability and glottal sound production. However, the pulsed KTP laser was substantially easier to use because of its enhanced hemostasis due to its longer pulse width. Vessel wall rupture was commonplace during use of the 585-nm PDL, but rarely occurred during photoangiolysis with the 532-nm pulsed KTP laser. C1 Harvard Univ, Massachusetts Gen Hosp, Sch Med, Ctr Laryngeal Surg & Voice Rehabil,Dept Surg, Boston, MA 02114 USA. Harvard Univ, Massachusetts Gen Hosp, Sch Med, Wellman Ctr Photomed,Dept Dermatol, Boston, MA 02114 USA. RP Zeitels, SM (reprint author), Harvard Univ, Massachusetts Gen Hosp, Sch Med, Ctr Laryngeal Surg & Voice Rehabil,Dept Surg, 1 Bowdoin Sq, Boston, MA 02114 USA. 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Otol. Rhinol. Laryngol. PD AUG PY 2006 VL 115 IS 8 BP 571 EP 580 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 073WS UT WOS:000239774000002 PM 16944655 ER PT J AU Cohen, SM Garrett, CG Dupont, WD Ossoff, RH Courey, MS AF Cohen, Seth M. Garrett, C. Gaelyn Dupont, William D. Ossoff, Robert H. Courey, Mark S. TI Voice-related quality of life in T1 glottic cancer: Irradiation versus endoscopic excision SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Laryngological-Association CY MAY 19-20, 2006 CL Chicago, IL SP Amer Laryngol Assoc DE glottic cancer; meta-analysis; quality of life; voice handicap ID VOCAL CORD CARCINOMA; POSTOPERATIVE VOICE; RADIATION-THERAPY; LASER RESECTION; RADIOTHERAPY; LARYNGEAL; OUTCOMES; MANAGEMENT; DYSPHONIA/; CORDECTOMY AB Objectives: Several studies have explored posttreatment voice outcomes for early glottic cancer with varying results. To further clarify the voice-related quality of life (QOL) of T1 glottic cancer patients treated by external beam radiotherapy (EBRT) compared to endoscopic carbon dioxide laser excision (CLE), we performed a meta-analysis. Methods: We performed a meta-analysis review for the years 1966 to 2005 for the Voice Handicap Index (VHI), laryngeal cancer, voice outcome, voice quality, and quality of life. Studies in which the VHI was assessed at least 3 months after treatment for T1 glottic cancer were identified and analyzed by meta-analysis techniques. Results: Six studies with 208 patients (6 T1b and 202 T1a) treated with CLE and 91 patients (6 T1b and 85 T1a) treated with EBRT were identified. The posttreatment VHI scores were similar for the EBRT- and CLE-treated patients (p = .1, Wilcoxon rank sum test). Conclusions: We conclude that CLE and EBRT provide comparable levels of voice handicap for patients with T1 glottic cancer. 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Otol. Rhinol. Laryngol. PD AUG PY 2006 VL 115 IS 8 BP 581 EP 586 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 073WS UT WOS:000239774000003 PM 16944656 ER PT J AU Bertholon, P Tringali, S Faye, MB Antoine, JC Martin, C AF Bertholon, Pierre Tringali, Stephane Faye, Mamadou B. Antoine, Jean Christophe Martin, Christian TI Prospective study of positional nystagmus in 100 consecutive patients SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE downbeat nystagmus; horizontal nystagmus; positional nystagmus ID VERTIGO; CANALOLITHIASIS; MANAGEMENT; FEATURES; ATAXIA; BPPV AB Objectives: The purpose of this study was to investigate the various diagnoses of patients who present with positional nystagmus. Methods: Positional maneuvers were systematically performed in the plane of the posterior canal (PC; Dix-Hallpike maneuver) and the horizontal canal (HC; patients were rolled to either side in a supine position) on 490 consecutive patients essentially referred for vertigo and/or gait unsteadiness. Results: One hundred patients (20%) presented positional nystagmus. This nystagmus had a peripheral origin in 83 patients, including 80 patients with benign paroxysmal positional vertigo (BPPV). In BPPV, the PC was involved in 61 patients, the HC in 18 patients (geotropic horizontal nystagmus in 11 and ageotropic in 7; changing from geotropic to ageotropic or the reverse in 4 patients), and both the PC and HC in 1 patient. There was evidence of central positional nystagmus in 12 patients, including positional downbeat nystagmus during the Dix-Hallpike maneuver in 7 patients with various neurologic disorders, and ageotropic horizontal nystagmus during the HC maneuver in 2 patients with, respectively, cerebellar ischemia and definite migrainous vertigo. The peripheral or central origin of the positional nystagmus could not be ascertained in 5 patients, including 1 patient with probable migrainous vertigo and another with possible anterior canal BPPV. Conclusions: A rotatory-upbeat nystagmus in the context of PC BPPV, a horizontal nystagmus, whether geotropic or ageotropic, due to HC BPPV, and a positional downbeat nystagmus related to various central disorders are the 3 most common types of positional nystagmus. Geotropic horizontal positional nystagmus and, most certainly, horizontal positional nystagmus changing from geotropic to ageotropic or the reverse point to HC BPPV. In contrast, an ageotropic horizontal positional nystagmus that is not changing (from ageotropic to geotropic) may indicate a central lesion. C1 CHU St Etienne, Hop Bellevue, Serv ORL, Dept Otorhinolaryngol Head & Neck Surg, F-42055 St Etienne, France. CHU St Etienne, Hop Bellevue, Dept Neurol, F-42055 St Etienne, France. RP Bertholon, P (reprint author), CHU St Etienne, Hop Bellevue, Serv ORL, Dept Otorhinolaryngol Head & Neck Surg, F-42055 St Etienne, France. CR BALOH RW, 1995, NEUROLOGY, V45, P1297 BALOH RW, 1987, NEUROLOGY, V37, P371 BARBER HO, 1984, OTOLARYNG HEAD NECK, V92, P649 Bertholon P, 2005, ANN OTO RHINOL LARYN, V114, P105 Bertholon P, 2002, J NEUROL NEUROSUR PS, V72, P366, DOI 10.1136/jnnp.72.3.366 BRANDT T, 1994, NEUROLOGY, V44, P796 Bronstein AM, 2003, J NEUROL NEUROSUR PS, V74, P289, DOI 10.1136/jnnp.74.3.289 Casani A, 1997, LARYNGOSCOPE, V107, P807, DOI 10.1097/00005537-199706000-00016 Crevits L, 2004, J NEUROL NEUROSUR PS, V75, P779, DOI 10.1136/jnnp.2003.025478 DelaMeilleure G, 1996, J NEUROL NEUROSUR PS, V60, P68, DOI 10.1136/jnnp.60.1.68 DIX MR, 1952, ANN OTO RHINOL LARYN, V61, P987 EPLEY JM, 1992, OTOLARYNG HEAD NECK, V107, P399 Fife TD, 1998, AM J OTOL, V19, P345 Imai T, 2005, NEUROLOGY, V64, P920 Katsarkas A, 1999, ACTA OTO-LARYNGOL, V119, P745, DOI 10.1080/00016489950180360 KATSARKAS A, 1982, J OTOLARYNGOL, V11, P91 Kattah JC, 2005, ANN NY ACAD SCI, V1039, P540, DOI 10.1196/annals.1325.063 Korres S, 2002, OTOL NEUROTOL, V23, P926, DOI 10.1097/00129492-200211000-00019 LEMPERT T, 1994, NEUROLOGY, V44, P2213 MCCLURE JA, 1985, J OTOLARYNGOL, V14, P30 NEUHAUSER H, 2001, NEUROLOGY, V56, P435 Nuti D, 1998, ACTA OTO-LARYNGOL, V118, P455, DOI 10.1080/00016489850154559 Nuti D, 1996, J VESTIBUL RES-EQUIL, V6, P173 Palla A, 2005, JARO-J ASSOC RES OTO, V6, P1, DOI 10.1007/s10162-004-4052-3 Semont A, 1988, Adv Otorhinolaryngol, V42, P290 Steddin S, 1996, ANN NEUROL, V40, P918 Vannucchi P, 1997, J VESTIBUL RES-EQUIL, V7, P1 von Brevern M, 2004, NEUROLOGY, V62, P469 Yabe I, 2003, J NEUROL, V250, P440, DOI 10.1007/s00415-003-1020-5 NR 29 TC 21 Z9 24 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2006 VL 115 IS 8 BP 587 EP 594 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 073WS UT WOS:000239774000004 PM 16944657 ER PT J AU Khan, AM Levine, SR Nadol, JB AF Khan, Aayesha M. Levine, Stephen R. Nadol, Joseph B., Jr. TI The widely patent cochleovestibular communication of Edward Cock is a distinct inner ear malformation: Implications for cochlear implantation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cochlear implant; Edward Cock; inner ear malformation; widely patent cochleovestibular communication ID CONGENITAL-MALFORMATIONS; MONDINI-DYSPLASIA; HUMAN EMBRYO; MENINGITIS; RECONSTRUCTION; CHILDREN; POPULATIONS; LABYRINTH; DEAFNESS; CT AB Objectives: In 1838, Edward Cock described the anatomic findings in 4 inner ears with a widely patent communication between the cochlea and the vestibule that is now frequently referred to as the "common cavity deformity" and is often confused with Michel's "otocyst deformity." Little is known about the anatomic characteristics, including the presence of neural elements in this malformation. Methods: Light microscopy and 2-dimensional and computerized 3-dimensional reconstructions were used to determine the histopathology and spiral ganglion cell counts in 7 temporal bones with a widely patent cochleovestibular communication. Results: In all 7 specimens, the cochlea, vestibule, and semicircular canals were distinguishable and a bony defect resulting in an abnormal communication of perilymphatic space between the cochlea and vestibule was present. The ductus reuniens was abnormally wide in all. The cochlear duct varied from less than 1 turn to up to 2 turns. The mean spiral ganglion cells were estimated as a percentage of age-matched normal controls at 2.3%, 16.5%, and 26.8% when the cochlea was approximately 1, 1(1/2), and 2 turns, respectively (p = .007). The cribrose area consisted of a thin membrane in 2 specimens, and Rosenthal's canal openly communicated with the cerebrospinal fluid space in 3 specimens. The stapes footplate was abnormal in all 7 specimens and consisted of a central defect bridged by a thin membrane in 4 specimens. The facial nerve was dehiscent in 5 specimens (71%) and also followed an anomalous course in 2 specimens (28%). Conclusions: The widely patent cochleovestibular communication is a distinct inner ear malformation, recognition of which may have important clinical implications. Estimates of spiral ganglion cells can be predicted from the number of cochlear turns. Although cochlear implantation is feasible in patients with this malformation, a higher risk of cerebrospinal fluid gushers, facial nerve injuries, meningitis, and poor performance would be predicted. A better understanding of the anatomy will allow more effective surgical planning and techniques and may have a significant impact in improving outcomes. C1 Massachusetts Eye & Ear Infirm, Dept Otolaryngol, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Otol & Laryngol, Boston, MA 02115 USA. Temporal Bone Fdn, Boston, MA USA. RP Nadol, JB (reprint author), Massachusetts Eye & Ear Infirm, Dept Otolaryngol, 243 Charles St, Boston, MA 02114 USA. CR ALTMANN F, 1950, ARCH OTOLARYNGOL, V51, P852 Anson BJ, 1981, SURG ANATOMY TEMPORA Casselman JW, 2001, EUR J RADIOL, V40, P94, DOI 10.1016/S0720-048X(01)00377-1 CLOPTON BM, 1980, ANN OTO RHINOL LARYN, V89, P5 Cock E, 1838, GUYS HOSP REP, p[7, 289] CURTIN HD, 1982, RADIOLOGY, V144, P335 Firszt J B, 1995, J Am Acad Audiol, V6, P235 FREY KW, 1965, ROFO FORTSCHR RONTG, V102, P1 GRAHAM JM, 2000, J LARYNGOL OTOL S, V25 Guild SR, 1921, ANAT REC, V22, P141 JACKLER RK, 1987, LARYNGOSCOPE S, V40, P97 JACKLER RK, 1987, LARYNGOSCOPE, V97, P15 JENSEN J, 1969, ACTA RADIOL DIAGN S, V286, P3 KONIGSMA.BW, 1970, NATURE, V228, P1335, DOI 10.1038/2281335a0 Luntz M, 1997, ARCH OTOLARYNGOL, V123, P974 MANGABEIRAALBERNAZ PL, 1983, ACTA OTO-LARYNGOL, V95, P627, DOI 10.3109/00016488309139454 McElveen JT, 1997, LARYNGOSCOPE, V107, P1032, DOI 10.1097/00005537-199708000-00005 MICHEL, 1863, GAZ MED STRASB, V4, P55 MIYAMOTO RT, 1986, AM J OTOL, V7, P258 MOLTER DW, 1993, OTOLARYNG HEAD NECK, V108, P174 NADOL JB, 1988, AM J OTOLARYNG, V9, P47, DOI 10.1016/S0196-0709(88)80007-3 Nishikori T, 1999, ANAT EMBRYOL, V200, P19, DOI 10.1007/s004290050255 OTTE J, 1978, LARYNGOSCOPE, V88, P1231 PAPARELLA MM, 1980, ANN OTO RHINOL LARYN, V89, P1 Park AH, 2000, LARYNGOSCOPE, V110, P1715, DOI 10.1097/00005537-200010000-00029 PHELPS PD, 1994, AM J OTOL, V15, P551 Phelps P D, 1978, Adv Otorhinolaryngol, V24, P51 PHELPS PD, 1975, BRIT J RADIOL, V48, P973 PHELPS PD, 1986, CLIN OTOLARYNGOL, V11, P79, DOI 10.1111/j.1365-2273.1986.tb00112.x PHELPS PD, 1992, J LARYNGOL OTOL, V106, P967, DOI 10.1017/S0022215100121486 Schuknecht H, 1993, PATHOLOGY EAR, P1 SCHUKNECHT HF, 1980, ANN OTOL RHINOL L S, V65, P89 SCHUKNECHT HF, 1960, NEURAL MECHANISMS AU, P76 SLATTERY WH, 1995, LARYNGOSCOPE, V105, P1184, DOI 10.1288/00005537-199511000-00008 Streeter GL, 1906, AM J ANAT, V6, P139, DOI 10.1002/aja.1000060103 Streeter GL, 1917, AM J ANAT, V21, P299, DOI 10.1002/aja.1000210203 Suzuki C, 1998, ARCH OTOLARYNGOL, V124, P462 SYKORA GF, 1980, RADIOLOGY, V135, P379 TERRAHE K, 1965, ROFO FORTSCHR RONTG, V102, P14 TSCHIANG H H, 1973, Journal of Laryngology and Otology, V87, P475, DOI 10.1017/S002221510007715X VALVASSO.GE, 1969, ANN OTO RHINOL LARYN, V78, P929 Westerhof JP, 2001, J COMPUT ASSIST TOMO, V25, P719, DOI 10.1097/00004728-200109000-00009 YUCEL OT, 2000, ARCH OTOLARYNGOL, V126, P797 NR 43 TC 4 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2006 VL 115 IS 8 BP 595 EP 606 PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 073WS UT WOS:000239774000005 PM 16944658 ER PT J AU Bhattacharyya, N Chien, W AF Bhattacharyya, Neil Chien, Wade TI Risk of second primary malignancy after radioactive iodine treatment for differentiated thyroid carcinoma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE differentiated thyroid carcinoma; radioactive iodine; second primary malignancy ID CANCER PATIENTS; I-131 THERAPY; RADIOIODINE; SURVIVAL; OUTCOMES AB Objectives: The association between second primary malignancy (SPM) and radioactive iodine (RAI) is controversial. We examined the association between RAI and SPM after treatment of differentiated thyroid carcinoma (DTC) using a large cohort from a national cancer database. Methods: From the Surveillance, Epidemiology and End Results (SEER) database, all index cases of DTC (papillary or follicular) were extracted for the years 1988 to 2001. Two cohorts were constructed: 1) patients with DTC who were not treated with RAI, and 2) patients with DTC who were treated with RAI. For each cohort, we tabulated all subsequent malignancies for each patient, identifying patients in each group with 1 of more SPMs. Results: According to inclusion criteria, 18,882 cases of DTC treated without RAI (mean follow-up, 55.5 months) and 10,349 cases treated with RAI (mean follow-up, 61.8 months) were identified. The most common SPM sites were breast or prostate followed by colon or lung for both groups. On univariate analysis, SPMs developed in 6.7% of patients without RAI versus 4.8% of those with RAI (p < .001, univariate chi(2)). However, on multivariate analysis, only age and male gender had statistically significant hazard ratios (1.052 and 1.438, respectively; p < .001); follicular carcinoma histology and use of RAI did not influence occurrence of SPM after DTC (p = .180 and p = .789, respectively). Conclusions: Use of RAI does not elevate the risk of SPM. Concern about SPM induction should not adversely affect the decision to administer RAI for DTC. C1 Brigham & Womens Hosp, Div Otolaryngol, Boston, MA 02115 USA. Massachusetts Eye & Ear Infirm, Dept Otolaryngol, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Otol & Laryngol, Boston, MA 02115 USA. RP Bhattacharyya, N (reprint author), Div Otolaryngol, 45 Francis St, Boston, MA 02115 USA. CR AKSLEN LA, 1992, EUR J CANCER, V28A, P491, DOI 10.1016/S0959-8049(05)80085-1 ALLWEISS P, 1984, J NUCL MED, V25, P755 BHATTACHARYYA N, 2003, OTOLARYNGOL HEAD NEC, V128, P118 Bhattacharyya N, 2005, AM J OTOLARYNG, V26, P39, DOI 10.1016/j.amjoto.2004.06.017 Bhattacharyya N, 2005, OTOLARYNG HEAD NECK, V132, P63, DOI 10.1016/j.otohns.2004.08.011 BRINCKER H, 1973, BRIT J CANCER, V28, P232, DOI 10.1038/bjc.1973.142 Chen AY, 2001, CANCER, V92, P225, DOI 10.1002/1097-0142(20010715)92:2<225::AID-CNCR1313>3.0.CO;2-B deVathaire F, 1997, BRIT J CANCER, V75, P734, DOI 10.1038/bjc.1997.130 DOTTORINI ME, 1995, J NUCL MED, V36, P21 Edhemovic I, 1998, EUR J CANCER, V34, P1813 EDMONDS CJ, 1986, BRIT J RADIOL, V59, P45 HALL P, 1990, ACTA ONCOL, V29, P869 HALL P, 1991, BRIT J CANCER, V64, P159, DOI 10.1038/bjc.1991.261 MAZZAFERRI EL, 1994, AM J MED, V97, P418, DOI 10.1016/0002-9343(94)90321-2 PACINI F, 1994, J NUCL MED, V35, P1418 Parkin DM, 1992, CANC INCIDENCE 5 CON, V6 Rubino C, 2003, BRIT J CANCER, V89, P1638, DOI 10.1038/sj.bjc.6601319 SCHLUMBERGER MJ, 2005, SURG THYROID PARATHY, P465 Shapiro NL, 2005, LARYNGOSCOPE, V115, P337, DOI 10.1097/01.mlg.0000154743.71184.09 NR 19 TC 24 Z9 25 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2006 VL 115 IS 8 BP 607 EP 610 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 073WS UT WOS:000239774000006 PM 16944659 ER PT J AU Roh, JL Lee, YW Park, HT AF Roh, Jong-Lyel Lee, Yong-Won Park, Hee Tae TI Subglottic wound healing in a new rabbit model of acquired subglottic stenosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE acquired subglottic stenosis; animal model; rabbit; wound healing ID CANINE MODEL; MANAGEMENT; EXTENT AB Objectives: It is difficult to develop models of subglottic stenosis in small animals that ensure reliable stenosis. We therefore sought to establish a new animal model of subglottic stenosis in rabbits and observe subglottic wound healing. Methods: Using a diode laser under endoscopic visualization after anterior tracheal incision, we induced full-thickness injury to the subglottis in 60 rabbits: 20 on the anterior 120 degrees, 20 on the posterior 120 degrees, and 20 circumferentially. The animals were painlessly sacrificed 2 or 4 weeks later, and their gross and histologic findings were compared with those of each other and with those of 16 age-matched nonwounded controls. Results: Of the 60 animals, 22 died, primarily of acute airway obstruction and mostly in the circumferential group. All of the injured rabbits showed subglottic stenosis compared with controls, ranging from 12% to 56% reduction in cross-sectional area in the 120 degrees injured groups and from 32% to 82% reduction in the 360 degrees injured group. The significant narrowing of the subglottic lumina resulted in substantial early mortality in the circumferential group. Histologic examination showed mucosal ulceration, inflammation, and formation of granulation tissues during the acute phase after wounding, and collapse of the injured cartilage and submucosal thickening and fibrosis at later times. Conclusions: Subglottic healing and stenosis depend on the extent of cartilaginous injury. This model may be useful for developing methods to treat subglottic stenosis. C1 Univ Ulsan, Coll Med, Asan Med Ctr, Dept Otolaryngol, Seoul 138736, South Korea. Chungnam Natl Univ, Coll Med, Dept Otolaryngol Head & Neck Surg, Taejon 305764, South Korea. RP Roh, JL (reprint author), Univ Ulsan, Coll Med, Asan Med Ctr, Dept Otolaryngol, 388-1,Pungnap Dong, Seoul 138736, South Korea. CR BOROWIECKI B, 1977, ANN OTO RHINOL LARYN, V86, P835 Charous Steven J., 1996, Wound Repair and Regeneration, V4, P444, DOI 10.1046/j.1524-475X.1996.40408.x Cotton RT, 2000, OTOLARYNG CLIN N AM, V33, P111, DOI 10.1016/S0030-6665(05)70210-3 DOHAR JE, 1995, OTOLARYNG CLIN N AM, V28, P897 Dohar JE, 1998, INT J PEDIATR OTORHI, V46, P159, DOI 10.1016/S0165-5876(98)00163-3 HOLINGER LD, 1987, LARYNGOSCOPE, V97, P19 Ingrams DR, 2000, ANN OTO RHINOL LARYN, V109, P422 Jewett BS, 2000, OTOLARYNG HEAD NECK, V122, P488, DOI 10.1016/S0194-5998(00)70089-1 Kwon OJ, 2003, EXP LUNG RES, V29, P329, DOI 10.1080/01902140390116517 Mathisen D J, 1998, Curr Probl Surg, V35, P453, DOI 10.1016/S0011-3840(98)80014-2 Minnigerode B, 1987, Prog Pediatr Surg, V21, P1 Pearson F G, 1996, Chest Surg Clin N Am, V6, P683 SHERMAN JM, 1986, J PEDIATR-US, V109, P322, DOI 10.1016/S0022-3476(86)80395-X SUPANCE JS, 1982, ARCH OTOLARYNGOL, V108, P727 NR 14 TC 13 Z9 14 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2006 VL 115 IS 8 BP 611 EP 616 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 073WS UT WOS:000239774000007 PM 16944660 ER PT J AU Kim, DH Park, YS Jeon, EJ Yeo, SW Chang, KH Lee, SK AF Kim, Dong-Hyun Park, Yong-Soo Jeon, Eun-ju Yeo, Sang-Won Chang, Ki-Hong Lee, Seung Kyun TI Effects of tumor necrosis factor alpha antagonist, platelet activating factor antagonist, and nitric oxide synthase inhibitor on experimental otitis media with effusion SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE nitric oxide synthase inhibitor; otitis media with effusion; platelet activating factor antagonist; tumor necrosis factor alpha antagonist ID MIDDLE-EAR EFFUSIONS; CYTOKINES; ENDOTOXIN; RECEPTOR; MODEL AB Objectives: We studied the inflammatory responses in otitis media with effusion induced by lipopolysaccharide (LPS) in rats, and compared the preventive effects of tumor necrosis factor (TNF) soluble receptor type I (sTNFRI, a TNF-alpha antagonist), platelet activating factor antagonist, and the nitric oxide synthase inhibitor N(G)-nitro-L-arginine methyl ester (L-NAME). Methods: We used 2 control groups of Sprague Dawley rats (untreated and saline-treated) and 4 experimental groups, which all received an intratympanic injection of LPS, followed in 3 groups by experimental treatment of the same ear. The LPS group had no additional treatment. The L-NAME group received intraperitoneal injection of L-NAME and was reinjected after 12 hours. The A-85783 group was first given an intraperitoneal injection of A-85783. The sTNFRI group was first given an intratympanic injection of sTNFRI. Twenty-four hours after the initial intratympanic injection of LPS, temporal bones from each group were examined histopathologically and the vascular permeability of the middle ear mucosa was measured by Evans blue vital dye staining. Results: The L-NAME, A-85783, and sTNFRI groups showed significantly reduced capillary permeability, subepithelial edema, and infiltration of inflammatory cells in comparison with the LPS group. There were no differences in capillary permeability, subepithelial edema, or infiltration of inflammatory cells between the A-85783 and sTNFRI groups. The L-NAME group showed no difference in vascular permeability or subepithelial edema in comparison with the A-85783 and sTNFRI groups, but showed more infiltration of inflammatory cells. Conclusions: We conclude that sTNFRI, A-85783, and L-NAME can be proposed as alternative future treatments for otitis media with effusion. However, L-NAME may be the least effective of these agents. C1 Catholic Univ Korea, Coll Med, Dept Otolaryngol Head & Neck Surg, Seoul, South Korea. Ajou Univ, Sch Med, Dept Otolaryngol, Suwon 441749, South Korea. RP Park, YS (reprint author), Our Lady Mercy Hosp, Dept Otolaryngol, 665 Bupyung Dong, Inchon 403720, South Korea. CR Ball SS, 1996, LARYNGOSCOPE, V106, P1021, DOI 10.1097/00005537-199608000-00022 Ball SS, 1997, ANN OTO RHINOL LARYN, V106, P633 CATANZARO A, 1991, LARYNGOSCOPE, V101, P271 DEMARIA TF, 1984, J CLIN MICROBIOL, V20, P15 Hebda PA, 2002, ACTA OTO-LARYNGOL, V122, P255, DOI 10.1080/000164802753648123 HIMI T, 1992, ANN OTO RHINOL LARYN, V101, P21 Jeon EJ, 2001, ANN OTO RHINOL LARYN, V110, P917 JUHN SK, 1994, ANN OTO RHINOL LARYN, V103, P43 Karasen RM, 2000, ANN OTO RHINOL LARYN, V109, P549 Lee DH, 2001, LARYNGOSCOPE, V111, P728, DOI 10.1097/00005537-200104000-00030 Maxwell K, 1997, ARCH OTOLARYNGOL, V123, P984 RHEE CK, 1993, ANN OTO RHINOL LARYN, V102, P600 Rhee CK, 2003, LARYNGOSCOPE, V113, P2059, DOI 10.1097/00005537-200312000-00001 Rose AS, 1997, OTOLARYNG HEAD NECK, V116, P308, DOI 10.1016/S0194-5998(97)70265-1 Ryan AF, 2001, LARYNGOSCOPE, V111, P301, DOI 10.1097/00005537-200102000-00021 YELLON RF, 1995, ARCH OTOLARYNGOL, V121, P1402 YELLON RF, 1991, LARYNGOSCOPE, V101, P165 YELLON RF, 1995, ARCH OTOLARYNGOL, V121, P865 NR 18 TC 10 Z9 12 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2006 VL 115 IS 8 BP 617 EP 623 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 073WS UT WOS:000239774000008 PM 16944661 ER PT J AU Maturo, SC Mair, EA AF Maturo, Stephen C. Mair, Eric A. TI Submucosal minimally invasive lingual excision: An effective, novel surgery for pediatric tongue base reduction SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE macroglossia; submucosal minimally invasive lingual excision; tongue base reduction ID OBSTRUCTIVE SLEEP-APNEA; MIDLINE GLOSSECTOMY; COMPLICATIONS; OUTCOMES AB Objectives: The aim of this study was to develop an effective single intraoral, minimally invasive technique to reduce the enlarged tongue base in children with obstructive macroglossia. Methods: We present the anatomic dissection of fresh cadavers and a representative case series of children who underwent submucosal minimally invasive lingual excision (SMILE) with a plasma-mediated radiofrequency device (coblation) under intraoral ultrasonic and endoscopic guidance. Multiple anatomic dissections determined the relative location of the hypoglossal nerve and lingual neurovascular bundle in relation to removable tongue base musculature. A pediatric case series demonstrates the straightforward SMILE technique. Results: Laboratory anatomic dissection and clinical lingual ultrasonography revealed the surgical safety borders for SMILE. The surgical safety and efficacy of SMILE is demonstrated by preoperative and postoperative clinical examinations and polysomnograms in children with obstructive macroglossia (such as Beckwith-Wiedemann and Down syndromes and tongue vascular malformation). Coblation submucosally removes excessive tongue base tissue through a small anterior tongue incision. SMILE was performed without excessive pain, bleeding, edema, infection, or tongue dysfunction. Conclusions: SMILE is an effective novel operation that incorporates coblation with ultrasonography and endoscopic guidance for children who need tongue base reduction. Anatomic dissection and clinical cases demonstrate the potential for aggressive yet relatively safe tissue removal by this minimally invasive technique. SMILE also has significant potential for adults with obstructive sleep apnea due to a large tongue base. C1 Wilford Hall USAF Med Ctr, Dept Otolaryngol, Pediat Otolaryngol Serv, San Antonio, TX 78236 USA. RP Mair, EA (reprint author), Charlotte EENT Associates, 6035 Fairview Rd, Charlotte, NC 28210 USA. EM emair@ceenta.com CR Anstead M, 1998, Curr Opin Pulm Med, V4, P351, DOI 10.1097/00063198-199811000-00008 FUJITA S, 1985, LARYNGOSCOPE, V95, P70 FUJITA S, 1991, LARYNGOSCOPE, V101, P805 Guan Jian, 2005, Lin Chuang Er Bi Yan Hou Ke Za Zhi, V19, P108 Guilleminault C, 2004, LARYNGOSCOPE, V114, P132, DOI 10.1097/00005537-200401000-00024 Kremer B, 2002, J PEDIATR SURG, V37, P1556, DOI 10.1053/jpsu.2002.36184 Kuhnel TS, 2005, LARYNGOSCOPE, V115, P475, DOI 10.1097/01.mlg.0000157842.40412.5f Lauretano AM, 1997, LARYNGOSCOPE, V107, P1057, DOI 10.1097/00005537-199708000-00010 Li KK, 2002, OTOLARYNG HEAD NECK, V127, P230, DOI 10.1067/mhn.2002.126900 Mickelson SA, 1997, LARYNGOSCOPE, V107, P614 Pazos G, 2001, OTOLARYNG HEAD NECK, V125, P462, DOI 10.1067/mhn.2001.119863 Robinson S, 2003, CLIN OTOLARYNGOL, V28, P341, DOI 10.1046/j.1365-2273.2003.00719.x Stuck BA, 2005, OTOLARYNG HEAD NECK, V132, P132, DOI 10.1016/j.otohns.2004.09.009 WOODSON BT, 1992, OTOLARYNG HEAD NECK, V107, P40 NR 14 TC 23 Z9 24 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2006 VL 115 IS 8 BP 624 EP 630 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 073WS UT WOS:000239774000009 PM 16944662 ER PT J AU Dresner, HS King, TA Clark, HB Juhn, SK Levine, SC AF Dresner, Harley S. King, Timothy A. Clark, H. Brent Juhn, Steven K. Levine, Samuel C. TI Peripheral facial nerve regeneration using collagen conduit entubulation in a cat model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE collagen conduit; entubulation; facial nerve; regeneration ID ACID) POROUS CONDUITS; IN-VIVO EVALUATION; ELECTROPHYSIOLOGICAL EVALUATION; SCHWANN-CELLS; REPAIR; TUBE; GRAFTS; GAP; ORGANIZATION; NUCLEUS AB Objectives: Facial nerve (FN) injuries are functionally, psychologically, and financially debilitating. Facial nerve autograft repairs produce significant donor nerve morbidity and functional results that rarely exceed House-Brackmann (HB) grade III over VI. In this study we sought to enhance FN regeneration via collagen conduit entubulation. Methods: Five control cats underwent right ("cut-side") FN transection and immediate microsurgical anastomosis repair. Five experimental cats underwent identical repairs plus collagen conduit entubulation of each anastomosis. Results: Postoperative behavioral observations revealed gradual FN functional recovery in all cats, who attained adapted HB grades of II to III over VI after 6 weeks. Electromyographic latencies and amplitudes from the bilateral orbicularis oculi and orbicularis oris muscles indicated restoration of FN continuity in all 10 cats. In comparison with FN repairs without conduits, repairs with conduits significantly enhanced recovery of amplitude in cut-side orbicularis oculi muscles (p = .037) and latency in cut-side orbicularis oris muscles (p = .048). In comparison with intact left ("uncut-side") FN latencies and amplitudes, more statistically significant differences in cut-side FN function were observed in repairs without conduits than in repairs with conduits. Conduits therefore facilitated a more complete return of electrophysiological function. Histologic analyses confirmed FN continuity and revealed more organized FN regenerative architecture in conduit-implanted repairs. Conclusions: The overall results support enhanced FN regeneration with collagen conduit entubulation. C1 Univ Minnesota, Dept Otolaryngol, Minneapolis, MN 55455 USA. Univ Minnesota, Dept Pathol, Minneapolis, MN 55455 USA. RP Levine, SC (reprint author), Univ Minnesota, Dept Otolaryngol, 420 Delaware St SE, Minneapolis, MN 55455 USA. CR ARCHIBALD SJ, 1995, J NEUROSCI, V15, P4109 ARCHIBALD SJ, 1991, J COMP NEUROL, V306, P685, DOI 10.1002/cne.903060410 BOYLE WF, 1966, LARYNGOSCOPE, V76, P1921 Chamberlain LJ, 1998, BIOMATERIALS, V19, P1393, DOI 10.1016/S0142-9612(98)00018-0 CHEN YS, 1989, EXP NEUROL, V103, P52, DOI 10.1016/0014-4886(89)90184-2 Choi D, 2001, ACTA NEUROCHIR, V143, P107 Dagum A B, 1998, J Hand Ther, V11, P111 DANIELSEN N, 1988, SCAND J PLAST RECONS, V22, P207 DASILVA CF, 1985, BRAIN RES, V342, P307, DOI 10.1016/0006-8993(85)91130-8 Evans GRD, 2000, J BIOMAT SCI-POLYM E, V11, P869, DOI 10.1163/156856200744066 Evans GRD, 2002, BIOMATERIALS, V23, P841, DOI 10.1016/S0142-9612(01)00190-9 Evans GRD, 1999, BIOMATERIALS, V20, P1109, DOI 10.1016/S0142-9612(99)00010-1 FAWCETT JW, 1990, ANNU REV NEUROSCI, V13, P43, DOI 10.1146/annurev.neuro.13.1.43 FRYKMAN GK, 1988, ORTHOP CLIN N AM, V19, P209 GACEK RR, 1982, LARYNGOSCOPE, V92, P547 Hadlock T, 1998, ARCH OTOLARYNGOL, V124, P1081 Hadlock T, 2000, TISSUE ENG, V6, P119, DOI 10.1089/107632700320748 Heath CA, 1998, TRENDS BIOTECHNOL, V16, P163, DOI 10.1016/S0167-7799(97)01165-7 Hou Z, 1999, Electromyogr Clin Neurophysiol, V39, P489 Hudson TW, 1999, CLIN PLAST SURG, V26, P617 JANECKA IP, 1987, LARYNGOSCOPE, V97, P942 Kitahara AK, 1999, SCAND J PLAST RECONS, V33, P187 Kiyotani T, 1996, BRAIN RES, V740, P66, DOI 10.1016/S0006-8993(96)00848-7 LI S-T, 1992, Clinical Materials, V9, P195, DOI 10.1016/0267-6605(92)90100-8 Liuzzi F J, 1991, Neurosurg Clin N Am, V2, P31 Mackinnon S E, 1985, J Reconstr Microsurg, V1, P185, DOI 10.1055/s-2007-1007073 Maquet V, 2000, J BIOMED MATER RES, V52, P639, DOI 10.1002/1097-4636(20001215)52:4<639::AID-JBM8>3.0.CO;2-G Martini DV, 1996, OTOLARYNG HEAD NECK, V114, P605, DOI 10.1016/S0194-5998(96)70254-1 Matsumoto K, 2000, BRAIN RES, V868, P315, DOI 10.1016/S0006-8993(00)02207-1 Matsumoto K, 2000, ASAIO J, V46, P415, DOI 10.1097/00002480-200007000-00009 Meek MF, 2001, BIOMATERIALS, V22, P1177, DOI 10.1016/S0142-9612(00)00340-9 O'Sullivan KL, 1998, ANN PLAS SURG, V40, P478, DOI 10.1097/00000637-199805000-00006 RADPOUR S, 1977, LARYNGOSCOPE, V87, P557 RADPOUR S, 1980, LARYNGOSCOPE, V90, P685 RADPOUR S, 1985, OTOLARYNG HEAD NECK, V93, P591 SECKEL BR, 1990, MUSCLE NERVE, V13, P785, DOI 10.1002/mus.880130904 Spector JG, 1998, ANN OTO RHINOL LARYN, V107, P141 Strauch B, 2000, HAND CLIN, V16, P123 TAKAHASHI M, 1988, ACTA PATHOL JAPON, V38, P1489 Terris DJ, 2001, ARCH OTOLARYNGOL, V127, P294 Walter M A, 1993, Facial Plast Surg, V9, P68, DOI 10.1055/s-2008-1064597 2004, INTEGR LS COM NR 42 TC 5 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2006 VL 115 IS 8 BP 631 EP 642 PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 073WS UT WOS:000239774000010 PM 16944663 ER PT J AU Vaiman, M Krakovski, D Gavriel, H AF Vaiman, Michael Krakovski, Daniel Gavriel, Haim TI Fibrin sealant reduces pain after tonsillectomy: Prospective randomized study SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE dysphagia; recurrent tonsillitis; surface electromyography; tonsillectomy ID 440 ADULTS; SURFACE ELECTROMYOGRAPHY; QUANTITATIVE DATA; MUSCLE PAIN; HUMAN JAW; TRIAL; GLUE; EMG AB Objectives: Postsurgical pain in adults following tonsillectomy with fibrin sealant or electrocoagulation was assessed by surface electromyography (sEMG), a dysphagia severity rating scale (DSRS), and a visual analog scale (VAS) pain score. Methods: For group I (n = 40), hemostasis was achieved by fibrin sealant spraying to the tonsillar fossae. For group 2 (n 40), hemostasis was achieved by bipolar or needle point electrocautery. The timing of single swallowing and continuous drinking and the mean electrical activity of the masseter, infrahyoid, and submental-submandibular muscles were compared with a normative database during 30 days and with DSRS and VAS scores. Results: Electrical activity of the masseter and infrahyoid muscles was significantly higher in both groups in comparison with the normative database (p < .05 to p < .005), whereas timing was less affected. The combined sEMG, DSRS, and VAS assessment showed that tonsillectomy ended with sealant causes less pain than electrocoagulation (p < .05). The DSRS score data were in strong positive correlation with the sEMG records, whereas the VAS pain score was less informative. Conclusions: The combined sEMG and pain score data indicate that the electrocautery hemostatic technique is more painful and traumatic than the sealant technique. Surface electromyography of swallowing is a simple, reliable evaluation. method for postsurgical odynophagia complaints and might be used as an objective tool for pain assessment. C1 Tel Aviv Univ, Assaf Harofe Med Ctr, Dept Otolaryngol, Tel Aviv, Israel. Tel Aviv Univ, Sackler Fac Med, Tel Aviv, Israel. RP Vaiman, M (reprint author), 33 Shapiro St, IL-59561 Bat Yam, Israel. CR Al-Saad M, 2001, INT J PROSTHODONT, V14, P15 COWAN DL, 1997, LARYNGOLOGY HEAD NEC, V5, P1 El-Hakim H, 2000, CLIN OTOLARYNGOL, V25, P413, DOI 10.1046/j.1365-2273.2000.00397.x Falla D, 2004, MANUAL THER, V9, P125, DOI 10.1016/j.math.2004.05.003 Glaros AG, 2004, J BEHAV MED, V27, P91, DOI 10.1023/B:JOBM.0000013646.04624.8f Gross CW, 2001, LARYNGOSCOPE, V111, P259, DOI 10.1097/00005537-200102000-00014 J Goodgold, 1975, ANATOMICAL CORRELATE, P2 Kendall SA, 2002, J REHABIL MED, V34, P73, DOI 10.1080/165019702753557863 Kitajiri S, 2001, LARYNGOSCOPE, V111, P642, DOI 10.1097/00005537-200104000-00015 MORALEE SJ, 1994, CLIN OTOLARYNGOL, V19, P526, DOI 10.1111/j.1365-2273.1994.tb01282.x Nicholson RA, 2000, APPL PSYCHOPHYS BIOF, V25, P203, DOI 10.1023/A:1026402720856 Salonen A, 2002, LARYNGOSCOPE, V112, P94, DOI 10.1097/00005537-200201000-00017 Shiau YY, 2003, J ORAL REHABIL, V30, P978, DOI 10.1046/j.1365-2842.2003.01159.x Stoeckli SJ, 1999, LARYNGOSCOPE, V109, P652, DOI 10.1097/00005537-199904000-00025 Svensson P, 2004, PAIN, V109, P225, DOI 10.1016/j.pain.2003.12.031 Vaiman M, 2004, OTOLARYNG HEAD NECK, V131, P977, DOI 10.1016/j.otohns.2004.03.015 Vaiman M, 2005, LARYNGOSCOPE, V115, P68, DOI 10.1097/01.mlg.0000150673.53107.20 Vaiman M, 2004, OTOLARYNG HEAD NECK, V131, P773, DOI 10.1016/j.otohns.2004.03.014 Vaiman M, 2004, OTOLARYNG HEAD NECK, V131, P548, DOI 10.1016/j.otohns.2004.03.013 Vaiman M, 2004, DYSPHAGIA, V19, P125, DOI 10.1007/s00455-003-0504-x Wang K, 2002, J DENT RES, V81, P650 NR 21 TC 11 Z9 12 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2006 VL 115 IS 7 BP 483 EP 489 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 064DI UT WOS:000239069000002 PM 16900801 ER PT J AU Sieskiewicz, A Olszewska, E Rogowski, M Grycz, E AF Sieskiewicz, Andrzej Olszewska, Ewa Rogowski, Marek Grycz, Ewa TI Preoperative corticosteroid oral therapy and intraoperative bleeding during functional endoscopic sinus surgery in patients with severe nasal polyposis: A preliminary investigation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE corticosteroid therapy; functional endoscopic sinus surgery; nasal polyposis; operative bleeding ID CONTROLLED HYPOTENSION; SODIUM-NITROPRUSSIDE; SURGICAL CONDITIONS; BLOOD-LOSS; ESMOLOL AB Objectives: The aim of the study was to investigate whether orally administered steroids might improve surgical field conditions during functional endoscopic sinus surgery. Methods: Total blood loss and visualization of the surgical field during the surgical procedure were compared in 2 groups of 18 patients each with severe nasal polyposis. The groups were similar in respect to age, body mass index, general health status, incidence of allergy, bronchial asthma, aspirin triad, and stage of disease. One group received 30 mg of prednisone daily for 5 consecutive days before the operation. The second group served as a control. Results: Although the total blood loss was only slightly less in the steroid group, the visual conditions of the surgical field improved significantly. Conclusions: Better surgical field conditions were the results of the powerful anti-inflammatory and antiedematous activity of the drug, which facilitated blood and secretion evacuation from the operated area and prevented the optic system from staining. C1 Med Univ Bialystok, Dept Otolaryngol, PL-15276 Bialystok, Poland. Med Univ Bialystok, Dept Intens Care, PL-15276 Bialystok, Poland. RP Sieskiewicz, A (reprint author), Med Univ Bialystok, Dept Otolaryngol, Ul Sklodowskiej 24A, PL-15276 Bialystok, Poland. CR BOEZAART AP, 1995, CAN J ANAESTH, V42, P373 CHYREKBOROWSKA S, 1993, FARMAKOTERAPIA CHORO Cincikas Darius, 2003, Medicina (Kaunas), V39, P852 Damm M, 1999, OTOLARYNG HEAD NECK, V120, P517, DOI 10.1053/hn.1999.v120.a88844 DAVIS WE, 1991, LARYNGOSCOPE, V101, P416 DEGOUTE CS, 1994, EUR J APPL PHYSIOL O, V69, P414, DOI 10.1007/BF00865405 Degoute CS, 2001, CAN J ANAESTH, V48, P20 Eberhart LHJ, 2003, LARYNGOSCOPE, V113, P1369, DOI 10.1097/00005537-200308000-00019 FROMME GA, 1986, ANESTH ANALG, V65, P683 GRIFFIES WS, 1989, LARYNGOSCOPE, V99, P1161 Jacobi KE, 2000, J CLIN ANESTH, V12, P202, DOI 10.1016/S0952-8180(00)00145-8 KENNEDY DW, 1992, LARYNGOSCOPE S57, V102 LEIGH JM, 1975, BRIT J ANAESTH, V47, P745, DOI 10.1093/bja/47.7.745 Levine H L, 1993, ENDOSCOPIC SINUS SUR LEVINE HL, 1990, LARYNGOSCOPE, V100, P79 MATTHEWS BL, 1991, OTOLARYNG HEAD NECK, V104, P244 MYGIND N, 1998, ALERGOLOGIA Nair S, 2004, LARYNGOSCOPE, V114, P1042, DOI 10.1097/00005537-200406000-00016 REIZ S, 1983, ANESTHESIOLOGY, V59, P91, DOI 10.1097/00000542-198308000-00004 SIMPSON P, 1992, BRIT J ANAESTH, V69, P498, DOI 10.1093/bja/69.5.498 TRACZUK Z, 1998, FIZJOLOGIA CZLOWIEKA, P413 WILHELM DL, 1977, PATHOLOGY, P25 NR 22 TC 36 Z9 40 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2006 VL 115 IS 7 BP 490 EP 494 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 064DI UT WOS:000239069000003 PM 16900802 ER PT J AU Schlosser, RJ Woodworth, BA Wilensky, EM Grady, MS Bolger, WE AF Schlosser, Rodney J. Woodworth, Bradford A. Wilensky, Eileen Maloney Grady, M. Sean Bolger, William E. TI Spontaneous cerebrospinal fluid leaks: A variant of benign intracranial hypertension SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cerebrospinal fluid leak; encephalocele; endoscopic surgery; intracranial hypertension ID EMPTY SELLA SYNDROME; MANAGEMENT; RHINORRHEA; PRESSURE; PROLACTIN; REPAIR AB Objectives: Previous reports indicate that elevated intracranial pressure (ICP) may cause spontaneous cerebrospinal fluid (CSF) leaks. In this study we examined the clinical diagnosis of benign intracranial hypertension (BIH) in this population using the modified Dandy criteria. Methods: We performed a retrospective review of clinical data and measurements of ICPs after surgical repair. Results: Sixteen patients with spontaneous CSF leaks were surgically treated from 1996 to 2002. In 11 patients with CSF pressure measurements, strict adherence to the modified Dandy criteria definitively confirmed a diagnosis of BIH in 8 patients (72%) and a likely diagnosis in the 3 remaining patients. The mean ICP was 31.1 cm H2O (range, 17.3 to 52 cm H2O). and 81% of the patients were obese middle-aged women. Clinically, all patients had signs and/or symptoms of elevated ICP, such as headache (91 %), pulsatile tinnitus (45%). hypertension (45%), balance problems (27%), and visual complaints (18%). Surgical repair was 100% successful in leak cessation over a mean follow-up of 14.1 months. Conclusions: Most patients with spontaneous CSF leaks fulfill the modified Dandy criteria; thus, this disorder appears to be a variant of BIH. Further investigation is needed to determine the exact cause of elevated CSF pressures in this group and whether medical or surgical treatments to correct the intracranial hypertension are warranted. C1 Med Univ S Carolina, Dept Otolarygol Head & Neck Surg, Charleston, SC 29425 USA. Univ Penn, Dept Neurosurg, Philadelphia, PA USA. Uniformed Serv Univ Hlth Sci, Dept Surg, Bethesda, MD USA. RP Schlosser, RJ (reprint author), Med Univ S Carolina, Dept Otolarygol Head & Neck Surg, 135 Rutledge Ave,Suite 1130,POB 250550, Charleston, SC 29425 USA. CR Badia L, 2001, AM J RHINOL, V15, P117, DOI 10.2500/105065801781543736 BJERRE P, 1990, Acta Neurologica Scandinavica Supplementum, V82, P1 Bolger WE, 1999, ENT-EAR NOSE THROAT, V78, P36 BRISMAR K, 1981, NEURORADIOLOGY, V21, P167 Casiano RR, 1999, OTOLARYNG HEAD NECK, V121, P745, DOI 10.1053/hn.1999.v121.a98754 CORBETT JJ, 1989, ARCH NEUROL-CHICAGO, V46, P1049 HUBBARD JL, 1985, NEUROSURGERY, V16, P314 MAIRA G, 1984, NEUROENDOCRINOLOGY, V38, P102, DOI 10.1159/000123876 MAIRA G, 1990, CAN J NEUROL SCI, V17, P92 MATTOX DE, 1990, LARYNGOSCOPE, V100, P857 OMMAYA AK, 1968, J NEUROL NEUROSUR PS, V31, P214, DOI 10.1136/jnnp.31.3.214 Schlosser RJ, 2004, OTOLARYNG HEAD NECK, V130, P443, DOI 10.1016/j.otohns.2003.12.018 Schlosser RJ, 2002, LARYNGOSCOPE, V112, P980, DOI 10.1097/00005537-200206000-00008 Shetty PG, 2000, AM J NEURORADIOL, V21, P337 SPAZIANTE R, 1981, SURG NEUROL, V16, P418, DOI 10.1016/0090-3019(81)90234-2 Zagardo MT, 1996, AM J NEURORADIOL, V17, P1953 NR 16 TC 63 Z9 67 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2006 VL 115 IS 7 BP 495 EP 500 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 064DI UT WOS:000239069000004 PM 16900803 ER PT J AU Nomoto, Y Suzuki, T Tada, Y Kobayashi, K Miyake, M Hazama, A Wada, I Kanemaru, S Nakamura, T Omori, K AF Nomoto, Yukio Suzuki, Teruhisa Tada, Yasuhiro Kobayashi, Ken Miyake, Masao Hazama, Akihiro Wada, Ikuo Kanemaru, Shinichi Nakamura, Tatsuo Omori, Koichi TI Tissue engineering for regeneration of the tracheal epithelium SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE regeneration; tissue engineering; trachea; tracheal epithelium ID DIFFERENTIATION; REPLACEMENT; PROSTHESIS; CELLS; MESH AB Objectives: The slowness of epithelialization on the artificial trachea that has been successfully used in humans is a problem. The purpose of this study was to develop a way to regenerate the epithelium on the surface of this artificial trachea. Methods: In an in vitro study, isolated rat tracheal epithelial cells were seeded on a collagenous get that was stratified on a collagenous sponge. Histologic and immunohistochemical examinations were made. III an in vivo study, we transplanted grafts with green fluorescent protein-positive tracheal epithelial cells onto the tracheal defects of normal rats. At 3, 7. 14, and 30 days after the operation, histologic and immunohistochemical examinations were made. Results: In the in vitro study, the 3 layers - the epithelium, gel, and sponge - could be observed. The epithelium expressed cytokeratin 14, cytokeratin 18, and occludin. In the in vivo study, the artificial trachea was covered with epithelium at 3 days after operation, and then the epithelium differentiated from single- or double-stratified squamous epithelium into columnar ciliated epithelium. Green fluorescent protein-positive cells were found 3 days after operation. Conclusions: We believe that the method used in our experiment is an effective way to regenerate the epithelium on the surface of an artificial trachea. With further experimentation, this method should be suitable for clinical application. C1 Fukushima Med Univ, Sch Med, Dept Otorhinolaryngol, Fukuoka 9601295, Japan. Fukushima Med Univ, Sch Med, Dept Otolaryngol, Fukuoka 9601295, Japan. Fukushima Med Univ, Sch Med, Dept Physiol 1, Fukuoka 9601295, Japan. Fukushima Med Univ, Sch Med, Inst Biomed Sci, Dept Cell Sci, Fukuoka 9601295, Japan. Kyoto Univ, Inst Frontier Med Sci, Dept Bioartificial Organs, Kyoto, Japan. Kyoto Univ, Grad Sch Med, Dept Otorhinolaryngol Head & Neck Surg, Kyoto, Japan. RP Omori, K (reprint author), Fukushima Med Univ, Sch Med, Dept Otorhinolaryngol, 1 Hikarigaoka, Fukuoka 9601295, Japan. CR BEALL AC, 1962, ARCH SURG-CHICAGO, V84, P390 Grillo HC, 2002, ANN THORAC SURG, V73, P1995, DOI 10.1016/S0003-4975(02)03564-6 JETTEN AM, 1987, LAB INVEST, V56, P654 Nakamura T, 2000, INT J ARTIF ORGANS, V23, P718 OKUMURA N, 1994, J THORAC CARDIOV SUR, V108, P337 Omori K, 2005, ANN OTO RHINOL LARYN, V114, P429 Teramachi M, 1997, ANN THORAC SURG, V64, P965, DOI 10.1016/S0003-4975(97)00755-8 WHITCUTT MJ, 1988, IN VITRO CELL DEV B, V24, P420 YAMAYA M, 1993, AM J PHYSIOL, V265, pL170 NR 9 TC 17 Z9 23 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2006 VL 115 IS 7 BP 501 EP 506 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 064DI UT WOS:000239069000005 PM 16900804 ER PT J AU Dauer, EH Ponikau, JU Smyrk, TC Murray, JA Thompson, DM AF Dauer, Eileen H. Ponikau, Jens U. Smyrk, Thomas C. Murray, Joseph A. Thompson, Dana M. TI Airway manifestations of pediatric eosinophilic esophagitis: A clinical and histopathologic report of an emerging association SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE dysphagia; eosinophil; esophagitis; fluticasone; major basic protein; pediatrics; reflux esophagitis; subglottic stenosis ID MAJOR BASIC-PROTEIN; ALLERGIC ESOPHAGITIS; GASTROESOPHAGEAL-REFLUX; CHILDREN; ADULTS; DYSPHAGIA; CORTICOSTEROIDS; SINUSITIS AB Objectives: Pediatric eosinophilic esophagitis (EE) typically presents with dysphagia, vomiting, dyspepsia, or food impaction. The purpose of this study was to highlight the emerging association of pediatric EE and airway disease. An additional goal of this study was to describe the unique histopathologic findings found in EE and specifically explore the potential role of the cytotoxic protein called eosinophil major basic protein (MBP) in the pathophysiology of the disease. Methods: A retrospective review of 3 children with EE and airway symptoms included symptom presentation, aerodigestive tract endoscopic findings, ambulatory 24-hour dual pH-metry, allergy tests, treatment modalities, and treatment response. Esophageal tissue obtained from biopsies of each patient was evaluated by hematoxylin and eosin to determine the number of eosinophils per high-power field, by immunofluorescent anti-MBP staining to determine the presence of MBP, and by standard light and transmission electron microscopy to evaluate eosinophil migration patterns. Results: All patients had airway inflammation that included nonspecific laryngeal edema and grade I or 11 subglottic stenosis. Allergy testing was positive in the 2 patients who were tested. All patients had symptoms refractory to standard reflux therapy. Ambulatory pH-metry findings were normal in 2 patients and abnormal in I patient despite maximum treatment. Two patients had visual abnormalities seen during esophageal examination. The number of eosinophils ranged from 20 to 45 per high-power field. Intracellular and extracellular MBP deposition was found in all esophageal biopsy specimens. All patients were treated with swallowed fluticasone, and 2 had symptom relapses that required repeat treatment. Conclusions: The spectrum of pediatric EE can include upper airway disease. Intracellular and extracellular MBP deposition is present in EE, which potentially releases cytotoxic mediators that explain the esophageal and airway clinical symptoms seen in those with the disease. Eosinophilic esophagitis should be considered in patients with a history of atopic diseases and unexplained upper airway findings refractory to reflux treatment. Treatment with swallowed fluticasone is successful; however, relapses are common and require repeat treatment and close follow-up. C1 Univ Cincinnati, Childrens Hosp, Med Ctr, Dept Pediat Otolaryngol, Cincinnati, OH 45229 USA. Mayo Clin & Mayo Coll Med, Dept Internal Med, Div Gastroenterol & Hepatol, Rochester, MN USA. Mayo Clin & Mayo Coll Med, Dept Lab Med & Pathol, Rochester, MN USA. RP Thompson, DM (reprint author), Univ Cincinnati, Childrens Hosp, Med Ctr, Dept Pediat Otolaryngol, MCL 2018,3333 Burnet Ave, Cincinnati, OH 45229 USA. 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Otol. Rhinol. Laryngol. PD JUL PY 2006 VL 115 IS 7 BP 507 EP 517 PG 11 WC Otorhinolaryngology SC Otorhinolaryngology GA 064DI UT WOS:000239069000006 PM 16900805 ER PT J AU Cianfrone, G Turchetta, R Mazzei, F Bartolo, M Parisi, L AF Cianfrone, Giancarlo Turchetta, Rosaria Mazzei, Filippo Bartolo, Michelangelo Parisi, Leoluca TI Temperature-dependent auditory neuropathy: Is it an acoustic Uhthoff-like phenomenon? A case report SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE auditory neuropathy; demyelination; neuropathy; otoacoustic emission; transitory deafness; Uhthoff; vestibulocochlear nerve ID BRAIN-STEM RESPONSE; PROFOUND HEARING-LOSS; MULTIPLE-SCLEROSIS; EVOKED-POTENTIALS; NERVE-FIBERS; OTOACOUSTIC EMISSIONS; COCHLEAR MICROPHONICS; COMPUTER-SIMULATIONS; VISUAL IMPAIRMENT; CONDUCTION AB Objectives: We describe the case of a young girl in whom transient deafness occurred when her core body temperature rose. Methods: The patient was referred for a series of audiological and neurologic evaluations performed over time in both afebrile and febrile states, as well as after a stress test (with a treadmill) in which the body temperature rise simulated the febrile state. Results: The patient was found to have a temporary bilateral hearing loss, but had normal distortion product otoacoustic emissions. Moreover, auditory brain stem responses revealed the absence of neural synchrony when her core body temperature increased. Conclusions: These results are consistent with a temperature-dependent auditory neuropathy, a rare condition in which patients show normal outer hair cell function and abnormal neural function of the eighth cranial nerve. The symptom is reminiscent of Uhthoff's phenomenon, which is described as transient visual loss and is usually observed in multiple sclerosis. This case of temperature-dependent auditory neuropathy is noteworthy because it sheds light on a disorder of which there have been few reports in the literature. We discuss its similarity to Uhthoff's phenomenon. C1 Univ Roma La Sapienza, Dept Otorhinolaryngol Audiol & Phoniatr, I-00185 Rome, Italy. Univ Roma La Sapienza, Dept Neurol & Otorhinolaryngol, I-00185 Rome, Italy. RP Cianfrone, G (reprint author), Univ Roma La Sapienza, Dept Otorhinolaryngol Audiol & Phoniatr, Vle Policlin 155, I-00185 Rome, Italy. 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Otol. Rhinol. Laryngol. PD JUL PY 2006 VL 115 IS 7 BP 518 EP 527 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 064DI UT WOS:000239069000007 PM 16900806 ER PT J AU Amin, MR Harris, D Cassel, SG Grimes, E Heiman-Patterson, T AF Amin, Milan R. Harris, Donna Cassel, Stacy Gallese Grimes, Eric Heiman-Patterson, Terry TI Sensory testing in the assessment of laryngeal sensation in patients with amyotrophic lateral sclerosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE amyotrophic lateral sclerosis; aspiration pneumonia; deglutition; FEESST; larynx; sensory dysfunction ID OROPHARYNGEAL DYSPHAGIA; ENDOSCOPIC EVALUATION; EVOKED-POTENTIALS; REFLUX AB Objectives: Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease of unknown cause. Mortality in the population is frequently due to aspiration pneumonia. Although typically considered to be a disorder limited to motor neuron involvement, some investigators have indicated that decreased sensory function in ALS patients additionally contributes to the disease process. The objective of this study was to evaluate laryngopharyngeal sensation in the ALS population in order to quantify the range of sensory deficits and correlate any abnormalities with demographic data to determine which patients are at risk of having sensory deficits. Methods: We examined the sensation of the larynx in 22 patients with ALS to determine whether a sensory deficit was present. After completion of a dysphagia questionnaire and medical history, patients underwent flexible endoscopic evaluation of swallowing with sensory testing (FEESST) to evaluate sensory function. Threshold values were determined and recorded for initiation of the adductor reflex. Results: The results of the sensory and swallowing function assessments performed on 22 patients demonstrate abnormal sensation in 54.5% of the tested population. Asymmetric findings were noted in 75% of these patients. There was no correlation noted between the presence of sensory deficits and the severity or duration of the disease. Conclusions: Progressive dysphagia in the ALS population has typically been attributed to muscle weakness. This study points to the presence of sensory deficits in the larynx, which can further affect proper swallowing function. C1 Drexel Univ, Coll Med, Voice Ctr, Philadelphia, PA USA. Drexel Univ, Dept Otolaryngol, Philadelphia, PA USA. Drexel Univ, Dept Neurol, MDA ALS Ctr Hope, Philadelphia, PA USA. Temple Univ, Dept Otolaryngol, Philadelphia, PA USA. Med Coll Penn & Hahnemann Univ, Dept Speech Pathol, Philadelphia, PA 19102 USA. RP Amin, MR (reprint author), NYU, Sch Med, Dept Otolaryngol, 550 1St Ave,NBV 4 East 5, New York, NY 10016 USA. 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PD JUL PY 2006 VL 115 IS 7 BP 528 EP 534 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 064DI UT WOS:000239069000008 PM 16900807 ER PT J AU Zeitels, SM Kobler, JB Heaton, JT Faquin, W AF Zeitels, Steven M. Kobler, James B. Heaton, James T. Faquin, William TI Carbon dioxide laser fiber for laryngeal cancer surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE cancer; carbon dioxide laser; glottis; larynx; laser; microlaryngoscopy; photonic bandgap fiber; vocal fold ID CLINICAL EXPERIENCE; CO2-LASER; CARCINOMA AB Objectives: The carbon dioxide laser has evolved to be the premier dissecting instrument for hemostatic cutting during endolaryngeal cancer resection. However, dissection is limited to mirror-reflected line-of-sight delivery of the laser. A recently developed flexible, hollow photonic bandgap fiber (PBF) appears to offer advantages in endolaryngeal dissection. Methods: The suitability of the PBF for human application was evaluated in a canine experiment in which human surgical procedures for microlaryngoscopic en bloc partial laryngectomy were simulated. The specimens that were resected endoscopically and the completion laryngectomy specimen were evaluated histologically. Results: Observations from this experiment revealed that en bloc partial laryngectomy procedures were substantially easier to achieve as compared with prior experience in humans. This improvement resulted from three factors: 1) enhanced tangential dissection due to increased angulation of the laser energy, 2) enhanced procedural orientation due to proprioception of the tissues in contact mode, and 3) improved hemostasis. Histopathologic analysis of the resection margins revealed minimal thermal trauma. Conclusions: The PBF shows substantial promise for human application in endoscopic partial laryngectomy. It will likely enhance the ability of any surgeon to extend his or her indications for performing endoscopic laryngeal cancer resections regardless of philosophy (en bloc resection or piecemeal). C1 Harvard Univ, Massachusetts Gen Hosp, Sch Med, Ctr Laryngeal Surg & Voice Rehabil,Dept Surg, Boston, MA 02114 USA. Harvard Univ, Med Sch, Dept Pathol, Boston, MA 02114 USA. RP Zeitels, SM (reprint author), Harvard Univ, Massachusetts Gen Hosp, Sch Med, Ctr Laryngeal Surg & Voice Rehabil,Dept Surg, 1 Bowdoin Sq,11th Floor, Boston, MA 02114 USA. CR DAVIS RK, 1983, LARYNGOSCOPE, V93, P429 Fink Y, 1998, SCIENCE, V282, P1679, DOI 10.1126/science.282.5394.1679 Fraenkel B, 1886, ARCH KLIN CHIR, V12, P283 JAKO GJ, 1962, CORRES DOCUMENTS G J JAKO GJ, 1972, LARYNGOSCOPE, V82, P2204, DOI 10.1288/00005537-197212000-00009 JAKO GJ, 1966, 115 ANN M AM MED ASS JELINEK E, 1884, WIEN MED WOCHENSCHR, V34, P1334 Killian G, 1912, ARCH LARYNGOLOGIE RH, V26, P277 Kirstein A., 1897, AUTOSCOPY LARYNX TRA Kirstein A, 1895, ARCH LARYNGOL RHINOL, V3, P156 KLEINSASSER O, 1968, MICROLARYNGOSCOPY EN, P48 Lillie JC, 1973, T AM ACAD OPHTHALMOL, V77, P92 Lynch RC, 1920, T AM LARYNGOL ASS, V40, P119 Lynch RC, 1915, ANN OTO RHINOL LARYN, V24, P429 POLANYI TG, 1970, MED BIOL ENG, V8, P541, DOI 10.1007/BF02478228 RUDERT HH, 1994, INT CONGR SER, V1063, P457 SCALCO A N, 1960, Ann Otol Rhinol Laryngol, V69, P1134 SHAPIRO J, 1992, OPER TECH OTOLARYNOL, V23, P84 Solis-Cohen J, 1869, MED REC, V4, P244 Steiner W, 1988, Adv Otorhinolaryngol, V39, P135 STEINER W, 1984, FUNCTIONAL PARTIAL L, P121 STRONG M, 1976, WORKSH CENT C LAR CA, P154 STRONG MS, 1972, ANN OTO RHINOL LARYN, V81, P791 STRONG MS, 1975, LARYNGOSCOPE, V85, P1286, DOI 10.1288/00005537-197508000-00003 THUMFART WF, 1990, HNO, V38, P174 Tucker GF, 1971, HUMAN LARYNX CORONAL VAUGHAN CW, 1978, LARYNGOSCOPE, V88, P1399 VAUGHAN CW, 1978, AM J SURG, V136, P490, DOI 10.1016/0002-9610(78)90267-2 ZEITELS SM, 1990, OTOLARYNG HEAD NECK, V103, P337 Zeitels SM, 1997, HEAD NECK-J SCI SPEC, V19, P342, DOI 10.1002/(SICI)1097-0347(199707)19:4<342::AID-HED13>3.0.CO;2-B Zeitels SM, 2004, LARYNGOSCOPE, V114, P175, DOI 10.1097/00005537-200401000-00033 Zeitels SM, 2001, ATLAS PHONOMICROSURG ZEITELS SM, 1994, LARYNGOSCOPE, V104, P71 ZEITELS SM, 1999, ANN OTO RHINOL LARYN, V179, P108 ZEITELS SM, 1990, OTOLARYNG HEAD NECK, V103, P487 Zeitels SM, 2004, ANN OTO RHINOL LARYN, V113, P16 ZEITELS SM, 1995, LARYNGOSCOPE S, V67, P105 NR 37 TC 19 Z9 19 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2006 VL 115 IS 7 BP 535 EP 541 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 064DI UT WOS:000239069000009 PM 16900808 ER PT J AU Damen, GWJA van den Oever-Goltstein, MHL Langereis, MC Chute, PM Mylanus, EAM AF Damen, Godelieve W. J. A. van den Oever-Goltstein, Marilene H. L. Langereis, Margreet C. Chute, Patricia M. Mylanus, Emmanuel A. M. TI Classroom performance of children with cochlear implants in mainstream education SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE classroom performance; cochlear implant; mainstream education ID SPEECH-PERCEPTION PERFORMANCE; PRELINGUALLY DEAF-CHILDREN; CONVENTIONAL HEARING-AIDS; LANGUAGE; AGE; SKILLS AB Objectives: We compared classroom performance of children with a cochlear implant (CI) with that of their normal-hearing peers in mainstream education. Methods: Thirty-two Cl children in mainstream education, congenitally or prelingually deaf, participated in this study, as did 37 hearing classmates. Their teachers filled out 2 questionnaires: the Assessment of Mainstream Performance (AMP) and the Screening Instrument for Targeting Educational Risk (SIFTER). A high Fletcher index and open-set speech perception scores were obtained. Results: The children with CIs scored above average on the AMP and sufficiently well in all but one area (communication) of the SIFTER questionnaire. Class rankings did not differ significantly between the Cl students and their normal-hearing peers. Overall, the normal-hearing group outperformed the Cl group. The classroom performance of Cl children correlated negatively with duration of deafness and age at implantation. All longitudinal audiological data of the CI children showed improvement in open-set speech recognition. Conclusions: Although the results are encouraging, the Cl group scored significantly less well than their normal-hearing peers on most questionnaire domains of both the AMP and the SIFTER. The most important variables for the outcome in this study were age at implantation and duration of deafness. C1 Radboud Univ, Nijmegen Med Ctr, Dept Otorhinolaryngol, NL-6500 HB Nijmegen, Netherlands. Univ Nijmegen, Med Ctr, Viataal Inst, Cochlear Implant Team, St Michielsgestel, Netherlands. Childrens Hearing Inst, Res Dept, New York, NY USA. RP Damen, GWJA (reprint author), Radboud Univ, Nijmegen Med Ctr, Dept Otorhinolaryngol, Philips Van Leydenlaan 15,POB 9101, NL-6500 HB Nijmegen, Netherlands. RI Mylanus, Emmanuel/D-2255-2010 CR Anderson K., 1996, PRESCHOOL SCREENING ANDERSON KL, 1989, SIFTER SCREENING IDE Anderson K.L., 1989, SCREENING IDENTIFICA Blamey PJ, 2001, J SPEECH LANG HEAR R, V44, P264, DOI 10.1044/1092-4388(2001/022) BOSMAN AJ, 1989, THESIS U UTRECHT UTR CHUTE PM, 2004, ESPCI P GEN SWITZ CONINX F, 1994, ADV COCHLEAR IMPLANT, P512 Connor CM, 2000, J SPEECH LANG HEAR R, V43, P1185 Francis HW, 1999, ARCH OTOLARYNGOL, V125, P499 Geers A, 2003, EAR HEARING, V24, p2S, DOI 10.1097/01.AUD.0000051685.19171.BD Geers A, 2003, EAR HEARING, V24, p24S, DOI 10.1097/01.AUD.0000051687.99218.0F Geers AE, 2003, EAR HEARING, V24, p46S, DOI 10.1097/01.AUD.0000051689.57380.1B Gordon KA, 2000, INT J PEDIATR OTORHI, V56, P101, DOI 10.1016/S0165-5876(00)00400-6 Govaerts PJ, 2002, OTOL NEUROTOL, V23, P885, DOI 10.1097/00129492-200211000-00013 JONES JA, 2004, SOUND WAVE KIRK KI, 2002, ANN OTOL RHINOL S189, V101, P69 Miyamoto RT, 1997, ACTA OTO-LARYNGOL, V117, P154, DOI 10.3109/00016489709117758 Miyamoto RT, 2003, ACTA OTO-LARYNGOL, V123, P241, DOI 10.1080/00016480310001079 Moog JS, 2002, ANN OTO RHINOL LARYN, V111, P138 Nikolopoulos TP, 1999, LARYNGOSCOPE, V109, P595, DOI 10.1097/00005537-199904000-00014 Niparko John K, 2004, JAMA, V291, P2378, DOI 10.1001/jama.291.19.2378 O'Donoghue GM, 1998, AM J OTOL, V19, P762 Osberger Mary Joe, 2002, Ann Otol Rhinol Laryngol Suppl, V189, P62 Pyman B, 2000, AM J OTOL, V21, P57, DOI 10.1016/S0196-0709(00)80113-1 Sharma Anu, 2002, Ear and Hearing, V23, P532, DOI 10.1097/00003446-200212000-00004 Snik AFM, 1997, ACTA OTO-LARYNGOL, V117, P755, DOI 10.3109/00016489709113473 Snik AFM, 1997, AM J OTOL, V18, pS138 Snik AFM, 1997, ACTA OTO-LARYNGOL, V117, P750, DOI 10.3109/00016489709113472 Spencer LJ, 2004, LARYNGOSCOPE, V114, P1576, DOI 10.1097/00005537-200409000-00014 Tobey EA, 2003, EAR HEARING, V24, p36S, DOI 10.1097/01.AUD.0000051688.48224.A6 NR 30 TC 11 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2006 VL 115 IS 7 BP 542 EP 552 PG 11 WC Otorhinolaryngology SC Otorhinolaryngology GA 064DI UT WOS:000239069000010 PM 16900809 ER PT J AU Kelley, R Reynders, A Seidberg, N AF Kelley, R Reynders, A Seidberg, N TI Nonsurgical management of pediatric tracheal perforation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE bronchoscopy; intubation injury; tracheal perforation ID ENDOTRACHEAL INTUBATION; CONSERVATIVE MANAGEMENT; WALL PERFORATION; RUPTURE; PREVENTION; TRACHEOSTOMY; TRACHEOCELE; INJURY AB Tracheal perforation is a rare complication of intubation. In the pediatric population, the rates of morbidity and mortality are high if diagnosis and management are delayed. Recommendations for treatment in these patients are based on the several reports of this injury in the adult and neonate populations. Surgical repair is generally favored over conservative care in the majority of cases. We describe the case of a 10-year-old girl who presented with subcutaneous emphysema after intubation in the emergency department. The patient had a 3-cm injury to the distal trachea. Nonsurgical management resulted in a normal-appearing trachea and a healed perforation site as confirmed by repeat tracheobronchoscopy 4 months after the initial injury. In clinically stable pediatric patients, nonsurgical management of tracheal perforations should be considered. C1 SUNY Upstate Med Univ, Dept Otolaryngol, Syracuse, NY 13210 USA. SUNY Upstate Med Univ, Dept Pediat Crit Care, Syracuse, NY 13210 USA. RP Kelley, R (reprint author), SUNY Upstate Med Univ, Dept Otolaryngol, 750 E Adams St, Syracuse, NY 13210 USA. CR Borasio P, 1997, EUR J CARDIO-THORAC, V12, P98, DOI 10.1016/S1010-7940(97)00111-5 DODEMONT JP, 1991, CHEST, V99, P1290, DOI 10.1378/chest.99.5.1290 Doherty KM, 2005, INT J PEDIATR OTORHI, V69, P111, DOI 10.1016/j.ijporl.2004.07.020 Baena MF, 1997, PAEDIATR ANAESTH, V7, P325, DOI 10.1046/j.1460-9592.1997.d01-80.x Goudy SL, 2002, LARYNGOSCOPE, V112, P791, DOI 10.1097/00005537-200205000-00005 Harris R, 2000, J EMERG MED, V18, P35, DOI 10.1016/S0736-4679(99)00159-6 MACKINNON D, 1953, J PATHOL BACTERIOL, V65, P513, DOI 10.1002/path.1700650223 MARTYANE CH, 1995, ANN THORAC SURG, V60, P1367, DOI 10.1016/0003-4975(95)00643-Y MENON AS, 1993, CHEST, V104, P636, DOI 10.1378/chest.104.2.636 MOLLER GM, 1994, EUR RESPIR J, V7, P1376 OTHERSEN HB, 1979, ANN SURG, V189, P601, DOI 10.1097/00000658-197905000-00009 Santambrogio L, 1998, INT SURG, V83, P106 SCHOLL PD, 1994, OTOLARYNG HEAD NECK, V111, P519 Sternfeld D, 2003, ANN EMERG MED, V42, P88, DOI 10.1067/mem.2003.278 Trottier SJ, 1999, CHEST, V115, P1383, DOI 10.1378/chest.115.5.1383 Westphal K, 2002, ANAESTHESIA, V57, P89 WEYMULLER EA, 1992, AM J OTOLARYNG, V13, P139, DOI 10.1016/0196-0709(92)90114-9 Zettl R, 1999, CRIT CARE MED, V27, P661, DOI 10.1097/00003246-199903000-00051 NR 18 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 408 EP 411 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000002 PM 16805370 ER PT J AU Vibert, D Blaser, B Ozdoba, C Hausler, R AF Vibert, D Blaser, B Ozdoba, C Hausler, R TI Fabry's disease: Otoneurologic findings in twelve members of one family SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 28th International Congress of the Barany-Society CY JUL 09, 2004 CL Paris, FRANCE SP Barany Soc DE Fabry's disease; hearing loss; magnetic resonance imaging; Meniere's disease; tinnitus; vertigo ID CORPORIS DIFFUSUM FABRY; ALPHA-GALACTOSIDASE; HEARING-LOSS; MANIFESTATIONS; COMPLICATIONS AB Fabry's disease corresponds to an inherited disorder transmitted by an X-linked recessive gene. It generates a dysfunction of glycosphingolipid metabolism due to an enzymatic deficiency of alpha-galactosidase activity, resulting in glycosphingolipid deposits in all areas of the body. The clinical (heart, kidney, and central nervous system) manifestations are more severe in hemizygous boys than in heterozygous girls. They appear during childhood or adolescence: acroparesthesia, joint pain, angiokeratoma, corneal dystrophy, hypohydrosis or anhydrosis, and renal failure. The otoneurologic symptoms consist of hearing fluctuation, progressive unilateral or bilateral hearing loss, and episodes of vertigo or dizziness. Otoneurologic findings in 12 of 26 members of the same family are presented: the mother and 9 of her 12 children, as well as 2 of her 14 grandchildren: 4 healthy persons, 4 heterozygous female carriers, and 4 hemizygous male patients. Three of the male patients had fluctuation of hearing, sudden hearing loss, and episodes of vertigo and dizziness. The otoneurologic examinations showed a bilateral cochleovestibular deficit (n = 1), a right cochleovestibular deficit (n = 1), and a bilateral hearing loss combined with a right vestibular deficit (n = 1). Histopathologic evidence of glycosphingolipid accumulation in vascular endothelial and ganglion cells, as well as atrophy of the stria and spiral ligament, might explain the otoneurologic symptoms and findings. C1 Univ Bern, Dept Otorhinolaryngol Head & Neck Surg, Inselspital, CH-3010 Bern, Switzerland. Univ Bern, Inst Diagnost & Intervent Neuroradiol, Inselspital, CH-3010 Bern, Switzerland. RP Vibert, D (reprint author), Univ Bern, Dept Otorhinolaryngol Head & Neck Surg, Inselspital, CH-3010 Bern, Switzerland. CR Anderson W.A., 1898, BRIT J DERMATOL, V18, P113 BARTIMMO EE, 1972, AM J MED, V53, P755, DOI 10.1016/0002-9343(72)90194-5 BIRD TD, 1978, ANN NEUROL, V4, P537, DOI 10.1002/ana.410040610 BLASER B, 2002, THESIS HUMAN MED FAC CONTI G, 2003, ACTA PAEDIATR, V92, P27 DEGROOT WP, 1964, DERMATOLOGICA, V128, P321 Fabry J., 1898, ARCH DERMATOL SYPHIL, V43, P187, DOI 10.1007/BF01986897 Garcin R, 1967, Presse Med, V75, P435 Garman SC, 2004, J MOL BIOL, V337, P319, DOI 10.1016/j.jmb.2004.01.035 GERMAIN DP, 2002, BMC MED GENET, V3, P1 Hajioff D, 2003, J INHERIT METAB DIS, V26, P787, DOI 10.1023/B:BOLI.0000009948.86528.72 Hajioff D, 2003, ACTA PAEDIATR, V92, P27 Khetarpal U, 2000, LARYNGOSCOPE, V110, P1379, DOI 10.1097/00005537-200008000-00030 Lemaire FX, 2003, OTOL NEUROTOL, V24, P743, DOI 10.1097/00129492-200309000-00009 MacDermot KD, 2001, J MED GENET, V38, P750, DOI 10.1136/jmg.38.11.750 Mitsias P, 1996, ANN NEUROL, V40, P8, DOI 10.1002/ana.410400105 MIYATAKE T, 1972, J NEUROCHEM, V19, P1911, DOI 10.1111/j.1471-4159.1972.tb01479.x MORGAN SH, 1990, Q J MED, V75, P491 Onishi A, 1974, Arch Neurol, V31, P120 OPITZ JM, 1965, AM J HUM GENET, V17, P325 PABICO RC, 1973, AM J MED, V55, P415, DOI 10.1016/0002-9343(73)90140-X Ruiter M, 1939, ARCH DERMATOL SYPH-G, V179, P165, DOI 10.1007/BF01949466 SCHACHERN PA, 1989, ANN OTO RHINOL LARYN, V98, P359 SHOWS TB, 1978, CYTOGENET CELL GENET, V22, P541, DOI 10.1159/000131020 STOUGHTON RB, 1959, ARCH DERMATOL, V79, P601 NR 25 TC 4 Z9 5 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 412 EP 418 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000003 PM 16805371 ER PT J AU Sewnaik, A Hakkesteegt, MM Meeuwis, CA de Gier, HHW Kerrebijn, JDF AF Sewnaik, A Hakkesteegt, MM Meeuwis, CA de Gier, HHW Kerrebijn, JDF TI Supracricoid partial laryngectorny with cricohyoidoepiglottopexy for recurrent laryngeal cancer SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cricohyoidoepiglottopexy; recurrent glottic cancer; swallowing; voice ID GLOTTIC CARCINOMA; VOICE; CRICOHYOIDOPEXY; RADIOTHERAPY; FAILURE; INDEX AB Objectives: Recurrent laryngeal cancer can be treated either with total laryngectomy or in selected cases with supracricoid laryngectomy with cricohyoidoepiglottopexy (CHEP). We performed a retrospective study to analyze the functional and oncological results of supracricoid laryngectomy with CHEP. Methods: Fourteen patients were treated with supracricoid laryngectomy with CHER In 8 patients, flexible endoscopic evaluation of swallowing was performed. Preoperative and postoperative voice evaluation was performed in 5 patients. Oncological and functional follow-up, postoperative complications, and data concerning rehabilitation were recorded on standard forms. Results: After the supracricoid laryngectomy with CHEP, 11 of the 14 patients were alive and disease-free. No local recurrences were found, but 2 patients had regional recurrences. The voice was worse after the operation; however, most patients were satisfied. Swallowing was uncompromised. Conclusions: Supracricoid laryngectomy with CHEP for recurrent glottic laryngeal cancer after radiotherapy appears to be oncologically safe and functional. C1 Erasmus Univ, Med Ctr, Dept Otorhinolaryngol Head & Neck Surg, NL-3015 GD Rotterdam, Netherlands. RP Sewnaik, A (reprint author), Erasmus Univ, Med Ctr, Dept Otorhinolaryngol Head & Neck Surg, NL-3015 GD Rotterdam, Netherlands. CR Bron L, 2002, LARYNGOSCOPE, V112, P1289, DOI 10.1097/00005537-200207000-00027 Bron L, 2000, LARYNGOSCOPE, V110, P627, DOI 10.1097/00005537-200004000-00017 Chevalier D, 1997, ANN OTO RHINOL LARYN, V106, P364 de Vincentiis M, 1998, HEAD NECK-J SCI SPEC, V20, P504, DOI 10.1002/(SICI)1097-0347(199809)20:6<504::AID-HED3>3.0.CO;2-T Dworkin JP, 2003, OTOLARYNG HEAD NECK, V129, P311, DOI 10.1016/S0194-5998(03)01314-7 Ferrand CT, 2002, J VOICE, V16, P480, DOI 10.1016/S0892-1997(02)00123-6 Karasalihoglu AR, 2004, J LARYNGOL OTOL, V118, P671 Laccourreye O, 1996, LARYNGOSCOPE, V106, P495, DOI 10.1097/00005537-199604000-00019 LACCOURREYE O, 2000, ORGAN PRESERVATION S, P53 Langmore SE, 2001, ENDOSCOPIC EVALUATIO, P73 Luna-Ortiz K, 2004, J LARYNGOL OTOL, V118, P284 PIQUET JJ, 1991, AM J SURG, V162, P357, DOI 10.1016/0002-9610(91)90148-7 SCHUTTE HK, 1983, FOLIA PHONIATR, V35, P286 SCHWAAB G, 1994, AM J SURG, V168, P474, DOI 10.1016/S0002-9610(05)80104-7 Sewnaik A, 2005, HEAD NECK-J SCI SPEC, V27, P101, DOI 10.1002/hed.20125 Spriano G, 2002, HEAD NECK-J SCI SPEC, V24, P759, DOI 10.1002/hed.10117 Weinstein GS, 2002, ANN OTO RHINOL LARYN, V111, P1 Wuyts FL, 2000, J SPEECH LANG HEAR R, V43, P796 NR 18 TC 10 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 419 EP 424 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000004 PM 16805372 ER PT J AU Dunn, CC Tyler, RS Witt, SA Gantz, BJ AF Dunn, CC Tyler, RS Witt, SA Gantz, BJ TI Effects of converting bilateral cochlear implant subjects to a strategy with increased rate and number of channels SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Otological-Society CY MAY 14-15, 2005 CL Baca Raton, FL SP Amer Otol Soc DE bilateral cochlear implants; HiResolution strategy; sound processing; speech perception in noise AB Objectives: Three different Advanced Bionics processing strategies were evaluated: 1) 8-channel, 813 pulses per second (pps), Continuous Interleaved Sampling (CIS); 2) 16-channel, 5,100 pps, HiResolution Paired (HiRes P); and 3) 16-channel, 2,900 pps, HiResolution Sequential (HiRes S). Methods: Seven adult bilateral Clarion CII cochlear implant recipients who had been using a CIS processing strategy for at least 18 months participated in this study. Sentence recognition in multitalker babble from the front was collected on subjects using their CIS strategy and after subjects were programmed for the first time with HiRes P and HiRes S strategies. An ABAB design was implemented for 1 month whereby subjects used each HiResolution strategy every other day. Sentence recognition testing was repeated at the 1- and 3-month post-HiResolution test intervals. Results: Comparisons between the CIS and HiResolution strategies showed immediate improvements for 5 subjects in favor of the HiResolution strategies. After 1 month of alternating between the HiRes P and HiRes S strategies, remarkably, 2 subjects showed improvements of 60%, 2 subjects showed improvements of 40%, and 2 subjects showed improvements of 30% over the CIS strategy that they had previously used for at least 18 months. The results after 3 months of use were consistent with those obtained at 1 month. Conclusions: The HiRes S and HiRes P strategies resulted in dramatic improvements in speech perception in noise for a subset of subjects who had been using the CIS strategy bilaterally. This finding demonstrates that these subjects were able to tolerate a more difficult signal-to-noise ratio. Further work is needed to determine the independent effects of rate versus number of channels. C1 Univ Iowa, Dept Otorhinolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. RP Dunn, CC (reprint author), Univ Iowa, Dept Otorhinolaryngol Head & Neck Surg, 200 Hawkins Dr,PFP 21038, Iowa City, IA 52242 USA. CR Boothroyd A., 1985, SENTENCE TEST SPEECH Bosco E, 2005, ACTA OTO-LARYNGOL, V125, P148, DOI 10.1080/00016480410023010 Filipo R, 2004, ACTA OTO-LARYNGOL, V124, P368, DOI 10.1080/00016480410016324 FIRSZT JB, 2003, ADV BIONICS CORP Koch DB, 2004, AUDIOL NEURO-OTOL, V9, P214, DOI 10.1159/000078391 NILSSON M, 1994, J ACOUST SOC AM, V95, P1085, DOI 10.1121/1.408469 Tyler R. S., 1983, IOWA COCHLEAR IMPLAN NR 7 TC 9 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 425 EP 432 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000005 PM 16805373 ER PT J AU Prasad, KC Sreedharan, S Dannana, NK Prasad, SC Chandra, S AF Prasad, KC Sreedharan, S Dannana, NK Prasad, SC Chandra, S TI Early oral feeds in laryngectomized patients SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE carcinoma of larynx; early oral feeds; laryngectomy; pharyngocutaneous fistula ID PHARYNGOCUTANEOUS FISTULA; GASTROESOPHAGEAL REFLUX; PREDISPOSING FACTORS; NECK; HEAD; TUBE AB Objectives: It is a common practice to start oral feeding after 7 to 10 days in patients who have undergone laryngeal surgeries. It was our observation that when oral feeds were initiated earlier than this period, there was no increase in the incidence of pharyngocutaneous fistulas. This prospective study is about our experience in initiating early oral feeds in the postoperative period (on the 2nd day) in laryngectornized patients. Methods: Seventy-eight patients underwent laryngectomy with or without partial pharyngectomy over a period of 38 months between October 2001 and December 2004. The oral feeds were initiated on the 2nd postoperative day in 40 patients. Thirty-eight patients served as controls in whom feeds were initiated after the 10th postoperative day. Results: Only 1 patient in the study group and 2 patients in the control group developed pharyngocutaneous fistulas. Most patients in the control group wished to avoid nasogastric intubation in the recovery period because of discomfort, gastric symptoms, and the need to taste food. Conclusions: With this study we can assume that in a select group of patients, it is possible to initiate oral feeding much earlier in the postoperative period than was formerly thought. C1 Kasturba Med Coll & Affiliated Hosp, Dept Otorhinolaryngol Head & Neck Surg, Mangalore, India. RP Prasad, KC (reprint author), 1st Floor,Nethravathi Bldg, Mangalore 575001, Karnataka, India. CR Akyol M U, 1995, Ear Nose Throat J, V74, P28 ALFONSO JM, 1954, CANC IARINGEO APPLEBAUM EL, 1977, LARYNGOSCOPE, V87, P1884 APRIGLIANO F, 1990, ANN OTO RHINOL LARYN, V99, P513 BOYCE SE, 1989, HEAD NECK-J SCI SPEC, V11, P269, DOI 10.1002/hed.2880110314 CANTRELL RW, 1978, LARYNGOSCOPE, V88, P1204 CHERNOFF R, 1999, GERIATRIC NUTR HLTH, P420 DEDO DD, 1975, ANN OTO RHINOL LARYN, V84, P833 DHARMARAJAN TS, 2003, CLIN GERIATRICS, P104 DRICKAMER MA, 1993, J AM GERIATR SOC, V41, P672 DUMOULIN GC, 1982, LANCET, V1, P242 Gillick MR, 2000, NEW ENGL J MED, V342, P206, DOI 10.1056/NEJM200001203420312 Gussenbauer C., 1874, ARCH KLIN CHIR, V17, P343 HARDY JF, 1988, CAN J ANAESTH, V35, P162 HOSAL N, 1982, 15 TURK NAT ORL C P, P904 IBANEZ J, 1992, JPEN-PARENTER ENTER, V16, P419, DOI 10.1177/0148607192016005419 JANSEN A, 1981, SURG GYNECOL OBSTET, V152, P51 KOYBASIOGLU A, 1999, GAZI MED J, V10, P33 LACY ER, 1988, J CLIN GASTROENTE S1, pS72 Markou KD, 2004, EUR ARCH OTO-RHINO-L, V261, P61, DOI 10.1007/s00405-003-0643-6 Medina JE, 2001, LARYNGOSCOPE, V111, P368, DOI 10.1097/00005537-200103000-00002 NUZUM R, 1993, MANUAL GASTROENTEROL, P10 ORRINGER MB, 1996, PEARSONS OESOPHAGEAL, P683 POSTLETHWAIT RW, 1988, INT TRENDS GEN THORA, V4, P288 RADEMAKER AW, 1993, HEAD NECK-J SCI SPEC, V15, P325, DOI 10.1002/hed.2880150410 SEIKALY H, 1995, LARYNGOSCOPE, V105, P1220, DOI 10.1288/00005537-199511000-00015 Shah A K, 1985, J Postgrad Med, V31, P95 Soylu L, 1998, HEAD NECK-J SCI SPEC, V20, P22, DOI 10.1002/(SICI)1097-0347(199801)20:1<22::AID-HED4>3.0.CO;2-5 Thornton FJ, 1997, SURG CLIN N AM, V77, P549, DOI 10.1016/S0039-6109(05)70568-5 VIOLARIS N, 1990, J LARYNGOL OTOL, V104, P225, DOI 10.1017/S0022215100112344 NR 30 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 433 EP 438 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000006 PM 16805374 ER PT J AU Cohen, SM Garrett, CG Netterville, JL Courey, MS AF Cohen, SM Garrett, CG Netterville, JL Courey, MS TI Laryngoscopy in bilateral vocal fold immobility: Can you make a diagnosis? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 108th Annual Meeting of the American-Academy-of-Otolaryngology-Head-and-Neck-Surgery CY SEP 19-22, 2004 CL New York, NY SP Amer Acad Otolaryngol Head & Neck Surg DE laryngotracheal stenosis; posterior glottic stenosis; vocal fold paralysis ID POSTERIOR GLOTTIC STENOSIS; MANAGEMENT; PARALYSIS; RECURRENT; FIXATION AB Objectives: This study explores whether videoendoscopic findings and patient history help make the diagnosis in bilateral vocal fold immobility (BVFI). Methods: Medical records from 1995 to 2003 were searched to identify patients with posterior glottic stenosis (PGS) and bilateral vocal fold paralysis (BVFP) who also had videoendoscopic examinations. Videoendoscopic examination findings that could help differentiate PGS from BVFP were identified a priori. A weighted scoring index, based on the adjusted odds ratios of significant examination findings on multiple logistic regression, was derived. Associations between the weighted scoring index, patient history, and diagnosis were then evaluated. Results: Twenty-six patients with BVFP and 28 patients with PGS were identified. Posterior glottic scar (weight = 2), medial arytenoid erosion with a widened posterior glottis (weight = 1), and appropriate vocal fold motion (weight = 1) were significant variables (p <= .05, multiple logistic regression) and constituted the weighted scoring index. A weighted scoring index of >= 2 and a history of prolonged intubation predicted PGS in 95.2% of cases. A weighted scoring index of <= 1 and a history of neck surgery predicted BVFP in 95.0% of cases. Conclusions: The weighted scoring index with the patient history provides an objective tool for diagnosing BVFI. C1 Univ Calif San Francisco, Voice Ctr, San Francisco, CA 94115 USA. Univ Calif San Francisco, Swallowing Ctr, San Francisco, CA 94115 USA. Vanderbilt Univ, Med Ctr, Vanderbilt Voice Ctr, Nashville, TN USA. Vanderbilt Univ, Med Ctr, Vanderbilt Bill Wilkerson Ctr Otolaryngol & Commu, Nashville, TN USA. RP Courey, MS (reprint author), Univ Calif San Francisco, Voice Ctr, 2330 Post St,5th Floor, San Francisco, CA 94115 USA. CR BENJAMIN B, 1993, ANN OTOL RHINOL LA S, V102 Benninger MS, 1998, LARYNGOSCOPE, V108, P1346, DOI 10.1097/00005537-199809000-00016 Carrat X, 2000, ANN OTO RHINOL LARYN, V109, P736 Crumley RL, 2000, ANN OTO RHINOL LARYN, V109, P365 DONNELLY WH, 1969, ARCH PATHOL, V88, P511 Eckel HE, 2003, ANN OTO RHINOL LARYN, V112, P103 Gardner GM, 2000, OTOLARYNG CLIN N AM, V33, P855, DOI 10.1016/S0030-6665(05)70248-6 Hillel AD, 1999, OTOLARYNG HEAD NECK, V121, P760, DOI 10.1053/hn.1999.v121.a98733 Hoasjoe DK, 1997, LARYNGOSCOPE, V107, P675, DOI 10.1097/00005537-199705000-00022 HOFFMAN H T, 1991, Annals of Otology Rhinology and Laryngology, V100, P1 KASHIMA HK, 1991, ANN OTO RHINOL LARYN, V100, P717 Yin SS, 1997, AM J OTOLARYNG, V18, P9, DOI 10.1016/S0196-0709(97)90042-9 NR 12 TC 7 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 439 EP 443 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000007 PM 16805375 ER PT J AU Hafezi, F Naghibzadeh, B Nouhi, A AF Hafezi, F Naghibzadeh, B Nouhi, A TI Management of the thick-skinned nose: A more effective approach SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the Iranian-Society-of-Plastic-and-Reconstructive-Surgeons CY APR 27-30, 2004 CL Tehran, IRAN SP Iranian Soc Plastic & Reconstruct Surg DE bulky nose; rhinoplasty; soft tissue modification ID INTERDOMAL FAT PAD; AESTHETIC RHINOPLASTY; HISPANIC RHINOPLASTY; TIP AB A bulky nose is a challenging issue to manage, and surgeons have not found the ultimate solution to this problem in the evolution of rhinoplastic surgery. Because of the multiplicity of techniques and controversies published in the literature, it has become confusing for the operating surgeon to find the most appropriate and effective way of solving this frustrating dilemma. The subcutaneous fat is the thickest in the supratip area, and the soft tissue thickness over the tip of the nose varies considerably from patient to patient. The focus of this study was to find a method for reducing the overlying soft tissue of the tip for better re-draping of skin over the nasal skeleton. The hallmark of this technique is to undermine the nasal skin in two layers. We believe that soft tissue trimming in biplane dissection can minimize the thickness of the tip skin in a relatively safe and homogeneous way. With this report we introduce a new method of dissection of nasal soft tissue and of trimming it in different areas of the nose for different purposes. In the authors' opinion, this approach is one of the most effective ways of handling unpliable, thick nasal skin. C1 Iran Univ Med Sci, Motahary Burn & Reconstruct Ctr, Dept Plast Surg, Tehran, Iran. Shahidbeheshty Univ Med Sci, Dept Otolaryngol Head & Neck Surg, Dept Plast Surg, Tehran, Iran. RP Hafezi, F (reprint author), 15,Esmaeeli St,Keyhan Ave, Tehran 1986884813, Iran. CR Botti G, 1996, AESTHET PLAST SURG, V20, P421, DOI 10.1007/BF02390318 Copcu E, 2004, SURG RADIOL ANAT, V26, P14, DOI 10.1007/s00276-003-0172-4 Copcu E, 2003, AESTHET PLAST SURG, V27, P116, DOI 10.1007/s00266-002-0067-5 Daniel RK, 2003, PLAST RECONSTR SURG, V112, P244, DOI 10.1097/01.PRS.0000066363.37479.EE FANOUS N, 1991, PLAST RECONSTR SURG, V87, P662, DOI 10.1097/00006534-199104000-00009 GONZALEZULLOA M, 1984, AESTHET PLAST SURG, V8, P135, DOI 10.1007/BF01597515 Guyuron B, 2001, PLAST RECONSTR SURG, V107, P856, DOI 10.1097/00006534-200103000-00032 KLATSKY SA, 1983, ANN PLAS SURG, V11, P10, DOI 10.1097/00000637-198307000-00002 Leach J, 2002, LARYNGOSCOPE, V112, P1903, DOI 10.1097/00005537-200211000-00001 MATORY WE, 1986, PLAST RECONSTR SURG, V77, P239 McKinney P, 2000, PLAST RECONSTR SURG, V106, P906, DOI 10.1097/00006534-200009040-00029 Oneal RM, 1996, CLIN PLAST SURG, V23, P195 ORTIZMONASTERIO F, 1981, PLAST RECONSTR SURG, V67, P597, DOI 10.1097/00006534-198105000-00003 Peck GC, 1996, PLAST RECONSTR SURG, V97, P33, DOI 10.1097/00006534-199601000-00005 SHEEN JH, 1993, PLAST RECONSTR SURG, V91, P48, DOI 10.1097/00006534-199301000-00007 Sheen JH, 2000, PLAST RECONSTR SURG, V105, P1820, DOI 10.1097/00006534-200004050-00033 Sun G K, 2000, Arch Facial Plast Surg, V2, P260, DOI 10.1001/archfaci.2.4.260 NR 17 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 444 EP 449 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000008 PM 16805376 ER PT J AU Wang, X Dong, Z Zhu, DD Guan, B AF Wang, X Dong, Z Zhu, DD Guan, B TI Expression profile of immune-associated genes in nasal polyps SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE gene chip; gene expression; immunity; interleukin-17; interleukin-17 receptor; nasal polyp ID EPITHELIAL-CELLS; PROTEIN-KINASE; RECEPTOR; IL-17; EOSINOPHILS; CYTOKINES; PATHWAY; MUCOSA AB Objectives: We performed this study to investigate the expression profile of immune-associated genes and to probe the role of related genes in the immune pathogenesis of nasal polyps. Methods: Microarray analysis was used to find the expression profile of 491 immune-associated genes in nasal polyps. In validation studies, immunohistochemical staining and Western blot analysis were used to detect interleukin (IL)-17 and IL-17 receptor (IL-17R) in nasal polyps and controls. Results: Eighty-seven genes were differentially expressed in the immune-associated gene profile of nasal polyps, and 15 genes showed differential expression in both chips. In nasal polyp tissues, IL-17 was expressed mainly in the cytoplasm of plasma cells and to a lesser degree in the prickle cell layer of the epithelium and the acinus of the serous gland. In turbinates, IL-17 was also expressed in the same location, but the expression of IL-17 in nasal polyps and that in turbinates differed significantly (p <.05). Both IL-17 and IL-17R displayed specific bands in nasal polyps and turbinates, but the bands of IL-17 and IL-17R in nasal polyps were stronger than those in turbinates. Conclusions: The differentially expressed genes in immune-associated gene chips will provide clues about, and a theoretical foundation for, the pathogenesis of nasal polyps. Furthermore, IL-17 may play an important role in the occurrence of nasal polyps by overexpression. C1 Jilin Univ, Bethune Fac Med, China Japan Union Hosp, Dept Otorhinolaryngol Head & Neck Surg, Changchun 130031, Peoples R China. RP Dong, Z (reprint author), Jilin Univ, Bethune Fac Med, China Japan Union Hosp, Dept Otorhinolaryngol Head & Neck Surg, XianTai Dajie 2, Changchun 130031, Peoples R China. CR Attur MG, 1997, ARTHRITIS RHEUM, V40, P1050, DOI 10.1002/art.1780400609 Bachert C, 1998, ALLERGY, V53, P2, DOI 10.1111/j.1398-9995.1998.tb03767.x Fossiez F, 1996, J EXP MED, V183, P2593, DOI 10.1084/jem.183.6.2593 Heath H, 1997, J CLIN INVEST, V99, P178, DOI 10.1172/JCI119145 Imhof Beat A., 2001, Trends in Immunology, V22, P411, DOI 10.1016/S1471-4906(01)01961-5 JAHNSEN FL, 1995, AM J RESP CELL MOL, V12, P624 Lee SH, 2002, ANN OTO RHINOL LARYN, V111, P135 Molet S, 2001, J ALLERGY CLIN IMMUN, V108, P430, DOI 10.1067/mai.2001.117929 Molet SM, 2003, LARYNGOSCOPE, V113, P1803, DOI 10.1097/00005537-200310000-00027 Morinaka S, 2000, Auris Nasus Larynx, V27, P59, DOI 10.1016/S0385-8146(99)00038-3 Muzio M, 2001, BIOCHEM SOC T, V29, P869 Muzio M, 2000, BIOCHEM SOC T, V28, P563 OHNO I, 1995, AM J RESP CELL MOL, V13, P639 Papon JF, 2002, LARYNGOSCOPE, V112, P2067, DOI 10.1097/00005537-200211000-00030 Pawankar Ruby, 2003, Curr Opin Allergy Clin Immunol, V3, P1, DOI 10.1097/00130832-200302000-00001 Rudack C, 2003, J INTERF CYTOK RES, V23, P113, DOI 10.1089/107999003321455507 Schwandner R, 2000, J EXP MED, V191, P1233, DOI 10.1084/jem.191.7.1233 Shin HCK, 1999, CYTOKINE, V11, P257, DOI 10.1006/cyto.1998.0433 STIERNA PLE, 1997, OCEANSIDE PUBLICATIO Thomas MS, 2002, J IMMUNOL, V169, P7045 Tuma E, 2002, LARYNGO RHINO OTOL, V81, P580, DOI 10.1055/s-2002-33362 Wain JH, 2002, CLIN EXP IMMUNOL, V127, P436, DOI 10.1046/j.1365-2249.2002.01764.x Yao Zhengbin, 1995, Journal of Immunology, V155, P5483 Yao ZB, 1995, IMMUNITY, V3, P811, DOI 10.1016/1074-7613(95)90070-5 NR 24 TC 28 Z9 28 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 450 EP 456 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000009 PM 16805377 ER PT J AU Lee, HK Kim, IS Lee, WS AF Lee, HK Kim, IS Lee, WS TI New method of identifying the internal auditory canal as seen from the middle cranial fossa approach SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anatomy; internal auditory canal; middle cranial fossa ID VESTIBULAR NEURECTOMY; SURGERY; ANATOMY; BONE AB Objectives: The middle cranial fossa approach allows one to remove acoustic tumors and preserve the facial nerve and hearing. However, there are no consistent landmarks on the surface of the temporal bone to identify the internal auditory canal. This study was designed to identify the internal auditory canal by use of external and internal references as seen during the middle cranial fossa approach. Methods: We dissected 32 temporal bones using the middle cranial fossa approach and measured the distances from the posterior origin of the zygomatic arch to an imaginary coronal line between the foramen spinosum and the foramen ovale. We measured the angle between the lines drawn from the posterior origin of the zygomatic root to the foramen spinosum and from the foramen spinosum to the porus of the internal auditory canal. Results: The distances were 14.7 mm and 22.9 mm, respectively, and the angle was roughly 90 degrees. Conclusions: In this study, we found external and internal landmarks that help to locate the internal auditory canal. C1 Yonsei Univ, Coll Med, Dept Otorhinolaryngol, Seoul 120752, South Korea. RP Lee, WS (reprint author), Yonsei Univ, Coll Med, Dept Otorhinolaryngol, 134 Shinchon Dong, Seoul 120752, South Korea. CR CATALANO PJ, 1993, OTOLARYNG HEAD NECK, V108, P111 DELACRUZ A, 1984, LARYNGOSCOPE, V94, P874 FISCH U, 1970, ADV OTO-RHINO-LARYNG, V17, P203 GARCIAIBANEZ E, 1980, OTOLARYNG HEAD NECK, V88, P486 Gunkel AR, 1999, LARYNGOSCOPE, V109, P1793, DOI 10.1097/00005537-199911000-00013 HOUSE W F, 1961, Laryngoscope, V71, P1363 KARTUSH JM, 1985, ANN OTO RHINOL LARYN, V94, P25 Lee HK, 2003, ANN OTO RHINOL LARYN, V112, P531 Low WK, 1999, ORL J OTO-RHINO-LARY, V61, P142, DOI 10.1159/000027659 Matsunaga T, 1991, Acta Otolaryngol Suppl, V487, P48 PELLET W, 1990, OTONEUROSURGERY, P67 SANNA M, 1995, GEORG THIEME, P88 Sennaroglu L, 2003, LARYNGOSCOPE, V113, P332, DOI 10.1097/00005537-200302000-00025 NR 13 TC 5 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 457 EP 460 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000010 PM 16805378 ER PT J AU Janssen, LM Maur, CDID Bos, PK Hardillo, JA van Osch, GJVM AF Janssen, LM Maur, CDID Bos, PK Hardillo, JA van Osch, GJVM TI Short-duration enzymatic treatment promotes integration of a cartilage graft in a defect SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cartilage; enzyme treatment; integration ID ARTICULAR-CARTILAGE; REPAIR; MODEL; CHONDROCYTES; STRENGTH; REMOVAL; REGION AB Objectives: Surgical manipulation of cartilage tissue is associated with chondrocyte death in the wound edges that hinders integration. The objective of this study was to evaluate the effect of a short course of treatment of a cartilage graft with a combination of hyaluronidase and collagenase on chondrocyte density and integrative capacity. Methods: Cartilage explants were treated with enzymes for various time periods and at various concentrations. A central core was punched out of a larger explant, treated with enzymes, reimplanted, and placed subcutaneously in athymic mice. The number of chondrocytes in the wound edges was counted, and the integrative capacity of the grafts was evaluated by histology. Results: Treatment with collagenase for 48 hours led to a significant increase in the number of vital chondrocytes and restored it to normal after 14 days of culture. Treatment with hyaluronidase and collagenase for 48 hours further increased chondrocyte densities to supranormal values. Shortening the treatment to I hour restored the chondrocyte density to normal after 14 days of culture. In vivo integration experiments showed increased chondrocyte densities in treated wound edges and extracellular matrix fibers crossing over from enzyme-treated parts to untreated parts. Conclusions: Short-duration treatment of a cartilage graft with a combination of hyaluronidase and collagenase increases cell density at wound edges and promotes integrative repair. C1 Erasmus Univ, Med Ctr, Dept Otorhinolaryngol, NL-3000 DR Rotterdam, Netherlands. Erasmus Univ, Med Ctr, Dept Orthopaed, NL-3000 DR Rotterdam, Netherlands. RP van Osch, GJVM (reprint author), Erasmus Univ, Med Ctr, Dept Otorhinolaryngol, Room Ee 1655,POB 1738, NL-3000 DR Rotterdam, Netherlands. CR Bos PK, 2001, OSTEOARTHR CARTILAGE, V9, P382, DOI 10.1053/joca.2000.0399 Bos PK, 2002, ARTHRITIS RHEUM, V46, P976, DOI 10.1002/art.10208 Caplan AI, 1997, CLIN ORTHOP RELAT R, P254 Hunter CJ, 2004, OSTEOARTHR CARTILAGE, V12, P117, DOI 10.1016/j.joca.2003.08.009 Hunziker EB, 1998, J BONE JOINT SURG BR, V80B, P144, DOI 10.1302/0301-620X.80B1.7531 Hunziker EB, 2003, J BONE JOINT SURG AM, V85A, P85 Kim HA, 1999, ARTHRITIS RHEUM, V42, P1528, DOI 10.1002/1529-0131(199907)42:7<1528::AID-ANR28>3.0.CO;2-9 Lee MC, 2000, CLIN ORTHOP RELAT R, P286 MANKIN HJ, 1982, J BONE JOINT SURG AM, V64, P460 MOW VC, 1992, BIOMATERIALS, V13, P67, DOI 10.1016/0142-9612(92)90001-5 Obradovic B, 2001, J ORTHOPAED RES, V19, P1089, DOI 10.1016/S0736-0266(01)00030-4 Peretti GM, 1999, TISSUE ENG, V5, P317, DOI 10.1089/ten.1999.5.317 REINDEL ES, 1995, J ORTHOPAED RES, V13, P751, DOI 10.1002/jor.1100130515 SHAPIRO F, 1993, J BONE JOINT SURG AM, V75A, P532 Stockwell RA, 1979, BIOL CARTILAGE CELLS Tew SR, 2000, ARTHRITIS RHEUM-US, V43, P215, DOI 10.1002/1529-0131(200001)43:1<215::AID-ANR26>3.0.CO;2-X Bravenboer JV, 2004, ARTHRITIS RES THER, V6, pR469, DOI 10.1186/ar1216 Verwoerd-Verhoef HL, 1998, INT J PEDIATR OTORHI, V43, P241, DOI 10.1016/S0165-5876(98)00003-2 NR 18 TC 11 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 461 EP 468 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000011 PM 16805379 ER PT J AU Tateya, T Tateya, I Bless, DM AF Tateya, T Tateya, I Bless, DM TI Collagen subtypes in human vocal folds SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE collagen type I; collagen type III; human vocal fold; immunohistochemistry; lamina propria ID ELASTIN AB Objectives: The collagen subtypes in human vocal folds are of particular interest, because each collagen subtype has different features that make it uniquely suited for performing specific tissue tasks and each collagen subtype can affect the tissue properties of the vocal fold lamina propria. Methods: Human vocal folds from 5 autopsy cases (less than 65 years old) were examined by immunohistochemistry for collagen types I, III, IV, and V and elastin. Results: Collagen type III was distributed throughout the whole lamina propria. Type I was found just beneath the basal membrane, in the deep layer of the lamina propria and in the anterior and posterior maculae flavae. Types IV and V were present in the epithelial and endothelial basal membrane. Three-dimensional images from thick specimens reconstructed with confocal microscopy showed 2 distinct patterns: type III fibers were wavy, collagenous fibers, as previously observed in the vocal folds, and type I fibers were thinner than type III fibers. These results suggest that type III fibers help maintain the lamina propria structure and that type I fibers provide the tensile strength required around the basal membrane and vocal ligament to maintain the vocal fold shape while withstanding vibratory forces. C1 Univ Wisconsin, Div Otolaryngol Head & Neck Surg, Madison, WI 53706 USA. RP Tateya, T (reprint author), Kyoto Univ, Grad Sch Med, Sakyo Ku, 54 Kawahara Cho, Kyoto 6060057, Japan. CR DAYAN D, 1989, HISTOCHEMISTRY, V93, P27, DOI 10.1007/BF00266843 de Melo ECM, 2003, LARYNGOSCOPE, V113, P2187 FAN K, 1980, STAIN TECHNOL, V55, P307 FAWCETT DW, 1994, TXB HISTOLOGY, P133 GAY S, 1987, HISTOCHEMISTRY PATHO, P755 Gray S, 1993, VOCAL FOLD PHYSL FRO, P1 GRAY SD, 1995, ANN OTO RHINOL LARYN, V104, P13 Gray SD, 2000, ANN OTO RHINOL LARYN, V109, P77 Hammond TH, 1997, J VOICE, V11, P59, DOI 10.1016/S0892-1997(97)80024-0 Hammond TH, 1998, OTOLARYNG HEAD NECK, V119, P314, DOI 10.1016/S0194-5998(98)70071-3 Hirano M., 1975, OTOLOGIA FUKUOKA S1, V21, P239 POSTLETHWAITE AE, 1992, INFLAMMATION BASIC P, P747 NR 12 TC 21 Z9 21 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 469 EP 476 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000012 PM 16805380 ER PT J AU Tran, LP Zalzal, GH AF Tran, LP Zalzal, GH TI Laryngotracheal stenosis repair using cartilage-derived pilot study SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE laryngotracheal reconstruction; laryngotracheal stenosis ID POSTERIOR CRICOID SPLIT; MORPHOGENETIC PROTEINS; GROWTH; ANTERIOR; RABBITS; RECONSTRUCTION AB Objectives: This pilot study evaluated the role of cartilage-derived morphogenic proteins (CDMPs) as promoters of cartilage growth and differentiation and as a possible alternative to autologous cartilage grafts in laryngotracheal reconstruction. Methods: In phase 1, 6 New Zealand rabbits underwent subperichondrial injection of CDMP-1, CDMP-2, or CDMP-3 in the right thyroid ala and normal saline solution in the left thyroid ala as controls. In phase 2, 14 rabbits underwent anterior cricoid split and interposition of a fibrillar collagen sponge saturated with normal saline solution, CDMP-2, or CDMP-3. Results: In both phases, saline solution failed to induce new cartilage or bone growth. Small foci of cartilage and/or bone formation were observed within the thyroid subperichondria of those rabbits injected with CDMP-2 or CDMP-3. In phase 2, a few small foci of new cartilage and/or bone formation were observed at the edges of the cricoid split with CDMP-2 and CDMP-3. Conclusions: A different carrier of CDMP, a change in dosage, or a combination of CDMPs might yield more significant neochondrification. The role of CDMPs as promoters of cartilage and differentiation could not be disqualified in this study and should be further investigated. C1 George Washington Univ, Sch Med, Childrens Natl Med Ctr, Dept Pediat Otolaryngol, Washington, DC 20052 USA. George Washington Univ, Sch Med, Dept Otolaryngol, Washington, DC 20052 USA. George Washington Univ, Sch Med, Dept Pediat, Washington, DC 20052 USA. RP Tran, LP (reprint author), Kapiolani Med Ctr Women & Children, 1319 Punahou St,Suite 1010, Honolulu, HI 96826 USA. CR BEAN JK, 1994, INT J PEDIATR OTORHI, V29, P129, DOI 10.1016/0165-5876(94)90092-2 CHANG SC, 1994, J BIOL CHEM, V269, P28227 FOGGIA DA, 1991, OTOLARYNG HEAD NECK, V105, P826 HARTIG GK, 1994, ANN OTO RHINOL LARYN, V103, P901 Luyten F P, 1995, Acta Orthop Scand Suppl, V266, P51 MACARTHUR CJ, 1992, LARYNGOSCOPE, V102, P250 Thomas JT, 1996, NAT GENET, V12, P315, DOI 10.1038/ng0396-315 Tomaski SM, 1999, ARCH OTOLARYNGOL, V125, P901 ZALZAL GH, 1992, ARCH OTOLARYNGOL, V118, P407 ZALZAL GH, 1989, OTOLARYNG HEAD NECK, V100, P119 ZALZAL GH, 1986, OTOLARYNG HEAD NECK, V94, P204 NR 11 TC 0 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2006 VL 115 IS 6 BP 477 EP 481 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 053HU UT WOS:000238297000013 PM 16805381 ER PT J AU Pierrot, S Bernardeschi, D Morrisseau-Durand, MP Manach, Y Couloigner, V AF Pierrot, S Bernardeschi, D Morrisseau-Durand, MP Manach, Y Couloigner, V TI Dissection of the internal carotid artery following trauma of the soft palate in children SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 6th International Conference on Pediatric ORL CY MAY 16-19, 2004 CL Athens, GREECE DE carotid artery; diffusion sequence; dissection; heparin; magnetic resonance imaging; oropharynx ID BLUNT CEREBROVASCULAR INJURIES; JUGULAR-VEIN THROMBOSIS; PENETRATING TRAUMA; DIAGNOSIS; COMPLICATION; CHILDHOOD; OUTCOMES; THERAPY; STROKE AB Objectives: We undertook this report to underline the risks of lesions of the internal carotid artery after lateral oropharyngeal trauma in children and to discuss the diagnosis and treatment of this complication. Methods: We present 2 pediatric cases of carotid dissection following lateral soft palate trauma. Results: In 1 case, transient symptomatic cerebral ischemia Occurred 24 hours after the initial traumatic injury. In both patients, the carotid dissection was assessed by magnetic resonance imaging with vascular and diffusion sequences. Treatment with low-molecular weight heparin calcium was maintained for several months. At the end of follow-up, both children were asymptomatic. Conclusions: We suggest noninvasive imaging of the carotid artery by enhanced computed tomographic scanning after trauma to the lateral part of the soft palate in children. Magnetic resonance imaging with vascular and diffusion sequences is useful in assessing the extension of the dissection toward the cerebral circulation and in early detection of cerebral ischemia. Anticoagulation with heparin probably reduces the risks of cerebral infarction. Patients must regularly undergo physical examination and noninvasive imaging of the carotid artery for at least 1 year after the traumatic injury. C1 Hop Necker Enfants Malad, Pediat ENT Dept, AP HP, F-75015 Paris, France. Hop Necker Enfants Malad, Dept Pediat Otohinolaryngol, AP HP, F-75015 Paris, France. RP Couloigner, V (reprint author), Hop Necker Enfants Malad, Pediat ENT Dept, AP HP, 149,Rue Sevre, F-75015 Paris, France. CR Bar T, 2002, ORAL SURG ORAL MED O, V94, P15, DOI 10.1067/moe.2002.124860 Berletti Riccardo, 2004, Radiol Med, V107, P35 Biffl WL, 2002, J TRAUMA, V53, P850, DOI 10.1097/01.TA.0000027419.40682.49 Biffl WL, 2002, ANN SURG, V235, P699, DOI 10.1097/00000658-200205000-00012 Borges G, 2000, PEDIATR NEUROSURG, V32, P150, DOI 10.1159/000028921 COGBILL TH, 1994, J TRAUMA, V37, P473, DOI 10.1097/00005373-199409000-00024 Cohen JE, 2003, STROKE, V34, pE254, DOI 10.1161/01.STR.0000101915.11128.3D Cothren CC, 2004, ARCH SURG-CHICAGO, V139, P540, DOI 10.1001/archsurg.139.5.540 Duke BJ, 1997, NEUROSURGERY, V41, P680, DOI 10.1097/00006123-199709000-00036 Fabian TC, 1996, ANN SURG, V223, P513, DOI 10.1097/00000658-199605000-00007 Frush DP, 2003, PEDIATRICS, V112, P951, DOI 10.1542/peds.112.4.951 HELLMANN JR, 1993, INT J PEDIATR OTORHI, V26, P157, DOI 10.1016/0165-5876(93)90021-T HENGERER AS, 1984, LARYNGOSCOPE, V94, P1571 HIGGINS GL, 1991, J FAM PRACTICE, V32, P319 HIGGINS GL, 1991, J FAM PRACTICE, V32, P316 Kaplan DM, 1998, INT J PEDIATR OTORHI, V44, P183, DOI 10.1016/S0165-5876(98)00065-2 Koch S, 2004, ARCH NEUROL-CHICAGO, V61, P510, DOI 10.1001/archneur.61.4.510 KRAJEWSKI LP, 1980, ANN SURG, V191, P341, DOI 10.1097/00000658-198003000-00014 LEVY C, 1994, RADIOLOGY, V190, P97 LOES DJ, 1987, PEDIATR NEUROL, V3, P44, DOI 10.1016/0887-8994(87)90055-5 MARTIN RF, 1991, J VASC SURG, V14, P789 Melio Frantz, 1996, Journal of Emergency Medicine, V14, P429, DOI 10.1016/0736-4679(96)00079-0 Miller PR, 2002, ANN SURG, V236, P386, DOI 10.1097/01.SLA.0000027184.01008.A0 Miller PR, 2001, J TRAUMA, V51, P279, DOI 10.1097/00005373-200108000-00009 Moriarty KP, 1997, J TRAUMA, V42, P541, DOI 10.1097/00005373-199703000-00025 PITNER SE, 1966, NEW ENGL J MED, V274, P764, DOI 10.1056/NEJM196604072741403 RADKOWSKI D, 1993, LARYNGOSCOPE, V103, P991 Suskind DL, 1997, INT J PEDIATR OTORHI, V39, P41, DOI 10.1016/S0165-5876(96)01460-7 Windfuhr JP, 2001, INT J PEDIATR OTORHI, V61, P155, DOI 10.1016/S0165-5876(01)00557-2 NR 29 TC 10 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 323 EP 329 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600001 PM 16739661 ER PT J AU Hsu, YC Su, CY AF Hsu, YC Su, CY TI Tympanoplasty for chronic otitis media in post-irradiated nasopharyngeal carcinoma patients SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE chronic otitis media; nasopharyngeal carcinoma; radiation injury; tympanoplasty ID EUSTACHIAN-TUBE DYSFUNCTION; VELI-PALATINI MUSCLES; TEMPORAL BONE; OSTEORADIONECROSIS; MYRINGOPLASTY; TENSOR AB Objectives: We evaluated the surgical outcome of tympanoplasty for chronic otitis media in post-irradiated patients with nasopharyngeal carcinoma. Methods: Nineteen ears were treated in 15 patients with nasopharyngeal carcinoma who had undergone radiotherapy in this retrospective clinical series. Only patients with simple perforations of the tympanic membrane and normal or near-normal eustachian tube function were enrolled in this study. All patients underwent type 1 tympanoplasty. Results: All patients had been treated with radiotherapy of 64.8 to 81.0 Gy. The intervals between radiotherapy and surgery ranged from 17 months to 20 years. The tympanic membranes in 10 of 19 ears were intact after surgery. Otorrhea had subsided in 11 ears (58%), and the incidence of otorrhea was decreased in 6 ears (32%). Thirteen of the 15 patients (86.7%) reported that their quality of life had improved. Conclusions: Surgical intervention benefits some patients with nasopharyngeal carcinoma with chronic otitis media resulting from radiotherapy. C1 Chang Gung Univ, Chang Gung Mem Hosp, Dept Otolaryngol, Kaohsiung Med Ctr, Kaohsiung, Taiwan. RP Su, CY (reprint author), 883,123,Ta Pei Rd,Niaosung Hsiang, Kaohsiung, Taiwan. CR Bhat NA, 2000, J OTOLARYNGOL, V29, P229 JUROVITZKI I, 1988, AM J OTOL, V9, P52 LAU S K, 1991, Journal of the Hong Kong Medical Association, V43, P37 MORETTI JA, 1976, LARYNGOSCOPE, V86, P598, DOI 10.1288/00005537-197604000-00018 ONEILL JV, 1979, OTOLARYNG HEAD NECK, V87, P359 RAMSDEN RT, 1975, J LARYNGOL OTOL, V89, P941, DOI 10.1017/S0022215100081226 SU CY, 1995, J LARYNGOL OTOL, V109, P486 SU CY, 1993, LARYNGOSCOPE, V103, P673 SU CY, 1993, CANCER, V71, P1193, DOI 10.1002/1097-0142(19930215)71:4<1193::AID-CNCR2820710404>3.0.CO;2-# WURSTER CF, 1982, OTOLARYNG HEAD NECK, V90, P126 YOUNG YH, 1992, EUR ARCH OTO-RHINO-L, V249, P206 YOUNG YH, 1994, RECENT ADVANCES IN OTITIS MEDIA, P307 YUEN PW, 1994, J OTOLARYNGOL, V23, P302 NR 13 TC 2 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 330 EP 333 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600002 PM 16739662 ER PT J AU Sato, K Nakashima, T AF Sato, K Nakashima, T TI Human adult deglutition during sleept SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Laryngol Assoc DE deglutition; nocturnal swallowing; sleep; swallowing AB Objectives: Clearance of the pharynx by deglutition is important in protecting the airway. The pattern of deglutition during sleep was investigated. Methods: Deglutition during sleep was examined in 8 normal human adults via time-matched recordings of polysomnography and surface electromyography (EMG) of the thyrohyoid and suprahyoid muscles. Results: During sleep, deglutition was episodic, and was absent for long periods. The mean number of swallows per hour (+/- SD) during the total sleep time was 2.9 +/- 1.3. The mean period of the longest absence of deglutition was 50.6 +/- 10.2 minutes. Most deglutition occurred in association with spontaneous electroencephalographic arousal in rapid eye movement (REM) sleep and non-REM sleep. Deglutition was related to sleep stage. The mean number of swallows per hour was 7.2 +/- 3.5 during stage 1 sleep and 2.0 +/- 0.7 during stage 2 sleep. There was little deglutition during stages 3 and 4. The deeper the sleep stage became, the lower the mean deglutition frequency became. The mean number of swallows per hour was 2.7 +/- 2.2 during REM sleep. The EMG amplitude dropped to the lowest level of recording and hypotonic EMG activity increased during REM sleep. Conclusions: Deglutition, a vital function, is infrequent during sleep. C1 Kurume Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Kurume, Fukuoka 8300011, Japan. RP Sato, K (reprint author), Kurume Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, 67 Asahimachi, Kurume, Fukuoka 8300011, Japan. CR BUKOV N, 1996, ATLAS CLIN POLYSOMNO, V1 EEG arousals: Scoring rules and examples, 1992, SLEEP, V15, P173 HAYASHI I, 1997, OTOLOGIA FUKUOKA, V43, P666 LEAR C. S. C., 1965, ARCH ORAL BIOL, V10, P83, DOI 10.1016/0003-9969(65)90060-9 LICHTER I, 1975, ELECTROEN CLIN NEURO, V38, P427, DOI 10.1016/0013-4694(75)90267-9 Rechtschaffen A, 1968, MANUAL STANDARDIZED NR 6 TC 16 Z9 17 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 334 EP 339 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600003 PM 16739663 ER PT J AU Li, JC Mayr, NA Yuh, WTC Wang, JZ Jiang, GL AF Li, JC Mayr, NA Yuh, WTC Wang, JZ Jiang, GL TI Cranial nerve involvement in nasopharyngeal carcinoma: Response to radiotherapy and its clinical impact SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cranial nerve palsy; nasopharyngeal carcinoma; neurologic recovery; radiotherapy ID BASE; EROSION; SYSTEM AB Objectives: To evaluate the cranial nerve (CN) palsy associated with nasopharyngeal carcinoma (NPC), we studied factors that influenced the neurologic outcome of radiotherapy (RT), and the patterns and time course of neurologic recovery of CN palsy. Methods: Between July 1987 and July 1989, 93 patients who presented with CN palsy at the time of diagnosis of NPC were studied. All patients underwent external-beam RT with either cobalt-60 or 6-MV photon beams to a dose of 69 to 84 Gy at 2 Gy per fraction. The time course and pattern of neurologic recovery (complete, partial, or none) from CN palsy were evaluated. Age, sex, stage, histology, incidence and distribution of types of CNs involved, duration of CN palsy, and time course of tumor response during RT were correlated with the patterns and the time course of neurologic CN recovery by univariate and multivariate analyses. Results: The cases of CN palsy most commonly involved CN V (38%), CN VI (26%), and CN XII (11%), which accounted for the majority of the cases (75%). The time course of CN recovery was variable and protracted. Most patients showed significant improvement upon completion of RT (51%, 19%, and 30% complete, partial, and no recovery, respectively) and further improvement 6 months after RT (58%,17%, and 25%, respectively). Cranial nerves V, VI, and XII accounted for 75% of cases with no recovery. Recovery was best for CNs II, IX, and XI and the sympathetic nerve (100%, 87%, 100%, and 100%, respectively) and worst for CNs IV, VIl, and XII (67%, 60%, and 40%, respectively, with no recovery). Neurologic CN recovery correlated significantly with the pretherapy duration (< 3 months versus 3 months) of CN palsy (88% versus 62%; p = .002, multivariate analysis), the time course of clinical tumor regression, and neurologic symptom improvement during RT. Age, sex, T stage, N stage, histology, anterior versus posterior CN palsies, and base of skull involvement were not significant. Conclusions: According to our limited data, most patients with CN palsy respond well to RT. That the time course of neurologic recovery is variable and can be protracted indicates a need for continuous and close neurologic surveillance. The poorer neurologic outcome associated with a longer duration of CN symptoms may be related to a more severe longterm CN compression that results in irreversible damage. Timely diagnosis of NPC and fast institution of therapy are therefore critical to improving the neurologic outcome. C1 Ohio State Univ, Univ Hosp, Dept Radiol, Columbus, OH 43210 USA. Fudan Univ, Affiliated Canc Hosp, Dept Radiat Oncol, Shanghai 200433, Peoples R China. Ohio State Univ, Dept Radiat Med, Columbus, OH 43210 USA. Ohio State Univ, Dept Radiol, Columbus, OH 43210 USA. Univ Maryland, Sch Med, Dept Radiat Oncol, Baltimore, MD 21201 USA. RP Yuh, WTC (reprint author), Ohio State Univ, Univ Hosp, Dept Radiol, 630 Means Hall,1654 Upham Dr, Columbus, OH 43210 USA. CR Chan JW, 2003, NEUROLOGY, V61, P1417 Faivre S, 2004, CURR OPIN ONCOL, V16, P231, DOI 10.1097/00001622-200405000-00007 Gaspar C, 2000, Acta Otorrinolaringol Esp, V51, P691 Gibb AG, 2000, J LARYNGOL OTOL, V114, P139 Ilhan O, 2002, EUR J OPHTHALMOL, V12, P55 Kam MKM, 2003, INT J RADIAT ONCOL, V56, P145, DOI 10.1016/S0360-3016(03)00075-0 Lee AWM, 1999, INT J CANCER, V84, P179, DOI 10.1002/(SICI)1097-0215(19990420)84:2<179::AID-IJC15>3.0.CO;2-6 Leung S F, 1990, Clin Oncol (R Coll Radiol), V2, P138, DOI 10.1016/S0936-6555(05)80146-3 Lu TX, 2001, INT J RADIAT ONCOL, V51, P589, DOI 10.1016/S0360-3016(01)01678-9 MIN HQ, 1994, INT J RADIAT ONCOL, V30, P1037 Mould RF, 2002, BRIT J RADIOL, V75, P307 Ozyar E, 1994, Radiat Med, V12, P65 Roh JL, 2004, AM J OTOLARYNG, V25, P26, DOI 10.1016/S0196-0709(03)00126-1 Sanguineti G, 1997, INT J RADIAT ONCOL, V37, P985, DOI 10.1016/S0360-3016(97)00104-1 SHAM JST, 1991, CANCER, V68, P422, DOI 10.1002/1097-0142(19910715)68:2<422::AID-CNCR2820680235>3.0.CO;2-F Teo P, 1996, INT J RADIAT ONCOL, V36, P291, DOI 10.1016/S0360-3016(96)00323-9 NR 16 TC 12 Z9 14 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 340 EP 345 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600004 PM 16739664 ER PT J AU Nicollas, R Sudre-Levillain, I Roman, S Triglia, JM AF Nicollas, R Sudre-Levillain, I Roman, S Triglia, JM TI Surgical repair of laryngotracheoesophageal clefts by tracheoesophagoplasty with two overlapping flaps SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anterior approach; laryngotracheoesophageal cleft; overlapping flaps ID LARYNGEAL CLEFTS; IV; MANAGEMENT AB We report a technique for surgical repair of laryngotracheoesophageal clefts from type II to IV through an anterior approach that involves performing a tracheoesophagoplasty with two overlapping flaps (TEP-TOF). We offer a technical description, a retrospective study, and a review of the literature. Ten children were operated on for laryngotracheoesophageal clefts of types II, III, or IV of the Benjamin and Inglis classification by the TEP-TOF procedure. After a median follow-up of 58 months (2 months to 12 years), neither complications nor recurrences were observed. All surgical details of the TEP-TOF procedure, including the approach, the kind of sutures, the method of creating the flaps, and the preoperative and postoperative management, are discussed and compared with the data found in the literature. C1 La Timone Childrens Hosp, Dept Pediat Otolaryngol Head & Neck Surg, F-13385 Marseille 5, France. RP Nicollas, R (reprint author), La Timone Childrens Hosp, Dept Pediat Otolaryngol Head & Neck Surg, 264 Rue St Pierre, F-13385 Marseille 5, France. CR BENJAMIN B, 1989, ANN OTO RHINOL LARYN, V98, P417 DUBOIS JJ, 1990, J PEDIATR SURG, V25, P855, DOI 10.1016/0022-3468(90)90191-B Garabedian EN, 1998, LARYNGOSCOPE, V108, P899, DOI 10.1097/00005537-199806000-00020 HOTALING AJ, 1996, PEDIAT OTOLARYNGOLOG, V2, P1131 Lipshutz GS, 1998, J PEDIATR SURG, V33, P400, DOI 10.1016/S0022-3468(98)90471-7 MCGILL TJ, 1996, LARYNX MULTIDISCPLIN, P155 Moukheiber AK, 2002, ANN OTO RHINOL LARYN, V111, P1076 PETTERSSON G, 1955, Acta Chir Scand, V110, P250 Pinlong E, 1996, INT J PEDIATR OTORHI, V36, P253, DOI 10.1016/0165-5876(96)01340-7 ROBIE DK, 1991, J PEDIATR SURG, V26, P971, DOI 10.1016/0022-3468(91)90845-K RYAN DP, 1991, J PEDIATR SURG, V26, P962, DOI 10.1016/0022-3468(91)90844-J NR 11 TC 0 Z9 0 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 346 EP 349 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600005 PM 16739665 ER PT J AU Bernstein, JM Hasse, E Scannapieco, F Dryja, D Wolf, J Briles, D King, J Wilding, GE AF Bernstein, JM Hasse, E Scannapieco, F Dryja, D Wolf, J Briles, D King, J Wilding, GE TI Bacterial interference of penicillin-sensitive and -resistant Streptococcus pneumoniae by Streptococcus oralis in an adenoid organ culture: Implications for the treatment of recurrent upper respiratory tract infections in children and adults SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE adenoid; bacterial interference; Streptococcus oralis; Streptococcus pneumoniae ID ALPHA-HEMOLYTIC STREPTOCOCCI; NORMAL THROAT FLORA; OTITIS-MEDIA; RECOLONIZATION; PREVENTION; PHARYNGOTONSILLITIS; PROPHYLAXIS AB Objectives: The role of the viridans group of streptococci (Streptococcus oralis) in the prevention of colonization with Streptococcus pneumoniae was investigated in an adenoid organ culture system. Methods: The adenoids from 10 patients who were undergoing adenoidectomy for either hypertrophy or recurrent otitis media were used. Results: Streptococcus oralis Parker and S oralis Booth (two organisms isolated from the nasopharynges of patients under-going adenoidectomy only and patients undergoing adenoidectomy and bilateral tympanostomy with tubes, respectively) uniformly inhibited both penicillin-sensitive and penicillin-resistant Spneumoniae. Although both strains of Soralis inhibited the growth of both S pneumoniae strains, strain Parker provided more complete inhibition than did strain Booth. Conclusions: The results indicate that some strains of S oralis may inhibit the growth of the most serious pathogens in the nasopharynx. It is therefore possible that colonization of inhibitory strains of viridans streptococci may be used in the nasopharynx as a relatively safe and inexpensive approach to prevention of recurrent otitis media in some children and of recurrent suppurative sinusitis in both children and adults. C1 SUNY Buffalo, Sch Med & Biomed Sci, Dept Otolaryngol, Buffalo, NY 14260 USA. SUNY Buffalo, Sch Med & Biomed Sci, Dept Pediat, Buffalo, NY 14260 USA. SUNY Buffalo, Sch Dent Med, Dept Commun Disorders & Sci, Buffalo, NY 14260 USA. SUNY Buffalo, Sch Dent Med, Dept Oral Biol, Buffalo, NY 14260 USA. SUNY Buffalo, Sch Publ Hlth Profess, Dept Biostat, Buffalo, NY 14260 USA. Kaleida Hlth Syst, Flint St Lab, Microbiol Lab, Williamsville, NY USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. RP Bernstein, JM (reprint author), 2430 N Forest Rd,Suite 150, Getzville, NY 14068 USA. CR ANTHONY BF, 1967, J EXP MED, V125, P319, DOI 10.1084/jem.125.2.319 Bernstein JM, 2002, ANN OTO RHINOL LARYN, V111, P696 Bernstein JM, 1997, ANN NY ACAD SCI, V830, P19, DOI 10.1111/j.1749-6632.1997.tb51876.x BRILES DE, 1992, INFECT IMMUN, V60, P111 CROWE CC, 1973, J INFECT DIS, V128, P527 Falck G, 1999, ACTA OTO-LARYNGOL, V119, P944 Hillman J D, 1987, Adv Dent Res, V1, P119 Huovinen P, 2001, BRIT MED J, V323, P353, DOI 10.1136/bmj.323.7309.353 MAIBACH HI, 1969, BRIT J DERMATOL, VS 81, P69, DOI 10.1111/j.1365-2133.1969.tb12836.x National Committee for Clinical Laboratory Standards, 2004, PERF STAND ANT SUS S Reid G, 2001, TRENDS MICROBIOL, V9, P424, DOI 10.1016/S0966-842X(01)02132-1 Roos K, 1996, SCAND J INFECT DIS, V28, P459 ROOS K, 1989, EUR J CLIN MICROBIOL, V8, P318, DOI 10.1007/BF01963463 Roos K, 2001, BRIT MED J, V322, P210, DOI 10.1136/bmj.322.7280.210 SANDERS CC, 1976, INFECT IMMUN, V13, P808 SHINEFIELD HR, 1963, AM J DIS CHILD, V105, P683 SPRUNT K, 1988, CAN J MICROBIOL, V34, P332 SPRUNT K, 1968, ANN INTERN MED, V68, P579 SPRUNT K, 1971, J INFECT DIS, V123, P1 Tano K, 2003, ACTA OTO-LARYNGOL, V123, P724, DOI 10.1080/00016480310000403 Tano K, 2002, INT J PEDIATR OTORHI, V62, P17, DOI 10.1016/S0165-5876(01)00581-X Tano K, 2002, ACTA OTO-LARYNGOL, V122, P78 Verbeke G, 2000, LINEAR MIXED MODELS NR 23 TC 10 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 350 EP 356 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600006 PM 16739666 ER PT J AU Borschmann, ME Berkowitz, RG AF Borschmann, ME Berkowitz, RG TI One-off streptococcal serologic testing in young children with recurrent tonsillitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anti-deoxyribonuclease B; antistreptolysin; Streptococcus pyogenes; tonsillitis diagnosis ID PHARYNGITIS AB Objectives: Recurrent acute tonsillitis in children under 4 years of age is usually viral, making antibiotic therapy inappropriate and the indication for tonsillectomy uncertain. Identifying those young children with bacterial infections is therefore important. The purpose of this study was to determine whether one-off streptococcal serologic testing is a useful tool in assessing recurrent acute tonsillitis in young children. Methods: We performed a retrospective study of 45 children (35 male and 10 female) under the age of 4 years who were found by a staff otolaryngologist to have recurrent acute tonsillitis over a 5-year period and had one-off serologic testing for anti-streptolysin O titers and anti-deoxyribonuclease B levels. Data were collected by chart review. Results: Three children (6.7%) had clearly positive titers for either one or both streptococcal antibodies. Children with negative serologic results were significantly less likely to have shown a significant response to antibiotic therapy for their acute episodes (26% versus 100%; p =.026). Nine children (20%) eventually underwent tonsillectomy, all of whom had negative serologic results. Conclusions: Anti-streptolysin O and anti-deoxyribonuclease B levels may aid clinical evaluation of recurrent acute tonsillitis in young children in differentiating between those cases due to group A P-hemolytic Streptococcus and those that are viral in origin. C1 Royal Childrens Hosp, Dept Otolaryngol, Parkville, Vic 3052, Australia. RP Berkowitz, RG (reprint author), Royal Childrens Hosp, Dept Otolaryngol, Flemington Rd, Parkville, Vic 3052, Australia. CR AYOUB EM, 1962, PEDIATRICS, V29, P527 BRIDGESWEBB C, 1992, MED J AUST S, V157 Edmond KM, 1996, MED J AUSTRALIA, V165, P420 Kaplan EL, 1998, PEDIATRICS, V101, P86, DOI 10.1542/peds.101.1.86 Martin DR, 1999, STREPTOCOCCAL INFECTIONS, P266 MELAND E, 1993, SCAND J INFECT DIS, V25, P177, DOI 10.3109/00365549309008482 Nussinovitch M, 1999, CLIN PEDIATR, V38, P357, DOI 10.1177/000992289903800606 Perez E, 2002, CURR OPIN PEDIATR, V14, P678, DOI 10.1097/00008480-200212000-00005 RANTZ LA, 1948, AM J MED, V5, P3, DOI 10.1016/0002-9343(48)90003-5 NR 9 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 357 EP 360 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600007 PM 16739667 ER PT J AU Mortensen, M Genden, EM AF Mortensen, M Genden, EM TI Role of the island deltopectoral flap in contemporary head and neck reconstruction SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE head and neck reconstruction; island deltopectoral flap AB Objectives: The deltopectoral flap (DP) was originally described 40 years ago for head and neck reconstruction. Since that time, use of pedicled myocutaneous flaps and free tissue transfer has supplanted the DP flap as a first-line reconstructive tool. The island DP flap, a variation of the DP flap wherein the skin bridge is de-epithelialized, provides a source of thin and pliable tissue that can be useful for select head and neck reconstruction. The purpose of this review is to assess the utility of the island DP flap in contemporary head and neck reconstruction. Methods: A retrospective review of 16 consecutive cases utilizing the island DP flap was performed. Indications, complications, and outcome were reviewed in an effort to determine the role of the island DP in contemporary head and neck reconstruction. Results: Sixteen island DP flap procedures were successfully performed in 16 patients for a variety of reconstructions, including esophageal, laryngeal, cutaneous, and pharyngeal defects. The donor skin paddles averaged 22.4 cm(2) (range, 14 to 40.8 cm(2)). There were no recipient site complications; however, there was 1 donor site hematoma that was managed with drainage. In all 16 cases, the island DP flap provided an appropriate source of donor tissue for reconstruction of limited defects of the pharynx, esophagus, and skin of the neck. Conclusions: The island DP flap is a reliable donor site that provides an excellent source of thin and pliable tissue for limited defects of the head and neck. C1 Mt Sinai Sch Med, Dept Otolaryngol, New York, NY 10029 USA. Mt Sinai Sch Med, Dept Otolaryngol Head & Neck Surg, New York, NY 10029 USA. RP Genden, EM (reprint author), Mt Sinai Sch Med, Dept Otolaryngol, Box 1189,1 Gustave L Levy Pl, New York, NY 10029 USA. CR BAKAMJIAN V Y, 1965, Plast Reconstr Surg, V36, P173 Bakamjian V Y, 1971, Br J Plast Surg, V24, P174, DOI 10.1016/S0007-1226(71)80037-1 DANIEL RK, 1975, PLAST RECONSTR SURG, V55, P275, DOI 10.1097/00006534-197555030-00002 JACKSON IT, 1971, PLAST RECONSTR SURG, V48, P155, DOI 10.1097/00006534-197108000-00007 KIRKBY B, 1980, SCAND J PLAST RECONS, V14, P151 LASH H, 1977, PLAST RECONSTR SURG, V59, P235 TIWARI RM, 1981, HEAD NECK SURG, V3, P379, DOI 10.1002/hed.2890030506 NR 7 TC 2 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 361 EP 364 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600008 PM 16739668 ER PT J AU Fujihara, K Koltai, PJ Hayashi, M Tamura, S Yamanaka, N AF Fujihara, K Koltai, PJ Hayashi, M Tamura, S Yamanaka, N TI Cost-effectiveness of tonsillectomy for recurrent acute tonsillitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 5th International Symposium on Tonsils and Mucosal Barriers of Upper Airways CY APR 09-11, 2003 CL Wakayama, JAPAN HO Barriers Upper Airways DE break-even time analysis; recurrent acute tonsillitis; tonsillectomy ID QUALITY-OF-LIFE; THROAT INFECTION; CHILDREN; EFFICACY; ADENOTONSILLECTOMY; CHILDHOOD; GROWTH; ADULTS AB Objectives: We used a retrospective case series to perform a preliminary study to determine the clinical effectiveness and cost-effectiveness of tonsillectomy for recurrent acute tonsillitis. Methods: We studied 25 children and 16 adults who had tonsillectomy for recurrent acute tonsillitis. The adult patients and the children's caregivers were asked to respond to a questionnaire regarding the efficacy of their tonsillectomy. The cost of medical care and the work disability cost for tonsillitis and for tonsillectomy were calculated. We then applied the technique of break-even time analysis to assess when the total health care cost savings from surgery overtook the total cost of tonsillectomy. Results: In children, the overall economic costs (medical costs and work-related costs) were recovered at 1.6 years after tonsillectomy (break-even point). In adults, the overall economic costs (medical costs and work-related costs) were recovered at 2.5 years after tonsillectomy (break-even point). Conclusions: Tonsillectomy for recurrent acute tonsillitis is both clinically effective and cost-effective for children and adults in Japan. C1 Wakayama Med Univ, Dept Otolaryngol Head & Neck Surg, Wakayama 6418509, Japan. Stanford Univ, Sch Med, Div Pediat Otolaryngol, Stanford, CA 94305 USA. RP Fujihara, K (reprint author), Wakayama Med Univ, Dept Otolaryngol Head & Neck Surg, 811-1 Kimiidera, Wakayama 6418509, Japan. CR *AM AC OT HEAD NEC, 2000, B AM AC OT HEAD NECK, V19 Berdeaux G, 1998, QUAL LIFE RES, V7, P501, DOI 10.1023/A:1008874324258 Bhattacharyya N, 2001, ARCH OTOLARYNGOL, V127, P1347 Bhattacharyya N, 2002, ANN OTO RHINOL LARYN, V111, P983 Burton MJ, 2000, COCHRANE DB SYST REV CAMILLERI AE, 1995, CLIN OTOLARYNGOL, V20, P153, DOI 10.1111/j.1365-2273.1995.tb00034.x Conlon BJ, 1997, INT J PEDIATR OTORHI, V41, P155, DOI 10.1016/S0165-5876(97)00073-6 Gliklich RE, 1998, OTOLARYNG HEAD NECK, V118, P344, DOI 10.1016/S0194-5998(98)70313-4 Johansson E, 2003, INT J PEDIATR OTORHI, V67, P981, DOI 10.1016/S0165-5876(03)00196-4 Mui S, 1998, LARYNGOSCOPE, V108, P1325, DOI 10.1097/00005537-199809000-00012 Paradise Jack L, 2002, Pediatrics, V110, P7, DOI 10.1542/peds.110.1.7 PARADISE JL, 1984, NEW ENGL J MED, V310, P674, DOI 10.1056/NEJM198403153101102 Pickering AE, 2002, BRIT J ANAESTH, V88, P72, DOI 10.1093/bja/88.1.72 Schweitzer EJ, 1998, TRANSPLANTATION, V66, P1702, DOI 10.1097/00007890-199812270-00023 Stanton MS, 2000, CIRCULATION, V101, P1067 Stanton MS, 2000, CIRCULATION, V101, P2872 WILLIAMS EF, 1991, OTOLARYNG HEAD NECK, V104, P509 Windfuhr JP, 2003, ANN OTO RHINOL LARYN, V112, P63 Wolfensberger M, 2000, INT J PEDIATR OTORHI, V56, P199, DOI 10.1016/S0165-5876(00)00441-9 NR 19 TC 14 Z9 16 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 365 EP 369 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600009 PM 16739669 ER PT J AU Chan, RW Fu, M Tirunagari, N AF Chan, RW Fu, M Tirunagari, N TI Elasticity of the human false vocal fold SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 147th Annual Meeting of the Acoustical-Society-of-America (ASA) CY MAY 24-28, 2004 CL New York, NY SP Acoust Soc Amer DE biomechanical modeling; elastic modulus; larynx; ventricular fold; vestibular fold ID VENTRICULAR DYSPHONIA; STRESS-STRAIN; COMPUTATIONAL AEROACOUSTICS; PHONATION; BIOMECHANICS; COMPRESSION; MECHANISMS; BEHAVIOR; TISSUES AB Objectives: Very little is known about the elasticity of the human ventricular fold (false vocal fold). To better understand the potential role of the false fold in the fluid dynamics and aeroacoustics of phonation, we made some measurements on the elastic properties of human ventricular fold tissues in vitro. Methods: Uniaxial tensile stress-strain characteristics of 6 male and 6 female false fold specimens were quantified with sinusoidal stretch-release deformation. Midcoronal sections of 3 specimens were examined to quantify the relative densities of collagen, elastin, seromucous glandular tissue, and adipose tissue by digital image analysis. Results: Nonlinear stress-strain curves with hysteresis (viscous energy loss) were observed, with large interindividual differences. A hybrid linear-exponential model was used to determine the elastic modulus (tangent Young's modulus) of the false fold. On average, the male false fold was twice as stiff as the female at a tensile strain of 20% to 30%. Conclusions: This preliminary gender-related difference in elasticity could be attributed to a higher proportion of glandular tissue in the female false fold, due to the lower elastic modulus of glands. The present data allow one to develop a more comprehensive biomechanical model of phonation, for optimizing postoperative voice production following laryngeal reconstruction procedures. C1 Univ Texas, SW Med Ctr, Dept Otolaryngol Head & Neck Surg, Dallas, TX 75390 USA. Univ Texas, SW Med Ctr, Grad Program Biomed Engn, Dallas, TX 75390 USA. RP Chan, RW (reprint author), Univ Texas, SW Med Ctr, Dept Otolaryngol Head & Neck Surg, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. CR Agarwal M, 2003, J VOICE, V17, P97, DOI 10.1016/S0892-1997(03)00012-2 Alipour F, 2000, J ACOUST SOC AM, V108, P3003, DOI 10.1121/1.1324678 ALIPOURHAGHIGHI F, 1991, J ACOUST SOC AM, V90, P1326, DOI 10.1121/1.401924 Aoyagi S, 1995, Nihon Jibiinkoka Gakkai Kaiho, V98, P627 Behrman A, 2003, J VOICE, V17, P403, DOI 10.1067/S0892-1997(03)00018-3 Chan RW, 2001, OTOLARYNG HEAD NECK, V124, P607, DOI 10.1067/mhn.2001.115906 Chan RW, 1999, J ACOUST SOC AM, V106, P2008, DOI 10.1121/1.427947 DICKSON DR, 1982, ANATOMICAL PHYSL BAS Fink B. R., 1978, LARYNGEAL BIOMECHANI Fung Y.C., 1993, BIOMECHANICS MECH PR Gray SD, 1999, LARYNGOSCOPE, V109, P845, DOI 10.1097/00005537-199906000-00001 Gray SD, 2000, ANN OTO RHINOL LARYN, V109, P77 HAJI T, 1992, ACTA OTO-LARYNGOL, V112, P559, DOI 10.3109/00016489209137440 Hammond TH, 1998, OTOLARYNG HEAD NECK, V119, P314, DOI 10.1016/S0194-5998(98)70071-3 Hammond TH, 2000, ANN OTO RHINOL LARYN, V109, P913 Hendriks FM, 2003, SKIN RES TECHNOL, V9, P274, DOI 10.1034/j.1600-0846.2003.00019.x HIRANO M, 1993, HISTOLOGICAL COLOR A Hirano M., 1983, VOCAL FOLD PHYSL CON, P22 GRACCO C, 1989, Journal of Voice, V3, P204, DOI 10.1016/S0892-1997(89)80002-5 Kendall KA, 1997, LARYNGOSCOPE, V107, P948, DOI 10.1097/00005537-199707000-00022 KOTBY MN, 1991, ACTA OTO-LARYNGOL, V111, P396, DOI 10.3109/00016489109137409 Krouskop TA, 1998, ULTRASONIC IMAGING, V20, P260 Kutta H, 2002, ANAT EMBRYOL, V205, P315, DOI 10.1007/s00429-002-0255-8 MIN YB, 1995, ANN OTO RHINOL LARYN, V104, P563 Nasri S, 1996, AM J OTOLARYNG, V17, P427, DOI 10.1016/S0196-0709(96)90080-0 PERLMAN AL, 1985, THESIS U IOWA IOWA Pinho SMR, 1999, J VOICE, V13, P36, DOI 10.1016/S0892-1997(99)80059-9 Sakakibara K. I., 2001, P INT COMP MUS C HAV, P135 SAKAKIBARA KI, 2002, J ACOUST SOC AM, V112, P2264 Stager SV, 2003, J VOICE, V17, P395, DOI 10.1067/S0892-1997(03)00034-1 Stiblar-Martincic D, 1997, Acta Otolaryngol Suppl, V527, P138 TSAI CG, 2004, INT C VOIC PHYS BIOM Varghese T, 2000, ULTRASOUND MED BIOL, V26, P839, DOI 10.1016/S0301-5629(00)00199-X VONDOERSTEN PG, 1992, LARYNGOSCOPE, V102, P1296, DOI 10.1288/00005537-199211000-00018 Zhang C, 2002, J ACOUST SOC AM, V112, P2147, DOI 10.1121/1.1506694 Zhao W, 2002, J ACOUST SOC AM, V112, P2134, DOI 10.1121/1.1506693 NR 36 TC 10 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 370 EP 381 PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600010 PM 16739670 ER PT J AU Eliashar, R Ochana, M Maly, B Pines, M Sichel, JY Nagler, A AF Eliashar, R Ochana, M Maly, B Pines, M Sichel, JY Nagler, A TI Halofuginone prevents subglottic stenosis in a canine model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the Western Section of the American-Laryngological-Rhinological-and-Otological-Society CY JAN 30, 2004 CL Scottsdale, AZ SP Amer Laryngol Rhinol & Otol Soc DE halofuginone; larynx; mitomycin; stenosis; subglottic stenosis; wound healing ID MITOMYCIN-C; IN-VIVO; LARYNGOTRACHEAL RECONSTRUCTION; GROWTH-INHIBITION; ANGIOGENESIS AB Objectives: Halofuginone is a low-molecular weight quinazolinone alkaloid coccidiostat that inhibits collagen type I synthesis, extracellular matrix deposition, and angiogenesis. This study was conducted to assess its potential in preventing subglottic stenosis (SGS). Methods: We induced SGS in 10 dogs randomly divided into 2 groups. Each group received treatment between 3 days before and 21 days after the induction of SGS. One group received oral halofuginone 40 mu g/kg, and the other was given placebo. The area of the subglottic lumen was measured at baseline and 3 months later. In addition, human tracheal fibroblasts were cultured. The inhibitory effect of halofuginone was compared to the effect of mitomycin. Results: All dogs survived throughout the study with no side effects. Three months after the operation, no halofuginone-treated dog had SGS, in contrast to a 66% to 80% stenosis rate (mean, 72%) in controls (p < .008). Thick fibrotic tissue was found in the placebo-treated larynges, whereas an almost normal architecture was observed in halofuginone-treated larynges. Halofuginone inhibited the growth of human tracheal fibroblasts by 75%, in comparison with 60% inhibition by mitomycin (no statistically significant difference). Conclusions: This preliminary study shows that halofuginone is effective in preventing SGS caused by an acute injury. Halofuginone has a potential therapeutic role in preventing SGS in humans. C1 Hebrew Univ Jerusalem, Hadassah Med Ctr, Sch Med, Dept Otolaryngol Head & Neck Surg, Jerusalem, Israel. Hebrew Univ Jerusalem, Hadassah Med Ctr, Sch Med, Liver Lab, Jerusalem, Israel. Hebrew Univ Jerusalem, Hadassah Med Ctr, Sch Med, Dept Pathol, Jerusalem, Israel. Volcani Ctr, Inst Anim Sci, IL-50250 Bet Dagan, Israel. Chaim Sheba Med Ctr, Div Hematol & Bone Marrow Transplantat, IL-52621 Tel Hashomer, Israel. RP Eliashar, R (reprint author), Hebrew Univ Jerusalem, Hadassah Med Ctr, Sch Med, Dept Otolaryngol Head & Neck Surg, Jerusalem, Israel. CR Coppit G, 2000, INT J PEDIATR OTORHI, V53, P125, DOI 10.1016/S0165-5876(00)00322-0 Correa Alex J., 1999, Annals of Otology Rhinology and Laryngology, V108, P1053 CUMMINGS CW, 1998, OTOLARYNGOLOGY HEAD, P303 Eliashar R, 2004, LARYNGOSCOPE, V114, P743, DOI 10.1097/00005537-200404000-00028 Eliashar R, 1999, LARYNGOSCOPE, V109, P1594, DOI 10.1097/00005537-199910000-00009 Eliashar R, 2000, OTOLARYNG HEAD NECK, V122, P84, DOI 10.1016/S0194-5998(00)70149-5 Elkin M, 1999, CANCER RES, V59, P4111 Elkin M, 2000, FASEB J, V14, P2477, DOI 10.1096/fj.00-0292com Garrett CG, 2001, ANN OTO RHINOL LARYN, V110, P25 Gavish Z, 2002, PROSTATE, V51, P73, DOI 10.1002/pros.10059 Gross DJ, 2003, CLIN CANCER RES, V9, P3788 Hardillo J, 2001, LARYNGOSCOPE, V111, P1174, DOI 10.1097/00005537-200107000-00009 Hartnick CJ, 2001, ARCH OTOLARYNGOL, V127, P1260 McGaha TL, 2002, J INVEST DERMATOL, V118, P461, DOI 10.1046/j.0022-202x.2001.01690.x Nagler A, 1998, ANN SURG, V227, P575, DOI 10.1097/00000658-199804000-00021 Nagler A, 2000, J UROLOGY, V164, P1776, DOI 10.1016/S0022-5347(05)67105-4 Ozcelik MF, 2004, AM J SURG, V187, P257, DOI 10.1016/j.amjsurg.2003.11.008 Pines Mark, 2003, Biol Blood Marrow Transplant, V9, P417, DOI 10.1016/S1083-8791(03)00151-4 Pines M, 1998, GEN PHARMACOL, V30, P445, DOI 10.1016/S0306-3623(97)00307-8 Rahbar R, 2002, ARCH OTOLARYNGOL, V128, P401 Rahbar R, 2001, ANN OTO RHINOL LARYN, V110, P1 Singer AJ, 1999, NEW ENGL J MED, V341, P738 Spector JE, 1999, LARYNGOSCOPE, V109, P1125, DOI 10.1097/00005537-199907000-00022 Spira G, 2002, J HEPATOL, V37, P331, DOI 10.1016/S0168-8278(02)00164-2 Valdez TA, 2002, ANN OTO RHINOL LARYN, V111, P690 Xavier S, 2004, J BIOL CHEM, V279, P15167, DOI 10.1074/jbc.M309798200 NR 26 TC 10 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 382 EP 386 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600011 PM 16739671 ER PT J AU Nishio, T Koike, S Okano, H Bamba, H Hisa, Y AF Nishio, T Koike, S Okano, H Bamba, H Hisa, Y TI Age-related expression of alpha-gustducin in the rat larynx SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE age; alpha-gustducin; larynx; taste bud ID TASTE BUD DISTRIBUTION; NERVE-ENDINGS; G-PROTEIN; CELLS; ORGAN; IDENTIFICATION; EPITHELIUM; HAMSTER; PAPILLA; SYSTEM AB Objectives: The age-related changes in distribution of alpha-gustducin-immunoreactive structures in the larynx of Sprague-Dawley rats were studied. Methods: For this purpose, tissues obtained from 12 male rats ranging in age from 5 to 21 weeks were compared with respect to the distribution and morphology of laryngeal taste buds immunoreactive for alpha-gustducin, the alpha-subunit of a taste cell-specific G protein. Results: Three different morphological types of alpha-gustducin-immunoreactive structures were seen: typical gemmal forms, clusters composed of 2 or 3 cells, and isolated immunoreactive cells not associated with taste buds. alpha-Gustducin-immunoreactive structures were most abundant in the epiglottis in all age groups. alpha-Gustducin-immunoreactive cells in rats seem to be located along the lateral food channels, in which they may come in contact with food. The total number of these alpha-gustducin-immunoreactive structures did not show any age-related changes, but the percentage of,e solitary immunoreactive cells in 5-week-old rats was significantly larger than the percentages in 8-, 14-, and 21-week-old animals. Conclusions: Solitary alpha-gustducin-immunoreactive cells, which are abundant in 5-week-old rats but are found in fewer numbers along the base of the epiglottis in mature rats, may be nociceptic in function, whereas the chemosensory clusters or buds that contain alpha-gustducin-positive cells and are distributed along the lateral food channels on the pharyngeal side of the larynx may have a role in gustatory reception. C1 Kyoto Prefectural Univ Med, Dept Otolaryngol Head & Neck Surg, Kyoto 6028566, Japan. RP Hisa, Y (reprint author), Kyoto Prefectural Univ Med, Dept Otolaryngol Head & Neck Surg, Kyoto 6028566, Japan. 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Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 387 EP 393 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600012 PM 16739672 ER PT J AU Chao, SS Graham, SM Brown, CL Kline, JN Hussain, I AF Chao, SS Graham, SM Brown, CL Kline, JN Hussain, I TI Cysteinyl leukotriene 1 receptor expression in nasal polyps SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE aspirin sensitivity; asthma; chronic hyperplastic sinusitis; cysteinyl leukotriene; cysteinyl leukotriene 1 receptor; nasal polyp ID CYSTEINYL LEUKOTRIENE-1 RECEPTOR; ASTHMA; EOSINOPHIL; RHINOSINUSITIS; ANTAGONISTS; EFFICACY; MUCOSA; CELLS; LUNG AB Objectives: The pathogenesis of nasal polyps, thought to involve complex interactions between different factors, is currently not fully understood. Recent studies have suggested the involvement of cysteinyl leukotrienes (CysLTs) in nasal polyp development. To further understand the role of CysLTs in polyp pathogenesis, we studied the expression of CysLT1 receptors in nasal polyps. Methods: The study group comprised polyps removed endoscopically from 20 consecutive patients. Samples of ethmoid mucosa from 4 patients who underwent orbital decompression for Graves' ophthalmopathy were used as controls. The presence of CysLT1 receptors was determined with a rabbit anti-human anti-CysLT1 receptor polyclonal antibody. Cells with and without CysLT1 receptor expression were counted within the epithelial layer and stroma by means of light microscopy (40x magnification). Results: There were significantly more cells expressing CysLT1 receptors in the stroma than in the epithelium in both nasal polyps and control specimens. The stroma of polyps also contained more CysLT1 receptor-expressing cells than did controls (29 x 10(3) +/- 7 x 10(3) versus 3 x 10(3) +/- 3 x 10(3) cells per square millimeter; p < .01). In the epithelium of polyps, there was significantly higher expression of CysLT1 receptors than in controls (7 x 10(3) +/- 3 x 10(3) versus 0 cells per square millimeter; p = .02). No significant differences in polyps were found between patients with and patients without Samter's triad and asthma. Conclusions: The significant up-regulation of CysLT1 receptors we found in both the stroma and the epithelium of nasal polyps suggests the presence of an inflammatory component in the pathogenesis of polyps, and possibly explains the efficacy of leukotriene modifiers in their treatment. C1 Washington Univ, Dept Med, St Louis, MO 63110 USA. Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. Univ Iowa Hosp & Clin, Dept Med, Div Occupat & Environm Hlth, Iowa City, IA 52242 USA. Univ Iowa Hosp & Clin, Dept Med, Div Allergy & Immunol, Iowa City, IA 52242 USA. RP Hussain, I (reprint author), Washington Univ, Dept Med, 660 S Euclid Ave,Campus Box 8122, St Louis, MO 63110 USA. 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M., 2000, ENT-EAR NOSE THROAT, V79, P24 Parnes S M, 2000, Ear Nose Throat J, V79, P18 Riccioni G, 2001, INT J IMMUNOPATH PH, V14, P87 Settipane GA, 1996, ALLERGY ASTHMA PROC, V17, P231, DOI 10.2500/108854196778662246 Shirasaki H, 2002, CLIN EXP ALLERGY, V32, P1007, DOI 10.1046/j.1365-2222.2002.01425.x Smith LJ, 2001, BIODRUGS, V15, P239, DOI 10.2165/00063030-200115040-00004 Sousa AR, 2002, NEW ENGL J MED, V347, P1493, DOI 10.1056/NEJMoa013508 SPADA CS, 1994, J LEUKOCYTE BIOL, V55, P183 STAMMBERGER HR, 1999, RHINITIS MECH MANAGE, P165 Steinke JW, 2003, J ALLERGY CLIN IMMUN, V111, P342, DOI 10.1067/mai.2003.67 Terada N, 1996, ACTA OTO-LARYNGOL, V116, P883, DOI 10.3109/00016489609137945 Thivierge M, 2001, J IMMUNOL, V167, P2855 Ulualp SO, 1999, ENT-EAR NOSE THROAT, V78, P613 Ulualp SO, 1999, ENT-EAR NOSE THROAT, V78, P608 Ulualp S O, 1999, Ear Nose Throat J, V78, P604 Vargaftig BB, 2003, AM J PHYSIOL-LUNG C, V285, pL808, DOI 10.1152/ajplung.00377.2002 NR 33 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2006 VL 115 IS 5 BP 394 EP 397 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600013 PM 16739673 ER PT J AU Zaugg, Y Cuffel, C Monnier, P AF Zaugg, Y Cuffel, C Monnier, P TI Releasing tension on a tracheal anastomosis: An ex vivo study on a sheep model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Congress of the Swiss-ENT-Society CY JUN 08-09, 2005 CL Basel, SWITZERLAND SP Swiss ENT Soc DE anastomosis; glue; tension; tissue adhesive; trachea ID RESECTION; SURGERY; STENOSIS; PUPPIES AB Objectives: Tension is the limiting factor in long tracheal resection with end-to-end anastomosis. Complications such as dehiscence and restenosis are well correlated with the degree of anastomotic tension. The objective of our study was to investigate the effects of patches of auricular cartilage glued craniocaudally along a tracheal anastomosis. Methods: Rupture tests were performed on sheep tracheas collected from a slaughterhouse. In group A (n = 5), 3 patches of auricular cartilage of 0.5 x 5 cm were glued with albumin-glutaraldehyde tissue adhesive (BioGlue) craniocaudally along the left, right, and anterior borders of the transected tracheas. In group B (n = 10), the patches were fixed with 2 transparietal intercartilaginous stitches without adhesive. In group C (n = 10), adhesive and stitches were used. Results: Three patches of cartilage glued along the tracheal anastomosis held tension as high as 11.1 N. Adhesive maintained the tracheal extremities in closer contact than did stitches alone. It increased the anastomotic resistance strength (50.8 N in group C versus 29.6 N in group B). This increase was statistically significant. Conclusions: Gluing auricular cartilage patches along ex vivo tracheal anastomoses strengthened them and helped diminish tension on the suture line. C1 CHU Vaudois, Serv ORL & Chirurg Cervico Faciale, Dept Otolaryngol Head & Neck Surg, CH-1011 Lausanne, Switzerland. RP Zaugg, Y (reprint author), CHU Vaudois, Serv ORL & Chirurg Cervico Faciale, Dept Otolaryngol Head & Neck Surg, Rue Bugnon 46, CH-1011 Lausanne, Switzerland. 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PD MAY PY 2006 VL 115 IS 5 BP 398 EP 402 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 043MG UT WOS:000237604600014 PM 16739674 ER PT J AU Eller, RL Livingston, WJ Morgan, CE Peters, GE Sillers, MJ Magnuson, JS Rosenthal, EL AF Eller, RL Livingston, WJ Morgan, CE Peters, GE Sillers, MJ Magnuson, JS Rosenthal, EL TI Expandable tracheal stenting for Benign disease: Worth the complications? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE complication; stent; tracheal stenosis ID STENOSIS; MITOMYCIN; LARYNGEAL; AIRWAY; METAANALYSIS; ANGIOPLASTY; RESTENOSIS; INTUBATION; STRICTURES AB Objectives: To characterize the limitations of self-expandable stents in the management of benign tracheal stenosis, we performed a retrospective review at a tertiary care medical center. Methods: Patients who underwent tracheal stenting were assessed for the cause and severity of tracheal stenosis, comorbidities, stent-related complications, and follow-up airway procedures. Results: Sixteen adults (12 women, 4 men; mean age, 47 years) had a total of 26 stents placed for benign disease. Intubation-related stenoses were most frequent (81%). The average follow-up time was 20 months (range, 1 to 40 months). Each stent remained functional for an average of 12.4 months. In the study group, 87% had a complication that required surgical intervention to maintain a patent airway. The most common problem was granulation tissue formation at the ends of the stent causing airway restenosis (81%), and 5 patients (31%) required tracheotomy as a result of restenosis around the stent. Fourteen of the stents (56%) were removed or expelled from the patients. Conclusions: The implantation of self-expandable stents is a minimally invasive method of managing benign tracheal stenosis. Although a small subset of patients may benefit from placement, the majority of patients have complications that require intervention to maintain a patent airway. Thoughtful discretion is critical in selecting patients for this intervention. C1 Univ Alabama, Sch Med, Dept Surg, Div Otolaryngol Head & Neck Surg, Birmingham, AL 35249 USA. RP Rosenthal, EL (reprint author), Univ Alabama, Sch Med, Dept Surg, Div Otolaryngol Head & Neck Surg, BDB Suite 563,1530 3rd Ave S, Birmingham, AL 35249 USA. CR Arya M, 2001, BJU INT, V88, P339, DOI 10.1046/j.1464-410X.2001.02322.x Ashiku SK, 2004, J THORAC CARDIOV SUR, V127, P99, DOI 10.1016/j.jtcvs.2002.11.001 Barbalias GA, 2002, J UROLOGY, V168, P2383, DOI 10.1097/01.ju.0000032172.60874.6d COLICE GL, 1989, CHEST, V96, P877, DOI 10.1378/chest.96.4.877 Correa Alex J., 1999, Annals of Otology Rhinology and Laryngology, V108, P1053 Daskalopoulos G, 2001, EUR J RADIOL, V39, P194, DOI 10.1016/S0720-048X(01)00331-X Dundar Y, 2004, SCAND CARDIOVASC J, V38, P200, DOI 10.1080/14017430410032325 Eliashar R, 2004, LARYNGOSCOPE, V114, P743, DOI 10.1097/00005537-200404000-00028 Elkouri Stephane, 2004, Vasc Endovascular Surg, V38, P401, DOI 10.1177/153857440403800502 Gaissert HA, 2003, J THORAC CARDIOV SUR, V126, P744, DOI 10.1016/S0022-5223(03)00361-1 GRILLO HC, 1995, J THORAC CARDIOV SUR, V109, P486, DOI 10.1016/S0022-5223(95)70279-2 Grillo HC, 2000, ANN THORAC SURG, V70, P1142, DOI 10.1016/S0003-4975(00)01796-3 Hartnick CJ, 2001, ARCH OTOLARYNGOL, V127, P1260 Kamineni Raghunandan, 2004, J Interv Cardiol, V17, P437, DOI 10.1111/j.1540-8183.2004.04087.x Karthikeyan G, 2004, CURR OPIN CARDIOL, V19, P500, DOI 10.1097/01.hco.0000133658.77024.59 Lim LHY, 2004, OTOLARYNG HEAD NECK, V131, P355, DOI 10.1016/j.otohns.2004.04.007 Madden BP, 2005, J LARYNGOL OTOL, V119, P731 Perepelitsyn I, 2004, OTOLARYNG HEAD NECK, V131, P16, DOI 10.1016/j.otohns.2004.03.001 Rahbar R, 2001, ANN OTO RHINOL LARYN, V110, P1 Saad CP, 2003, CHEST, V124, P1993, DOI 10.1378/chest.124.5.1993 Vaitkus PT, 2004, CATHETER CARDIO INTE, V62, P425, DOI 10.1002/ccd.20074 Wahidi MM, 2003, CLIN CHEST MED, V24, P437, DOI 10.1016/S0272-5231(03)00042-X WHITED RE, 1984, LARYNGOSCOPE, V94, P367 Wood DE, 2003, ANN THORAC SURG, V76, P167, DOI 10.1016/S0003-4975(03)00033-X Zakaluzny SA, 2003, OTOLARYNG HEAD NECK, V128, P478, DOI 10.1016/mhn.2003.107 NR 25 TC 13 Z9 13 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 247 EP 252 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900001 PM 16676820 ER PT J AU Hirano, S Yamashita, M Kitamura, M Takagita, S AF Hirano, S Yamashita, M Kitamura, M Takagita, S TI Photocoagulation of microvascular and hemorrhagic lesions of the vocal fold with the KTP laser SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Laryngol Assoc DE KTP laser; microvascular lesion; photocoagulation; vocal fold ID SURGERY AB Objectives: Ectasias and varices of the vocal fold are microvascular lesions that are often due to chronic abuse of the voice, and are occasionally encountered in association with other disorders such as polyps. Reinke's edema. and hematoma. The KTP laser can be used for photocoagulation of small vascular lesions, because the laser beam is well absorbed by hemoglobin, and damage to the epithelium is minimal. The present pilot study examined how the KTP laser could be used for microvascular lesions and their associated lesions. Methods: Twelve patients who had undergone phonomicrosurgery were enrolled in the present study. The microvascular lesions were treated by photocoagulation with the laser set at a low power of 1.5 W in the continuous mode. while preserving the epithelium, and associated lesions were then treated by microdissection with cold instruments. The postoperative phonatory function was assessed by maximum phonation time, a perceptual test rating (GRBAS scale). and stroboscopy. Results: The procedures were completed Successfully in all cases. An exceptional case of a small hemorrhagic polyp allowed treatment with the laser only. The postoperative stroboscopic findings. maximum phonation time. and perceptual test rating all showed significant improvement compared with the preoperative state. No adverse effects. such as scarring or reduction of the inucosal wave, were observed in the current series. Conclusions: KTP laser photocoagulation is a relatively simple and safe procedure for treating microvascular lesions of the vocal fold. It is not recommended for photocoagulation of hemorrhagic polyps or hematomas. because Such lesions have little blood flow inside and thus photocoagulation is usual I impossible or requires too much laser energy. However, photocoagulation of perimeter or feeding vessels of such disorders may facilitate the following procedure by avoiding unnecessary bleeding, its well as preventing recurrence of hemorrhagic lesions. C1 Kyoto Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Sakyo Ku, Kyoto 6068507, Japan. Kyoto Med Ctyr, Dept Otolaryngol, Kyoto, Japan. RP Hirano, S (reprint author), Kyoto Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Sakyo Ku, Kyoto 6068507, Japan. RI Yamashita, Masaru/B-2411-2009 CR Abitbol J, 1988, J VOICE, V2, P261, DOI 10.1016/S0892-1997(88)80084-5 BAKER D C Jr, 1962, Laryngoscope, V72, P902 FEDER RJ, 1983, OTOLARYNG HEAD NECK, V91, P435 HIRANO M, 1993, HISTOLOGICAL COLOR A, P106 Hochman I, 1999, ANN OTO RHINOL LARYN, V108, P10 Hsiung MW, 2003, ANN OTO RHINOL LARYN, V112, P534 JAKO GJ, 1972, LARYNGOSCOPE, V82, P2204, DOI 10.1288/00005537-197212000-00009 KOSCHKEE D, 1997, VOICE CARE MED SETIN Nakai Y, 1991, Acta Otolaryngol Suppl, V486, P254 Postma GN, 1998, ANN OTO RHINOL LARYN, V107, P472 SPIEGEL J, 1997, PROFESSIONAL VOICE S, P541 STRONG MS, 1972, ANN OTO RHINOL LARYN, V81, P791 ZEITELS SM, 2001, ATLAS PHONOMICROSURG, P69 NR 13 TC 15 Z9 15 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 253 EP 259 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900002 PM 16676821 ER PT J AU Shaw, GY Sechtem, P Searl, J Dowdy, ES AF Shaw, GY Sechtem, P Searl, J Dowdy, ES TI Predictors of laryngeal complications in patients implanted with the cyberonics vagal nerve stimulator SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE vagal nerve stimulator; voice complications ID REFRACTORY EPILEPSY; THERAPY; PHENYTOIN AB Objectives: Since its approval by the US Food and Drug Administration in 1997 for management of medically refractory seizures, more than 35,000 patients have been implanted with the Cyberonics vagal nerve stimulator. Preliminary reports described transient vocal changes in the majority of subjects, which were thought to be short-term. However, these reports were for the most part based upon perceptual evaluations by the subjects themselves. Later reports described possibly more permanent recurrent laryngeal nerve injury and recommended measuring the nerve diameter to use the safest spiral cuff electrode. To date. no Study has systematically evaluated vocal fold mobility in subjects before and after implantation. The objectives of this study were to determine the true incidence of both short- and long-term recurrent laryngeal nerve injuries and determine whether there are any potential indicators to predict in which patients long-term nerve deficits may develop. Methods: Thirteen subjects underwent preimplantation laryngeal electromyography, videolaryngoscopy, measurement of the maximum phonation time, Voice Handicap Index determination, and Consensus Auditory-Perceptual Evaluation of Voice. Two weeks after implantation, all Subjects underwent videolaryngoscopy. Three months after implantation and activation of the device, all subjects were reevaluated. Results: Six of the 13 subjects had significant vocal fold mobility abnormalities at 2 weeks. Significant electromyographic abnormalities were detected before implantation in 5 subjects. All 5 of these subjects. at 3 months after implantation, had prolonged left vocal fold paresis. Conclusions: The authors conclude that perioperative vocal fold paresis occurs in approximately 50% of subjects. Further. laryngeal electromyography performed before implantation of the vagal nerve stimulator is a statistically significant predictor (p < .05) of which patients may be at risk for extended vocal fold abnormalities. Possible explanations for this phenomenon are offered. Surgical modifications to limit vagal nerve injury are offered. C1 Kansas City Univ Med & Biosci, Voice & Swallowing Care Ctr, Med Res Ctr, Kansas City, KS USA. Kansas City Univ Med & Biosci, Dept Surg, Kansas City, KS USA. Univ Kansas, Med Ctr, Dept Speech Language Pathol, Kansas City, KS 66103 USA. RP Shaw, GY (reprint author), Lees Summit Ear Nose & Throat Ctr, 296 NE Tudor Rd, Lees Summit, MO 64086 USA. 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Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 260 EP 267 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900003 PM 16676822 ER PT J AU Attias, J Buller, N Rubel, Y Raveh, E AF Attias, J Buller, N Rubel, Y Raveh, E TI Multiple auditory steady-state responses in children and adults with normal hearing, sensorineural hearing loss, or auditory neuropathy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE adult; audiogram; auditory neuropathy; auditory steady-state response; child; cochlear implant; hearing loss ID AMPLITUDE-MODULATED TONES; EVOKED-POTENTIALS; THRESHOLDS; STIMULATION; INFANTS; MASTER AB Objectives: We tested the clinical effectiveness of multiple auditory steady-state responses (ASSRs) for the objective assessment of hearing thresholds in patients with and without hearing loss, candidates for cochlear implants, and children with auditory neuropathy. Methods: The study sample included 29 subjects with sensorineural hearing loss (SNFLL), 18 candidates for cochlear implants, 11 subjects with auditory neuropathy, and 18 subjects with normal hearing thresholds. Behavioral hearing thresholds and ASSRs to carrier frequencies of 0.5. 1, 2. and 4 kHz were obtained. Special care was taken to minimize possible aliasing and high-intensity multiple stimulation effects. Differences and correlations between the ASSRs and the behavioral thresholds were determined. Results: The ASSR estimation of behavioral thresholds in the normal-hearing group was elevated, whereas very close predictions were found for the SNHL group. The correlations between the two measures ranged from 0.86 at 0.5 kHz carrier frequency to 0.94 at 2 kHz. In the cochlear implant candidates and the auditory neuropathy group, the ASSR thresholds generally overestimated the behavioral audiogram. In these groups the number of detected ASSRs was higher than the number of behavioral responses, especially for the high-frequency carrier stimuli. Conclusions: Multiple ASSRs may reliably predict the behavioral threshold in subjects with SNHL and may serve as a valuable objective measure for assessing the hearing threshold across different frequencies in candidates for cochlear implants and children with auditory neuropathy. C1 Schneider Childrens Med Ctr Israel, Inst Clin Neurophysiol & Audiol, IL-49202 Petah Tiqwa, Israel. Univ Haifa, Dept Communicat Disorders, IL-31999 Haifa, Israel. Schneider Childrens Med Ctr Israel, Dept Otorhinolaryngol, Petah Tiqwa, Israel. Rabin Med Ctr, Petah Tiqwa, Israel. Rabin Med Ctr, Inst Audiol, Petah Tiqwa, Israel. Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel. RP Attias, J (reprint author), Schneider Childrens Med Ctr Israel, Inst Clin Neurophysiol & Audiol, 14 Kaplan St, IL-49202 Petah Tiqwa, Israel. 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Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 268 EP 276 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900004 PM 16676823 ER PT J AU Klein, AM Pierce, MC Zeitels, SM Anderson, RR Kobler, JB Shishkov, M de Boer, JF AF Klein, AM Pierce, MC Zeitels, SM Anderson, RR Kobler, JB Shishkov, M de Boer, JF TI Imaging the human vocal folds in vivo with optical coherence tomography: A preliminary experience SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Laryngol Assoc DE glottis; laryngeal imaging; optical coherence tomography; vocal fold ID BIREFRINGENCE; FEASIBILITY; CARCINOMA; MUCOSA AB Objectives: Optical coherence tomography (OCT) and polarization-sensitive OCT (PS-OCT) are promising noninvasive methods for in vivo, cross-sectional imaging of the microstructure of the vocal folds. Previous studies in other tissues have shown an axial resolution of less than 10 mu m and a maximum imaging depth of about 2 mm. The objectives of this pilot study were to obtain images from the vocal folds of subjects who were being evaluated and/or treated for vocal fold disease and to evaluate how well normal and pathologic microstructure could be seen in these images. Methods: Twenty-six vocal folds in 13 subjects were imaged with a flexible OCT probe. The images were successfully collected from subjects who were either topically anesthetized or under general anesthesia for microlaryngoscopic procedures. Results: The thickness of the epithelium, the relative collagen content of the subepithelial connective tissue, and certain characteristic features of lesions (including cysts, scarring, and papilloma) were seen in the OCT and PS-OCT images. Conclusions: "Live microscopy" of the human vocal folds is very promising for improved diagnosis. mapping, and treatment planning. To our knowledge, this study is the first application of PS-OCT for in vivo imaging of the human vocal folds. C1 Massachusetts Gen Hosp, Wellman Ctr Photomed, Boston, MA 02114 USA. Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Surg, Cambridge, MA 02138 USA. Harvard Univ, Sch Med, Dept Dermatol, Cambridge, MA 02138 USA. RP de Boer, JF (reprint author), Massachusetts Gen Hosp, Wellman Ctr Photomed, 50 Blossom St,Bar 724, Boston, MA 02114 USA. RI de Boer, Johannes/B-7590-2012 OI de Boer, Johannes/0000-0003-1253-4950 CR Bibas AG, 2003, P SOC PHOTO-OPT INS, V4956, P95, DOI 10.1117/12.477886 Bibas AG, 2004, CLIN OTOLARYNGOL, V29, P713, DOI 10.1111/j.1365-2273.2004.00902.x BISHOP J, 1836, EXPT RES PHYSL HUMAN Bouma BE, 2002, ACAD RADIOL, V9, P942, DOI 10.1016/S1076-6332(03)80465-8 Burns JA, 2005, ANN OTO RHINOL LARYN, V114, P671 de Boer JF, 2002, J BIOMED OPT, V7, P359, DOI 10.1117/1.1483879 deBoer JF, 1997, OPT LETT, V22, P934, DOI 10.1364/OL.22.000934 Gladkova ND, 2002, HANDBOOK OF OPTICAL COHERENCE TOMOGRAPHY, P705 Hammond TH, 2000, ANN OTO RHINOL LARYN, V109, P913 Hirano M., 1975, OTOLOGIA FUKUOKA S1, V21, P239 Hirano M., 1981, P C ASSESSMENT VOCAL, P11 Hirano M, 1991, PHONOSURGERY ASSESSM, P25 HUANG D, 1991, SCIENCE, V254, P1178, DOI 10.1126/science.1957169 Park BH, 2003, OPT EXPRESS, V11, P782, DOI 10.1364/OE.11.000782 Pierce MC, 2002, OPT LETT, V27, P1534, DOI 10.1364/OL.27.001534 Pitris C, 1998, AM J RESP CRIT CARE, V157, P1640 Shakhov AV, 2001, J SURG ONCOL, V77, P253, DOI 10.1002/jso.1105 Strasswimmer J, 2004, J BIOMED OPT, V9, P292, DOI [10.1117/1.1644118, 10.1117/1.16441181] TITZE IR, 1994, PRINCIPLES VOICE PRO, P16 NR 19 TC 21 Z9 23 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 277 EP 284 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900005 PM 16676824 ER PT J AU Tateya, T Tateya, L Sohn, JH Bless, DM AF Tateya, T Tateya, L Sohn, JH Bless, DM TI Histological study of acute vocal fold injury in a rat model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE acute vocal fold injury; collagen type I; collagen type III; fibronectin; hyaluronic acid; rat model; wound healing ID DISEASE; WOUNDS AB Objectives: We used an acute vocal fold injury in a rat model to characterize vocal fold wound healing by studying the expression pattern of the extracellular matrix components in the vocal fold lamina propria. Methods: Vocal fold stripping was performed unilaterally in 27 Sprague-Dawley rats. The vocal folds were harvested at 5 time points (1, 3, 5, 7, and 14 days) and histologically analyzed by Alcian blue stain. trichrome stain. and immunofluorescence with antibodies to collagen type 1, collagen type III. and fibronectin. Results: Re-epithelialization occurred by day 3 and was complete by day 14. Granulation tissue was formed by day 3. Hyaluronic acid and collagen type I appeared in injured vocal folds by day 3, peaked at day 5. and thereafter decreased. Collagen type III and fibronectin appeared by day I and continued to be intense at all time points after day 3. Conclusions: These results suggest that the expression of these extracellular matrix components peaks in the period around days 3 to 5. and that the characteristics of wound healing in the vocal fold are similar to those in the skin in the early phases. but differ during the subsequent remodeling phase. C1 Univ Wisconsin, Dept Surg, Div Otolaryngol Head & Neck Surg, Sch Med, Madison, WI 53792 USA. RP Tateya, T (reprint author), Univ Wisconsin, Dept Surg, Div Otolaryngol Head & Neck Surg, Sch Med, 600 Highland Ave,K4-789, Madison, WI 53792 USA. CR Armstrong DG, 2002, J AM PODIAT MED ASSN, V92, P12 BATEMAN E, 1981, THORAX, V36, P645, DOI 10.1136/thx.36.9.645 Benninger MS, 1996, OTOLARYNG HEAD NECK, V115, P474, DOI 10.1016/S0194-5998(96)70087-6 BETZ P, 1995, AM J FOREN MED PATH, V16, P203, DOI 10.1097/00000433-199509000-00003 Cornelissen AMH, 2000, J ORAL PATHOL MED, V29, P1, DOI 10.1034/j.1600-0714.2000.290101.x Ehrlich HP, 2000, SCARLESS WOUND HEALI, P99 Inagi K, 1998, LARYNGOSCOPE, V108, P1048, DOI 10.1097/00005537-199807000-00018 Kurita S., 1983, VOCAL FOLD PHYSL CON, P3 Nowak R. M., 1999, WALKERS MAMMALS WORL, P1243 Peled ZM, 2000, CLIN PLAST SURG, V27, P489 Rousseau B, 2003, LARYNGOSCOPE, V113, P620, DOI 10.1097/00005537-200304000-00007 Rousseau B, 2004, J VOICE, V18, P116, DOI 10.1016/j.jvoice.2003.06.001 Singer AJ, 1999, NEW ENGL J MED, V341, P738 Stephens P, 2002, J Wound Care, V11, P253 Suzuki T, 2002, ANN OTO RHINOL LARYN, V111, P684 Tateya T, 2005, ANN OTO RHINOL LARYN, V114, P183 Thibeault SL, 2004, LARYNGOSCOPE, V114, P760, DOI 10.1097/00005537-200404000-00031 Thibeault SL, 2002, J VOICE, V16, P96, DOI 10.1016/S0892-1997(02)00078-4 WEIGEL PH, 1986, J THEOR BIOL, V119, P219, DOI 10.1016/S0022-5193(86)80076-5 NR 19 TC 38 Z9 42 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 285 EP 292 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900006 PM 16676825 ER PT J AU Brown, CL Bolger, WE AF Brown, CL Bolger, WE TI Safety and feasibility of balloon catheter dilation of paranasal sinus ostia: A preliminary investigation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE balloon catheter; dilation; rhinosinusitis; sinus ID ARTERY AB Objectives: Endoscopic sinus surgery (ESS) is an effective option for managing patients in whom medical therapy for rhinosinusitis fails. However. ESS is not always successful, and serious complications can occur. New techniques and instrumentation that improve outcomes and reduce complications would be seriously welcomed. Innovative catheter-based technology has improved treatment of several conditions such as coronary artery disease. peripheral vascular disease, and stroke. Recently, catheter devices have been developed for the paranasal sinuses. Cadaver studies confirm the potential use of these devices in rhinosinusitis. The objective of this investigation was to ascertain the feasibility and safety of these newly developed devices in performing catheter-based dilation of sinus ostia and recesses in patients with rhinosinusitis. Methods: A nonrandomized prospective cohort of 10 ESS candidates was offered treatment with a new technique of balloon catheter dilation of targeted sinus ostia. The frontal. maxillary. and sphenoid sinuses were considered appropriate for this innovative catheter-based technology. The primary study end points were intraoperative procedural success and absence of adverse events. Results: A total of 18 sinus ostial regions were successfully catheterized and dilated, including 10 maxillary, 5 sphenoid, and 3 frontal recesses. No adverse events occurred. Mucosal trauma and bleeding appeared to be less with catheter dilation than is typically observed with ESS techniques. Conclusions: Dilation of sinus ostial regions via balloon catheter-based technology appears to be relatively safe and feasible. Larger multicenter clinical trials are now warranted to further establish safety and to determine the role of this new technique. C1 Alfred Hosp, Dept Otolaryngol Head & Neck Surg, Bayside Network, Melbourne, Vic, Australia. Maryland Sinus Clin, Rockville, MD USA. RP Brown, CL (reprint author), Ctr Clin Studies, Level 5,Burnet Tower,89 Commercial Rd, Melbourne, Vic 3004, Australia. CR Abul-Khoudoud OR, 2000, J INVASIVE CARDIOL, V12, P221 Ahrendt SA, 1998, ANN SURG, V227, P412, DOI 10.1097/00000658-199803000-00014 BOLGER WE, IN PRESS AM J RHINOL Ebeid M R, 2001, J Invasive Cardiol, V13, P44 MESTRES CA, 1985, TEX HEART I J, V12, P345 NR 5 TC 63 Z9 68 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 293 EP 299 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900007 PM 16676826 ER PT J AU Genden, EM Govindaraj, S AF Genden, EM Govindaraj, S TI Allograft tracheoplasty technique for management of refractory tracheal stenosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE allograft tracheoplasty; tracheal stenosis ID RECONSTRUCTION AB Objectives: Extensive tracheal airway defects represent a clinical dilemma. Although resection and reanastomosis and staged tracheoplasty may prove beneficial in some cases, recurrent or extensive circumferential stenosis remains a reconstructive challenge. We report the use of the allograft tracheoplasty technique for the reconstruction of recurrent, extensive defects of the trachea and cricoid. Methods: Nine consecutive patients with recurrent tracheal stenosis were treated with the two-stage allograft tracheoplasty technique. A retrospective review was performed to evaluate for prior surgery, length of stenosis. surgical technique, and outcome. All 9 patients underwent multiple surgical procedures for acquired tracheal stenosis (average, 3.4 procedures) before undergoing the allograft tracheoplasty technique. Before surgery, all patients were tracheotomy-dependent. Results: The patients were assessed 8 to 39 months after allograft tracheoplasty. The primary airway disorders included postintubation stenosis (n = 6), surgical resection for malignancy (n = 1). and idiopathic stenosis (n = 2). Three defects involved 30% to 60% of the cricoid cartilage. and 4 defects were complete circumferential tracheal defects. Five patients underwent an island deltopectoral flap for closure of the tracheoplasty site. One patient had a superficial wound infection at the cartilage recipient site, and 1 patient had a hematoma at the deltopectoral flap donor site. All 9 patients were successfully decannulated without shortness of breath, stridor, or recurrent stenosis at the time of follow-up. Conclusions: Allograft tracheoplasty is a new technique for the reconstruction of recurrent tracheal stenosis. It appears to be reliable for extensive airway defects that are refractory to conventional tracheoplasty techniques. C1 Mt Sinai Sch Med, Dept Otolaryngol, New York, NY 10029 USA. Mt Sinai Sch Med, Immunobiol Ctr, New York, NY 10029 USA. Mt Sinai Sch Med, Recanti Miller Transplant Inst, New York, NY 10029 USA. RP Genden, EM (reprint author), Mt Sinai Sch Med, Dept Otolaryngol, Box 1189,1 Gustave L Levy Pl, New York, NY 10029 USA. CR BILLER HF, 1986, ANN OTO RHINOL LARYN, V95, P586 Elliott MJ, 1996, EUR J CARDIO-THORAC, V10, P707, DOI 10.1016/S1010-7940(96)80328-9 Herberhold C, 2001, Laryngorhinootologie, V80, pOP57 Jacobs JP, 1999, ANN THORAC SURG, V68, P1043, DOI 10.1016/S0003-4975(99)00878-4 Nakanishi R, 1992, Nihon Geka Gakkai Zasshi, V93, P664 NR 5 TC 9 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 302 EP 305 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900009 PM 16676827 ER PT J AU Stjernquist-Desatnik, A Skoog, E Aurelius, E AF Stjernquist-Desatnik, A Skoog, E Aurelius, E TI Detection of herpes simplex and varicella-zoster viruses in patients with Bell's palsy by the polymerase chain reaction technique SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE Bell's palsy; herpes simplex virus; polymerase chain reaction; varicella-zoster virus ID PERIPHERAL FACIAL PALSY; CEREBROSPINAL-FLUID; VIRAL-DNA; PARALYSIS; REACTIVATION; ASSAY; ANTIBODIES; PREDNISONE; ACYCLOVIR AB Objectives: Infectious causes of peripheral facial paralysis are well known. Bell's palsy, however, is an idiopathic facial paralysis, and the genesis is still unknown. Herpes simplex virus type 1 (HSV-1) and varicella-zoster virus (VZV) have been suggested as etiologic agents. Methods: Twenty consecutive adult patients with Bell's palsy were included in the study. Ten adult patients operated on for chronic otitis served as controls. A biopsy specimen from the posterior auricular muscle was resected within 72 hours after the onset of Bell's palsy and was analyzed together with cerebrospinal fluid (CSF) by nested polymerase chain reaction for HSV-1 and VZV DNA. Serum samples were analyzed for antibodies to HSV-1 and VZV. Results: HSV-1 DNA was found in the muscle biopsy specimen from I of the 20 patients. but was not found in any of the CSF samples. VZV DNA was detected in the muscle biopsy as well as the CSF from I other patient. All controls were negative. Seventeen of 19 patients had stationary serum antibody concentrations to HSV-1. and none displayed an antibody titer rise. A significant antibody titer rise to VZV was found in 1 of 19 patients. whereas 17 of 19 had stationary antibody levels. Conclusions: HSV-1 or VZV DNA was detected in 10% of patients with Bell's palsy in the present study. Viral replication might already have declined in many cases at the onset of the palsy. Use of an HSV-1/VZV polymerase chain reaction on a muscle biopsy specimen or CSF does not seem to be the method of choice for rapid etiologic diagnosis in the acute phase of Bell's palsy. C1 Univ Lund Hosp, Dept Otorhinolaryngol Head & Neck Surg, SE-22185 Lund, Sweden. Karolinska Univ Hosp, Karolinska Inst, Dept Med, Infect Dis Unit, Stockholm, Sweden. Karolinska Univ Hosp, Karolinska Inst, Dept Clin Med, Stockholm, Sweden. RP Stjernquist-Desatnik, A (reprint author), Univ Lund Hosp, Dept Otorhinolaryngol Head & Neck Surg, SE-22185 Lund, Sweden. CR ADOUR KK, 1975, JAMA-J AM MED ASSOC, V233, P527, DOI 10.1001/jama.233.6.527 Adour KK, 1996, ANN OTO RHINOL LARYN, V105, P371 Aurelius E, 2002, SCAND J INFECT DIS, V34, P278, DOI 10.1080/00365540110080485 AURELIUS E, 1991, LANCET, V337, P189, DOI 10.1016/0140-6736(91)92155-U Axelsson S, 2003, ANN OTO RHINOL LARYN, V112, P197 BERGLUND J, 1995, NEW ENGL J MED, V333, P1319, DOI 10.1056/NEJM199511163332004 BURGESS RC, 1994, ANN OTO RHINOL LARYN, V103, P775 EKSTRAND T, 1979, J LARYNGOL OTOL, V93, P271, DOI 10.1017/S0022215100087016 Furuta Y, 1998, J MED VIROL, V54, P162, DOI 10.1002/(SICI)1096-9071(199803)54:3<162::AID-JMV3>3.0.CO;2-3 Furuta Y, 2000, CLIN INFECT DIS, V30, P529, DOI 10.1086/313721 Grogan PM, 2001, NEUROLOGY, V56, P830 HAMEY M, 2003, MED J, V96, P197 HOUSE JW, 1985, OTOLARYNG HEAD NECK, V93, P146 JEANSSON S, 1983, J CLIN MICROBIOL, V18, P1160 JONSSON L, 1988, ACTA OTO-LARYNGOL, V106, P1, DOI 10.3109/00016488809107364 MCCORMIC.DP, 1972, LANCET, V1, P937 MULKENS PSJZ, 1980, CLIN OTOLARYNGOL, V5, P303, DOI 10.1111/j.1365-2273.1980.tb00895.x Murakami S, 1996, ANN INTERN MED, V124, P27 Ohtani F, 2000, J MED VIROL, V62, P37, DOI 10.1002/1096-9071(200009)62:1<37::AID-JMV6>3.0.CO;2-1 PUCHHAMMERSTOCKL E, 1991, J CLIN MICROBIOL, V29, P1513 ROBILLARD RB, 1986, OTOLARYNG HEAD NECK, V95, P292 SUGITA T, 1995, ANN OTO RHINOL LARYN, V104, P574 VAHLNE A, 1981, ARCH OTOLARYNGOL, V107, P79 NR 23 TC 22 Z9 25 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 306 EP 311 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900010 PM 16676828 ER PT J AU Halum, SL Shemirani, NL Merati, AL Jaradeh, S Toohill, RJ AF Halum, SL Shemirani, NL Merati, AL Jaradeh, S Toohill, RJ TI Electromyography findings of the cricopharyngeus in association with ipsilateral pharyngeal and laryngeal muscles SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE cricopharyngeal dysfunction; cricopharyngeus; electromyography; innervation; laryngeal muscle; upper esophageal sphincter ID UPPER ESOPHAGEAL SPHINCTER; MOTOR INNERVATION; NERVE AB Objectives: We reviewed a large series of cricopharyngeal (CP) muscle electromyography (EMG) results and compared them with the EMG results from the inferior constrictor (IC). thyroarytenoid, (TA), cricothyroid (CT), and posterior cricoarytenoid (PCA) muscles. Methods: We performed a retrospective review of all CP muscle EMG reports from studies performed between January 1996 and June 2003. All of the tested elements from the CP muscle EMG reports were recorded. The EMG results were recorded for the ipsilateral IC, TA, CT, and PCA muscles if they were simultaneously tested. Each muscle result was classified as normal, neurogenic inactive axonal injury (IAI), or neurogenic active axonal injury (AAI), and the muscle findings were compared. A patient chart review was performed to determine a clinical correlation. Results: Fifty-nine patients underwent CP muscle EMG. Eighteen patients had bilateral EMG studies, making a total of 77 CP muscle studies. Nineteen sets of CP muscle results were normal. 43 demonstrated neurogenic IAL and 15 demonstrated neuro genic AAI. The ipsilateral IC and CP muscles had the same innervation status in 27 of 28 Studies (p < .0001). When the ipsilateral TA muscle was studied simultaneously with the CP muscle, 31 of 50 studies had the same innervation status (p =.005). The ipsilateral CT and CP muscles demonstrated the same innervation status in 40 of 50 studies (p < .0001). The correlations between the CP and IC muscle findings and between the CP and CT muscle findings were both stronger than the correlation between the CP and TA muscle findings (p < .0001 and p = .024, respectively). The chart review demonstrated the clinical findings to be consistent with the EMG results. Conclusions: The EMG studies demonstrated that CP muscle findings have the strongest correlation with IC muscle findings, followed by the CT and TA muscles. This outcome does not support theories indicating that the recurrent laryngeal nerve innervates the CP muscle in all cases. C1 Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Ctr Voice & Swallowing Disorders, Milwaukee, WI 53226 USA. Med Coll Wisconsin, Dept Neurol, Milwaukee, WI 53226 USA. RP Toohill, RJ (reprint author), Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Ctr Voice & Swallowing Disorders, 9200 W Wisconsin Ave, Milwaukee, WI 53226 USA. CR Brok HAJ, 1999, LARYNGOSCOPE, V109, P705, DOI 10.1097/00005537-199905000-00005 BUCHTHAL FRITZ, 1959, QUART JOUR EXPTL PHYSIOL, V44, P137 Cathala H P, 1969, J Fr Otorhinolaryngol Audiophonol Chir Maxillofac, V18, P31 Ertekin C, 2002, MUSCLE NERVE, V26, P729, DOI 10.1002/mus.10267 FAABORGANDERSEN K, 1956, NATURE, V177, P340, DOI 10.1038/177340a0 Furlan JC, 2002, CLIN ANAT, V15, P271, DOI 10.1002/ca.10029 Hirano M, 1969, Kurume Med J, V16, P119 HIROSE H, 1998, OTOLARYNGOLOGY HEAD, V3, P1891 HOLLINSHEAD WH, 1954, HEAD NECK-J SCI SPEC, P421 HWANG K, 1948, AM J PHYSIOL, V154, P343 Jaradeh Safwan S., 2000, American Journal of Medicine, V108, p40S KIRCHNER J A, 1958, Laryngoscope, V68, P1119 Lemere F, 1932, AM J ANAT, V51, P417, DOI 10.1002/aja.1000510206 LERUT T, 1986, DIS ESOPHAGUS, P1018 Maranillo E, 2003, LARYNGOSCOPE, V113, P525, DOI 10.1097/00005537-200303000-00024 Mu LC, 1998, ANN OTO RHINOL LARYN, V107, P370 RUSTAD WH, 1952, LARYNGOSCOPE, V62, P237 WU BL, 1994, ARCH OTOLARYNGOL, V120, P1321 Sanudo JR, 1999, LARYNGOSCOPE, V109, P983 Sasaki CT, 1999, ANN OTO RHINOL LARYN, V108, P1132 Schulze SL, 2002, ANN OTO RHINOL LARYN, V111, P573 Sprague JM, 1944, ANAT REC, V90, P197, DOI 10.1002/ar.1090900304 NR 22 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 312 EP 316 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900011 PM 16676829 ER PT J AU Sarac, S McKenna, MJ Mikulec, AA Rauch, SD Nadol, JB Merchant, SN AF Sarac, S McKenna, MJ Mikulec, AA Rauch, SD Nadol, JB Merchant, SN TI Results after revision stapedectomy with malleus grip prosthesis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE conductive hearing loss; malleus; prosthesis; revision; stapedectomy ID STAPES SURGERY; HEARING AB Revision stapedectomy with a malleus grip prosthesis is a technically challenging otologic procedure. The prosthesis is usually longer and extends deeper into the vestibule than a conventional stapes prosthesis, creating the potential to affect the vestibular sense organs. The prosthesis also bypasses the ossicular joints, which are thought to play a role in protecting the inner car from large changes in static pressure within the middle ear. The prosthesis is in close proximity to the tympanic membrane, thus increasing the risk for its extrusion. We reviewed our experience with revision stapedectomy with the Schuknecht Teflon-wire malleus grip prosthesis in 36 ears with a mean follow-up of 23 months. The air-bone gap was closed to within 10 dB in 16 ears (44%) and to within 20 dB in 26 ears (72%). The incidence of postoperative sensorineural hearing loss was 8% (3 ears). There were no dead cars. Extrusion of the prosthesis occurred in 1 case (3%). Nearly 50% of patients reported various degrees of vertigo or disequilibrium during the first 3 weeks after surgery. These vestibular symptoms resolved by 6 weeks in all but I case. We did not find evidence of damage to the inner ear due to the length of the prosthesis or due to the potential for direct transmission of changes in static pressures within the middle ear to the labyrinth. Our results are similar to those published in the literature for malleus attachment stapedectomy and conventional revision incus stapedectomy. C1 Massachusetts Eye & Ear Infirm, Dept Otolaryngol, Boston, MA 02114 USA. Harvard Univ, Dept Otol & Laryngol, Boston, MA 02115 USA. RP Merchant, SN (reprint author), Massachusetts Eye & Ear Infirm, Dept Otolaryngol, Boston, MA 02114 USA. CR Berenholz L, 2002, OTOL NEUROTOL, V23, P850, DOI 10.1097/00129492-200211000-00007 De la Cruz A, 2000, OTOLARYNG HEAD NECK, V123, P728, DOI 10.1067/mhn.2000.111285 Fisch U, 2001, OTOL NEUROTOL, V22, P776, DOI 10.1097/00129492-200111000-00011 Hammerschlag PE, 1998, LARYNGOSCOPE, V108, P1794, DOI 10.1097/00005537-199812000-00006 Han WW, 1997, LARYNGOSCOPE, V107, P1185, DOI 10.1097/00005537-199709000-00006 HAUSLER R, 2004, INT S POL SOC OT STA Hausler R, 2004, MIDDLE EAR SURG RECE, P95 Huttenbrink KB, 2003, OTOL NEUROTOL, V24, P548 Kohan D, 2003, LARYNGOSCOPE, V113, P1520, DOI 10.1097/00005537-200309000-00020 Krieger LW, 1998, OTOLARYNG HEAD NECK, V119, P370, DOI 10.1016/S0194-5998(98)70081-6 Lippy WH, 2003, OTOL NEUROTOL, V24, P560, DOI 10.1097/00129492-200307000-00005 Magliulo G, 1997, AM J OTOL, V18, P408 SCHUKNECHT HF, 1986, ANN OTO RHINOL LARYN, V95, P531 SHEEHY JL, 1982, LARYNGOSCOPE, V92, P258 Somers T, 1997, J LARYNGOL OTOL, V111, P233 Tange R. A., 1996, ORL (Basel), V58, P143 NR 16 TC 5 Z9 5 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2006 VL 115 IS 4 BP 317 EP 322 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 033BJ UT WOS:000236820900012 PM 16676830 ER PT J AU Bolger, WE AF Bolger, WE TI Management of cerebral vascular structures during endoscopic treatment of encephaloceles: A clinical report SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cerebrospinal fluid leak; encephalocele; endoscopic surgery AB Objectives: Otolaryngologists are increasingly being called upon to treat patients with cerebrospinal fluid leak and encephaloceles. The endoscopic approach to the skull base through the nose and paranasal sinuses has proven effective and is well tolerated by patients. With its more widespread and frequent use, unusual cases and potential complications are becoming more apparent. Methods: Treatment of two clinical cases in which a cerebral vascular structure was encountered during endoscopic treatment of an encephalocele is presented, and the condition is reviewed. Results: Two patients presented after a skull base injury that occurred during endoscopic sinus surgery. In each case the initial treating surgeon attempted endoscopic repair of a cerebrospinal fluid leak, but the repair failed and the leak persisted. Upon referral to the author, in each case, a traumatic encephalocele with an active leak was apparent, and during repair a cerebral vessel was encountered. It appeared that the vessel had been "pulled down" into the skull base defect with the encephalocele's migration into the sinonasal cavity. Conclusions: This unusual clinical condition is discussed along with the potential complications that can result from it. Otolaryngologists who treat encephaloceles should be aware of the possibility of encountering a cerebral vessel and should understand the potential complications and management options. C1 Uniformed Serv Univ Hlth Sci, Div Otolaryngol, Bethesda, MD 20814 USA. RP Bolger, WE (reprint author), Uniformed Serv Univ Hlth Sci, Div Otolaryngol, Bethesda, MD 20814 USA. CR CARPENTER MB, 1983, HUMAN NEUROANATOMY, P714 Lanza DC, 1996, LARYNGOSCOPE, V106, P1119, DOI 10.1097/00005537-199609000-00015 MARTIN JH, 2003, NEUROANATOMY TEXT AT, V89 NR 3 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 167 EP 170 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700001 PM 16572603 ER PT J AU Maragos, NE AF Maragos, NE TI Pyriform sinus mucosa stabilization for prevention of postoperative airway obstruction in arytenoid adduction SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE airway obstruction; arytenoid adduction; posterior thyroplasty window; tracheotomy; vocal fold paralysis ID I THYROPLASTY; PARALYSIS; SURGERY AB Objectives: The Isshiki arytenoid adduction procedure directly closes the open posterior glottis. Postoperative airway obstruction that necessitates emergent tracheotomy is an important complication in arytenoid adduction patients when the standard posterior thyroplasty window is used to approach the posterolateral larynx. Immediate postoperative fiberoptic laryngoscopy shows ipsilateral edema and/or hematoma of the arytenoid and supraglottic mucosa, with occasional obstructing inspiratory collapse. In this study, I sought to modify the posterior window approach during arytenoid adduction surgery, and thereby decrease the incidence of immediate postoperative airway obstruction. Methods: I performed a retrospective chart review of 246 arytenoid adduction patients, looking for immediate postoperative airway compromise. Results: There were no episodes of postoperative airway obstruction that necessitated tracheotomy in the first 30 patients in whom I approached the posterolateral larynx using the classic Isshiki techniques. Nine of the succeeding 132 adduction patients required emergent tracheotomy when the standard posterior window technique was used instead of a classic Isshiki approach (6.8%). In the most recent 84 patients, I used one tacking suture to stabilize the elevated pyriform sinus mucosa to the upper margin of the posterior window cartilage at closure. Four of the 84 patients had audible postoperative airway turbulence that abated with medical treatment, and 1 patient required an emergent tracheotomy (1.2%; p =.0495). Conclusions: Suture stabilization of the pyriform sinus mucosa is effective and is recommended for prevention of posterior glottic airway obstruction after arytenoid adduction when the posterior window technique is used. C1 Mayo Clin & Mayo Fdn, Dept Otorhinolaryngol, Rochester, MN 55905 USA. RP Maragos, NE (reprint author), Mayo Clin & Mayo Fdn, Dept Otorhinolaryngol, 200 1st St SW, Rochester, MN 55905 USA. CR ISSHIKI N, 1978, ARCH OTOLARYNGOL, V104, P555 ISSHIKI N, 1974, ACTA OTO-LARYNGOL, V78, P451, DOI 10.3109/00016487409126379 Isshiki N, 1989, PHONOSURGERY THEORY ISSHIKI N, 1985, AURIS NASUS LARYNX S, V12, P217 MARAGOS NE, 1994, 3 INT S PHON P KYOT, P62 Maragos NE, 1999, LARYNGOSCOPE, V109, P834, DOI 10.1097/00005537-199905000-00029 Maragos NE, 1999, LARYNGOSCOPE, V109, P1228, DOI 10.1097/00005537-199908000-00008 SLAVIT DH, 1992, ANN OTO RHINOL LARYN, V101, P321 SLAVIT DH, 1994, J VOICE, V8, P84, DOI 10.1016/S0892-1997(05)80324-8 THOMPSON DM, 1995, LARYNGOSCOPE, V105, P481, DOI 10.1288/00005537-199505000-00006 THOMPSON DM, 1995, LARYNGOSCOPE, V105, P1148 Weinman EC, 2000, LARYNGOSCOPE, V110, P1082, DOI 10.1097/00005537-200007000-00003 NR 12 TC 8 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 171 EP 174 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700002 PM 16572604 ER PT J AU Naiman, AN Abedipour, D Ayari, S Fresnel, E Coulombeau, B Bour, JB Froehlich, P AF Naiman, AN Abedipour, D Ayari, S Fresnel, E Coulombeau, B Bour, JB Froehlich, P TI Natural history of adult-onset laryngeal papillomatosis following multiple cidofovir injections SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cidofovir; endoscopy; larynx; microdebrider; papillomatosis; surgical excision ID RECURRENT RESPIRATORY PAPILLOMATOSIS; INTRALESIONAL CIDOFOVIR; LASER-SURGERY; THERAPY; CHILDREN; RADIOSENSITIVITY; COMPLICATIONS; CARCINOMA; PROTOCOL; CANCER AB Objectives: A prospective study was per-formed to assess the intermediate and long-term efficacy of intralesional cidofovir therapy associated with surgical excision in laryngeal papillomatosis in adults. Methods: Endoscopy with intralesional injection of cidofovir 5 mg/mL was performed 3 times at 4-week intervals. The concentration was later increased to 7.5 mg/mL and the interval between injections shortened to 2 weeks. Further treatment was performed at 3 or 6 months, depending on the evolution of the papillomas. After complete remission, the treatment was stopped and the patients were reviewed every 6 months. Results: Nineteen patients completed the protocol, with a mean of 4.5 injections each. Complete remission was obtained in 17 cases (89%) after a mean of 3.8 procedures. Remission was stable after a mean follow-up of 24 months (range, 8 to 57 months). With higher cidofovir concentrations at shorter intervals, patients needed fewer injections to achieve remission (mean, 2.1 versus 4.7 injections). Conclusions: The effectiveness of intralesional cidofovir therapy in adult-onset recurrent respiratory papillomatosis was impressive. Once obtained, complete remission was stable on intermediate or long-term follow-up. The concentration and the interval between injections seemed to influence the number of injections necessary to achieve remission. C1 Hop Edouard Herriot, Dept Otolaryngol, F-69437 Lyon 03, France. Amer Hosp Paris, Dept Otolaryngol, Paris, France. Univ Hosp Dijon, Dept Virol, Dijon, France. RP Froehlich, P (reprint author), Hop Edouard Herriot, Dept Otolaryngol, 5 Pl Arsonval, F-69437 Lyon 03, France. CR Abdulkarim B, 2002, ONCOGENE, V21, P2334, DOI 10.1038/sj/onc/1205006 Abdulkarim B, 2003, ONCOGENE, V22, P2260, DOI 10.1038/sj.onc.1206402 Akst LM, 2003, ARCH OTOLARYNGOL, V129, P841, DOI 10.1001/archotol.129.8.841 Andrei G, 2001, ONCOL RES, V12, P397 Armstrong LR, 1999, ARCH OTOLARYNGOL, V125, P743 Bielamowicz S, 2002, LARYNGOSCOPE, V112, P696, DOI 10.1097/00005537-200204000-00019 Chhetri DK, 2003, ARCH OTOLARYNGOL, V129, P1081, DOI 10.1001/archotol.129.10.1081 CROCKETT DM, 1987, ANN OTO RHINOL LARYN, V96, P639 Dedo HH, 2001, LARYNGOSCOPE, V111, P1639, DOI 10.1097/00005537-200109000-00028 Derkay CS, 1998, LARYNGOSCOPE, V108, P935, DOI 10.1097/00005537-199806000-00026 El-Bitar MA, 2002, ARCH OTOLARYNGOL, V128, P425 FREI E, 1985, CANCER RES, V45, P6523 Grau JJ, 1997, ONCOLOGY, V54, P38 LEVENTHAL BG, 1991, NEW ENGL J MED, V325, P613, DOI 10.1056/NEJM199108293250904 LINDEBERG H, 1991, CLIN OTOLARYNGOL, V16, P149, DOI 10.1111/j.1365-2273.1991.tb01965.x Milczuk HA, 2003, OTOLARYNG HEAD NECK, V128, P788, DOI 10.1016/S0194-5998(03)00259-6 Naiman AN, 2003, LARYNGOSCOPE, V113, P2174, DOI 10.1097/00005537-200312000-00024 Naiman AN, 2004, LARYNGOSCOPE, V114, P1151, DOI 10.1097/00005537-200407000-00004 Neumann K, 2003, LARYNGO RHINO OTOL, V82, P700 Neyts J, 1998, CANCER RES, V58, P384 OSSOFF RH, 1991, LARYNGOSCOPE, V101, P1162 Pashley NRT, 2002, ARCH OTOLARYNGOL, V128, P783 Patel N, 2003, ANN OTO RHINOL LARYN, V112, P7 Pransky SM, 2000, ARCH OTOLARYNGOL, V126, P1239 Pransky SM, 2003, LARYNGOSCOPE, V113, P1583, DOI 10.1097/00005537-200309000-00032 Rosen CA, 2004, J VOICE, V18, P248, DOI 10.1016/j.jvoice.2003.05.005 Schraff S, 2004, ARCH OTOLARYNGOL, V130, P1039, DOI 10.1001/archotol.130.9.1039 Shikowitz MJ, 1998, LARYNGOSCOPE, V108, P962, DOI 10.1097/00005537-199807000-00002 Shirley WP, 2004, INT J PEDIATR OTORHI, V68, P413, DOI 10.1016/j.ijporl.2003.11.007 Snoeck R, 1998, J MED VIROL, V54, P219, DOI 10.1002/(SICI)1096-9071(199803)54:3<219::AID-JMV13>3.0.CO;2-C Wachsman M, 1996, ANTIVIR RES, V29, P153, DOI 10.1016/0166-3542(95)00829-2 YODER MG, 1980, OTOLARYNG HEAD NECK, V88, P745 NR 32 TC 15 Z9 17 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 175 EP 181 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700003 PM 16572605 ER PT J AU Businco, LD Turchio, P Guazzaroni, M Tirelli, GC AF Businco, LD Turchio, P Guazzaroni, M Tirelli, GC TI Virtual versus conventional laryngeal endoscopy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE computed tomography; fiberoptic laryngoscopy; larynx; virtual endoscopy; virtual laryngoscopy ID LARYNGOSCOPY AB We have evaluated the capacity of virtual laryngoscopy and conventional laryngoscopy conducted with a rigid or flexible instrument to visualize laryngeal structures in 64 patients with normal endoluminal anatomy. Virtual laryngoscopy allowed total visualization of laryngeal structures, including those that could not be reached by a flexible instrument. There was good correlation between virtual laryngoscopy and "real" images, indicating satisfactory diagnostic accuracy (p < .05). Although virtual laryngoscopy does not provide histologic data, it is a fast and noninvasive technique that can be added to and integrated with conventional laryngoscopy, and it can be an alternative in cases in which conventional laryngoscopy is difficult, contraindicated, or impossible. It is particularly useful for the study of laryngeal narrow spaces and in the visualization of subglottic regions and of other more restricted areas (inferior tonsil region, posterior surface of the epiglottis, glossoepiglottic vallecula, Morgagni's ventricle, anterior commissure). C1 St Eugenio Hosp, Dept Otolaryngol, Rome, Italy. St Eugenio Hosp, Dept Diagnost Imaging & Intervent Radiol, Rome, Italy. RP Businco, LD (reprint author), Via Agrigento,6, I-00161 Rome, Italy. CR Di Rienzo L, 2003, ANN OTO RHINOL LARYN, V112, P139 Fried MP, 1999, ANN OTO RHINOL LARYN, V108, P221 Gluecker T, 2001, EUR RADIOL, V11, P50, DOI 10.1007/s003300000567 Graham SM, 2000, AM J OTOLARYNG, V21, P263, DOI 10.1053/ajot.2000.8379 Guazzaroni M, 2001, Radiol Med, V101, P265 Walshe P, 2002, CLIN OTOLARYNGOL, V27, P98, DOI 10.1046/j.1365-2273.2002.00539.x NR 6 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 182 EP 185 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700004 ER PT J AU Rosenblut, A Santolaya, ME Gonzalez, P Borel, C Cofre, J AF Rosenblut, A Santolaya, ME Gonzalez, P Borel, C Cofre, J TI Penicillin resistance is not extrapolable to amoxicillin resistance in Streptococcus pneumoniae isolated from middle ear fluid in children with acute otitis media SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE acute otitis media; antibiotic resistance; Streptococcus pneumoniae ID ANTIBIOTIC-RESISTANCE; PNEUMOCOCCAL INFECTIONS; CONJUGATE VACCINES; SUSCEPTIBILITY; SURVEILLANCE; EMERGENCE; DISEASE; CLONES AB Objectives: We evaluated the in vitro antibacterial activity of amoxicillin against penicillin-susceptible and -nonsusceptible Streptococcus pneumoniae strains isolated from children with acute otitis media (AOM). Methods: Children more than 3 months of age with AOM who were seen in the Dr Sotero del Rio and Luis Calvo Mackenna Hospitals in Santiago, Chile, between July 1998 and December 2002 were subjected to tympanic puncture for middle ear fluid culture. The penicillin and amoxicillin Susceptibilities of the S pneumoniae isolates were determined by epsilometer test (E test). Results: A bacterial pathogen was isolated in 432 of 543 children (80%) as follows: S pneumoniae, 40%; Haemophilus influenzae, 29%; Moraxella catarrhalis, 7%; and Streptococcus pyogenes, 4%. Penicillin-susceptible S pneumoniae strains were less common than amoxicillin-susceptible strains (60% versus 95%; odds ratio [OR], 0.08; 95% confidence interval [CI], 0.04 to 0.18). Both intermediate- and high-resistance strains were more common for penicillin (22% versus 4.5%; OR, 5.6; 95% CI, 2.5 to 12.7) than for amoxicillin (18% versus 0.5%; OR, 41.3; 95% CI, 6.0 to 821). Conclusions: Penicillin resistance is not extrapolable to amoxicillin among S pneumoniae strains isolated from middle ear fluid of children with AOM. Our results support the recommendation to evaluate the minimal inhibitory concentrations of penicillin-nonsusceptible S pneumoniae for amoxicillin and to continue use of this antimicrobial as a first-line antimicrobial choice for children with AOM. C1 Hosp Dr Sotero del Rio, Serv Otorhinolaryngol, Santiago, Chile. Hosp Dr Sotero del Rio, Microbiol Lab, Santiago, Chile. Hosp Ninos Luis Calvo Mackenna, Infect Dis Unit, Santiago, Chile. Hosp Ninos Luis Calvo Mackenna, Serv Otorhinolaryngol, Santiago, Chile. Univ Chile, Fac Med, Dept Pediat, Santiago 7, Chile. RP Rosenblut, A (reprint author), Los Huasos 1948,Las Condes, Santiago, Chile. CR Lieberthal AS, 2004, PEDIATRICS, V113, P1451 Arguedas A, 2003, PEDIATR INFECT DIS J, V22, P1063, DOI 10.1097/01.inf.0000101189.81501.e9 BAQUERO F, 1991, J ANTIMICROB CHEMOTH, V28, P31 Bavestrello L, 2002, REV MED CHILE, V130, P1265, DOI 10.4067/S0034-98872002001100009 Butler JC, 1996, J INFECT DIS, V174, P986 Dagan R, 2000, J INFECT DIS, V181, P1322, DOI 10.1086/315383 Dagan R, 1997, J INFECT DIS, V176, P1253 Dagan R, 2000, PEDIATR INFECT DIS J, V19, P275 Dowell SF, 1999, PEDIATR INFECT DIS J, V18, P341, DOI 10.1097/00006454-199904000-00006 Durbin WJ, 2004, PEDIATR REV, V25, P418 FILE TM, 2002, CLIN INFECT DIS S1, V34, P17 FRIEDLAND IR, 1992, AM J DIS CHILD, V146, P920 GONZALEZ P, 2002, REV CHILD INFECT S2, V19, pS135 Greenberg D, 2002, J CLIN MICROBIOL, V40, P68, DOI 10.1128/JCM.40.1.68-74.2002 Hanage WP, 2004, INFECT IMMUN, V72, P76, DOI 10.1128/IAI.72.1.76-81.2004 HAUSMAN D, 1967, LANCET, V2, P264 Jacobs MR, 2000, PEDIATR INFECT DIS J, V19, pS47, DOI 10.1097/00006454-200005001-00008 Kaplan SL, 2002, PEDIATR ANN, V31, P250 Nagai K, 2002, ANTIMICROB AGENTS CH, V46, P1273, DOI 10.1128/AAC.46.5.1273-1280.2002 National Committee for Clinical Laboratory Standard, 2003, METH DIL ANT SUSC TE Perez-Trallero E, 2001, ANTIMICROB AGENTS CH, V45, P3334, DOI 10.1128/AAC.45.12.3334-3340.2001 Piglansky L, 2003, PEDIATR INFECT DIS J, V22, P405, DOI 10.1097/00006454-200305000-00003 Rosenblut A, 2001, PEDIATR INFECT DIS J, V20, P501, DOI 10.1097/00006454-200105000-00006 Smith AM, 2001, ANTIMICROB AGENTS CH, V45, P2393, DOI 10.1128/AAC.45.8.2393-2396.2001 SORENSEN UBS, 1993, J CLIN MICROBIOL, V31, P2097 TEELE DW, 1989, J INFECT DIS, V160, P83 Valenzuela B M. Teresa, 2003, Rev. chil. infectol., V20, P119, DOI 10.4067/S0716-10182003000200006 VIADA J, 1998, REV CHIL OTORRINOLAR, V58, P141 NR 28 TC 7 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 186 EP 190 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700005 PM 16572607 ER PT J AU Awwad, RJ Mortelliti, AJ AF Awwad, RJ Mortelliti, AJ TI Postcricoid hemangioma of childhood: Report of four cases SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the Society-for-Ear-Nose-and-Throat-Advances-in-Children CY DEC 02-05, 2004 CL Toronto, CANADA SP Soc Ear Nose Throat Adv Children DE hemangioma; hypopharynx; postcricoid region ID SUBGLOTTIC HEMANGIOMA; MANAGEMENT; DYSPHAGIA; INFANCY; LESIONS AB Hemangiomas are the most common tumor of infancy, and the vast majority occur in the head and neck region. In children, laryngeal hemangiomas typically occur below the level of the true vocal folds, in the region of the subglottis, and other sites are exceedingly rare. We present four cases of hemangiomas located in the postcricoid region of the hypopharynx. Because of the location of these lesions, children may present with obstructive symptoms such as dysphagia, intermittent aspiration, hypersalivation, or recurrent respiratory infections. Clinical diagnosis is relatively easily made with flexible laryngoscopy, as the lesions have a propensity to enlarge with crying or straining. When these patients are examined under general anesthesia in a relaxed state, however, the lesions are typically much smaller, and can even go unnoticed. Unlike other reported cases, the postcricoid hemangiomas in our patients were not causing any symptoms and were simply incidental findings. Thus, we believe that the true incidence of postcricoid hemangiomas is likely higher than reports suggest. To our knowledge, we report the longest follow-up (6 years) of a patient with a postcricoid hemangioma and are the first to describe the natural course of such a lesion. C1 SUNY Upstate Med Univ, Dept Otolaryngol & Commun Sci, Syracuse, NY 13210 USA. RP Awwad, RJ (reprint author), SUNY Upstate Med Univ, Dept Otolaryngol & Commun Sci, 750 E Adams St, Syracuse, NY 13210 USA. CR Bitar MA, 2005, OTOLARYNG HEAD NECK, V132, P226, DOI 10.1016/j.otohns.2004.09.136 Boon LM, 1996, J PEDIATR-US, V128, P329, DOI 10.1016/S0022-3476(96)70276-7 BOWERS RE, 1960, ARCH DERMATOL, V82, P667 Chiller KG, 2002, ARCH DERMATOL, V138, P1567, DOI 10.1001/archderm.138.12.1567 Desuter GRR, 2004, DYSPHAGIA, V19, P48, DOI 10.1007/s00455-003-0028-4 Discolo CM, 2004, ARCH OTOLARYNGOL, V130, P1420, DOI 10.1001/archotol.130.12.1420 FERGUSON CF, 1961, ANN OTO RHINOL LARYN, V70, P1095 FINN MC, 1983, J PEDIATR SURG, V18, P894 Gampper TJ, 2002, PLAST RECONSTR SURG, V110, P572, DOI 10.1097/00006534-200208000-00032 GOLDSMITH MM, 1987, LARYNGOSCOPE, V97, P851 PRATT AG, 1983, AMA ARCH DERM SYPHIL, V67, P302 Sweetser T, 1921, LARYNGOSCOPE, V31, P797 WERKHAVEN J, 1991, OTOLARYNG CLIN N AM, V24, P1179 Yellin SA, 1996, ANN OTO RHINOL LARYN, V105, P510 NR 14 TC 4 Z9 5 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 191 EP 194 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700006 PM 16572608 ER PT J AU Cadoni, G Scipione, S Rocca, B Agostino, S La Greca, C Bonvissuto, D Paludetti, G AF Cadoni, G Scipione, S Rocca, B Agostino, S La Greca, C Bonvissuto, D Paludetti, G TI Lack of association between inherited thrombophilic risk factors and idiopathic sudden sensorineural hearing loss in Italian patients SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE genetic polymorphism; inheritance; risk factor; sudden sensorineural hearing loss; thrombophilia ID FACTOR-V-LEIDEN; PROTHROMBIN G20210A MUTATION; CEREBRAL VENOUS THROMBOSIS; INNER-EAR HEMORRHAGE; ACTIVATED PROTEIN-C; TEMPORAL BONE; DOUBLE-BLIND; HIGH SIGNAL; DEAFNESS; THROMBOEMBOLISM AB Objectives: We investigated the presence of congenital thrombophilic risk factors in a population of consecutive Italian patients affected by idiopathic sudden sensorineural hearing loss (SSNHL). Methods: We investigated 48 patients with idiopathic SSNHL for the presence of congenital thrombophilic risk factors. The factor V Leiden G1691A, the prothrombin G20210A allele, and methylenetetrahydrofolate reductase (MTHFR) C677T genotypes were investigated. Allele frequencies and genotype distribution of all factors found in patients were compared to those of 48 healthy subjects of the same ethnic background by chi(2) and odds-ratio analysis. Odds ratios and 95% confidence intervals were calculated for allele and genotype frequencies of all thrombophilia variants. Statistical significance was accepted with a p value of less than .05. We also performed the following blood tests: hemacytometric analysis including platelet count, prothrombin time, activated partial thromboplastin time, fibrinogen, erythrocyte sedimentation rate, C-reactive protein, protein S, protein C, antithrombin III, and activated protein C resistance. Results: In our series, we did not find an association between SSNHL and abnormal levels of antithrombin III, protein C, protein S, D-dimer, or fibrinogen; activated protein C resistance; or factor V G1691A, prothrombin G20210A, or MTHFR C677T mutations. Conclusions: At present, the few studies regarding genetic polymorphisms of congenital thrombophilic factors in SSNHL are not conclusive. According to our data, factor V G1691A, prothrombin G20210A, and MTHFR C677T variants should be not considered risk factors for SSNHL. Further large prospective studies are needed to provide currently lacking information and to improve our knowledge in the field before we recommend the determination of genetic polymorphism in SSNHL as routine practice. C1 Univ Sacred Heart, Dept Otorhinolaryngol, I-00168 Rome, Italy. Univ Sacred Heart, Res Ctr Physiopathol Haemostasis, Dept Internal Med, I-00168 Rome, Italy. RP Cadoni, G (reprint author), Univ Sacred Heart, Dept Otorhinolaryngol, Largo A Gemelli,8, I-00168 Rome, Italy. CR BELAL A, 1980, LARYNGOSCOPE, V90, P1831, DOI 10.1288/00005537-198011000-00011 BERTINA RM, 1994, NATURE, V369, P64, DOI 10.1038/369064a0 Bertina RM, 2001, THROMB HAEMOSTASIS, V86, P92 Cadoni G, 2004, ACTA OTO-LARYNGOL, V124, P608, DOI 10.1080/00016480410016216 CIUFFETTI G, 1991, LARYNGOSCOPE, V101, P65 Corral J, 1999, BRIT J HAEMATOL, V105, P560, DOI 10.1111/j.1365-2141.1999.01362.x DAHLBACK B, 1993, P NATL ACAD SCI USA, V90, P1004, DOI 10.1073/pnas.90.3.1004 De Kleyn A., 1944, ACTA OTO-LARYNGOL, V32, P407, DOI 10.3109/00016484409119921 Deschiens MA, 1996, STROKE, V27, P1724 GREAVES M, 1993, J NEUROL NEUROSUR PS, V56, P433, DOI 10.1136/jnnp.56.5.433 GRIFFIN JH, 1981, J CLIN INVEST, V68, P1370, DOI 10.1172/JCI110385 GUSSEN R, 1976, ANN OTO RHINOL LARYN, V85, P94 HALLBERG O E, 1956, Laryngoscope, V66, P1237 Heit JA, 2001, THROMB HAEMOSTASIS, V86, P452 JOHNSON A, 1984, J OTOLARYNGOL, V13, P201 KRONENBERG J, 1992, LARYNGOSCOPE, V102, P65 Martinelli I, 2001, THROMB HAEMOSTASIS, V86, P395 MATTOX DE, 1980, OTOLARYNG HEAD NECK, V88, P111 Mercier E, 1999, BLOOD, V93, P3150 Patscheke JH, 2001, THROMB HAEMOSTASIS, V86, P1118 Poort SR, 1996, BLOOD, V88, P3698 PROBST R, 1992, ACTA OTO-LARYNGOL, V112, P435, DOI 10.3109/00016489209137424 Rosendaal FR, 1999, LANCET, V353, P1167, DOI 10.1016/S0140-6736(98)10266-0 RUBEN RJ, 1969, J AMER MED ASSOC, V209, P1364, DOI 10.1001/jama.209.9.1364 Rudack C, 2004, HEARING RES, V191, P41, DOI 10.1016/j.heares.2004.01.002 SAITO T, 1986, ARCH OTO-RHINO-LARYN, V243, P242, DOI 10.1007/BF00464438 SANDO I, 1977, ANN OTO RHINOL LARYN, V86, P518 SCHUKNEC.HF, 1973, ACTA OTO-LARYNGOL, V76, P75, DOI 10.3109/00016487309121486 SCHUKNECHT HF, 1986, ARCH OTO-RHINO-LARYN, V243, P1, DOI 10.1007/BF00457899 SCHWARZ HP, 1984, BLOOD, V64, P1297 Shinohara S, 2000, EUR ARCH OTO-RHINO-L, V257, P480, DOI 10.1007/s004050000236 SIEGEL LG, 1975, OTOLARYNG CLIN N AM, V8, P467 Suckfull M, 2002, OTOL NEUROTOL, V23, P309, DOI 10.1097/00129492-200205000-00013 Suzuki H, 2003, ACTA OTO-LARYNGOL, V123, P46, DOI 10.1080/0036554021000028082 Tosetto A, 1999, THROMB HAEMOSTASIS, V82, P1395 ULLRICH D, 1992, EUR ARCH OTO-RHINO-L, V249, P273, DOI 10.1007/BF00714491 WEISSMAN JL, 1992, AM J NEURORADIOL, V13, P1183 WILKINS SA, 1987, OTOLARYNG HEAD NECK, V97, P474 Zuber M, 1996, STROKE, V27, P1721 NR 39 TC 18 Z9 21 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 195 EP 200 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700007 PM 16572609 ER PT J AU Louizos, AA Pandazi, AB Koraka, CP Davilis, DI Georgiou, LG AF Louizos, AA Pandazi, AB Koraka, CP Davilis, DI Georgiou, LG TI Preoperative administration of rofecoxib versus ketoprofen for pain relief after tonsillectomy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anti-inflammatory; ketoprofen; meperidine; opioid analgesic; postoperative pain; rofecoxib; tonsillectomy ID POSTOPERATIVE PAIN; CONTROLLED-TRIAL; SURGERY; DICLOFENAC; ANALGESIA; ACETAMINOPHEN; VOLUNTEERS; KETOROLAC; INHIBITOR; CELECOXIB AB Objectives: We evaluated the analgesic efficacy and the opioid-sparing effect of oral rofecoxib compared with intramuscular (IM) ketoprofen in tonsillectomy. Methods: Seventy-seven adult patients were randomized into 2 groups: group R (n = 39), which received a single oral preoperative dose of rofecoxib 50 mg, and group K (n = 38), which received 2 IM doses of ketoprofen 100 mg (before surgery and after 12 hours). In both groups, additional IM meperidine hydrochloride 1 mg/kg was given. All patients received general anesthesia. A pain score (visual analog scale, 0 to 100) was assessed both at rest and during swallowing at 30 minutes and at 4, 8, 12, 16, and 24 hours after operation. If the pain score exceeded 40, patients were given meperidine as rescue analgesia. Results: The pain scores during rest and swallowing in group R were significantly lower (p < .05) than those of group K at 4, 8, and 12 hours after operation. Meperidine was given as rescue medication in significantly more patients of group K (76%) than of group R (38%; p < .05). Conclusions: Oral premedication with rofecoxib seems to be more effective than use of ketoprofen in decreasing postoperative pain and the need for opioid rescue medication after elective tonsillectomy. Both drugs seem to be relatively safe as far as postoperative bleeding is concerned. C1 Hippocrat Gen Hosp, Dept Anesthesiol, Athens, Greece. Hippocrat Gen Hosp, Dept Otolaryngol, Athens, Greece. RP Louizos, AA (reprint author), Terpsichoris 8A, Athens 19005, Greece. CR Breivik EK, 1999, CLIN PHARMACOL THER, V66, P625, DOI 10.1053/cp.1999.v66.103629001 Chung F, 1997, ANESTH ANALG, V85, P986 Chung F, 1999, CAN J ANAESTH, V46, pR18 COMFORT VK, 1992, CAN J ANAESTH, V39, P349 DAHL JB, 1991, BRIT J ANAESTH, V66, P703, DOI 10.1093/bja/66.6.703 Greenberg HE, 2000, J CLIN PHARMACOL, V40, P1509 Hawkey CJ, 1999, LANCET, V353, P307, DOI 10.1016/S0140-6736(98)12154-2 Huang JJ, 2001, J CLIN ANESTH, V13, P94, DOI 10.1016/S0952-8180(01)00219-7 Jellish WS, 1998, OTOLARYNG HEAD NECK, V118, P785, DOI 10.1016/S0194-5998(98)70269-4 KEHLET H, 1993, ANESTH ANALG, V77, P1048 Kokki H, 2003, OTOLARYNG HEAD NECK, V128, P273, DOI 10.1067/mhn.2003.82 Morrison BW, 1999, CLIN THER, V21, P943, DOI 10.1016/S0149-2918(99)80016-2 Niemi TT, 1997, ACTA ANAESTH SCAND, V41, P1353 Raeder JC, 2001, ANESTH ANALG, V92, P1470 REINER SA, 1990, OTOLARYNG HEAD NECK, V102, P161 Reuben SS, 2000, ANESTH ANALG, V91, P1221, DOI 10.1097/00000539-200011000-00032 Salonen A, 2001, BRIT J ANAESTH, V86, P377, DOI 10.1093/bja/86.3.377 SCHUG SA, 1991, DRUGS, V42, P228 Solca M, 2002, Eur J Anaesthesiol Suppl, V25, P3 Tarkkila P, 1999, BRIT J ANAESTH, V82, P56 Turan A, 2002, ANESTH ANALG, V95, P1308, DOI 10.1213/01.ANE.0000031043.37475.1C Watcha MF, 2003, ANESTH ANALG, V96, P987, DOI 10.1213/01.ANE.0000053255.93270.31 Weaver AL, 2001, CLIN THER, V23, P1323, DOI 10.1016/S0149-2918(01)80112-0 Wei JL, 2000, OTOLARYNG HEAD NECK, V123, P229, DOI 10.1067/mhm.2000.107454 NR 24 TC 5 Z9 5 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 201 EP 204 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700008 PM 16572610 ER PT J AU Kim, LS Jeong, SW Huh, MJ Park, YD AF Kim, LS Jeong, SW Huh, MJ Park, YD TI Cochlear implantation in children with inner ear malformations SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Asia Pacific Symposium on Cochlear Implant and Related Sciences CY DEC 04-06, 2003 CL Taipei, TAIWAN DE child; cochlear implantation; inner ear malformation ID VESTIBULOCOCHLEAR NERVE; MALFORMED COCHLEA; 8TH NERVE; APLASIA; STIMULATION; MENINGITIS; HYPOPLASIA; THRESHOLDS; PROMONTORY AB Objectives: The aim of this study was to assess the outcomes of cochlear implantation in children with inner ear malformations (IEMs). Methods: A retrospective review of 212 children who received implants from September 1994 to May 2004 was performed. Forty-six of them had radiologic evidence of IEMs. The preoperative evaluations, intraoperative findings, postoperative complications, and performance outcomes were analyzed. For the comparative analysis of performance outcomes, the children with IEMs were matched and compared with children with a normal inner ear who had received implants. Statistical analysis was performed with a repeated-measures analysis of variance. Results: All of the children were studied with computed tomography and magnetic resonance imaging. Three-dimensional volume rendering of magnetic resonance images was performed in cases that were difficult to interpret because of structural complexity. The operative findings included aberrant facial nerves in 2 children and cerebrospinal fluid gushers in 22 children. Intraoperative fluoroscopic examination was performed to evaluate electrode placement. There were no serious postoperative complications. All children with IEMs achieved open-set speech perception abilities, except for the children with a narrow internal auditory canal (IAC), and showed progressive improvement of their speech perception abilities over time. There were no statistically significant differences in performance measured by the Common Phrases test between the 2 groups. Although the repeated-measures analysis of variance indicated that children with IEMs performed more poorly than those with a normal inner ear on the Phonetically Balanced Kindergarten test for phonemes, statistical significance was not found at 2 years after implantation. The children with a narrow IAC benefited from the implantation and used the device every day, although their speech perception abilities were limited. Conclusions: The results of the present study show that cochlear implantation can be performed relatively safely in deaf children with IEMs and that they receive considerable benefit from their implants. Substantial benefit can be expected from implantation in children with most kinds of IEMs, except for a narrow IAC, which is often associated with limited results. C1 Dong A Univ, Coll Med, Dept Otolaryngol Head & Neck Surg, Pusan 602715, South Korea. RP Kim, LS (reprint author), Dong A Univ, Coll Med, Dept Otolaryngol Head & Neck Surg, 3-1 Dongdaeshin Dong, Pusan 602715, South Korea. CR Acker T, 2001, INT J PEDIATR OTORHI, V57, P171, DOI 10.1016/S0165-5876(00)00458-4 Antonelli PJ, 1999, LARYNGOSCOPE, V109, P1642, DOI 10.1097/00005537-199910000-00018 Bamiou DE, 2001, OTOL NEUROTOL, V22, P492, DOI 10.1097/00129492-200107000-00014 BATTMER RD, 1990, EAR HEARING, V11, P370, DOI 10.1097/00003446-199010000-00008 Bent JP, 1999, LARYNGOSCOPE, V109, P1019, DOI 10.1097/00005537-199907000-00001 Brown CJ, 2000, EAR HEARING, V21, P151, DOI 10.1097/00003446-200004000-00009 Casselman JW, 1997, RADIOLOGY, V202, P773 Eisenman DJ, 2001, OTOL NEUROTOL, V22, P834, DOI 10.1097/00129492-200111000-00020 GRAHAM JM, 2000, J LARYNGOL OTOL S, V25 Gray RF, 1998, J LARYNGOL OTOL, V112, P646 Hoffman RA, 1997, AM J OTOL, V18, P184 Hughes ML, 2000, EAR HEARING, V21, P164, DOI 10.1097/00003446-200004000-00010 Ito J, 1999, OTOLARYNG HEAD NECK, V121, P495, DOI 10.1016/S0194-5998(99)70244-5 JACKLER RK, 1987, LARYNGOSCOPE, V97, P2 Kelsall DC, 1997, AM J OTOL, V18, P336 Luntz M, 1997, ARCH OTOLARYNGOL, V123, P974 Maxwell AP, 1999, AM J OTOL, V20, P335 McElveen JT, 1997, LARYNGOSCOPE, V107, P1032, DOI 10.1097/00005537-199708000-00005 Miyamoto RT, 2002, LARYNGOSCOPE, V112, P1178, DOI 10.1097/00005537-200207000-00006 MOLTER DW, 1993, OTOLARYNG HEAD NECK, V108, P174 Nikolopoulos TP, 2000, EAR HEARING, V21, P236, DOI 10.1097/00003446-200006000-00007 Page EL, 1997, OTOLARYNG HEAD NECK, V116, P104, DOI 10.1016/S0194-5998(97)70358-9 PAPSIN BC, 2005, LARYNGOSCOPE S106, V115 PHELPS PD, 1994, AM J OTOL, V15, P551 Schmidt AM, 2003, AM J NEURORADIOL, V24, P201 SCHMIDT JM, 1985, ACTA OTO-LARYNGOL, V99, P14, DOI 10.3109/00016488509119140 SHELTON C, 1989, OTOLARYNG HEAD NECK, V100, P227 SLATTERY WH, 1995, LARYNGOSCOPE, V105, P1184, DOI 10.1288/00005537-199511000-00008 TUCCI DL, 1995, ARCH OTOLARYNGOL, V121, P833 Weber BP, 1997, AM J OTOL, V18, pS64 Weber BP, 1998, AM J OTOL, V19, P747 Woolley AL, 1998, ANN OTO RHINOL LARYN, V107, P492 NR 32 TC 21 Z9 22 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 205 EP 214 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700009 PM 16572611 ER PT J AU Tateya, T Tateya, I Munoz-del-Rio, A Bless, DM AF Tateya, T Tateya, I Munoz-del-Rio, A Bless, DM TI Postnatal development of rat vocal folds SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Laryngol Assoc DE postnatal development; rat model; vimentin-positive cell; vitamin A; vocal fold ID STELLATE CELLS; VITAMIN-A; LAMINA PROPRIA; HUMAN NEWBORN; MACULA FLAVA AB Objectives: In this study we aimed to determine the feasibility of using a rat model for the study of postnatal vocal fold (VF) development. Methods: Eighteen male rats that were 3 days old, 3 weeks old, or 8 months old were analyzed histologically with Alcian blue stain used for detecting hyaluronic acid, elastin-van Gieson stain for elastin, Oil Red O and gold chloride stains for vitamin A-containing lipid droplets, and immunohistochemistry for vimentin (general fibroblast marker) and collagen types I and III. Results: The macula flava (MF) was observed as a mass of cells that expressed vimentin intensively in the cytoplasm. The MF showed denser hyaluronic acid and collagen type I than did the midmembranous portion of the VF lamina propria. Clear developmental changes were evident in the MF and other regions. The vimentin-positive cells of the 3-day-old MF were mainly oval-shaped and had less cytoplasm, whereas those of the 8-month-old MF were spindle- and stellate-shaped and had more cytoplasm, similar to that reported in humans. Vitamin A-containing lipid droplets were limited to the 3-week-old and 8-month-old MFs and were not present in the 3-day-old VF. Conclusions: These results suggest that a rat model is useful in studying VF development and that vitamin A is related to the maturity of the VF. C1 Univ Wisconsin, Div Otolaryngol Head & Neck Surg, Madison, WI 53792 USA. RP Tateya, T (reprint author), Univ Wisconsin, Div Otolaryngol Head & Neck Surg, 600 Highland Ave,K4-789 CSC, Madison, WI 53792 USA. CR Agresti A, 1998, AM STAT, V52, P119, DOI 10.2307/2685469 Bland JM, 1996, BRIT MED J, V313, P106 Bland JM, 1996, BRIT MED J, V313, P744 Catten M, 1998, OTOLARYNG HEAD NECK, V118, P663, DOI 10.1177/019459989811800516 Hirano M, 1999, ACTA OTO-LARYNGOL, V119, P271 Ihaka R., 1996, J COMPUTATIONAL GRAP, V5, P299, DOI DOI 10.2307/1390807 Ishii K, 2000, ANN OTO RHINOL LARYN, V109, P1055 KASTURI I, 1982, J BIOL CHEM, V257, P12224 Maden M, 2004, PHILOS T ROY SOC B, V359, P799, DOI 10.1098/rstb.2004.1470 McGowan SE, 2002, CHEST, V121, p206S, DOI 10.1378/chest.121.5_suppl.206S Nagata K., 1982, OTOLOGIA FUKUOKA S2, V28, P699 Nagy NE, 1997, J LIPID RES, V38, P645 Nowak RM, 1999, WALKERS MAMMALS WORL, V2 PINHEIRO JC, 2000, MIXED EFFECTS MODELS, V210 R Development Core Team, 2004, R LANG ENV STAT COMP Sato K, 2003, ACTA OTO-LARYNGOL, V123, P106, DOI 10.1080/0036554021000028077 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P138 Sato K, 2001, ANN OTO RHINOL LARYN, V110, P319 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P556 Sato K, 2001, ANN OTO RHINOL LARYN, V110, P417 Tateya T, 2005, ANN OTO RHINOL LARYN, V114, P183 WAKE K, 1986, STAIN TECHNOL, V61, P193 Wind J., 1970, PHYLOGENY ONTOGENY H NR 23 TC 9 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 215 EP 224 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700010 PM 16572612 ER PT J AU Hahn, MS Kobler, JB Zeitels, SM Langer, R AF Hahn, MS Kobler, JB Zeitels, SM Langer, R TI Quantitative and comparative studies of the vocal fold extracellular matrix II: Collagen SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE animal model; collagen; collagen turnover; lamina propria; quantitative histology; vocal fold ID TISSUE INHIBITORS; LAMINA PROPRIA; SENESCENT EXPRESSION; FIBERS; METALLOPROTEINASES; ATHEROSCLEROSIS; SECTIONS; THERAPY; MUCOSA; LUNGS AB Objectives: This study examines the collagen content and turnover in the midmembranous vocal fold laminae propriae (LPs) of humans, dogs, pigs, and ferrets. Methods: The LP collagen levels were assessed by quantifying tissue hydroxyproline. Quantitative histology allowed evaluation of the collagen content in specific LP regions. Several collagen types and two markers of collagen turnover were examined immunohistochemically. Results: Collagen made up 43.4% +/- 2.6% of human LP total protein (TP), with men having approximately 30% higher collagen content than women (p < .024). The collagen levels in pigs (52.6% +/- 1.9% of TP) and ferrets (29.8% +/- 3.7% of TP), but not that in dogs (45.3% +/- 1.2% of TP), varied significantly from that in humans (pigs, p < .016; ferrets, p < .011). Quantitative histology indicated marked interspecies differences in total collagen distribution. Collagen types I, III, and IV were detected in the LP, and spatially complex staining patterns were observed for the two markers of collagen turnover studied. Conclusions: The collagen content of the human LP is approximately 60% to 70% of that of human dermis. Although canine LP collagen levels are most similar to those of humans, quantitative histology indicates that the collagen distribution of the human LP is best matched by the porcine LP. Collagen types I and III seem to be the dominant LP collagens. Spatial variations in collagen turnover appear to exist that may contribute to normal LP physiology. C1 Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Dept Surg, Boston, MA 02114 USA. MIT, Dept Comp Sci & Elect Engn, Boston, MA USA. MIT, Dept Chem Engn, Boston, MA USA. Harvard Univ, Sch Med, Boston, MA USA. RP Zeitels, SM (reprint author), Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Dept Surg, 1 Bowdoin Square,11th Floor, Boston, MA 02114 USA. CR Culav EM, 1999, PHYS THER, V79, P308 de Melo ECM, 2003, LARYNGOSCOPE, V113, P2187 Ding H, 2001, J SPEECH LANG HEAR R, V44, P317, DOI 10.1044/1092-4388(2001/026) Ding H, 2001, J GERONTOL A-BIOL, V56, pB145 Garrett CG, 2000, LARYNGOSCOPE, V110, P814, DOI 10.1097/00005537-200005000-00011 Goldsmith LA, 1991, PHYSL BIOCH MOL BIOL Gray SD, 2000, ANN OTO RHINOL LARYN, V109, P77 Hahn MS, 2005, ANN OTO RHINOL LARYN, V114, P451 Hahn MS, 2006, ANN OTO RHINOL LARYN, V115, P156 Hammond TH, 2000, ANN OTO RHINOL LARYN, V109, P913 HANSON AN, 1983, ANAL BIOCHEM, V130, P32, DOI 10.1016/0003-2697(83)90646-2 Heeneman S, 2003, J PATHOL, V200, P516, DOI 10.1002/path.1395 Ishii K, 2000, ANN OTO RHINOL LARYN, V109, P1055 JUNQUEIRA LCU, 1979, HISTOCHEM J, V11, P447, DOI 10.1007/BF01002772 Kratky RG, 1996, MATRIX BIOL, V15, P141, DOI 10.1016/S0945-053X(96)90155-9 KURITA S, 1983, COMP STUDY LAYER STR, P3 Lodish H. F., 2000, MOL CELL BIOL LOPEZDELEON A, 1985, J HISTOCHEM CYTOCHEM, V33, P737 MILLER EJ, 1982, METHOD ENZYMOL, V82, P3 Moriggl B, 2001, J ANAT, V199, P539, DOI 10.1046/j.1469-7580.2001.19950539.x Myllyharju J, 2004, TRENDS GENET, V20, P33, DOI 10.1016/j.tig.2003.11.004 Pardo A, 2005, INT J BIOCHEM CELL B, V37, P283, DOI 10.1016/j.biocel.2004.06.017 PROCKOP DJ, 1995, ANNU REV BIOCHEM, V64, P403, DOI 10.1146/annurev.biochem.64.1.403 Sato K, 2002, ANN OTO RHINOL LARYN, V111, P15 Sato K, 1998, ANN OTO RHINOL LARYN, V107, P1023 Seibel MJ, 1999, DYNAMICS BONE CARTIL Titze IR, 2004, J BIOMECH, V37, P1521, DOI 10.1016/j.jbiomech.2004.01.007 Visse R, 2003, CIRC RES, V92, P827, DOI 10.1161/01.RES.0000070112.80711.3D NR 28 TC 47 Z9 48 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 225 EP 232 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700011 PM 16572613 ER PT J AU Ohtani, F Furuta, Y Aizawa, H Fukuda, S AF Ohtani, F Furuta, Y Aizawa, H Fukuda, S TI Varicella-zoster virus load and cochleovestibular symptoms in Ramsay Hunt syndrome SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cochleovestibular symptom; quantitative polymerase chain reaction; Ramsay Hunt syndrome; varicellazoster virus ID POLYMERASE-CHAIN-REACTION; GANGLIA; OTICUS; SYSTEM; DNA AB Objectives: The mechanism by which varicella-zoster virus (VZV) reactivation causes cochleovestibular symptoms (CVSs) in patients with Ramsay Hunt syndrome (RHS) remains to be elucidated. The present study analyzed the relationship between VZV load and the onset of CVSs in RHS. Methods: The subjects consisted of 56 patients with RHS; 29 exhibited CVSs and facial paralysis (FP; group 1), and 27 exhibited FP without CVSs (group 2). The VZV DNA copy number in the saliva was measured with a quantitative polymerase chain reaction. Anti-VZV antibodies were assayed by an enzyme-linked immunosorbent assay with paired sera. Results: There was no significant difference in maximum viral copy number between the two groups. In group 1, CVSs occurred at various times between the early phase and the regression phase of VZV reactivation. In some patients, CVSs occurred in the early phase of VZV reactivation, before the onset of zoster lesions and FP. Conclusions: There are various different patterns in the development of eighth cranial nerve dysfunction, which is caused by progression of neuritis or labyrinthitis following VZV reactivation. Our data suggest that CVSs in RHS may also be caused by reactivation of VZV in the spiral and/or vestibular ganglia. C1 Hokkaido Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Kita Ku, Sapporo, Hokkaido 0608638, Japan. RP Furuta, Y (reprint author), Hokkaido Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Kita Ku, Kita 15,Nishi 7, Sapporo, Hokkaido 0608638, Japan. RI Fukuda, Satoshi/A-8433-2012 CR Aizawa H, 2004, J MED VIROL, V74, P355, DOI 10.1002/jmv.20181 Blackley B, 1967, Acta Otolaryngol, V63, P533, DOI 10.3109/00016486709128786 Echevarria JM, 1997, INTERVIROLOGY, V40, P72, DOI 10.1159/000150535 FUJIWARA Y, 1990, ANN OTO RHINOL LARYN, V99, P359 Furuta Y, 1997, J MED VIROL, V51, P214, DOI 10.1002/(SICI)1096-9071(199703)51:3<214::AID-JMV12>3.0.CO;2-K Furuta Y, 2001, J CLIN MICROBIOL, V39, P2856, DOI 10.1128/JCM.39.8.2856-2859.2001 FURUTA Y, 1992, J INFECT DIS, V166, P1157 HOUSE JW, 1985, OTOLARYNG HEAD NECK, V93, P146 Hunt JR, 1907, J NERV MENT DIS, V34, P0073, DOI 10.1097/00005053-190702000-00001 Kaberos A, 2002, ANN OTO RHINOL LARYN, V111, P68 Kuhweide R, 2002, J LARYNGOL OTOL, V116, P844 Lu YC, 2003, LARYNGOSCOPE, V113, P307, DOI 10.1097/00005537-200302000-00020 Murakami S, 1998, ACTA OTO-LARYNGOL, V118, P145 Wackym PA, 1997, LARYNGOSCOPE, V107, P1165, DOI 10.1097/00005537-199709000-00003 WAYMAN DM, 1990, J LARYNGOL OTOL, V104, P104, DOI 10.1017/S0022215100111971 NR 15 TC 10 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 233 EP 238 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700012 PM 16572614 ER PT J AU Demir, Z Ozdil, K Karamursel, S Yuce, S Oktem, F Celebioglu, S AF Demir, Z Ozdil, K Karamursel, S Yuce, S Oktem, F Celebioglu, S TI Reconstruction of the columella with bilateral nostril sill flaps SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE columella reconstruction; nostril sill flap ID NASOLABIAL FLAPS; NASAL COLUMELLA AB The treatment of total columellar defects is very difficult, and there is not any first choice in reconstruction of these defects. Various techniques have been reported for this purpose. Each technique has its own drawbacks, and few can be performed in one stage. We report a pediatric patient with a defect involving the entire columella. Reconstruction of the defect was accomplished with laterally based bilateral nostril sill flaps. An acceptable cosmetic result was obtained. This method can be done as a single-stage operation with an excellent color and texture match. We think that this method leads to good aesthetic results, and should be considered for total columellar reconstruction. C1 Ankara Res Hosp, Social Secur Fdn, Dept Plast & Reconstruct Surg, Ankara, Turkey. RP Demir, Z (reprint author), Turan Gunes Bul 12,Cad 11-4,Aytekimler Apt, TR-06450 Oran, Ankara, Turkey. CR BAKER SR, 1985, ARCH OTOLARYNGOL, V111, P425 Bilkay U, 2004, J CRANIOFAC SURG, V15, P60, DOI 10.1097/00001665-200401000-00018 Cronin T D, 1978, Ann Plast Surg, V1, P75, DOI 10.1097/00000637-197801000-00015 CRONIN T D, 1958, Plast Reconstr Surg Transplant Bull, V21, P417, DOI 10.1097/00006534-195806000-00001 EARLEY MJ, 1989, BRIT J PLAST SURG, V42, P270, DOI 10.1016/0007-1226(89)90145-8 Gucer T, 2002, PLAST RECONSTR SURG, V109, P1090 Kaplan I, 1972, Br J Plast Surg, V25, P37, DOI 10.1016/S0007-1226(72)80010-9 Larsen J, 1997, SCAND J PLAST RECONS, V31, P229 Margulis A, 2003, PLAST RECONSTR SURG, V112, P1948, DOI 10.1097/01.PRS.0000089264.31445.E3 Mavili ME, 2000, PLAST RECONSTR SURG, V106, P393, DOI 10.1097/00006534-200008000-00022 NICOLAI JPA, 1982, HEAD NECK SURG, V4, P374, DOI 10.1002/hed.2890040505 Ozek C, 2002, MICROSURG, V22, P53, DOI 10.1002/micr.21724 OZKUS I, 1992, ANN PLAS SURG, V29, P461 Penn J, 1967, Br J Plast Surg, V20, P369, DOI 10.1016/S0007-1226(67)80069-9 PINCUS RL, 1990, ARCH OTOLARYNGOL, V116, P973 Sherris David A, 2002, Arch Facial Plast Surg, V4, P42, DOI 10.1001/archfaci.4.1.42 YANAI A, 1986, PLAST RECONSTR SURG, V77, P129 NR 17 TC 2 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 239 EP 242 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700013 PM 16572615 ER PT J AU Savastano, M Celadin, M Pittoni, M Plebani, M Marioni, G AF Savastano, M Celadin, M Pittoni, M Plebani, M Marioni, G TI Western blot immunoassay for HSP-70 antibodies in idiopathic tinnitus: A preliminary report SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE circulating immune complex; heat shock protein 70; HSP-70; idiopathic tinnitus; nonspecific immune test ID SENSORINEURAL HEARING-LOSS; INNER-EAR DISEASE; SHOCK PROTEIN 70; MENIERES-DISEASE; HEAT-SHOCK-PROTEIN-70; SERA AB Objectives: Our preliminary study investigated the role of nonspecific immunologic tests and immunoassay for heat shock protein 70 (HSP-70) in supporting the possibility of an autoimmune inner ear process determining idiopathic tinnitus. Methods: Thirty-six consecutive patients with idiopathic tinnitus without other otologic or autoimmune diseases and 20 healthy blood donor subjects underwent determinations of circulating immune complexes (CICs) and other nonspecific immunologic factors and immunoassay for HSP-70. Results: The mean CIC values were 4.2 mu g/mL in the tinnitus patients and 0.9 mu g/mL in the control group (p = .012). Thirteen of the 36 tinnitus patients and none of the control group were HSP-70-positive. Ten of the 13 HSP-70-positive patients had CIC values higher than normal. In the tinnitus group, the mean CIC values were 6.9 mu g/mL and 2.6 mu g/mL in the HSP-70-positive and -negative subgroups, respectively (p = .024). Conclusions: It may be hypothesized that in a significant number of cases, idiopathic tinnitus could be induced by immune response to inner ear-specific HSP-70. C1 Univ Padua, Dept Otolaryngol Head & Neck Surg, I-35128 Padua, Italy. Univ Padua, Dept Lab Med, I-35128 Padua, Italy. RP Savastano, M (reprint author), Univ Padua, Dept Otolaryngol Head & Neck Surg, Via Giustiniani 2, I-35128 Padua, Italy. CR Berrocal JRG, 2002, LARYNGOSCOPE, V112, P304 BILLINGS PB, 1995, ANN OTO RHINOL LARYN, V104, P181 BLOCH DB, 1995, ARCH OTOLARYNGOL, V121, P1167 Harris Jeffrey P., 1997, P381 HARRIS JP, 1990, LARYNGOSCOPE, V100, P516 Hebert L. A., 1994, IMMUNOCHEMISTRY, P653 Hirose K, 1999, LARYNGOSCOPE, V109, P1749, DOI 10.1097/00005537-199911000-00005 HUGHES GB, 1994, AM J OTOL, V15, P198 Kanzaki J, 1983, Acta Otolaryngol Suppl, V393, P77 Moine A, 1994, Ann Otolaryngol Chir Cervicofac, V111, P363 MOSCICKI RA, 1994, JAMA-J AM MED ASSOC, V272, P611, DOI 10.1001/jama.272.8.611 Rahman MU, 2001, CURR OPIN RHEUMATOL, V13, P184, DOI 10.1097/00002281-200105000-00006 Rauch SD, 2000, LARYNGOSCOPE, V110, P1516, DOI 10.1097/00005537-200009000-00020 SAVASTANO M, 1994, EUR ARCH OTO-RHINO-L, V251, P275 Shin SO, 1997, LARYNGOSCOPE, V107, P222, DOI 10.1097/00005537-199702000-00015 Stone JH, 2000, CURR OPIN RHEUMATOL, V12, P32, DOI 10.1097/00002281-200001000-00006 Yeom K, 2003, LARYNGOSCOPE, V113, P1770, DOI 10.1097/00005537-200310000-00020 NR 17 TC 0 Z9 0 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2006 VL 115 IS 3 BP 243 EP 246 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 022PI UT WOS:000236067700014 PM 16572616 ER PT J AU Chitkara, A Meyer, T Keidar, A Blitzer, A AF Chitkara, A Meyer, T Keidar, A Blitzer, A TI Singer's dystonia: First report of a variant of spasmodic dysphonia SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Laryngol Assoc DE botulinum toxin; laryngeal dystonia; singer's dystonia; spasmodic dysphonia ID LARYNGEAL DYSTONIA; SPASTIC DYSPHONIA AB Objectives: We discuss the phonatory characteristics of a previously undescribed focal laryngeal dystonia present in the singing voice. Methods: We performed a retrospective chart review of 5 patients with singer's dystonia at a neurolaryngology referral center. Results: Four patients reviewed demonstrated phonatory characteristics consistent with adductor spasmodic dysphonia present in their singing voice. One patient demonstrated abductor spasmodic dysphonia in the singing voice. Each patient initially exhibited normal connected speech in conversational voicing. The treatment protocol and outcome are discussed, including the use of botulinum toxin. Conclusions: Singer's dystonia is a previously undescribed neurologic disorder that should be understood by those who treat voice performers and voice disorders. C1 New York Ctr Voice & Swallowing Disorders, New York, NY USA. RP Chitkara, A (reprint author), 29 Manor Rd, Smithtown, NY 11787 USA. EM aechitkara@yahoo.com CR ARONSON AE, 1985, CLIN VOICE DISORDERS, P187 Blitzer A, 1998, LARYNGOSCOPE, V108, P1435, DOI 10.1097/00005537-199810000-00003 BLITZER A, 1985, ANN OTO RHINOL LARYN, V94, P591 BRIN MF, 1992, NEUROLOGICAL DISORDE, P240 CANNITO MP, 1981, J COMMUN DISORD, V14, P215, DOI 10.1016/0021-9924(81)90037-X GRILLONE GA, 1994, LARYNGOSCOPE, V104, P30 Klotz DA, 2004, ANN OTO RHINOL LARYN, V113, P602 MARSDEN CD, 1985, BRAIN, V108, P463, DOI 10.1093/brain/108.2.463 Tubiana R, 2003, HAND CLIN, V19, P303, DOI 10.1016/S0749-0712(02)00099-9 NR 9 TC 7 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 89 EP 92 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500001 PM 16514788 ER PT J AU Sasaki, CT Leder, SB Acton, LM Maune, S AF Sasaki, CT Leder, SB Acton, LM Maune, S TI Comparison of the glottic closure reflex in traditional "open" versus endoscopic laser supraglottic laryngectomy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE endoscopic laser supraglottic laryngectomy; glottic closure reflex; open supraglottic laryngectomy ID DEGLUTITION; ASPIRATION AB Objectives: Cancer of the supraglottic larynx may be surgically treated with either traditional "open" supraglottic laryngectomy (OSL) or endoscopic laser supraglottic laryngectomy (ELSL). Pharyngeal dysphagia is a well-documented consequence of traditional OSL from which near-normal swallowing characteristically recovers 14 to 40 days after surgery. Conversely, ELSL results in the resumption of serviceable swallowing within 2 to 7 days after surgery. Methods: A prospective assessment of the glottic closure reflex in 6 consecutive patients who had ELSL was performed by fiberoptic endoscopic evaluation of swallowing with sensory testing Results: All 6 patients with ELSL demonstrated an intact glottic closure reflex both before surgery and 48 to 72 hours after surgery. In contrast, 7 of 8 historical control patients who had OSL demonstrated a persistent absence of the glottic closure reflex 3 weeks to 12 years later. Conclusions: Although a number of clinical factors influence swallowing recovery, one important factor separating our patient groups was the preservation of the glottic closure reflex in patients who underwent endoscopic laser resection. Because the loss of the glottic closure response persists for years after traditional OSL, it is concluded that the sensory field deficit caused by superior laryngeal nerve section is largely not recoverable, however, compensatory mechanisms, preservation of the glottic closure remain important in serviceable recovery, even if delayed after operation. Indeed. response appears to enhance swallowing recovery when equivalent compensatory mechanisms are used. C1 Yale Univ, Sch Med, Dept Surg, Otolaryngol Sect, New Haven, CT 06520 USA. RP Sasaki, CT (reprint author), Yale Univ, Sch Med, Dept Surg, Otolaryngol Sect, 333 Cedar St,POB 208041, New Haven, CT 06520 USA. CR ALONSO J M, 1947, Trans Am Acad Ophthalmol Otolaryngol, V51, P633 Ambrosch P, 1998, ANN OTO RHINOL LARYN, V107, P680 ARDRAN GM, 1952, BRIT J RADIOL, V25, P406 Aviv Jonathan E., 1993, Annals of Otology Rhinology and Laryngology, V102, P777 Aviv JE, 1996, ANN OTO RHINOL LARYN, V105, P92 Bernal-Sprekelsen M, 2004, HEAD NECK-J SCI SPEC, V26, P103, DOI 10.1002/hed.10363 FLORES TC, 1982, ANN OTO RHINOL LARYN, V91, P579 HIRANO M, 1987, ANN OTO RHINOL LARYN, V96, P7 Jafari S, 2003, J PHYSIOL-LONDON, V550, P287, DOI 10.1113/jphysiol.2003.039966 MCCONNEL FMS, 1987, HEAD NECK-J SCI SPEC, V9, P142, DOI 10.1002/hed.2890090303 Medda BK, 2003, AM J PHYSIOL-GASTR L, V284, pG933, DOI 10.1152/ajpgi.00395.2002 OGURA JH, 1969, OTOLARYNG CLIN N AM, V2, P641 Ohmae Y, 1996, ANN OTO RHINOL LARYN, V105, P123 RUDERT H, 1998, HEAD NECK SURG, V3, P355 Sasaki CT, 2005, ANN OTO RHINOL LARYN, V114, P271 Sasaki CT, 2001, DYSPHAGIA, V16, P19, DOI 10.1007/s004550000039 Som M L, 1970, J Laryngol Otol, V84, P655, DOI 10.1017/S0022215100072388 Steiner W, 2000, ENDOSCOPIC LASER SUR NR 18 TC 11 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 93 EP 96 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500002 PM 16514789 ER PT J AU Koufman, JA Rees, CJ Halum, SL Blalock, D AF Koufman, JA Rees, CJ Halum, SL Blalock, D TI Treatment of adductor-type spasmodic dysphonia by surgical myectomy: A preliminary report SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Laryngol Assoc DE adductor spasmodic dysphonia; Botox; botulinum toxin A; myectomy ID RECURRENT LARYNGEAL NERVE; HUMAN THYROARYTENOID MUSCLE; SPASTIC DYSPHONIA; AVULSION; DYSTONIA; SECTION AB Objectives: Despite the belief that it represents a central neurologic dysfunctional process, adductor-type spasmodic dysphonia without tremor is usually effectively treated by inject io n of botulinum toxin A; however, in most cases such injections must be repeated every few months. A promising new surgical procedure is herein reported. Methods: Under local anesthesia with intravenous sedation. a large laryngoplasty window is created, and under direct vision with intraoperative voice monitoring, fibers front the thyroarytenoid and lateral cricoarytenoid muscles are removed until breathiness occurs. The two sides are staged, that is, one side is done at a time, with surgery on the second side being performed 3 to 6 months after that on the first side, if needed. Results: This was a retrospective, unblinded study of 5 patients who underwent myectomy of the thyroarytenoid and lateral cricoarytenoid muscles. The preliminary results show improved voice fluency in all patients at 5 to 19 months of follow-up. There was no period of prolonged breathiness or dysphagia in any of the patients, and there were no surgical complications. Conclusions: Myectomy of the thyroarytenoid and lateral cricoarytenoid Muscles is a promising new surgical treatment for adductor-type spasmodic dysphonia that may effectively mimic "permanent" botulinum toxin injections. C1 Wake Forest Univ, Dept Otolaryngol, Ctr Voice & Swallowing Disorders, Baptist Med Ctr, Winston Salem, NC 27157 USA. RP Koufman, JA (reprint author), Wake Forest Univ, Dept Otolaryngol, Ctr Voice & Swallowing Disorders, Baptist Med Ctr, Med Ctr Blvd, Winston Salem, NC 27157 USA. CR Bach KK, 2005, ARCH OTOLARYNGOL, V131, P961, DOI 10.1001/archotol.131.11.961 Berke GS, 1999, ANN OTO RHINOL LARYN, V108, P227 Blitzer A, 1998, LARYNGOSCOPE, V108, P1435, DOI 10.1097/00005537-199810000-00003 CARPENTER RJ, 1979, LARYNGOSCOPE, V89, P2000 CHAN SW, 2003, LARYNGOSCOPE, V114, P1604 DEDO HH, 1976, ANN OTO RHINOL LARYN, V85, P451 DEDO HH, 1978, OTOLARYNG HEAD NECK, V86, P875 GENACK SH, 1993, OTOLARYNG HEAD NECK, V108, P256 HILLEL AD, 2001, LARYNGOSCOPE S97, V111 Klotz DA, 2004, ANN OTO RHINOL LARYN, V113, P602 KOUFMAN JA, 1999, PHONOSCOPE, V2, P159 Malmgren LT, 1999, OTOLARYNG HEAD NECK, V121, P441, DOI 10.1016/S0194-5998(99)70235-4 Maranillo E, 2005, LARYNGOSCOPE, V115, P358, DOI 10.1097/01.mlg.0000154745.78808.02 Nash EA, 1996, LARYNGOSCOPE, V106, P484, DOI 10.1097/00005537-199604000-00017 NETTERVILLE JL, 1991, ANN OTO RHINOL LARYN, V100, P10 RONTAL E, 1975, LARYNGOSCOPE, V85, P47, DOI 10.1288/00005537-197501000-00004 SCHAEFER S, 1985, ANN OTO RHINOL LARYN, V94, P595 Takeda N, 2000, LARYNGOSCOPE, V110, P1018, DOI 10.1097/00005537-200006000-00025 Weed DT, 1996, ANN OTO RHINOL LARYN, V105, P592 WOLFE VI, 1976, J SPEECH HEAR DISORD, V41, P325 NR 20 TC 11 Z9 14 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 97 EP 102 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500003 PM 16514790 ER PT J AU Sittel, C Echternach, M Federspil, PA Plinkert, PK AF Sittel, C Echternach, M Federspil, PA Plinkert, PK TI Polydimethylsiloxane particles for permanent injection laryngoplasty SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE glottic gap; glottic insufficiency; injection laryngoplasty; recurrent laryngeal nerve paralysis; vocal fold augmentation; voice disorder ID VOCAL FOLD AUGMENTATION; TERM FOLLOW-UP; CALCIUM HYDROXYLAPATITE; TEXTURED MICROIMPLANTS; SUBDERMAL IMPLANTATION; CORD PARALYSIS; POLYTEF TEFLON; FAT INJECTION; HUMAN LARYNX; MEDIALIZATION AB Objectives: Polydimethylsiloxane (PDMS) particles are a nonresorbable material that allows for permanent vocal fold augmentation. This study investigated morbidity and voice quality in patients treated for unilateral vocal fold paralysis by injection of PDMS particles. Methods: Fourteen patients who had neurogenic unilateral vocal fold paralysis of different causes were included in this prospective study. Each patient underwent videostroboscopic assessment before and after operation. Friedrich's dysphonia index (DI), a score system combining subjective and objective parameters, was used to describe voice quality. A DI of 0 reflects a normal voice, and a DI of 3 stands for complete aphonia. The PDMS particles were injected into the paraglottic space by microlaryngoscopy under general anesthesia. Results: The median follow-up was 4.1 months. There was no complication attributable to the injection of PDMS particles. The mean DI was 2.8 before operation. After the operation, voice quality improved significantly in each patient, as reflected by a mean postinjection DI of 1.4. Conclusions: Particles of PDMS provide a relatively safe and minimally invasive option for permanent vocal fold augmentation. The functional results in terms of voice improvement are comparable to those obtained with other techniques, including thyroplasty. In the European Community, PDMS particles are officially approved for use in the human larynx. C1 Univ Heidelberg, Dept Otorhinolaryngol Head & Neck Surg, Heidelberg, Germany. Univ Homburg, Dept Otorhinolaryngol Head & Neck Surg, D-6650 Homburg, Germany. RP Sittel, C (reprint author), Univ HNO Klin, Neuenheimer Feld 400, D-69120 Heidelberg, Germany. RI Echternach, Matthias/E-3464-2010 CR ALLEN O, 1992, AESTHET PLAST SURG, V16, P227, DOI 10.1007/BF00190068 Alves CB, 2002, CLIN OTOLARYNGOL, V27, P387, DOI 10.1046/j.1365-2273.2002.00601.x ARNOLD GE, 1961, ARCHIV OTOLARYNGOL, V73, P290 BEISANG AA, 1992, AESTHET PLAST SURG, V16, P83, DOI 10.1007/BF00455154 Belafsky PC, 2004, OTOLARYNG HEAD NECK, V131, P351, DOI 10.1016/j.otohns.2004.03.025 BENNINGER MS, 1994, OTOLARYNG HEAD NECK, V111, P497 Brown S L, 1998, J Am Med Womens Assoc, V53, P21 Caballero M, 2003, J BIOMED MATER RES B, V67B, P666, DOI 10.1002/jbm.b.10061 Chan RW, 1999, LARYNGOSCOPE, V109, P1142, DOI 10.1097/00005537-199907000-00026 Colombo T, 1997, BRIT J UROL, V80, P923, DOI 10.1046/j.1464-410X.1997.00472.x DANTONIO LL, 1995, LARYNGOSCOPE, V105, P256, DOI 10.1288/00005537-199503000-00007 Dejonckere P H, 1998, Rev Laryngol Otol Rhinol (Bord), V119, P265 Dejonckere PH, 2001, EUR ARCH OTO-RHINO-L, V258, P77, DOI 10.1007/s004050000299 Ersek RA, 1997, PLAST RECONSTR SURG, V100, P1570, DOI 10.1097/00006534-199711000-00031 FORD CN, 1986, OTOLARYNG HEAD NECK, V94, P104 Friedrich G, 1996, HNO, V44, P401 Friedrich G, 1999, ANN OTO RHINOL LARYN, V108, P79 FURUISSEAU O, 2004, OTOLARYNGOL HEAD NEC, V131, P241 Gerszten K, 1998, ONCOLOGY-NY, V12, P1427 GROFF GD, 1981, ARTHRITIS RHEUM, V24, P1578, DOI 10.1002/art.1780241220 Guys JM, 1999, J UROLOGY, V162, P2133, DOI 10.1016/S0022-5347(05)68141-4 Hallen L, 1999, ACTA OTO-LARYNGOL, V119, P107 Harries ML, 1996, J LARYNGOL OTOL, V110, P111 Harries ML, 1998, ANN OTO RHINOL LARYN, V107, P332 Harriss DR, 1996, BRIT J UROL, V78, P722, DOI 10.1046/j.1464-410X.1996.17510.x HOFLER H, 1993, ZENTRALBL HNO, V577 Karpenko AN, 2003, ANN OTO RHINOL LARYN, V112, P927 MALIZIA AA, 1984, JAMA-J AM MED ASSOC, V251, P3277, DOI 10.1001/jama.251.24.3277 Marotta JS, 1999, J BIOMED MATER RES, V48, P354, DOI 10.1002/(SICI)1097-4636(1999)48:3<354::AID-JBM21>3.0.CO;2-# McCulloch TM, 2002, LARYNGOSCOPE, V112, P1235, DOI 10.1097/00005537-200207000-00017 MIKUS JL, 1995, LARYNGOSCOPE, V105, P17, DOI 10.1288/00005537-199501000-00007 REMACLE M, 1990, Annals of Otology Rhinology and Laryngology, V99, P438 Rihkanen H, 1998, LARYNGOSCOPE, V108, P51, DOI 10.1097/00005537-199801000-00010 Robinson B., 1990, PVP CRITICAL REV KIN Rosen CA, 2004, J VOICE, V18, P387, DOI 10.1016/j.jvoice.2004.02.001 RUBIN HJ, 1975, ARCH OTOLARYNGOL, V101, P114 Shaw GY, 1997, LARYNGOSCOPE, V107, P177, DOI 10.1097/00005537-199702000-00008 Sittel C, 2000, J BIOMED MATER RES, V53, P646, DOI 10.1002/1097-4636(2000)53:6<646::AID-JBM5>3.0.CO;2-0 Sittel C, 2005, HNO, V53, P6, DOI 10.1007/s00106-004-1196-8 Sittel C, 2001, ARCH OTOLARYNGOL, V127, P155 Sittel C, 2004, J BIOMED MATER RES B, V69B, P251, DOI 10.1002/jbm.b.30025 VARVARES MA, 1995, ANN OTO RHINOL LARYN, V104, P511 Zapanta PE, 2004, LARYNGOSCOPE, V114, P1522, DOI 10.1097/00005537-200409000-00002 NR 43 TC 17 Z9 18 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 103 EP 109 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500004 PM 16514791 ER PT J AU Otto, KJ Hapner, ER Baker, M Johns, MM AF Otto, KJ Hapner, ER Baker, M Johns, MM TI Blinded evaluation of the effects of high definition and magnification on perceived image quality in laryngeal imaging SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE charge-coupled device camera; high-definition camera; laryngeal imaging; magnification AB Objectives: Advances in commercial video technology have improved office-based laryngeal imaging. This study investigates the perceived image quality of a true high-definition (HD) video camera and the effect of magnification on laryngeal videostroboscopy. Methods: We performed a prospective, dual-armed, single-blinded analysis of a standard laryngeal videostroboscopic examination comparing 3 separate add-on camera systems: a 1-chip charge-coupled device (CCD) camera, a 3-chip CCD camera, and a true 720p (progressive scan) HD camera. Displayed images were controlled for magnification and image size (20-inch [50-cm] display, red-green-blue, and S-video cable for 1-chip and 3-chip cameras; digital visual interface cable and HD monitor for HD camera). Ten blinded observers were then asked to rate the following 5 items on a 0-to-100 visual analog scale: resolution, color, ability to see vocal fold vibration, sense of depth perception, and clarity of blood vessels. Eight unblinded observers were then asked to rate the difference in perceived resolution and clarity of laryngeal examination images when displayed on a 10-inch (25-cm) monitor versus a 42-inch (105-cm) monitor. A visual analog scale was used. These monitors were controlled for actual resolution capacity. Results: For each item evaluated, randomized block design analysis demonstrated that the 3-chip camera scored significantly better than the 1-chip camera (p < .05). For the categories of color and blood vessel discrimination, the 3-chip camera scored significantly better than the HD camera (p < .05). For magnification alone, observers rated the 42-inch monitor statistically better than the 10-inch monitor. Conclusions: The expense of new medical technology must be judged against its added value. This study suggests that HD laryngeal imaging may not add significant value over currently available video systems, in perceived image quality, when a small monitor is used. Although differences in clarity between standard and HD cameras may not be readily apparent on small displays, a large display size coupled with HD technology may impart improved diagnosis of subtle vocal fold lesions and vibratory anomalies. C1 Emory Univ, Dept Otolaryngol, Emory Voice Ctr, Atlanta, GA 30308 USA. RP Johns, MM (reprint author), Emory Univ, Dept Otolaryngol, Emory Voice Ctr, 550 Peachtree St,9th Floor,Suite 400, Atlanta, GA 30308 USA. CR JACK K, 2004, VIDEO DEMYSTIFIED HD POYNTON C, 2002, DIGITAL VIDEO HDTV A NR 2 TC 6 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 110 EP 113 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500005 PM 16514792 ER PT J AU Loh, WS Chong, SM Loh, KS AF Loh, WS Chong, SM Loh, KS TI Intralaryngeal thyroglossal duct cyst: Implications for the migratory pathway of the thyroglossal duct SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE larynx; thyroglossal duct cyst ID TRACT; EXTENSION AB An atypically located thyroglossal duct cyst in a 42-year-old man is described. A purely intralaryngeal thyroglossal duct cyst is extremely rare and can mimic other laryngeal lesions. This case demonstrates that thyroglossal duct cyst is a possible cause of intralaryngeal swellings and would have significant implications for the manner in which they are managed. C1 Natl Univ Singapore, Dept Otolaryngol, Singapore 119074, Singapore. RP Loh, KS (reprint author), Natl Univ Singapore, Dept Otolaryngol, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore. CR Chandra RK, 2001, LARYNGOSCOPE, V111, P1002, DOI 10.1097/00005537-200106000-00014 CHOI SS, 1998, PRACTICAL PEDIATRIC, P952 ELLIS PDM, 1977, LARYNGOSCOPE, V87, P765 KARMODY CS, 2002, PEDIAT OTOLARYNGOLOG, P1648 Lubben B, 2001, OTOLARYNG HEAD NECK, V125, P426, DOI 10.1067/mhn.2001.117168 Quah HM, 2002, ANN ACAD MED SINGAP, V31, P238 SHAARI CM, 1994, HEAD NECK-J SCI SPEC, V16, P586, DOI 10.1002/hed.2880160616 Sprinzl GM, 2000, ANN OTO RHINOL LARYN, V109, P1135 NR 8 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 114 EP 116 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500006 PM 16514793 ER PT J AU Sichel, JY Attal, P Hocwald, E Eliashar, R AF Sichel, JY Attal, P Hocwald, E Eliashar, R TI Redefining parapharyngeal space infections SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE abscess; deep neck; infection; parapharyngeal space ID DEEP NECK INFECTIONS; NONSURGICAL MANAGEMENT; COMPUTED-TOMOGRAPHY; CHILDREN; ABSCESS; DIAGNOSIS AB Objectives: Our intent was to review the clinical signs, computed tomography (CT) scans. treatment, and outcome of parapharyngeal space infections (PPIs), and to define 2 types of infections of the parapharyngeal space (PPS) according to the location of the infectious process. Methods: We performed a retrospective analysis of patients hospitalized in a tertiary university hospital with a diagnosis of PPI, abscess, or deep neck abscess between 1988 and 2004. Files and CT scans were reviewed after classification into 2 groups: 1) infection located in the posterior part of the PPS (PostPPI); and 2) infection located in the anterior part of the PPS (AntPPI). Results: Twenty-two patients had a PostPPI; their ages ranged from 10 months to 24 years. Five patients underwent surgical drainage, and 17 others were treated solely with intravenous antibiotic therapy. No pus was found during surgery in 2 patients. The average time of hospitalization was 10 days. Only 1 complication (aspiration pneumonia) was observed. Seven patients had an AntPPI; their acres ranged from 1.5 years to 65 years. All patients underwent surgical drainage, and pus was detected in all cases. The average time of hospitalization was 35 days. Complications (septic shock, respiratory arrest, mediastinitis, pleural empyema, pericarditis) were observed in 4 patients. Conclusions: The term "parapharyngeal abscess" was assigned long before the CT scan era. and was based on physical examination and plain film radiology. In essence, the entity PPS "abscess" or "infection" is composed of 2 different disorders. Infection located in the posterior part of the PPS with no invasion into the parapharyngeal fat and with no extension into other cervical spaces except the adjacent retropharyncreal space may be termed posterior parapharyngeal infection or parapharyngeal lymphadenitis. This is a relatively benign condition, and nonsurgical treatment should be considered. Infection involving the parapharyngeal fat may be termed parapharyngeal abscess or deep neck abscess. Diffusion into the mediastinum and other severe complications are frequent. Urgent surgical drainage is therefore mandatory. C1 Hebrew Univ Jerusalem, Sch Med, Hadassah Med Ctr, Dept Otolaryngol Head & Neck Surg, IL-91010 Jerusalem, Israel. RP Sichel, JY (reprint author), Shaare Zedek Med Ctr, Dept Otolaryngol Head & Neck Surg, Jerusalem, Israel. CR Amar YG, 2004, OTOLARYNG HEAD NECK, V130, P676, DOI 10.1016/j.otohns.2003.11.016 BROUGHTON RA, 1992, PEDIATR INFECT DIS J, V11, P14, DOI 10.1097/00006454-199201000-00005 BUCHWALD C, 1990, J LARYNGOL OTOL, V104, P829, DOI 10.1017/S0022215100114033 Chen MK, 1998, J OTOLARYNGOL, V27, P141 Cmejrek RC, 2002, ARCH OTOLARYNGOL, V128, P1361 DEMARIE S, 1989, REV INFECT DIS, V11, P975 Flanary VA, 1997, INT J PEDIATR OTORHI, V38, P263, DOI 10.1016/S0165-5876(96)01453-X Gidley PW, 1997, OTOLARYNG HEAD NECK, V116, P16, DOI 10.1016/S0194-5998(97)70345-0 Huang TT, 2004, HEAD NECK-J SCI SPEC, V26, P854, DOI 10.1002/hed.20014 Kirse DJ, 2001, LARYNGOSCOPE, V111, P1413, DOI 10.1097/00005537-200108000-00018 LANGENBR.DJ, 1971, ARCHIV OTOLARYNGOL, V94, P447 McClay JE, 2003, ARCH OTOLARYNGOL, V129, P1207, DOI 10.1001/archotol.129.11.1207 Nagy M, 1997, LARYNGOSCOPE, V107, P1627, DOI 10.1097/00005537-199712000-00010 Parhiscar A, 2001, ANN OTO RHINOL LARYN, V110, P1051 Reisner A, 1999, J NEUROSURG, V91, P510, DOI 10.3171/jns.1999.91.3.0510 Sakaguchi M, 1997, INT J ORAL MAX SURG, V26, P131, DOI 10.1016/S0901-5027(05)80835-5 Sichel JY, 2002, LARYNGOSCOPE, V112, P906, DOI 10.1097/00005537-200205000-00023 Sichel JY, 1996, INT J PEDIATR OTORHI, V35, P213, DOI 10.1016/0165-5876(95)01307-5 Wang LF, 2003, AM J OTOLARYNG, V24, P111, DOI 10.1053/ajot.2003.31 Wetmore RF, 1998, OTOLARYNG HEAD NECK, V119, P624, DOI 10.1016/S0194-5998(98)70023-3 NR 20 TC 13 Z9 17 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 117 EP 123 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500007 PM 16514794 ER PT J AU Wise, JB Moonis, G Mirza, N AF Wise, JB Moonis, G Mirza, N TI Magnetic resonance imaging findings in the evaluation of traumatic anosmia SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Rhinologic-Society CY MAY 02-03, 2003 CL Nashville, TN SP Amer Rhinol Soc DE anosmia; magnetic resonance imaging; trauma ID POSTTRAUMATIC OLFACTORY DYSFUNCTION; SMELL AB Objectives: Head trauma is a common cause of anosmia, but diagnosis is typically late, owing to more life-threatening sequelae of the injury. Herein, we describe our workup for a case of traumatic anosmia and the magnetic resonance imaging (MRI) findings both at the time of injury and at the 18-month follow-up. Methods: We present a case report and a review of the literature. Results: A 33-year-old woman presented to our institution with a chief complaint of loss of smell and taste following an occipital blow to her head that occurred when she was hit by a car while riding a bicycle. We present the findings of MRI performed at the time of the injury and at the 18-month follow-up. We describe the clinical progression of her disease, from symptoms of parosmic and phantosmic episodes accompanied by dysgeusia to total anosmia at the 18-month follow-up. Conclusions: We advocate the use of MRI, coupled with otolaryngology consultation and formal olfactory testing, in the diagnosis, management, and counseling of patients with anosimia sustained from head injury. C1 Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. Univ Penn, Dept Radiol, Philadelphia, PA 19104 USA. RP Wise, JB (reprint author), Hosp Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, 3400 Spruce St,5 Ravdin, Philadelphia, PA 19104 USA. CR Costanzo RM, 1986, CLIN MEASUREMENT TAS, P565 Costanzo RM, 1991, SMELL TASTE HLTH DIS, P711 DEEMS DA, 1991, ARCH OTOLARYNGOL, V117, P519 Doty RL, 1997, ARCH NEUROL-CHICAGO, V54, P1131 GROSSMAN RI, 1994, NEURORADIOLOGY REQUI, P149 Kern RC, 2000, LARYNGOSCOPE, V110, P2106, DOI 10.1097/00005537-200012000-00025 LEVIN HS, 1985, BRAIN, V108, P579, DOI 10.1093/brain/108.3.579 POTTER H, 1980, NEUROPSYCHOLOGIA, V18, P621, DOI 10.1016/0028-3932(80)90101-3 SUMNER D, 1964, BRAIN, V87, P107, DOI 10.1093/brain/87.1.107 Yousem DM, 1996, AM J NEURORADIOL, V17, P1171 Yousem DM, 1999, ACAD RADIOL, V6, P264, DOI 10.1016/S1076-6332(99)80449-8 Yousem DM, 2001, SEMIN ULTRASOUND CT, V22, P456, DOI 10.1053/sult.2001.28800 ZUSHO H, 1982, ARCH OTOLARYNGOL, V108, P90 NR 13 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 124 EP 127 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500008 PM 16514795 ER PT J AU Cohen, SM Dupont, WD Courey, MS AF Cohen, SM Dupont, WD Courey, MS TI Quality-of-life impact of non-neoplastic voice disorders: A meta-analysis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Laryngol Assoc DE laryngeal disease; meta-analysis; quality of life; voice disorder ID RANDOMIZED CLINICAL-TRIAL; VOCAL FOLD LESIONS; HANDICAP INDEX; SPASMODIC DYSPHONIA; BOTULINUM TOXIN; OUTCOMES; VALIDATION; TEACHERS; REFLUX; THERAPY AB Objectives: We undertook to explore the relationship between non-neoplastic voice disorders and patients' quality of life. Methods: A PubMed search (1966 to 2003) for the terms Voice Handicap Index (VHI), Short Form-36 (SF-36), voice disorders, voice quality, treatment outcome, voice outcome, quality of life, and questionnaires was performed. Raw data were obtained whenever possible. Studies were analyzed by meta-analysis techniques. Results: Of 54 VHI studies identified, 11 were excluded, and of 21 SF-36 studies, 7 were excluded for incomplete data, non-English language, measuring malignant disease. or duplicate publication. Patients with neurologic and inflammatory or traumatic laryngeal disease had worse VHI scores than controls, and those with neurologic laryngeal disease had the most severe impairment (p < .001, Kruskal-Wallis analysis of variance; p < .05, Dunn's method of multiple comparisons). Those with neurologic laryngeal disease had worse SF-36 subdomain scores than did controls in 6 of 8 subdomains (p < .03, Kruskal-Wallis analysis of variance; p < .05, Dunn's method of multiple comparisons). Both patients with neurologic disease and patients with inflammatory or traumatic laryngeal disorders had changes in SF-36 subdomains similar to those of patients with other chronic disease states. Conclusions: Non-neoplastic voice disorders adversely impact patients' voice-related and general quality of life, and neurologic voice disorders have the greatest impact. C1 Univ Calif San Francisco, San Francisco Voice Ctr, San Francisco, CA 94115 USA. Vanderbilt Univ, Med Ctr, Dept Otolaryngol Head & Neck Surg, Nashville, TN USA. Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USA. RP Courey, MS (reprint author), Univ Calif San Francisco, San Francisco Voice Ctr, 2330 Post St,5th Floor, San Francisco, CA 94115 USA. RI Dupont, William/I-4430-2012 CR Behrman A, 2002, OTOLARYNG HEAD NECK, V127, P36, DOI 10.1067/mhn.2002.126589 Behrman A, 2001, OTOLARYNG HEAD NECK, V125, P193, DOI 10.1067/mhn.2001.117411 Behrman A, 2004, LARYNGOSCOPE, V114, P1693, DOI 10.1097/00005537-200410000-00004 Belafsky PC, 2002, J VOICE, V16, P274, DOI 10.1016/S0892-1997(02)00097-8 Benninger MS, 1998, J VOICE, V12, P540, DOI 10.1016/S0892-1997(98)80063-5 Benninger MS, 2001, ARCH OTOLARYNGOL, V127, P1083 Blumin JH, 2004, ANN OTO RHINOL LARYN, V113, P253 Bowling A, 1999, J PUBLIC HEALTH MED, V21, P255, DOI 10.1093/pubmed/21.3.255 Carrau RL, 2004, LARYNGOSCOPE, V114, P670, DOI 10.1097/00005537-200404000-00014 Courey MS, 2000, ANN OTO RHINOL LARYN, V109, P819 de Jong FICRS, 2003, FOLIA PHONIATR LOGO, V55, P91, DOI 10.1159/000070091 Gliklich RE, 1999, OTOLARYNG HEAD NECK, V120, P153, DOI 10.1016/S0194-5998(99)70399-2 GLIKLICH RE, 1995, OTOLARYNG HEAD NECK, V113, P104, DOI 10.1016/S0194-5998(95)70152-4 Guimaraes I, 2004, J VOICE, V18, P71, DOI 10.1016/j.jvoice.2003.07.002 Hill DS, 2000, CLIN OTOLARYNGOL, V25, P153, DOI 10.1046/j.1365-2273.2000.00345.x Hogikyan ND, 1999, J VOICE, V13, P557, DOI 10.1016/S0892-1997(99)80010-1 Hsiung MW, 2003, J LARYNGOL OTOL, V117, P478 Jacobson BH, 1997, AM J SPEECH-LANG PAT, V6, P66 Johns MM, 2004, ANN OTO RHINOL LARYN, V113, P597 Klein S, 2000, OTOLARYNG HEAD NECK, V123, P164, DOI 10.1067/mhm.2000.107682 Lee L, 2003, J VOICE, V17, P411, DOI 10.1067/S0892-1997(03)00075-4 Ma EPM, 2001, J SPEECH LANG HEAR R, V44, P511, DOI 10.1044/1092-4388(2001/040) MacKenzie K, 2001, BRIT MED J, V323, P658, DOI 10.1136/bmj.323.7314.658 Pearl AW, 2002, LARYNGOSCOPE, V112, P990, DOI 10.1097/00005537-200206000-00010 Powitzky ES, 2003, ANN OTO RHINOL LARYN, V112, P859 Pribuisiene R, 2005, EUR ARCH OTO-RHINO-L, V262, P35, DOI 10.1007/s00405-003-0728-2 Rosen CA, 2000, J VOICE, V14, P370, DOI 10.1016/S0892-1997(00)80082-X Rosen CA, 2004, J VOICE, V18, P387, DOI 10.1016/j.jvoice.2004.02.001 Rosen CA, 2004, LARYNGOSCOPE, V114, P1549, DOI 10.1097/00005537-200409000-00009 Rothman KJ, 1998, MODERN EPIDEMIOLOGY, P660 Roy N, 2002, J SPEECH LANG HEAR R, V45, DOI 10.1044/1092-4388(2002/050) Roy N, 2003, J SPEECH LANG HEAR R, V46, P670, DOI 10.1044/1092-4388(2003/053) Roy N, 2001, J SPEECH LANG HEAR R, V44, P286, DOI 10.1044/1092-4388(2001/023) Spector BC, 2001, OTOLARYNG HEAD NECK, V125, P176, DOI 10.1067/mhn.2001.117714 Speyer R, 2004, CLIN OTOLARYNGOL, V29, P66, DOI 10.1111/j.1365-2273.2004.00782.x Timmermans B, 2002, J VOICE, V16, P372, DOI 10.1016/S0892-1997(02)00108-X Ware Jr J. E., 1993, SF 36 HLTH SURVEY Wilson JA, 2002, CLIN OTOLARYNGOL, V27, P179, DOI 10.1046/j.1365-2273.2002.00559.x Wilson JA, 2004, CLIN OTOLARYNGOL, V29, P169, DOI 10.1111/j.0307-7772.2004.00775.x NR 39 TC 48 Z9 48 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 128 EP 134 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500009 PM 16514796 ER PT J AU Tateya, I Tateya, T Lim, XH Sohn, JH Bless, DM AF Tateya, I Tateya, T Lim, XH Sohn, JH Bless, DM TI Cell production in injured vocal folds: A rat study SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE cell production; fibroblast; macula flava; proliferation; vocal fold ID MACULA FLAVA; CANINE; PROLIFERATION; FIBROBLASTS AB Objectives: Fibroblasts are reported to play an important role in producing the extracellular matrix of the vocal fold. However, no reports have focused oil how and where these cells are generated in the vocal fold after injury. To reveal the characteristics of vocal fold cell production, we investigated cell proliferation in the acute phase of wound healing Methods: Using a telescope for guidance, we made an incision in the middle region of the vocal fold tissue in 24 rats and performed immunohistochemical staining for vimentin, alpha-smooth muscle actin, and 5-bromo-2-deoxyuridine. Results: After injury, epithelialization occurred with a peak at day 1, and fibroblasts proliferated in the lamina propria with a peak at day 3, whereas those in the macula flava did not show any increased proliferation. Conclusions: It is suggested that the fibroblasts in the macula flava have functions different from those of fibroblasts in the lamina propria and that the macula flava does not serve as a cell source for the vocal fold in response to injury. C1 Univ Wisconsin, Div Otolaryngol Head & Neck Surg, Madison, WI 53792 USA. RP Tateya, I (reprint author), Univ Wisconsin, Div Otolaryngol Head & Neck Surg, K4-789 CSC,600 Highland Ave, Madison, WI 53792 USA. CR BENNETT NT, 1993, AM J SURG, V165, P728, DOI 10.1016/S0002-9610(05)80797-4 Benninger MS, 1996, OTOLARYNG HEAD NECK, V115, P474, DOI 10.1016/S0194-5998(96)70087-6 Catten M, 1998, OTOLARYNG HEAD NECK, V118, P663, DOI 10.1177/019459989811800516 Duke SG, 2001, LARYNGOSCOPE, V111, P759, DOI 10.1097/00005537-200105000-00002 Fayoux P, 2004, ANN OTO RHINOL LARYN, V113, P498 Ford CN, 1999, LARYNGOSCOPE, V109, P1891, DOI 10.1097/00005537-199912000-00001 Garlick JA, 1996, J DENT RES, V75, P912 Gray SD, 1999, LARYNGOSCOPE, V109, P845, DOI 10.1097/00005537-199906000-00001 Gray SD, 2000, ANN OTO RHINOL LARYN, V109, P77 Hirano M, 2000, ACTA OTO-LARYNGOL, V120, P336 Hirano M, 1999, ACTA OTO-LARYNGOL, V119, P271 Hirano S, 2003, LARYNGOSCOPE, V113, P966, DOI 10.1097/00005537-200306000-00010 Kahane J. C., 1987, J VOICE, V1, P27, DOI 10.1016/S0892-1997(87)80020-6 KAJIKAWA K, 1984, CONNECT TISSUE, P19 KURITA S, 1983, VOCAL FOLD PHYSL CON, V3 Peled ZM, 2000, CLIN PLAST SURG, V27, P489 Rousseau B, 2003, LARYNGOSCOPE, V113, P620, DOI 10.1097/00005537-200304000-00007 Sato K, 2001, ANN OTO RHINOL LARYN, V110, P319 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P556 Singer AJ, 1999, NEW ENGL J MED, V341, P738 Smith PG, 2002, CELL TISSUE RES, V307, P281, DOI 10.1007/s00441-001-0477-8 THIBEAULT S, 2003, LARYNX, P431 Thibeault SL, 2002, J VOICE, V16, P96, DOI 10.1016/S0892-1997(02)00078-4 WOO P, 1994, LARYNGOSCOPE, V104, P1084 Yoshida K, 2002, INVEST OPHTH VIS SCI, V43, P364 NR 25 TC 20 Z9 21 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 135 EP 143 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500010 PM 16514797 ER PT J AU Hambek, M Adunka, O Baghi, M Gstoettner, W Knecht, R AF Hambek, M Adunka, O Baghi, M Gstoettner, W Knecht, R TI AdOnco: A database for clinical and scientific documentation of head and neck oncology SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE computer; electronic documentation; head and neck oncology; oncology; statistical analysis ID CANCER; SYSTEM; MANAGEMENT; RECORDS; DESIGN AB Objectives: The aim of this project was to design, develop, and implement a head and neck cancer computer database for clinical and scientific use. Methods: A relational database based on Filemaker Pro 6.0 was developed and integrated into our local network. A precise and easy-to-handle interface should allow for a quick overview of the patient's oncological history and for optimized data acquisition. An automatic report function was integrated to enhance the quality of daily patient care. For evaluation purposes, statistical analysis functions were implemented. Results: Over a 14-month period, 410 patient records were available through the local network. The automated report function and the well-organized screen desktop resulted in time-efficient and accurate patient care. Additionally, the quality of information presented to referring physicians increased notably. The statistical analysis data provided by the database were reliable and easy to export. Conclusions: We developed an oncology database for both clinical and scientific purposes and integrated it successfully into our patient documentation system. The combination of clinical and scientific features proved to be very effective in daily routine and research. C1 Univ Frankfurt, Dept Otolaryngol Head & Neck Surg, D-6000 Frankfurt, Germany. RP Hambek, M (reprint author), Univ Clin Frankfurt Main, ENT Ctr, Theodor Stern Kai 7, D-60590 Frankfurt, Germany. CR Apaydin F, 1996, HNO, V44, P333 BAILEY BJ, 1991, ARCH OTOLARYNGOL, V117, P369 BELINSON JL, 1987, GYNECOL ONCOL, V27, P264, DOI 10.1016/0090-8258(87)90245-9 BENJAMIN I, 1990, GYNECOL ONCOL, V38, P431, DOI 10.1016/0090-8258(90)90086-Z BUSETTO M, 1991, MED INFORM, V16, P253 Clive R E, 1983, Prog Clin Biol Res, V121, P155 FIENBERG SE, 1994, ANNU REV PUBL HEALTH, V15, P1 FLETCHER MM, 1987, LARYNGOSCOPE, V97, P1422 HOKANSON JA, 1983, CANCER, V51, P1556, DOI 10.1002/1097-0142(19830415)51:8<1556::AID-CNCR2820510834>3.0.CO;2-3 HUYGEN PLM, 1985, CLIN OTOLARYNGOL, V10, P157, DOI 10.1111/j.1365-2273.1985.tb01185.x Jacob R, 2002, LARYNGO RHINO OTOL, V81, P875, DOI 10.1055/s-2002-36104 Landis SH, 1999, CA-CANCER J CLIN, V49, P8, DOI 10.3322/canjclin.49.1.8 Liu CT, 2001, INT J MED INFORM, V61, P189, DOI 10.1016/S1386-5056(01)00141-1 Maier H, 1997, Acta Otolaryngol Suppl, V527, P160 MICHAELIS J, 1995, ANN ONCOL, V6, P344 Mira E, 1998, Acta Otorhinolaryngol Ital, V18, P155 O'Sullivan Brian, 2003, Semin Surg Oncol, V21, P30, DOI 10.1002/ssu.10019 PICCIRILLO JF, 1995, ARCH OTOLARYNGOL, V121, P145 Raab G, 2001, Zentralbl Gynakol, V123, P444, DOI 10.1055/s-2001-17241 Rogers S N, 1996, Ann R Coll Surg Engl, V78, P14 Sailer SL, 1997, SEMIN RADIAT ONCOL, V7, P4, DOI 10.1016/S1053-4296(97)80012-4 SCHLOEFFEL P R, 1988, Journal of Medical Systems, V12, P43, DOI 10.1007/BF01002375 SCIMECA PG, 1995, PEDIATR HEMAT ONCOL, V12, P259, DOI 10.3109/08880019509029567 NR 23 TC 6 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 144 EP 149 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500011 PM 16514798 ER PT J AU Uyar, Y Ozturk, K Keles, B Arbag, H Ulku, CH AF Uyar, Y Ozturk, K Keles, B Arbag, H Ulku, CH TI Anterior atticoantrostomy for cholesteatoma surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anterior atticoantrostomy; cholesteatoma; perforation; periosteal flap; retraction ID CANAL-WALL; SURGICAL-TREATMENT; FOLLOW-UP; TYMPANOPLASTY; MASTOIDECTOMY; RECONSTRUCTION; CHILDREN; STAGE; EAR; ATTICOTOMY AB Objectives: We aimed to investigate the long-term results of anterior atticoantrostomy in adult patients with cholesteatoma. Methods: A total of 83 ears in 78 patients were operated on by the anterior atticoantrostomy technique, supported by a periosteal flap, between 1991 and 2002. Results: Cholesteatoma recurred in only 4 ears (4.8%). In the 79 ears without recurrence, re-perforation was observed in 3 ears (3.8%), and retraction pockets developed in the attic of 5 ears (6.3%), 2 of which needed ventilation tubes. Absorption or migration of cartilage grafts was not seen in any of the patients. The mean air-bone gap was 34.8 +/- 13.4 dB and 16.9 +/- 14.7 dB, and the mean high-tone bone conduction was 19.0 +/- 6.2 dB and 21.1 +/- 6.6 dB, in the preoperative and postoperative periods, respectively. Conclusions: In the reconstruction of the posterior canal wall, a cartilage graft supported by a periosteal flap prevents attic retraction and may increase the vascularization of the graft. After anterior atticoantrostomy, the recurrence rate and the probability of leaving residual tissue are low. Therefore, we believe that anterior atticoantrostomy is a relatively safe and effective technique that can be used in the management of cholesteatoma. C1 Selcuk Univ, Meram Fac Med, Dept Otolaryngol, Kulak Burun Bogaz Anabilim Dali, TR-42090 Konya, Turkey. RP Ozturk, K (reprint author), Selcuk Univ, Meram Fac Med, Dept Otolaryngol, Kulak Burun Bogaz Anabilim Dali, TR-42090 Konya, Turkey. CR ABRAMSON M, 1977, LARYNGOSCOPE, V87, P1281, DOI 10.1288/00005537-197708000-00008 Albu S, 1998, AM J OTOL, V19, P136 AUSTIN DF, 1989, AM J OTOL, V10, P419 BRACKMANN DE, 1993, AM J OTOL, V14, P380 BROWN JS, 1982, LARYNGOSCOPE, V92, P390 CHANDLER JR, 1972, LARYNGOSCOPE, V82, P848, DOI 10.1288/00005537-197205000-00012 Chang CC, 2000, J OTOLARYNGOL, V29, P270 Committee on Hearing and Equilibrium. Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. American Academy of OtolaryngologyY Head and Neck Surgery Foundation Inc, 1995, OTOLARYNGOL HEAD NEC, V113, P186 Dodson EE, 1998, LARYNGOSCOPE, V108, P977, DOI 10.1097/00005537-199807000-00005 DONALD P, 1974, ANN OTO RHINOL LARYN, V83, P652 East DM, 1998, CLIN OTOLARYNGOL, V23, P248 FARRIOR JB, 1969, ARCH OTOLARYNGOL, V90, P706 Goksu N, 1997, AM J OTOL, V18, P304 Haynes D S, 2001, Ear Nose Throat J, V80, P8 HIRSCH BE, 1992, OTOLARYNG HEAD NECK, V106, P351 Hulka GF, 1998, AM J OTOL, V19, P574 JOHNSON RA, 1993, SURG EAR TEMPORAL BO, P111 SAKAI M, 1986, AM J OTOL, V7, P188 SHEEHY JL, 1988, ANN OTO RHINOL LARYN, V97, P30 SHEEHY JL, 1991, OTOLARYNG HEAD NECK, V104, P399 Soldati D, 2000, INT J PEDIATR OTORHI, V52, P269, DOI 10.1016/S0165-5876(00)00298-6 Stangerup SE, 1998, J LARYNGOL OTOL, V112, P742 Takahashi H, 2000, AM J OTOL, V21, P28, DOI 10.1016/S0196-0709(00)80108-8 TONER JG, 1990, AM J OTOL, V11, P247 VARTIAINEN E, 1993, AM J OTOL, V14, P507 VARTIAINEN E, 1992, INT J PEDIATR OTORHI, V24, P201, DOI 10.1016/0165-5876(92)90017-J Veldman JE, 1998, ANN OTO RHINOL LARYN, V107, P486 NR 27 TC 8 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 150 EP 155 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500012 PM 16514799 ER PT J AU Hahn, MS Kobler, JB Starcher, BC Zeitels, SM Langer, R AF Hahn, MS Kobler, JB Starcher, BC Zeitels, SM Langer, R TI Quantitative and comparative studies of the vocal fold extracellular matrix - I: Elastic fibers and hyaluronic acid SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE animal model; elastin; hyaluronic acid; lamina propria; quantitative histology; tropoelastin ID LAMINA PROPRIA; LAYER; SKIN AB Objectives: This study examines the elastic fiber and hyaluronic acid (HA) content of the midmembranous vocal fold laminae propriae (LPs) of humans, dogs, pigs, and ferrets. Methods: Lamina propria elastin was quantified by measuring the amino acid desmosine, and HA was measured by an enzyme-linked immunosorbent assay-based technique. Quantitative histology was used to evaluate elastin and HA levels in specific LP regions. The distributions of fibrillin-1, a primary microfibrillar component of elastic fibers, and of tropoelastin, an indicator of elastin synthesis, were immunohistochemically analyzed. Results: Elastin and HA constituted 8.5% 2.1% and 0.82% 0.11% of human LP, respectively, relative to tissue total protein. Although the mean LP desmosine levels were similar across species, the mean HA levels in canine (p < 3.1 x 10(-5)), porcine (p < 1.5 x 10(-5)), and ferret (p < 6.6 x 10(-4)) LPs were 3 to 4 times higher than that in humans. Marked interspecies differences in elastin, fibrillin-1, tropoelastin, and HA distributions were observed histologically. Conclusions: The elastin content of the human LP is roughly twice that of the dermis, whereas the HA content of the human LP is similar to that of the dermis. Although all species had similar levels of desmosine, histologic evaluation indicates that the porcine elastin distribution is most similar to that of the human LP. Fibrillin-1 staining suggests that stress in the human LP may be particularly high in the superior superficial layer, and tropoelastin staining indicates that the rate of LP elastin turnover may vary spatially. C1 Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Dept Surg, Boston, MA 02114 USA. MIT, Dept Elect Engn & Comp Sci, Boston, MA USA. MIT, Dept Chem Engn, Boston, MA USA. Harvard Univ, Sch Med, Boston, MA 02115 USA. Univ Texas, Hlth Sci Ctr Tyler, Dept Biomed Res, Tyler, TX 75710 USA. RP Zeitels, SM (reprint author), Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Dept Surg, 1 Bowdoin Sq,11th Floor, Boston, MA 02114 USA. CR Butler JE, 2001, LARYNGOSCOPE, V111, P907, DOI 10.1097/00005537-200105000-00029 Chan RW, 2001, OTOLARYNG HEAD NECK, V124, P607, DOI 10.1067/mhn.2001.115906 Culav EM, 1999, PHYS THER, V79, P308 DAVIDSON JM, 1993, J CELL PHYSIOL, V155, P149, DOI 10.1002/jcp.1041550119 Debelle L, 1999, INT J BIOCHEM CELL B, V31, P261, DOI 10.1016/S1357-2725(98)00098-3 Ding H, 2001, J SPEECH LANG HEAR R, V44, P317, DOI 10.1044/1092-4388(2001/026) FOSANG AJ, 1990, MATRIX, V10, P306 Garrett CG, 2000, LARYNGOSCOPE, V110, P814, DOI 10.1097/00005537-200005000-00011 Gray SD, 2000, ANN OTO RHINOL LARYN, V109, P77 Gunter HE, 2003, J ACOUST SOC AM, V113, P994, DOI 10.1121/1.1534100 Hahn MS, 2005, ANN OTO RHINOL LARYN, V114, P451 Hammond TH, 1997, J VOICE, V11, P59, DOI 10.1016/S0892-1997(97)80024-0 Hammond TH, 1998, OTOLARYNG HEAD NECK, V119, P314, DOI 10.1016/S0194-5998(98)70071-3 Hascall VC, HYALURONAN STRUCTURE Ishii K, 2000, ANN OTO RHINOL LARYN, V109, P1055 Kielty CM, 2002, J CELL SCI, V115, P2817 KING GS, 1980, CONNECT TISSUE RES, V7, P263, DOI 10.3109/03008208009152362 KURITA S, 1983, COMP STUDY LAYER STR, P3 LAURENT TC, 1992, FASEB J, V6, P2397 Luo Y., 2002, METHODS TISSUE ENG, P539, DOI 10.1016/B978-012436636-7/50160-9 Ramirez F, 1999, INT J BIOCHEM CELL B, V31, P255, DOI 10.1016/S1357-2725(98)00109-5 Sato K, 1997, ANN OTO RHINOL LARYN, V106, P44 Seibel MJ, 1999, DYNAMICS BONE CARTIL Sheehan D, 1980, THEORY PRACTICE HIST STARCHER BC, 1976, ANAL BIOCHEM, V74, P441, DOI 10.1016/0003-2697(76)90224-4 Zhou RX, 1996, MED PHYS, V23, P1977, DOI 10.1118/1.597841 NR 26 TC 50 Z9 51 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2006 VL 115 IS 2 BP 156 EP 164 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 012GY UT WOS:000235327500013 PM 16514800 ER PT J AU Derkay, CS Darrow, DH AF Derkay, CS Darrow, DH TI Recurrent respiratory papillomatosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cidofovir; human papillomavirus; interferon; microdebrider; recurrent respiratory papilloma; vaccine ID HUMAN-PAPILLOMAVIRUS INFECTION; DYE-LASER TREATMENT; JUVENILE-ONSET; LARYNGEAL PAPILLOMAS; INTRALESIONAL CIDOFOVIR; RISK-FACTORS; PERINATAL TRANSMISSION; VERTICAL TRANSMISSION; NATIONAL REGISTRY; CHILDREN AB Recurrent respiratory papillomatosis is a frustrating and challenging disease for surgeons, patients, and patients' families. Although the voice and airway manifestations are managed surgically, a "cure" for this disease remains elusive. In this edition of the "Seminar Series," we endeavor to review the current literature regarding the epidemiology, etiology, clinical manifestations, and surgical and medical treatments of this disorder. The key to future management of recurrent respiratory papillomatosis may lie in its prevention, if current efforts to develop an effective vaccine conic to fruition. C1 Eastern Virginia Med Sch, Dept Otolaryngol, Norfolk, VA 23507 USA. Eastern Virginia Med Sch, Dept Pediat, Norfolk, VA 23507 USA. Childrens Hosp Kings Daughters, Dept Pediat Otolaryngol, Norfolk, VA USA. RP Derkay, CS (reprint author), Eastern Virginia Med Sch, Dept Otolaryngol, 825 Fairfax Ave,Suite 510, Norfolk, VA 23507 USA. CR Aaltonen LM, 2002, LARYNGOSCOPE, V112, P700, DOI 10.1097/00005537-200204000-00020 Abramson AL, 2004, J MED VIROL, V72, P473, DOI 10.1002/jmv.20013 ABRAMSON AL, 1987, LARYNGOSCOPE, V97, P678 Armbruster C, 2002, EXPERT OPIN INV DRUG, V11, P1139, DOI 10.1517/13543784.11.8.1139 Armstrong LR, 1999, ARCH OTOLARYNGOL, V125, P743 Armstrong LR, 2000, CLIN INFECT DIS, V31, P107, DOI 10.1086/313914 BENNETT RS, 1987, PEDIATR INFECT DIS J, V6, P229, DOI 10.1097/00006454-198703000-00001 Bergler W, 1997, J LARYNGOL OTOL, V111, P381 Bielamowicz S, 2002, LARYNGOSCOPE, V112, P696, DOI 10.1097/00005537-200204000-00019 Bower CM, 1998, ANN OTO RHINOL LARYN, V107, P1001 Buchinsky FJ, 2004, LARYNGOSCOPE, V114, P349, DOI 10.1097/00005537-200402000-00032 Chhetri DK, 2002, OTOLARYNG HEAD NECK, V126, P642, DOI 10.1067/mhn.2002.125604 Co J, 2004, ANN OTO RHINOL LARYN, V113, P859 Cohn A M, 1981, Am J Otolaryngol, V2, P129, DOI 10.1016/S0196-0709(81)80030-0 COLE RR, 1989, HEAD NECK-J SCI SPEC, V11, P226, DOI 10.1002/hed.2880110306 Dean C, 1998, Ear Nose Throat J, V77, P882 Derkay CS, 1998, LARYNGOSCOPE, V108, P935, DOI 10.1097/00005537-199806000-00026 Derkay CS, 2005, ANN OTO RHINOL LARYN, V114, P730 DERKAY CS, 1995, ARCH OTOLARYNGOL, V121, P1386 Ho GYF, 1998, NEW ENGL J MED, V338, P423, DOI 10.1056/NEJM199802123380703 Holland BW, 2002, LARYNGOSCOPE, V112, P1926, DOI 10.1097/00005537-200211000-00003 KASHIMA H, 1993, ANN OTO RHINOL LARYN, V102, P580 KASHIMA HK, 1992, LARYNGOSCOPE, V102, P9 Kosko JR, 1996, INT J PEDIATR OTORHI, V35, P31, DOI 10.1016/0165-5876(95)01279-6 Koutsky LA, 2002, NEW ENGL J MED, V347, P1645, DOI 10.1056/NEJMoa020586 KOUTSKY LA, 1989, OBSTET GYN CLIN N AM, V16, P541 LINDEBERG H, 1990, CLIN OTOLARYNGOL, V15, P125, DOI 10.1111/j.1365-2273.1990.tb00444.x MCGLENNEN RC, 1993, HEAD NECK-J SCI SPEC, V15, P504, DOI 10.1002/hed.2880150605 McMillan K, 1998, LARYNGOSCOPE, V108, P968, DOI 10.1097/00005537-199807000-00003 MORGAN A H, 1986, Ear Nose and Throat Journal, V65, P22 MOUNTS P, 1982, P NATL ACAD SCI-BIOL, V79, P5425, DOI 10.1073/pnas.79.17.5425 NEWFIELD L, 1993, ANTICANCER RES, V13, P337 Pasquale K, 2003, LARYNGOSCOPE, V113, P139, DOI 10.1097/00005537-200301000-00026 Patel N, 2003, ANN OTO RHINOL LARYN, V112, P7 POU AM, 1995, ANN OTO RHINOL LARYN, V104, P758 Pransky SM, 2000, ARCH OTOLARYNGOL, V126, P1239 Pransky SM, 1999, ARCH OTOLARYNGOL, V125, P1143 Puranen M, 1996, AM J OBSTET GYNECOL, V174, P694, DOI 10.1016/S0002-9378(96)70452-0 Reeves WC, 2003, ARCH OTOLARYNGOL, V129, P976, DOI 10.1001/archotol.129.9.976 RIHKANEN H, 1993, CLIN OTOLARYNGOL, V18, P470, DOI 10.1111/j.1365-2273.1993.tb00616.x Rimell FL, 1997, LARYNGOSCOPE, V107, P915, DOI 10.1097/00005537-199707000-00015 Rosen CA, 1998, OTOLARYNG HEAD NECK, V118, P810, DOI 10.1016/S0194-5998(98)70274-8 Ruparelia S, 2003, ARCH OTOLARYNGOL, V129, P1275, DOI 10.1001/archotol.129.12.1275 Schraff S, 2004, ARCH OTOLARYNGOL, V130, P1039, DOI 10.1001/archotol.130.9.1039 SHAH K, 1986, OBSTET GYNECOL, V68, P795 Shah KV, 1998, PEDIATR INFECT DIS J, V17, P372, DOI 10.1097/00006454-199805000-00005 Shapiro AM, 1996, ANN OTO RHINOL LARYN, V105, P1 Shikowitz MJ, 2005, ARCH OTOLARYNGOL, V131, P99, DOI 10.1001/archotol.131.2.99 Silver RD, 2003, OTOLARYNG HEAD NECK, V129, P622, DOI 10.1016/j.otohns.2003.08.018 Silverberg MJ, 2003, OBSTET GYNECOL, V101, P645, DOI 10.1016/S0029-7844(02)03081-8 Silverberg MJ, 2004, ARCH OTOLARYNGOL, V130, P711, DOI 10.1001/archotol.130.6.711 SMITH EM, 1993, ARCH OTOLARYNGOL, V119, P554 SMITH EM, 1991, ANN OTO RHINOL LARYN, V100, P479 Snoeck R, 1998, J MED VIROL, V54, P219, DOI 10.1002/(SICI)1096-9071(199803)54:3<219::AID-JMV13>3.0.CO;2-C Snowden RT, 2001, LARYNGOSCOPE, V111, P404, DOI 10.1097/00005537-200103000-00007 Steinberg BM, 1996, CANCER METAST REV, V15, P91, DOI 10.1007/BF00049489 STEINBERG BM, 1983, NEW ENGL J MED, V308, P1261, DOI 10.1056/NEJM198305263082104 Tenti P, 1999, OBSTET GYNECOL, V93, P475, DOI 10.1016/S0029-7844(98)00459-1 Tseng CJ, 1998, OBSTET GYNECOL, V91, P92, DOI 10.1016/S0029-7844(97)00593-0 Wiatrak BJ, 2004, LARYNGOSCOPE, V114, P1, DOI 10.1097/01.mlg.000148224.83491.0f Zeitels SM, 2002, OTOLARYNG HEAD NECK, V126, P333, DOI 10.1067/mhn.2002.123546 Zeitels SM, 1999, J VOICE, V13, P123, DOI 10.1016/S0892-1997(99)80066-6 NR 62 TC 36 Z9 39 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 1 EP 11 PG 11 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200001 PM 16466093 ER PT J AU Davies, L Hardin, NJ Beatty, BG AF Davies, L Hardin, NJ Beatty, BG TI Can Ki-67 predict recurrence of NO squamous cell carcinoma of the tongue? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE head and neck cancer; Ki-67; molecular marker; squamous cell carcinoma ID LARYNGEAL-CANCER; PROLIFERATION; PROGNOSIS; ANTIGEN; NECK; PCNA; HEAD; P53 AB Objectives: Ki-67 is a molecular marker of cellular proliferation that predicts prognosis of some head and neck tumors. Studies of Ki-67 in oropharyngeal cancer have yielded conflicting findings. This study was designed to test Ki-67 as a marker for poor prognosis in NO tongue squamous cell carcinoma. Methods: We examined 29 cases in a retrospective cohort to test the hypothesis that a high rate of tumor cell proliferation (high levels of Ki-67 staining) at the invasive edge of NO squamous cell carcinoma of the tongue correlates with increased risk of recurrence. Results: There were 14 cases of recurrence. The average age of the patients with recurrence was 58 years. The average time to recurrence was 13.1 months. A 0% to 33% uptake of Ki-67 at the tumor's leading edge was associated with a 6times-greater risk of recurrence. The mean length of survival for the group with 0% to 33% uptake was 21 months; for the group with > 33% uptake, it was 33 months. Overall uptake of Ki-67 and histologic grade did not correlate with risk of recurrence. Conclusions: In this sample, low rates of Ki-67 staining at the invasive edge of the tumor predicted a risk of recurrence. These results need to be confirmed before Ki-67 can be used for predicting recurrence of tongue squamous cell carcinoma. C1 Fletcher Allen Hlth Care Univ Vermont, Div Otolaryngol, Burlington, VT USA. Fletcher Allen Hlth Care Univ Vermont, Dept Pathol, Burlington, VT USA. RP Davies, L (reprint author), VA Outcomes Grp, White River Junct VAMC, 111B,25 N Main St, White River Jct, VT 05009 USA. CR BROWN DC, 1990, HISTOPATHOLOGY, V17, P489, DOI 10.1111/j.1365-2559.1990.tb00788.x Chino O, 1998, J SURG ONCOL, V67, P18, DOI 10.1002/(SICI)1096-9098(199801)67:1<18::AID-JSO4>3.0.CO;2-P Golusinski W, 1999, EUR ARCH OTO-RHINO-L, V256, P306, DOI 10.1007/s004050050252 Gonzalez-Moles M A, 1996, Acta Stomatol Belg, V93, P159 Hagedorn HG, 1998, ANAL CELL PATHOL, V16, P177 Jacob R, 1996, LARYNGOSCOPE, V106, P1170, DOI 10.1097/00005537-199609000-00023 Krecicki T, 1998, CLIN OTOLARYNGOL, V23, P539, DOI 10.1046/j.1365-2273.1998.2360539.x Krecicki T, 1999, ORAL ONCOL, V35, P180 Matsumoto M, 1999, J Oral Sci, V41, P53 Nylander K, 1997, ANAL CELL PATHOL, V14, P101 Piffko J, 1996, VIRCHOWS ARCH, V429, P229 Pignataro L, 1998, J LARYNGOL OTOL, V112, P455 Pulkkinen JO, 1997, ACTA OTO-LARYNGOL, V117, P312, DOI 10.3109/00016489709117794 Valente G, 1999, ONCOL REP, V6, P289 Zhang X D, 1998, Dis Esophagus, V11, P215 NR 15 TC 7 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 12 EP 17 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200002 PM 16466094 ER PT J AU Tessema, B Sulica, L Yu, GP Sessions, RB AF Tessema, B Sulica, L Yu, GP Sessions, RB TI Tongue paresthesia and dysgeusia following operative microlaryngoscopy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE complication; dysaeusia; lingual nerve; microlarynaoscopy; paresthesia; tongue ID LINGUAL NERVE INJURY; DIRECT LARYNGOSCOPY; COMPLICATIONS; INTUBATION; AIRWAY AB Objectives: This study was performed to assess the overall incidence and duration of alterations in tongue sensation and taste after operative microlaryngoscopy, and the relation of these symptoms to operative time. Methods: We performed a retrospective review of information regarding tongue symptoms in patients who completed standard post-microlaryngoscopy follow-up at I week, I month, and 3 months. Results: One hundred patients (54 male and 46 female; mean age, 46 years; age range, 14 to 83 years) met the inclusion criteria. Eighteen patients had positive findings at I week: 15 complained of paresthesia and 3 of dysgeusia. The symptoms decreased over time without treatment (4% of patients at I month and 1% of patients at 3 months). Only I case of dysgeusia persisted past 3 months. Gender was found to be a significant independent risk factor for the development of symptoms (odds ratio, 5.63; 95% confidence interval, 1.36 to 31.29; p =.013). Patients whose operations lasted longer than I hour were almost 4 times more likely to develop tongue-related symptoms than those with an operative time less than 30 minutes, although these findings did not achieve statistical significance (odds ratio, 3.91; 95% confidence interval, 0.62 to 30.95; p =.182). Conclusions: Alterations in tongue sensation and taste, most likely due to lingual nerve injury, are common after microlaryngoscopy, especially in female patients. They also tend to be associated with longer operative times. Although transient in nearly every case, lingual paresthesia and dysgeusia should form part of the preoperative discussion with the patient. C1 Beth Israel Med Ctr, Dept Otolaryngol, New York, NY 10003 USA. New York Eye & Ear Infirm, Dept Otolaryngol, New York, NY 10003 USA. RP Sulica, L (reprint author), Beth Israel Med Ctr, Dept Otolaryngol, 10 Union Sq E,Suite 4J, New York, NY 10003 USA. CR Armstrong M, 1997, LARYNGOSCOPE, V107, P1060, DOI 10.1097/00005537-199708000-00011 Gaut A, 2000, ARCH OTOLARYNGOL, V126, P669 Graff-Radford SB, 2003, HEADACHE, V43, P975, DOI 10.1046/j.1526-4610.2003.03189.x HENDRIX RA, 1994, OTOLARYNG HEAD NECK, V110, P510 HILL RS, 1987, ANN OTO RHINOL LARYN, V96, P691 JAMES FM, 1975, ANESTHESIOLOGY, V42, P359, DOI 10.1097/00000542-197503000-00022 JONES BC, 1971, BRIT J ANAESTH, V43, P730 Klussmann JP, 2002, ANN OTO RHINOL LARYN, V111, P972 Laffon M, 2001, ANESTHESIOLOGY, V94, P719, DOI 10.1097/00000542-200104000-00041 Laxton CH, 1996, ANAESTHESIA, V51, P869, DOI 10.1111/j.1365-2044.1996.tb12621.x LOUGHMAN E, 1983, ANAESTH INTENS CARE, V11, P171 Muller A, 2002, HNO, V50, P1057, DOI 10.1007/s00106-002-0640-x ROBINSON PM, 1991, J LARYNGOL OTOL, V105, P356, DOI 10.1017/S0022215100115981 SILVA DA, 1992, ANESTHESIOLOGY, V76, P650, DOI 10.1097/00000542-199204000-00028 TEICHNER RL, 1971, BRIT J ANAESTH, V43, P413, DOI 10.1093/bja/43.4.413 WINTER R, 1989, ANESTHESIOLOGY, V71, P452, DOI 10.1097/00000542-198909000-00025 NR 16 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 18 EP 22 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200003 PM 16466095 ER PT J AU Yokoyama, S Kano, M Watanabe, M Ogawa, H Omori, K AF Yokoyama, S Kano, M Watanabe, M Ogawa, H Omori, K TI Morphological and histologic examination of the epiglottis: Implications for improving epiglottic closure technique SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE aspiration pneumonia; epiglottic cartilage; epialottic closure; epiglottis ID ASPIRATION AB Objectives: We conducted a histologic examination and measured the tension on the epiglottis to determine how dehiscence of the epiglottis can be prevented after epiglottic closure surgery. Methods: We classified configurations of the epiglottis into flat. intermediate, and omega types and studied the histology of each type. We also measured the tension in each of these 3 morphological types on 4 regions of the epialottis (upper, middle, and lower points, and the cuneiform tubercle) at 3 different times: before incision, after median incision, and after reversed-Y incision. Results: No histologic differences were evident among the epiglottic types. In the flat and intermediate types, the tension measured before incision decreased significantly upon completion of the median incision at every point. In these 2 types, the reversed-Y incision resulted in a further significant decrease in tension at the middle and lower points. In the omega type, the tension was low before incision and was not significantly reduced by either incision. Conclusions: We demonstrated that a median incision alone effectively decreased tension sufficiently to prevent dehiscence. The reversed-Y incision was even more effective for decreasing tension at the middle and lower points. C1 Fukushima Med Univ, Sch Med, Dept Otolaryngol, Fukushima 9601247, Japan. RP Omori, K (reprint author), Fukushima Med Univ, Sch Med, Dept Otolaryngol, 1 Hikarigaoka, Fukushima 9601247, Japan. CR AOKI K, 1993, J ADULT DIS, V23, P1760 BILLER HF, 1983, ARCH OTOLARYNGOL, V109, P69 COX RW, 1977, J ANAT, V123, P283 ENDO N, 1972, J JPN BRONCHOESOPHAG, V23, P322 LINDEMAN RC, 1975, LARYNGOSCOPE, V85, P157, DOI 10.1288/00005537-197501000-00012 MEITELES LZ, 1993, LARYNGOSCOPE, V103, P1395 ROTHER P, 1975, Zeitschrift fuer Mikroskopisch-Anatomische Forschung (Leipzig), V89, P839 TANABE M, 1992, JPN BROCHOESOPHAGOL, V43, P348 TANAKA F, 1996, OTOLOGIA FUKUOKA, V42, P354 TERADA A, 1999, PRACT OTOLOGIAC KYOT, V92, P509 NR 10 TC 1 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 23 EP 29 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200004 PM 16466096 ER PT J AU Schweinfurth, JM AF Schweinfurth, JM TI Endoscopic treatment of severe tracheal stenosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE dilation; endoscopy; incision; stent; tracheal stenosis ID DIOXIDE LASER-SURGERY AB Objectives: Endoscopic treatment of subglottic and tracheal stenosis has traditionally been reserved for short-segment and web-like stenoses with normal cartilage. This retrospective case series review was undertaken to examine my experience with definitive endoscopic treatment for circumferential and complete tracheal stenosis with loss of cartilaginous support. Methods: Patients who presented with tracheostomy dependence or dyspnea as a result of clinically significant tracheal stenosis over a 2-year period were treated endoscopically. Mitomycin C was applied after dilation in 19 patients. Three patients with complete stenosis and cartilage collapse underwent endoscopic placement of a silicone elastic stent, which was in place for less than 23 days. Results: Twenty patients were treated for tracheal stenosis over a 2-year period. No surgical complications were observed after operation in the endoscopic treatment group. Three of 6 patients with complete stenoses and 8 of 10 patients with circumferential stenoses with cartilage involvement gained airways that remained patent. Nine patients' stenoses resolved after the initial treatment. Three patients (15%) eventually required tracheal resection. The follow-up periods ranged from 5 to 25 months. Conclusions: Although some limitations apply, severe and complete tracheal stenoses may be successfully treated endoscopically with the techniques described. Definitive endoscopic treatment may be considered before tracheal resection in select cases. Endoscopic treatment is associated with few complications, low morbidity, a short operative time, and a short length of hospitalization. C1 Univ Mississippi, Med Ctr, Dept Otolaryngol, Jackson, MS 39216 USA. RP Schweinfurth, JM (reprint author), Univ Mississippi, Med Ctr, Dept Otolaryngol, 2500 N State St, Jackson, MS 39216 USA. CR JACKSON C, 1915, PERORAL ENDOSCOPY LA OSSOFF RH, 1985, LARYNGOSCOPE, V95, P1220 SHAPSHAY SM, 1987, ANN OTO RHINOL LARYN, V96, P661 STRONG MS, 1974, ANN OTO RHINOL LARYN, V83, P769 NR 4 TC 8 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 30 EP 34 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200005 PM 16466097 ER PT J AU Andrews, BT McCulloch, TM Funk, GF Graham, SM Hoffman, HT AF Andrews, BT McCulloch, TM Funk, GF Graham, SM Hoffman, HT TI Deltopectoral flap revisited in the microvascular era: A single-institution 10-year experience SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE Bakamjian flap; deltopectoral flap; pedicled flap ID NECK RECONSTRUCTION; PLASTIC-SURGERY; HEAD AB Objectives: In 1965, Bakamjian described the deltopectoral (DP) flap as a reconstructive option in head and neck surgery. It served as the premier flap for reconstructing complex head and neck defects until the late 1970s. Today, the DP flap is often overlooked; although its role has diminished, its use is still warranted in certain select clinical situations. Methods: A retrospective patient chart review of 25 DP flap procedures performed at the University of Iowa Hospitals and Clinics and Iowa City Veterans Administration Hospital between January 1, 1991, and June I 2002, was undertaken. The data collected included patient demographics and assessment of DP flap survival and its ability to accomplish established preoperative reconstructive goals. Results: The DP flap was used for the following situations: vascularized skin coverage of the neck, carotid arteries, and face (16 cases), including simultaneous coverage of other reconstructive flaps in 6 cases, controlled orocutaneous fistula development Q cases) or fistula closure (5 cases); and pharyngoesophageal reconstruction (4 cases). In 3 cases the flap was used for more than one of the preoperative goals described above (n = 25). Minor flap-related complications that required local wound treatment developed in 5 cases (20.0%), but the flaps were successfully salvaged and no subsequent reconstructive procedure was required. In an additional 5 cases (20.0%), the flap failed in some measure to accomplish its preoperative goal, necessitating further surgical reconstruction. Sixteen patients (64%) had undergone previous or simultaneous reconstructive procedures that limited other available reconstructive options. Conclusions: The technical simplicity of the DP flap, coupled with its predictable vascular supply, has allowed it to maintain a niche role in contemporary reconstructive surgery. The DP flap provides an excellent method of reconstruction in select cases in which vascularized skin coverage of the neck is needed. The DP flap also provides a valuable salvage option in situations in which other reconstructive techniques are not possible. C1 Univ Iowa Hlth Care, Dept Otolaryngol, Iowa City, IA 52242 USA. Univ Iowa, Coll Med, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. RP Andrews, BT (reprint author), Univ Iowa Hlth Care, Dept Otolaryngol, HNS-21272 PFP,200 Hawkins Dr, Iowa City, IA 52242 USA. CR Aymard JL, 1917, LANCET, V2, P888 BAKAMJIAN V Y, 1965, Plast Reconstr Surg, V36, P173 Bakamjian V Y, 1971, Br J Plast Surg, V24, P174, DOI 10.1016/S0007-1226(71)80037-1 Blackwell KE, 1997, HEAD NECK-J SCI SPEC, V19, P620, DOI 10.1002/(SICI)1097-0347(199710)19:7<620::AID-HED10>3.0.CO;2-6 CHAFFOO RAK, 1988, LARYNGOSCOPE, V98, P460 GILAS T, 1986, AM J SURG, V152, P430, DOI 10.1016/0002-9610(86)90318-1 Kingdom TT, 1996, LARYNGOSCOPE, V106, P1230, DOI 10.1097/00005537-199610000-00011 KIRKBY B, 1980, SCAND J PLAST RECONS, V14, P151 KRAG C, 1980, SCAND J PLAST RECONS, V14, P145 KRIZEK TJ, 1972, SURG GYNECOL OBSTETR, V135, P787 KRIZEK TJ, 1972, PLAST RECONSTR SURG, V50, P326, DOI 10.1097/00006534-197210000-00002 LASH H, 1977, PLAST RECONSTR SURG, V59, P235 MENDELSON BC, 1977, PLAST RECONSTR SURG, V59, P360, DOI 10.1097/00006534-197703000-00008 PARK JS, 1974, AM J SURG, V128, P548, DOI 10.1016/0002-9610(74)90273-6 RISTOW BVB, 1972, PLAST RECONSTR SURG, V49, P570, DOI 10.1097/00006534-197205000-00027 SOFFERMAN RA, 1979, LARYNGOSCOPE, V89, P1326 TIWARI RM, 1981, HEAD NECK SURG, V3, P379, DOI 10.1002/hed.2890030506 NR 17 TC 10 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 35 EP 40 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200006 PM 16466098 ER PT J AU Rohit Piccirillo, E Jain, Y Augurio, A Sanna, M AF Rohit Piccirillo, E Jain, Y Augurio, A Sanna, M TI Preoperative predictive factors for hearing preservation in vestibular schwannoma surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE hearing preservation; modified Sanna classification; predictive factor; vestibular schwannoma ID ACOUSTIC NEUROMA SURGERY; TUMOR SURGERY; PROGNOSTIC-FACTORS; CONSERVATION; NERVE AB Objectives: We performed a retrospective chart review to evaluate the various predictive factors for postoperative hearing preservation in the surgical management of vestibular schwannoma. Methods: Of 792 patients operated on for vestibular schwannoma between April 1987 and July 2002. 107 were candidates for hearing preservation surgery. These patients were divided into group I (hearing preserved) and group 2 (hearing not preserved), and both of these groups were evaluated for age, sex, pure tone average, sound discrimination score, tumor size, and auditory brain stem response parameters. A corrected chi(2) test and a corrected t-test were used for statistical analysis. Multiple regression analysis was further done to evaluate independent predictive factors. either alone or in combination. The results were evaluated by use of the modified Sanna classification and the guidelines of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). Results: Preoperative pure tone average and tumor size were the 2 predictive factors in our study. A Pearson correlation test showed that there was no multicollinearity between the factors. On multiple regression analysis by backward elimination of nonsignificant factors, we found that tumor size is an independent predictive factor for postoperative hearing. According to the modified Sanna classification, postoperative hearing was preserved in 11.2% of patients (equivalent to class A of AAO-HNS guidelines). Conclusions: In our series, preoperative pure tone average and tumor size were found to be predictors of postoperative hearing levels. C1 Grp Otol, I-29100 Piacenza, Italy. RP Sanna, M (reprint author), Grp Otol, Via Emmanueli 42, I-29100 Piacenza, Italy. CR Arriaga MA, 1997, LARYNGOSCOPE, V107, P1043, DOI 10.1097/00005537-199708000-00007 Brackmann DE, 2000, AM J OTOL, V21, P417, DOI 10.1016/S0196-0709(00)80054-X COHEN NL, 1993, AM J OTOL, V14, P423 Committee on Hearing and Equilibrium, 1995, OTOLARYNGOL HEAD NEC, V113, P179 DORNHOFFER JL, 1995, LARYNGOSCOPE, V105, P184, DOI 10.1288/00005537-199502000-00014 Dugar J, 2002, LARYNGOSCOPE, V112, P2051, DOI 10.1097/00005537-200211000-00026 Ferber-Viart C, 2000, LARYNGOSCOPE, V110, P145, DOI 10.1097/00005537-200001000-00026 FISCHER G, 1992, J NEUROSURG, V76, P910, DOI 10.3171/jns.1992.76.6.0910 GLASSCOCK ME, 1993, J NEUROSURG, V78, P864, DOI 10.3171/jns.1993.78.6.0864 HAINES SJ, 1993, J NEUROSURG, V79, P515, DOI 10.3171/jns.1993.79.4.0515 Holsinger FC, 2000, AM J OTOL, V21, P695 JOSEY AF, 1988, ANN OTO RHINOL LARYN, V97, P626 KEMINK JL, 1990, LARYNGOSCOPE, V100, P597 KOOS WT, 1985, MICRONEUROSURGERY, P335 MANGHAM CA, 1992, AM J OTOL, V13, P137 Moller AR, 1996, AM J OTOL, V17, P452 Moriyama T, 2002, J NEUROSURG, V97, P337, DOI 10.3171/jns.2002.97.2.0337 NADOL JB, 1992, LARYNGOSCOPE, V102, P1153, DOI 10.1288/00005537-199210000-00010 POST KD, 1995, J NEUROSURG, V83, P191, DOI 10.3171/jns.1995.83.2.0191 RASTOGI P, 1995, SKULL BASE SURG, V5, P137, DOI 10.1055/s-2008-1058927 Robinette MS, 1997, AM J OTOL, V18, P738 Samii M, 1997, NEUROSURGERY, V40, P248, DOI 10.1097/00006123-199702000-00005 Sanna M, 1998, ATLAS ACOUSTIC NEURI SANNA M, 2003, ACOUSTIC NEUROMA CON, V10, P169 SHELTON C, 1989, ARCH OTOLARYNGOL, V115, P1213 Slatterly W, 1997, AM J OTOL, V18, P796 Staecker H, 2000, AM J OTOL, V21, P399, DOI 10.1016/S0196-0709(00)80051-4 Tos Mirko, 2003, VVolume 10, P161 VALENTE M, 2002, STRATEGIES SELECTING, P257 NR 29 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 41 EP 46 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200007 PM 16466099 ER PT J AU Johnston, N Dettmar, PW Lively, MO Postma, GN Belafsky, PC Birchall, M Koufman, JA AF Johnston, N Dettmar, PW Lively, MO Postma, GN Belafsky, PC Birchall, M Koufman, JA TI Effect of pepsin on laryngeal stress protein (Sep70, Sep53, and Hsp70) response: Role in laryngopharyngeal reflux disease SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE laryngopharyngeal reflux; pepsin; reflux; stress protein ID MOLECULAR CHAPERONES; EPITHELIAL DEFENSES; CELL BIOLOGY; CARCINOMA; HEALTH AB Objectives: The objectives of this study were to define the conditions that give rise to a stress protein response in laryngeal epithelium and to investigate whether and how stress protein dysfunction contributes to reflux-related laryngeal disease. Methods: Western analysis was used to measure stress protein (squamous epithelial proteins Sep70 and Sep53 and heat shock protein Hsp70) and pepsin levels in esophageal and laryngeal tissue specimens taken from both normal control subjects and patients with pH-documented laryngopharyngeal reflux (LPR) who had documented lesions, some of whom had laryngeal cancer. A porcine organ culture model was used to examine the effects of low pH and pepsin (0.1% pore cine pepsin A) on stress protein levels. A laryngeal squamous carcinoma (FaDu) cell line was used to examine uptake of human pepsin 3b-tetramethyl-5 and -6 isothiocyanate. Results: Sep70, Sep53, and Hsp70 were found to be expressed at high levels, and pepsin was not detected, in esophageal and laryngeal specimens taken from normal control subjects and in esophageal specimens taken from LPR patients. The patients with LPR were found to have significantly less laryngeal Sep70 (p=.027) and marginally less laryngeal Sep53 (p=.056) than the normal control subjects. Laryngeal Hsp70 was expressed at high levels in the LPR patients. The patients with laryngeal cancer had significantly lower levels of Sep70, Sep53 (p <.01), and Hsp70 (p <.05) than the normal control subjects. A significant association was found between the presence of pepsin in laryngeal epithelium from LPR patients and depletion of laryngeal Sep70 (p <.001). Using the organ culture model, we demonstrated that laryngeal Sep70 and Sep53 proteins are induced after exposure to low pH. However, in the presence of pepsin, Sep70 and Sep53 levels are depleted. Confocal microscopy analysis of cultured cells exposed to labeled pepsin revealed that uptake is by receptor-mediated endocytosis. Conclusions: These findings suggest that receptor-mediated uptake of pepsin by laryngeal epithelial cells, as may occur in LPR, causes a change in the normal acid-mediated stress protein response. This altered stress protein response may lead to cellular injury and thus play a role in the development of disease. C1 Wake Forest Univ Hlth Sci, Ctr Voice & Swallowing Disorders, Dept Otolaryngol, Winston Salem, NC 27157 USA. Univ Calif Davis, Ctr Voice & Swallowing, Dept Otolaryngol Head & Neck Surg, Med Ctr, Sacramento, CA 95817 USA. Univ Liverpool, Univ Hosp Aintree, Div Surg & Oncol, Liverpool L69 3BX, Merseyside, England. RP Johnston, N (reprint author), Wake Forest Univ Hlth Sci, Ctr Voice & Swallowing Disorders, Dept Otolaryngol, Med Ctr Blvd, Winston Salem, NC 27157 USA. CR Axford SE, 2001, ANN OTO RHINOL LARYN, V110, P1099 BORTOLOTTI M, 1989, GUT, V30, P233, DOI 10.1136/gut.30.2.233 CHERRY J, 1968, LARYNGOSCOPE, V78, P1937, DOI 10.1288/00005537-196811000-00007 Delahunty J E, 1972, J Laryngol Otol, V86, P335, DOI 10.1017/S0022215100075356 Hartl FU, 1996, NATURE, V381, P571, DOI 10.1038/381571a0 Johnson PE, 2001, LARYNGOSCOPE, V111, P1970, DOI 10.1097/00005537-200111000-00019 Johnston N, 2004, LARYNGOSCOPE, V114, P2129, DOI 10.1097/01.mlg.0000149445.07146.03 Johnston N, 2003, ANN OTO RHINOL LARYN, V112, P481 KOUFMAN JA, 1991, LARYNGOSCOPE S, V53, P101 Liang P, 1997, J CELL SCI, V110, P1431 MINOWADA G, 1995, J CLIN INVEST, V95, P3, DOI 10.1172/JCI117655 MORRISON MD, 1988, OTOLARYNG HEAD NECK, V99, P370 Papapetropoulos N, 2004, PHARMACOLOGY, V72, P167, DOI 10.1159/000080101 Postma GN, 2000, ANN OTO RHINOL LARYN, V109, P10 RANGAN SRS, 1972, CANCER, V29, P117, DOI 10.1002/1097-0142(197201)29:1<117::AID-CNCR2820290119>3.0.CO;2-R Vaezi Michael F, 2003, Clin Cornerstone, V5, P32, DOI 10.1016/S1098-3597(03)90097-4 WARD PH, 1988, LARYNGOSCOPE, V98, P1195 Welch WJ, 1996, CELL STRESS CHAPERON, V1, P207 Yagui-Beltran A, 2001, EUR J BIOCHEM, V268, P5343, DOI 10.1046/j.0014-2956.2001.02468.x NR 19 TC 48 Z9 55 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 47 EP 58 PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200008 PM 16466100 ER PT J AU Resto, VA Krane, JF Faquin, WC Lin, DT AF Resto, VA Krane, JF Faquin, WC Lin, DT TI Immunohistochemical distinction of intestinal-type sinonasal adenocarcinoma from metastatic adenocarcinoma of intestinal origin SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cytokeratin 7; cytokeratin 20; intestinal-type sinonasal adenocarcinoma; mucin 2; sinonasal metastatic adenocarcinoma ID CLASSIFICATION; EXPRESSION; CDX-2; MUC2 AB Objectives: Distinction of intestinal-type sinonasal adenocarcinoma (ITAC) from adenocarcinoma of intestinal origin metastatic to the sinonasal cavity may be extremely difficult on histologic grounds alone. We studied the role of cytokeratin (CK) and mucin (MUC) expression in differentiating ITAC, metastatic adenocarcinoma of intestinal origin, and nonintestinal-type sinonasal adenocarcinoma (non-ITAC). Methods: We stained specimens from 5 cases of ITAC and 4 cases of non-ITAC, along with 4 colonic and 3 duodenal adenocarcinoma controls, with CK7 and CK20, MUC2 and MUC5, neuron-specific enolase (NSE), chromogranin (CHR), Z and carcinoembryonic antigen (CEA) in order to examine the possible combinations of markers that best aid in the diagnosis of these lesions. We also performed a retrospective review of our clinical experience with these rare lesions. Results: CK7 staining was positive in all ITAC and non-ITAC cases, whereas all cases displaying gastrointestinal-type differentiation (ITAC and metastatic intestinal cases) stained positive for both CK20 and MUC2. Staining for MUC5, NSE, CHR, and CEA was variable. Conclusions: Tumors with the CK7(+), CK20(+), MUC2(+) immunophenotype are likely primary sinonasal lesions, whereas tumors with the CK7(-), CK20(+), MUC2(+) profile warrant further clinical evaluation to exclude metastatic disease from the gastrointestinal tract. Complete surgical resection of ITAC remains the mainstay of therapy. C1 Massachusetts Eye & Ear Infirm, Dept Otolaryngol, Boston, MA 02114 USA. Brigham & Womens Hosp, Dept Pathol, Boston, MA 02115 USA. Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA. RP Lin, DT (reprint author), Massachusetts Eye & Ear Infirm, Dept Otolaryngol, 243 Charles St, Boston, MA 02114 USA. 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PD JAN PY 2006 VL 115 IS 1 BP 59 EP 64 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200009 PM 16466101 ER PT J AU Bernstein, JM Broderick, L Parsons, RR Bankert, RB AF Bernstein, JM Broderick, L Parsons, RR Bankert, RB TI Human nasal polyp microenvironment maintained in viable and functional states as xenografts in SCID mice SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE nasal polyp; SCID mouse; xenograft ID SEVERE COMBINED IMMUNODEFICIENCY; PROSTATE-CANCER; IMMUNE-SYSTEM; LYMPH-NODES; T-CELLS; TUMOR; MODEL; MOUSE; LYMPHOCYTES; EXPRESSION AB Objectives: We undertook to maintain human nasal polyp tissue in a viable and functional state in SCID (severe combined immunodeficiency) mice. Methods: Small, nondisrupted pieces of human nasal polyp tissues were subcutaneously implanted into SCID mice depleted of natural killer cells. The resulting xenografts were examined histologically, and the sera were evaluated for the presence of human protein. Results: The original histologic architecture of the polyp was maintained in the xenografts. The tissues, including pseudostratified columnar epithelial-lined polyps and subepithelial stroma. remained viable, and goblet cells continued to produce mucin for up to 26 weeks after engraftment. Human inflammatory leukocytes. including CD3(+) T cells, CD20(+) B cells, CD138(+) plasma cells, and CD68(+) monocytes and/or macrophages, were present. Identification of human immunoglobulin and human interferon-gamma in the sera of xenograft-bearing mice indicated that the B cells or plasma cells and T cells within the xenografts remained functional for 2 weeks after engraftment. Conclusions: The ability to engraft and maintain nasal polyps provides an in vivo human/mouse chimeric model with which to investigate the role of inflammatory leukocytes and stromal cells in the maintenance and progression of polyposis and to determine how exogenous cytokines may alter the interaction of inflammatory cells. stromal cells, and epithelial cells in the polyp. C1 SUNY Buffalo, Dept Microbiol & Immunol, Buffalo, NY 14214 USA. SUNY Buffalo, Dept Pediat & Otolaryngol, Sch Med & Biomed Sci, Buffalo, NY 14214 USA. SUNY Buffalo, Dept Communicat Disorders & Sci, Buffalo, NY 14214 USA. RP Bankert, RB (reprint author), SUNY Buffalo, Dept Microbiol & Immunol, 138 Farber Hall,3435 Main St, Buffalo, NY 14214 USA. 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Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 65 EP 73 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200010 PM 16466102 ER PT J AU Khariwala, SS Knott, PD Dan, O Klimczak, A Siemionow, M Strome, M AF Khariwala, SS Knott, PD Dan, O Klimczak, A Siemionow, M Strome, M TI Pulsed immunosuppression with everolimus and anti-alpha beta T-cell receptor: Laryngeal allograft preservation at six months SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE everolimus; laryngeal transplant; rat ID SDZ RAD; IN-VITRO; TRANSPLANTATION; CYCLOSPORINE; RAPAMYCIN; MODEL; REJECTION; INDUCTION; TOLERANCE; EFFICACY AB Objectives: Laryngeal transplantation can restore the voice in patients who have undergone laryngectomy. However, the prospect of lifelong immunosuppression is a drawback to this procedure. We present data from a study aimed at minimizing the need for immunosuppression while maintaining graft viability through a novel pulsed-dosing protocol. Methods: Larynges were transplanted from Lewis-brown Norway (RT1(l+n), F1) rats to Lewis (RT1(1)) recipients. All recipients received 7 days of treatment with everolimus and mouse anti-rat up T-cell receptor (anti-TCR) monoclonal antibodies beginning the day before transplantation. At 90 days after transplantation, all recipients received a pulse of the same treatment combination for 5 days. From 90 to 180 days after transplantation, the rats received no treatment (group 1, n = 5), 2.5 mg/kg everolimus per day (group 2, n = 5), or 1.0 mg/kg everolimus per day (group 3, n = 5). Results: Histologic analysis of rats that received everolimus as pulse therapy evidenced no signs. of rejection, whereas animals that were untreated after 90 days had normal to mild chronic rejection. T-cell reconstitution occurred 65 days after perioperative immunosuppressive treatment, but less rapidly after pulse therapy. Also, peripheral chimerism was generated in all 3 groups. Conclusions: In the rat laryngeal transplantation model, short-term perioperative therapy with everolimus and anti-TCR followed by pulsing is a viable alternative to the concerns associated with continuous, lifelong immunosuppression. C1 Cleveland Clin Fdn, Head & Neck Inst, Cleveland, OH 44195 USA. Cleveland Clin Fdn, Dept Plast Surg, Cleveland, OH 44195 USA. RP Strome, M (reprint author), 9500 Euclid Ave,A-71, Cleveland, OH 44195 USA. 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PD JAN PY 2006 VL 115 IS 1 BP 74 EP 80 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200011 PM 16466103 ER PT J AU Satoh, H Billings, P Firestein, GS Harris, JP Keithley, EM AF Satoh, H Billings, P Firestein, GS Harris, JP Keithley, EM TI Transforming growth factor beta expression during an inner ear immune response SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cochlear inflammation; inner ear immunity; transforming growth factor beta ID FIBRONECTIN-LIKE IMMUNOREACTIVITY; HUMAN TEMPORAL BONE; LATENT TGF-BETA; BASILAR-MEMBRANE; MAMMARY-GLAND; ACTIVATION; CELLS; AUTOIMMUNE; HEARING; PROTEIN AB Objectives: The involvement of transforming growth factor beta (TGF-beta), a strong mediator of fibrogenesis, during cochlear immune responses was investigated. Methods: An inner ear adaptive immune response to antigen was created in mice that were painlessly sacrificed 3 to 48 0 hours and 7 days after initiation of the immune response. The cochleas were assayed by immunocytochemistry for TGF-beta and latency-associated peptide (LAP). Results: We found LAP expressed in normal cochleas and the endolymphatic sac, in the small round cells in the cochlear scalae and the mesothelial cells under the basilar membrane, and in the endolymphatic sac perisaccular area. We found TGF-beta expressed in infiltrated, inflammatory cells in the scalae and the endolymphatic sac lumen 3 hours after cochlear antigen challenge. At this time, LAP immunoreactivity was decreased. This rapid shift in immunoreactivity provides evidence for activation of TGF-beta during an immune response. This reversal of expression persisted for 48 hours, but conditions reverted to normal after 7 days. Surgical controls did not show TGF-beta expression. Conclusions: We conclude that TGF-beta activation occurs in the early phase of a cochlear adaptive immune response and is down-regulated as the response resolves. This finding suggests that the process of cochlear fibrosis starts early and that proper treatment could prevent cochlear fibrosis. C1 Univ Calif San Diego, Div Otolaryngol Head & Neck Surg, San Diego, CA 92103 USA. Univ Calif San Diego, Div Rheumatol Allergy & Immunol, San Diego, CA 92103 USA. Res Serv, Dept Vet Affairs, San Diego, CA USA. RP Satoh, H (reprint author), Niigata Univ, Dept Otolaryngol, Fac Med, Asahi Machi 1, Niigata 9518510, Japan. 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Otol. Rhinol. Laryngol. PD JAN PY 2006 VL 115 IS 1 BP 81 EP 88 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 003BS UT WOS:000234657200012 PM 16466104 ER PT J AU Snik, AFM Mylanus, EAM Proops, DW Wolfaardt, JF Hodgetts, WE Somers, T Niparko, JK Wazen, JJ Sterkers, O Cremers, CWRJ Tjellstrom, A AF Snik, AFM Mylanus, EAM Proops, DW Wolfaardt, JF Hodgetts, WE Somers, T Niparko, JK Wazen, JJ Sterkers, O Cremers, CWRJ Tjellstrom, A TI Consensus statements on the BAHA system: Where do we stand at present? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE BAHA system; bone-anchored hearing aid system; hearing loss ID ANCHORED HEARING-AID; CHILDHOOD EAR ABNORMALITIES; AUDIOLOGICAL REHABILITATION; OSSEOINTEGRATED IMPLANTS; AUDIOMETRIC EVALUATION; UNILATERAL DEAFNESS; COCHLEAR IMPLANT; OTITIS-MEDIA; COST-UTILITY; BONE AB After more than 25 years of clinical experience, the BAHA (bone-anchored hearing aid) system is a well-established treatment for hearing-impaired patients with conductive or mixed hearing loss. Owing to its success, the use of the BAHA system has spread and the indications for application have gradually become broader. New indications, as well as clinical applications, were discussed during scientific roundtable meetings in 2004 by experts in the field, and the outcomes of these discussions are presented in the form of statements. The issues that were discussed concerned BAHA surgery, the fitting range of the BAHA system, the BAHA system compared to conventional devices, bilateral application, the BAHA system in children, the BAHA system in patients with single-sided deafness, and, finally, the BAHA system in patients with unilateral conductive hearing loss. C1 Univ Nijmegen St Radboud Hosp, Dept Otorhinolaryngol, NL-6500 HB Nijmegen, Netherlands. Univ Hosp Birmingham, Dept Otolaryngol, Birmingham, W Midlands, England. Univ Alberta, Craniofacial Osseointegrat & Maxillofacial Prosth, Misericordia Community Hosp, Edmonton, AB, Canada. Sint Augustinus Hosp Wilrijk, Dept Otorhinolaryngol, Antwerp, Belgium. Johns Hopkins Univ, Dept Otolaryngol Head & Neck Surg, Baltimore, MD USA. Columbia Univ, Dept Otolaryngol Head & Neck Surg, New York, NY USA. Univ Paris 07, INSERM, EMI 0112, Fac Xavier Bichat, Clichy, France. Hop Beaujon, Serv Otorhinolaryngol, Clichy, France. 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Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 SU 195 BP 2 EP 12 PN 2 PG 11 WC Otorhinolaryngology SC Otorhinolaryngology GA 995OC UT WOS:000234111000001 ER PT J AU Chang, CWD Liou, SS Netterville, JL AF Chang, CWD Liou, SS Netterville, JL TI Anatomic study of laser-assisted endoscopic cricopharyngeus myotomy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE cadaver; cricopharyngeus; endoscopy; laser; myotomy ID ZENKERS DIVERTICULUM; DYSFUNCTION; DYSPHAGIA AB Objectives: Laser-assisted endoscopic cricopharyngeus muscle (CPM) myotomy has been used to correct dysphagia caused by CPM dysfunction. The aim of this study was to anatomically characterize this procedure in hopes of demonstrating its safety and efficacy. Methods: A Dohlman endoscope was used to isolate the CPM in 5 lightly preserved, thawed cadavers. A carbon dioxide laser at 10 W continuous power was used to section through the CPM in conjunction with a micromanipulator connected to an operating microscope. The specimens were then carefully dissected and photographed to demonstrate the anatomy of the pharyngoesophageal segment, including the location of the incision and the condition of the tissue planes. The CPM was harvested for histologic studies, sectioned, and prepared with modified Gomori trichrome stain. Results: Gross examination of the retropharyngeal region revealed the presence of intact buccopharyngeal fascia between the lasered region and the retropharyngeal space. Histologic analysis demonstrated sectioning of the CPM with preservation of this fascia layer. Placement of the endoscope was difficult in I cadaver, in which we were unable to properly identify the CPM. Conclusions: The carbon dioxide laser-assisted endoscopic CPM myotomy is a potentially anatomically safe and viable procedure when properly performed. However, the potential for violation of the retropharyngeal space is real. C1 Vanderbilt Univ, Dept Otolaryngol Head & Neck Surg, Nashville, TN USA. RP Chang, CWD (reprint author), 1 Hosp Dr,MA314, Columbia, MO 65212 USA. CR Brais B, 1999, SEMIN NEUROL, V19, P59, DOI 10.1055/s-2008-1040826 Brøndbo K, 2000, Acta Otolaryngol Suppl, V543, P222 Chang CWD, 2004, LARYNGOSCOPE, V114, P519, DOI 10.1097/00005537-200403000-00025 Chang CY, 2003, LARYNGOSCOPE, V113, P957, DOI 10.1097/00005537-200306000-00009 DOHLMAN G, 1960, ARCHIV OTOLARYNGOL, V71, P744 GARFINKLE TJ, 1982, AM J OTOLARYNG, V3, P204, DOI 10.1016/S0196-0709(82)80056-2 Halvorson DJ, 1998, ENDOSCOPY, V30, P46, DOI 10.1055/s-2007-993729 JONES B, 1992, AM J ROENTGENOL, V158, P283 Lawson G, 2003, EUR ARCH OTO-RHINO-L, V260, P475, DOI 10.1007/s00405-003-0605-z Lim R Y, 1995, J Clin Laser Med Surg, V13, P241 Maune S, 2003, AM J MED, V115, p172S, DOI 10.1016/S0002-9343(03)00219-5 MCKENNA JA, 1992, ANN OTO RHINOL LARYN, V101, P216 Parameswaran MS, 2002, ANN OTO RHINOL LARYN, V111, P871 ROSS ER, 1982, OTOLARYNG HEAD NECK, V90, P434 Shaw GY, 2001, DYSPHAGIA, V16, P161, DOI 10.1007/s00455-001-0074-8 van Overbeek JJM, 2003, ANN OTO RHINOL LARYN, V112, P583 NR 16 TC 5 Z9 5 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 897 EP 901 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100001 PM 16425553 ER PT J AU Baskin, JZ Panagopoulos, G Parks, C Komisar, A AF Baskin, JZ Panagopoulos, G Parks, C Komisar, A TI Predicting outcome in aged and severely ill patients with prolonged respiratory failure SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 83rd Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 02-03, 2003 CL NASHVILLE, TN SP Amer Broncho Esophagol Assoc DE aging; APACHE III; Glasgow Coma Scale; intubation; respiratory insufficiency; tracheotomy ID GLASGOW COMA SCALE; CHRONIC HEALTH EVALUATION; INTENSIVE-CARE-UNIT; LINEAR-REGRESSION PREDICTION; ACUTE PHYSIOLOGY; INTUBATED PATIENTS; VERBAL SCORE; MOTOR SCORES; TRACHEOTOMY; MORTALITY AB Objectives: Consultations for tracheotomy are often sought on aged and severely ill patients with respiratory insufficiency. This patient population has high short-term mortality rates and is difficult to stratify on the basis of expected outcome. We examined whether APACHE III (Acute Physiology and Chronic Health Evaluation III) scores or neurologic status assessment (NSA) scores in sedated individuals are predictive of outcome. Methods: We performed a retrospective study examining aged patients who underwent tracheotomy for respiratory insufficiency and prolonged intubation. The APACHE Ill scores (n = 30) and NSA (based on a modified Glasgow Coma Scale) scores (n = 37) were calculated before tracheotomy. All patients were mildly sedated. Using APACHE III and NSA scores as predictor variables and using death and ability to be weaned from the ventilator as outcome variables, we performed a Kaplan-Meier survival analysis and a Cox proportional hazard regression. Results: The APACHE III was not significantly predictive of either outcome. Higher NSA scores were associated with increased survival rates (log rank = 19.7, p <.0001) and longer median survival (88 days versus 16 days for lower scorers). Higher NSA scores also predicted a higher rate of ventilator independence. Conclusions: Neurologic function in sedated patients (and not APACHE III scores) can be used to stratify aged individuals with respiratory insufficiency on the basis of expected outcome. C1 NYU, Sch Med, Dept Otolaryngol Head & Neck Surg, New York, NY USA. Lenox Hill Hosp, Dept Otolaryngol Head & Neck Surg, New York, NY 10021 USA. Lenox Hill Hosp, Dept Res, New York, NY 10021 USA. Lenox Hill Hosp, Dept Qual Assurance, New York, NY 10021 USA. RP Baskin, JZ (reprint author), Univ Hosp Cleveland, Case Sch Med, Dept Otolaryngol Head & Neck Surg, 11100 Euclid Ave, Cleveland, OH 44118 USA. CR Baskin JZ, 2004, HEAD NECK-J SCI SPEC, V26, P71, DOI 10.1002/hed.10356 BASTOS PG, 1993, CRIT CARE MED, V21, P1459, DOI 10.1097/00003246-199310000-00012 Glance LG, 1998, CRIT CARE MED, V26, P1842 Hannan EL, 2000, J TRAUMA, V48, P76, DOI 10.1097/00005373-200001000-00013 Kantu M, 1999, Ear Nose Throat J, V78, P500 KNAUS WA, 1981, CRIT CARE MED, V9, P591 LANZA DC, 1990, ANN OTO RHINOL LARYN, V99, P38 Livingston BM, 2000, CRIT CARE MED, V28, P389, DOI 10.1097/00003246-200002000-00017 Meredith W, 1998, J TRAUMA, V44, P839, DOI 10.1097/00005373-199805000-00016 Rutledge R, 1996, J TRAUMA, V41, P514, DOI 10.1097/00005373-199609000-00022 TERES D, 1982, CRIT CARE MED, V10, P86, DOI 10.1097/00003246-198202000-00004 WAGNER D, 1989, CRIT CARE MED, V17, pS199, DOI 10.1097/00003246-198912000-00008 NR 12 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 902 EP 906 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100002 PM 16425554 ER PT J AU Kanemaru, S Nakamura, T Yamashita, M Magrufov, A Kita, T Tamaki, H Tamura, Y Iguchi, F Kim, TS Kishimoto, M Omori, K Ito, J AF Kanemaru, S Nakamura, T Yamashita, M Magrufov, A Kita, T Tamaki, H Tamura, Y Iguchi, F Kim, TS Kishimoto, M Omori, K Ito, J TI Destiny of autologous bone marrow-derived stromal cells implanted in the vocal fold SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE bone marrow-derived stromal cells; cell-based tissue engineering; destiny of implanted cells; mesenchymal stem cells; regeneration; vocal fold ID MESENCHYMAL STEM-CELLS; PARALYSIS; INJECTION; COLLAGEN AB Objectives: The aim of this study was to investigate the destiny of implanted autologous bone marrow-derived stromal cells (BSCs) containing mesenchymal stem cells. We previously reported the successful regeneration of an injured vocal fold through implantation of BSCs in a canine model. However, the fate of the implanted BSCs was not examined. In this study, implanted BSCs were traced in order to determine the type of tissues resulting at the injected site of the vocal fold. Methods: After harvest of bone marrow from the femurs of green fluorescent transgenic mice, adherent cells were cultured and selectively amplified. By means of a fluorescence-activated cell sorter, it was confirmed that some cells were strongly positive for mesenchymal stem cell markers, including CD29, CD44, CD49e, and Sca-1. These cells were then injected into the injured vocal fold of a nude rat. Immunohistologic examination of the resected vocal folds was performed 8 weeks after treatment. Results: The implanted cells were alive in the host tissues and showed positive expression for keratin and desmin, markers for epithelial tissue and muscle, respectively. The implanted BSCs differentiated into more than one tissue type in vivo. Conclusions: Cell-based tissue engineering using BSCs may improve the quality of the healing process in vocal fold injuries. C1 Kyoto Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Sakyo Ku, Kyoto 6068507, Japan. Kyoto Univ, Dept Bioartificial Organs, Inst Frontier Med Sci, Kyoto 6068507, Japan. Fukushima Med Univ, Sch Med, Dept Otolaryngol, Fukushima, Japan. RP Kanemaru, S (reprint author), Kyoto Univ, Grad Sch Med, Dept Otolaryngol Head & Neck Surg, Sakyo Ku, 54 Kawahara Cho, Kyoto 6068507, Japan. RI Yamashita, Masaru/B-2411-2009 CR Brandenburg JH, 1996, LARYNGOSCOPE, V106, P174, DOI 10.1097/00005537-199602000-00013 Daley George Q, 2003, Hematology Am Soc Hematol Educ Program, P398 Deans RJ, 2000, EXP HEMATOL, V28, P875, DOI 10.1016/S0301-472X(00)00482-3 FORD CN, 1995, LARYNGOSCOPE, V105, P944, DOI 10.1288/00005537-199509000-00014 FORD CN, 1984, LARYNGOSCOPE, V94, P513, DOI 10.1288/00005537-198404000-00016 Hallen L, 1998, LARYNGOSCOPE, V108, P393, DOI 10.1097/00005537-199803000-00015 Ishii K, 1996, ACTA OTO-LARYNGOL, V116, P778, DOI 10.3109/00016489609137924 Kanemaru SI, 2003, ANN OTO RHINOL LARYN, V112, P915 Meirelles LD, 2003, BRIT J HAEMATOL, V123, P702, DOI 10.1046/j.1365-2141.2003.04669.x MIKAELIAN DO, 1991, LARYNGOSCOPE, V101, P465 Pittenger MF, 1999, SCIENCE, V284, P143, DOI 10.1126/science.284.5411.143 Rippon HJ, 2004, CELL PROLIFERAT, V37, P23, DOI 10.1111/j.1365-2184.2004.00298.x Rodgers BJ, 2000, LARYNGOSCOPE, V110, P2012, DOI 10.1097/00005537-200012000-00006 Sato K, 2001, ANN OTO RHINOL LARYN, V110, P417 TRAPP TK, 1989, ANN OTO RHINOL LARYN, V98, P220 Tuan RS, 2003, ARTHRITIS RES THER, V5, P32, DOI 10.1186/ar614 Woodbury D, 2000, J NEUROSCI RES, V61, P364, DOI 10.1002/1097-4547(20000815)61:4<364::AID-JNR2>3.0.CO;2-C NR 17 TC 38 Z9 42 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 907 EP 912 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100003 PM 16425555 ER PT J AU Gill, GA Johnston, N Buda, A Pignatelli, M Pearson, J Dettmar, PW Koufman, J AF Gill, GA Johnston, N Buda, A Pignatelli, M Pearson, J Dettmar, PW Koufman, J TI Laryngeal epithelial defenses against laryngopharyngeal reflux: Investigations of E-cadherin, carbonic anhydrase isoenzyme III, and pepsin SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE carbonic anhydrase; cell biology; cellular defense; E-cadherin; laryngopharyngeal reflux; pepsin ID HUMAN ESOPHAGEAL EPITHELIUM; GASTROESOPHAGEAL-REFLUX; CELL-ADHESION; ACID INJURY; DISEASE; RABBITS; RELIABILITY; VALIDITY; BIOLOGY; HEALTH AB Objectives: This is the third annual report of an international research network studying the cellular impact of laryngopharyngeal reflux (LPR) on laryngeal epithelium. The objective of this study was to investigate the presence of Ecadherin (epithelial cadherin; the intercellular junctional complex protein) in relation to the presence of (intracellular) pepsin and carbonic anhydrase isoenzyme III (CAIII). Methods: Fifty-four laryngeal biopsy specimens from 18 LPR patients were studied by immunohistochemistry and Western blotting for pepsin, E-cadherin, and CAIII. These data were compared to those from normal control subjects analyzed in another research study. Results: Intracellular pepsin was detected in LPR patients, but not in controls. E-cadherin expression was reduced in patients with LPR. Carbonic anhydrase III expression was not found in the vocal fold or in the majority of samples taken from the ventricle of LPR patients and was inversely associated with E-cadherin membranous expression. Conclusions: The findings of depleted E-cadherin and CAIII and the presence of pepsin appear to correlate with LPR. The reduced protective response indicated by the reduced expression of CAM may play an important role in the disruption of the intercellular barrier associated with the down-regulation of E-cadherin. C1 Wake Forest Univ, Dept Otolaryngol, Ctr Voice & Swallowing Disorders, Sch Med, Winston Salem, NC 27157 USA. Univ Newcastle Upon Tyne, Sch Cell & Mol Biosci, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England. Univ Bristol, Sch Med Sci, Dept Pathol & Microbiol, Bristol, Avon, England. RP Koufman, J (reprint author), Wake Forest Univ, Dept Otolaryngol, Ctr Voice & Swallowing Disorders, Sch Med, Med Ctr Blvd, Winston Salem, NC 27157 USA. CR Axford SE, 2001, ANN OTO RHINOL LARYN, V110, P1099 Belafsky PC, 2002, J VOICE, V16, P274, DOI 10.1016/S0892-1997(02)00097-8 Belafsky PC, 2001, LARYNGOSCOPE, V111, P1313, DOI 10.1097/00005537-200108000-00001 BELL NJV, 1992, GUT, V33, P118, DOI 10.1136/gut.33.1.118 BREMNER RM, 1992, AM J SURG, V164, P522, DOI 10.1016/S0002-9610(05)81193-6 Christie KN, 1997, J HISTOCHEM CYTOCHEM, V45, P35 Farrow DC, 2000, CANCER CAUSE CONTROL, V11, P231, DOI 10.1023/A:1008913828105 GOLDSTEIN JL, 1994, J LAB CLIN MED, V123, P653 Gumbiner BM, 2000, J CELL BIOL, V148, P399, DOI 10.1083/jcb.148.3.399 Gumbiner BM, 1996, CELL, V84, P345, DOI 10.1016/S0092-8674(00)81279-9 HELM JF, 1982, GASTROENTEROLOGY, V83, P69 Hicks DM, 2002, J VOICE, V16, P564, DOI 10.1016/S0892-1997(02)00132-7 Hopwood D, 1997, PROG HISTOCHEM CYTOC, V32, P1 ISMAIL-BEIGI F, 1970, Gastroenterology, V58, P163 Johnston N, 2004, LARYNGOSCOPE, V114, P2129, DOI 10.1097/01.mlg.0000149445.07146.03 Johnston N, 2003, ANN OTO RHINOL LARYN, V112, P481 KAHRILAS PJ, 1993, GASTROINTESTINAL DIS, V1, P378 Koufman James A, 2002, Ear Nose Throat J, V81, P7 KOUFMAN JA, 1991, LARYNGOSCOPE S, V53, P101 Lanas A, 1999, GASTROENTEROLOGY, V116, P97, DOI 10.1016/S0016-5085(99)70233-7 Lanas AI, 1995, EUR J GASTROEN HEPAT, V7, P1065, DOI 10.1097/00042737-199511000-00009 Orlando RC, 2003, AM J MED SCI, V326, P274, DOI 10.1097/00000441-200311000-00003 ORLANDO RC, 1994, AM J GASTROENTEROL, V89, P48 Parkkila S, 1996, SCAND J GASTROENTERO, V31, P305, DOI 10.3109/00365529609006403 Postma GN, 2001, ANN OTO RHINOL LARYN, V110, P1114 RC Orlando, 2000, GASTROESOPHAGEAL REF SALO JA, 1983, DIGEST DIS SCI, V28, P440, DOI 10.1007/BF02430533 SCHWEITZER EJ, 1985, GASTROENTEROLOGY, V88, P611 SHIMONO M, 1977, J ULTRA MOL STRUCT R, V59, P101, DOI 10.1016/S0022-5320(77)80032-4 SLY WS, 1995, ANNU REV BIOCHEM, V64, P375, DOI 10.1146/annurev.bi.64.070195.002111 Smith MEF, 1997, HISTOPATHOLOGY, V31, P107, DOI 10.1046/j.1365-2559.1997.2350845.x TAKEICHI M, 1991, SCIENCE, V251, P1451, DOI 10.1126/science.2006419 TAKEICHI M, 1995, CURR OPIN CELL BIOL, V7, P619, DOI 10.1016/0955-0674(95)80102-2 TASHIAN RE, 1989, BIOESSAYS, V10, P186, DOI 10.1002/bies.950100603 TAY HP, 1990, GUT, V31, P11, DOI 10.1136/gut.31.1.11 TOBEY NA, 1989, GASTROENTEROLOGY, V96, P1466 Tobey NA, 1996, GASTROENTEROLOGY, V111, P1200, DOI 10.1053/gast.1996.v111.pm8898633 Tobey NA, 2001, AM J GASTROENTEROL, V96, P3062 Tobey NA, 1997, GASTROENTEROLOGY, V112, P847, DOI 10.1053/gast.1997.v112.pm9041246 NR 39 TC 43 Z9 50 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 913 EP 921 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100004 PM 16425556 ER PT J AU Bosley, B Rosen, CA Simpson, CB McMullin, BT Gartner-Schmidt, JL AF Bosley, B Rosen, CA Simpson, CB McMullin, BT Gartner-Schmidt, JL TI Medial arytenoidectomy versus transverse cordotomy as a treatment for bilateral vocal fold paralysis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE airway restriction; bilateral vocal fold paralysis; medial arytenoidectomy; stridor; transverse cordotomy ID ELECTRICAL-STIMULATION; LARYNGEAL PARALYSIS; CORD PARALYSIS; MANAGEMENT; VOICE; IMMOBILITY; MUSCLE AB Objectives: Transverse cordotomy (TC) and medial arytenoidectomy (MA) are procedures performed to enlarge the glottic airway in patients with bilateral vocal fold paralysis (BVFP). Both are less destructive than total arytenoidectomy and have distinct theoretical advantages for voice preservation, but they have never been compared. Methods: The records of patients with BVFP treated with TC or MA were reviewed; information regarding the outcome measures of tracheotomy decannulation, dysphagia, Voice Handicap Index score, voice intensity, clinical course, and preoperative and postoperative voice quality was obtained. Results: Seventeen patients were available for evaluation (I I with TC, 6 with MA). All 6 patients with a preoperative tracheotomy were decannulated. Four patients in the MA group and 2 in the TC group had an increase in their postoperative Voice Handicap Index score. Two of the patients in the MA group had a decrease in phonatory sound pressure level of 3 dB, and 1 in the TC group had a decrease of 2 dB sound pressure level. Patient self-report of airway status following TC or MA showed that 62.5% (10 of 16) were significantly better and 25% (4 of 16) were somewhat better. Blinded audio perceptual analysis comparing preoperative and postoperative voice quality showed no difference between the MA and TC groups. A swallowing quality-of-life instrument confirmed a lack of swallowing difficulties postoperatively. Conclusions: Both TC and MA are good treatment options for BVFP, with a low incidence of complications in postoperative voice or of swallowing difficulties and a consistent improvement of laryngeal airway restriction symptoms. C1 Univ Pittsburgh, Voice Ctr, Dept Otolaryngol, Inst Eye & Ear, Pittsburgh, PA 15213 USA. Univ Texas, Hlth Sci Ctr, Dept Otolaryngol Head & Neck Surg, San Antonio, TX 78285 USA. RP Rosen, CA (reprint author), Univ Pittsburgh, Voice Ctr, Dept Otolaryngol, Inst Eye & Ear, Suite 500,200 Lothrop St, Pittsburgh, PA 15213 USA. CR Billante CR, 2002, ANN OTO RHINOL LARYN, V111, P328 CRUMLEY RL, 1993, ANN OTO RHINOL LARYN, V102, P81 DENNIS DP, 1989, ANN OTO RHINOL LARYN, V98, P930 DESANTO LW, 1995, ANN OTO RHINOL LARYN, V104, P763 FAIRBANKS G, 1959, VOICE ARTICULATION D Feehery JM, 2003, J VOICE, V17, P76, DOI 10.1016/S0892-1997(03)00030-4 Hillel AD, 1999, OTOLARYNG HEAD NECK, V121, P760, DOI 10.1053/hn.1999.v121.a98733 Jacobson BH, 1997, AM J SPEECH-LANG PAT, V6, P66 KASHIMA HK, 1991, ANN OTO RHINOL LARYN, V100, P717 MAISEL RH, 1974, LARYNGOSCOPE, V84, P302, DOI 10.1288/00005537-197402000-00012 McHorney CA, 2002, DYSPHAGIA, V17, P97, DOI 10.1007/s00455-001-0109-1 RAMIG LO, 1995, J SPEECH HEAR RES, V38, P1232 Rosen CA, 2004, LARYNGOSCOPE, V114, P1549, DOI 10.1097/00005537-200409000-00009 Zealear DL, 2002, ANN OTO RHINOL LARYN, V111, P500 Zealear DL, 2003, LARYNGOSCOPE, V113, P1149, DOI 10.1097/00005537-200307000-00010 NR 15 TC 18 Z9 19 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 922 EP 926 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100005 PM 16425557 ER PT J AU Onuki, J Takahashi, M Odagiri, K Wada, R Sato, R AF Onuki, J Takahashi, M Odagiri, K Wada, R Sato, R TI Comparative study of the daily lifestyle of patients with Meniere's disease and controls SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 18th International Congress of the Barany-Society CY JUL 09, 2004 CL Paris, FRANCE SP Barany Soc DE behavior pattern; Meniere's disease; questionnaire study; stress ID SYMPTOMS; DISORDER; STRESS; DIZZINESS; BEHAVIOR; ILLNESS; ANXIETY; VERTIGO; ATTACKS; TIME AB Objectives: This study was performed to investigate the possibility that daily lifestyle may have a causal relationship with Meniere's disease. Methods: We conducted a questionnaire study of daily lifestyles among groups of patients with Meniere's disease and those with low-frequency hearing loss, and compared the results with those of control groups of local residents matched individually by gender and age. Results: The Meniere's disease group diverged most widely from the control groups in their behavior patterns. Significant divergence was especially indicated in their engrossed, self-inhibiting, and time-constrained behaviors. Although the low-frequency hearing loss group also exhibited similar tendencies toward engrossment and in their feeling pressed for time, their self-inhibiting behavior was less pronounced. There was no major difference between the endolymphatic hydrops patient groups and the control groups on other items in the study such as daily lifestyle, environmental stress, and means of relaxation. Conclusions: The results of the present study strongly suggest that there may be a link between an individual's specific behavior patterns and the onset of Meniere's disease. C1 Tokai Univ, Sch Med, Dept Otolaryngol, Isehara, Kanagawa 2591193, Japan. RP Takahashi, M (reprint author), Tokai Univ, Sch Med, Dept Otolaryngol, Isehara, Kanagawa 2591193, Japan. CR Andersson G, 1997, J PSYCHOSOM RES, V43, P595, DOI 10.1016/S0022-3999(97)00184-0 Celestino D, 2003, Acta Otorhinolaryngol Ital, V23, P421 COKER NJ, 1989, ARCH OTOLARYNGOL, V115, P1355 Erlandsson S I, 1996, Scand Audiol Suppl, V43, P45 FRIEDMAN M, 1959, JAMA-J AM MED ASSOC, V169, P1286 FROMMBERGER U, 1993, NERVENARZT, V64, P377 Hagnebo C, 1998, PSYCHOTHER PSYCHOSOM, V67, P311, DOI 10.1159/000012296 HALLAM RS, 1985, J PSYCHOSOM RES, V29, P407, DOI 10.1016/0022-3999(85)90026-1 Havia M, 2004, ARCH OTOLARYNGOL, V130, P431, DOI 10.1001/archotol.130.4.431 Juhn SK, 1999, AM J OTOL, V20, P800 Kotimaki J, 1999, LARYNGOSCOPE, V109, P748, DOI 10.1097/00005537-199905000-00013 Kotimäki J, 2001, Acta Otolaryngol Suppl, V545, P14 Martin C, 1990, Ann Otolaryngol Chir Cervicofac, V107, P526 Mizukoshi K, 1979, Adv Otorhinolaryngol, V25, P106 Morales Angulo C, 2003, ACTA OTORRINOLARINGO, V54, P601 Rozanski A, 1999, CIRCULATION, V99, P2192 Savastano M, 1996, J OTOLARYNGOL, V25, P329 Sawada S, 1997, Acta Otolaryngol Suppl, V528, P109 Shojaku H, 1997, Acta Otolaryngol Suppl, V528, P94 Soderman ACH, 2002, OTOL NEUROTOL, V23, P941 Soderman ACH, 2004, LARYNGOSCOPE, V114, P1843 STAHLE J, 1976, ACTA OTO-LARYNGOL, V81, P113, DOI 10.3109/00016487609107484 STEPHENS SDG, 1975, J LARYNGOL OTOL, V89, P479, DOI 10.1017/S0022215100080646 Takahashi M, 2001, ACTA OTO-LARYNGOL, V121, P254 Watanabe Y, 1995, Acta Otolaryngol Suppl, V519, P206 YARDLEY L, 1994, CLIN OTOLARYNGOL, V19, P109, DOI 10.1111/j.1365-2273.1994.tb01192.x Zilstorff K, 1979, Adv Otorhinolaryngol, V25, P100 NR 27 TC 2 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 927 EP 933 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100006 PM 16425558 ER PT J AU Hashimoto, S Naganuma, H Tokumasu, K Itoh, A Okamoto, M AF Hashimoto, S Naganuma, H Tokumasu, K Itoh, A Okamoto, M TI Three-dimensional reconstruction of the human semicircular canals and measurement of each membranous canal plane defined by Reid's stereotactic coordinates SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 18th International Congress of the Barany-Society CY JUL 09, 2004 CL Paris, FRANCE SP Barany Soc DE inner ear morphology; semicircular canal; three-dimensional analysis; vestibulo-ocular reflex ID MORPHOLOGICAL ASPECTS; MACULA AB Objectives: Equations for estimating the planar relationships of the human semicircular canals were devised by Blanks et al from a dissected bony labyrinth in a human skull. However, a similar study on the membranous semicircular canal planes has never been published. Methods: In this study, the angle between each membranous canal plane and Reid's stereotactic horizontal plane was measured on serial histologic sections of 7 temporal bones from Japanese adults. We reconstructed the 3 semicircular canals by computer-aided 3-dimensional analysis. The angles between each pair of both bony and membranous canal planes were measured. Results: In the bony labyrinth, the angles between the 2 canal planes of the lateral-anterior, anterior-posterior, and lateral-posterior pairs were 90.51 degrees +/- 2.98 degrees (mean +/- SD), 91.70 degrees +/- 1.85 degrees, and 94.52 degrees +/- 3.32 degrees, respectively. The angles between the 2 membranous canal planes of the lateral-anterior, anterior-posterior, and lateral-posterior pairs were 90.05 degrees +/- 4.74 degrees, 91.03 degrees +/- 2.93 degrees, and 91.92 degrees +/- 5.22 degrees, respectively. Conclusions: The data from our study of the membranous labyrinth showed that the angles between each canal plane and the others were much closer to 900 than was found by Blanks et al for the bony labyrinth. C1 Kitasato Univ, Sch Med, Dept Otolaryngol, Sagamihara, Kanagawa 228, Japan. RP Hashimoto, S (reprint author), Kitasato Univ, Sch Med, Dept Otolaryngol, 1-15-1 Kitasato, Sagamihara, Kanagawa 228, Japan. CR BLANKS RHI, 1975, ACTA OTO-LARYNGOL, V80, P185, DOI 10.3109/00016487509121318 COHEN B, 1964, ANN OTO RHINOL LARYN, V73, P153 CORVERA J, 1958, Acta Otolaryngol, V49, P4, DOI 10.3109/00016485809134722 IGARASHI M, 1967, LARYNGOSCOPE, V77, P1806, DOI 10.1288/00005537-196710000-00003 Naganuma H, 2003, ANN OTO RHINOL LARYN, V112, P419 Naganuma H, 2001, ANN OTO RHINOL LARYN, V110, P1017 SCHUKNECHT HF, 1953, AMA ARCH OTOLARYNGOL, V58, P377 TAKAGI A, 1988, OTOLARYNG HEAD NECK, V98, P195 TAKAGI A, 1989, ANN OTO RHINOL LARYN, V98, P515 NR 9 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 934 EP 938 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100007 PM 16425559 ER PT J AU Lau, WYS Chow, CK AF Lau, WYS Chow, CK TI Radiation-induced petrous internal carotid artery aneurysm SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE aneurysm; internal carotid artery; radiation AB latrogenic internal carotid artery aneurysm is a rare complication of irradiation. There are few reported cases in the literature. A case of radiation-induced petrous internal carotid artery aneurysm in a patient with nasopharyngeal cancer treated with radiotherapy is reported. The approach to managing such an aneurysm is discussed. C1 Univ Hong Kong, Med Ctr, Dept Surg, Div Otorhinolaryngol,Queen Mary Hosp, Hong Kong, Hong Kong, Peoples R China. RP Chow, CK (reprint author), Univ Hong Kong, Med Ctr, Dept Surg, Div Otorhinolaryngol,Queen Mary Hosp, Hong Kong, Hong Kong, Peoples R China. CR Auyeung KM, 2003, AM J NEURORADIOL, V24, P1449 Cheng KM, 2001, ACTA NEUROCHIR, V143, P351, DOI 10.1007/s007010170089 JOHN DG, 1993, J LARYNGOL OTOL, V107, P137, DOI 10.1017/S002221510012242X NR 3 TC 10 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 939 EP 940 PG 2 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100008 PM 16425560 ER PT J AU Kieff, DA Busaba, NY AF Kieff, DA Busaba, NY TI Efficacy of montelukast in the treatment of nasal polyposis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE chronic sinusitis; eosinophilia; montelukast; nasal polyposis; rhinitis; symptom score ID SEASONAL ALLERGIC RHINITIS; CHRONIC RHINOSINUSITIS; DOUBLE-BLIND; ASTHMA; SINUSITIS; SYMPTOMS AB Objectives: Twenty-four consecutive patients with symptomatic nasal polyposis and nonallergic or perennial rhinitis who were undergoing chronic nasal steroid therapy were prospectively evaluated for response to adjunctive oral montelukast sodium therapy. Methods: The patients were undergoing daily intranasal steroid sprays for a minimum of 6 months before being started on montelukast sodium 10 mg by mouth per day for 3 months while intranasal steroids were continued. The patients were given a validated symptom score survey at the start and end of therapy, with a lower score indicating fewer symptoms. The nasal polyps were submitted to biopsy before and after treatment to determine their degree of eosinophilia. Eosinophilia was graded in a blinded fashion by an independent pathologist on a scale of 0 to 3, with 3 being severe. Patients with seasonal allergies were excluded, and the studied patients were treated during the winter season to avoid confounding by potential seasonal allergic responses. Results: The patients tended to improve on montelukast therapy in terms of their symptom scores and polyp eosinophil counts. The symptoms improved in 17 patients (71%) and remained the same or worsened in 7 patients (29%). The symptom score for the group improved from a pretreatment value of 33.4 (SD, 7.73) to a posttreatment value of 23.3 (SD, 13.73; p <.001). In addition, the eosinophilia score improved from 2.3 (SD, 0.68) to 1.5 (SD, 0.82; p <.01). The improvement was most noticeable in the patients with perennial allergies. Conclusions: These results suggest that montelukast appears to be beneficial for some patients with nasal polyposis. Patients with perennial allergies and nasal polyposis seem more likely to respond to the treatment than those with nonallergic nasal polyposis. C1 Massachusetts Eye & Ear Infirm, Dept Otolaryngol, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Otolaryngol, Boston, MA 02115 USA. Harvard Vanguard Med Associates, Div Otolaryngol, Boston, MA USA. RP Kieff, DA (reprint author), Massachusetts Eye & Ear Infirm, Dept Otolaryngol, 243 Charlest St, Boston, MA 02114 USA. CR Arango P, 2002, OTOLARYNG HEAD NECK, V127, P512, DOI 10.1067/mhn.2002.129858 Bhattacharyya N, 2005, AM J RHINOL, V19, P175 BROMS P, 1982, ACTA OTO-LARYNGOL, V93, P455, DOI 10.3109/00016488209130904 CLARKE RW, 1994, CLIN OTOLARYNGOL, V19, P502, DOI 10.1111/j.1365-2273.1994.tb01277.x Haye R, 1998, J LARYNGOL OTOL, V112, P1042 Hedman J, 1999, INT J EPIDEMIOL, V28, P717, DOI 10.1093/ije/28.4.717 HILBERG O, 1989, J APPL PHYSIOL, V66, P295 Larsen K, 2002, ACTA OTO-LARYNGOL, V122, P179, DOI 10.1080/00016480252814199 LUND VJ, 1995, ANN OTO RHINOL LARYN, V104, P17 *MERCK CO INC, SING MONT PROD CIRC Mygind N, 1999, ALLERGY, V54, P12 Nayak AS, 2002, ALLERGY ASTHMA PROC, V23, P359 Nayak AS, 2002, ANN ALLERG ASTHMA IM, V88, P592 Philip G, 2002, CLIN EXP ALLERGY, V32, P1020, DOI 10.1046/j.1365-2222.2002.01422.x Ponikau JU, 2003, J ALLERGY CLIN IMMUN, V112, P877, DOI 10.1067/mai.2003.1790 Rugina M, 2002, RHINOLOGY, V40, P75 Scadding Glenis K, 2002, Curr Allergy Asthma Rep, V2, P494, DOI 10.1007/s11882-002-0090-2 SETTIPANE GA, 1977, J ALLERGY CLIN IMMUN, V59, P17, DOI 10.1016/0091-6749(77)90171-3 Singh H, 2003, J INVEST ALLERG CLIN, V13, P6 Sousa AR, 2002, NEW ENGL J MED, V347, P1493, DOI 10.1056/NEJMoa013508 Stewart MG, 1999, AM J RHINOL, V13, P161, DOI 10.2500/105065899781389704 Tuncer U, 2003, AURIS NASUS LARYNX, V30, P263, DOI 10.1016/S0385-8146(03)00051-8 Ulualp SO, 1999, ENT-EAR NOSE THROAT, V78, P613 Ulualp SO, 1999, ENT-EAR NOSE THROAT, V78, P608 Ulualp S O, 1999, Ear Nose Throat J, V78, P604 2003, MED LETT DRUGS THER, V45, P21 NR 26 TC 21 Z9 24 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 941 EP 945 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100009 PM 16425561 ER PT J AU Van Daele, DJ AF Van Daele, DJ TI Conservative management of stapler failure in Zenker's endoscopic diverticulotomy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE complication; surgery; Zenker's diverticulum ID ASSISTED ESOPHAGODIVERTICULOSTOMY; ESOPHAGEAL-PERFORATION; PHARYNGEAL POUCHES; EXPERIENCE AB The endoscopic stapler has achieved widespread use in the management of Zenker's diverticulum owing to its ease of use and safety. However, complications associated with its use can and do occur. This study details the treatment course of 2 patients who underwent an endoscopic stapler approach to their Zenker's diverticulum complicated by the stapler's not sealing the mucosal edges. Although the patients' hospital stays were extended as a result, they suffered no long-term morbidity as a result of the complication. C1 Roy J & Lucille A Carver Coll Med, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. RP Van Daele, DJ (reprint author), Roy J & Lucille A Carver Coll Med, Dept Otolaryngol Head & Neck Surg, 21165 PFP,200 Hawkins Dr, Iowa City, IA 52242 USA. CR Chang CY, 2003, LARYNGOSCOPE, V113, P957, DOI 10.1097/00005537-200306000-00009 Hilton M, 2000, J LARYNGOL OTOL, V114, P549 Mirza S, 2003, J LARYNGOL OTOL, V117, P93 Nix PA, 2001, J LARYNGOL OTOL, V115, P668 Raut VV, 2002, OTOLARYNG HEAD NECK, V127, P225, DOI 10.1067/mhn.2002.127605 Richtsmeier WJ, 2002, ARCH OTOLARYNGOL, V128, P137 Richtsmeier WJ, 2005, ANN OTO RHINOL LARYN, V114, P341 Scher RL, 1998, LARYNGOSCOPE, V108, P200, DOI 10.1097/00005537-199802000-00008 NR 8 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 946 EP 948 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100010 PM 16425562 ER PT J AU Cakmak, O Tarhan, E Coskun, M Cankurtaran, M Celik, H AF Cakmak, O Tarhan, E Coskun, M Cankurtaran, M Celik, H TI Acoustic rhinometry: Accuracy and ability to detect changes in passage area at different locations in the nasal cavity SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE acoustic rhinometry; cast model; computed tomography; curved acoustic axis; nasal cavity ID MODEL; VALVE; RESOLUTION; GEOMETRY; CHILDREN; SURGERY AB Objectives: To evaluate the accuracy of acoustic rhinometry (AR) measurements, and to assess how well AR detects obstructions of various sizes at specific sites in the nasal cavity, we created a cast model from an adult cadaver nasal cavity. Methods: The actual cross-sectional areas of the cast model nasal passage were determined by computed tomography and compared with the corresponding areas measured by AR. To assess how nasal obstruction affects the AR results, we placed small wax spheres of different diameters at specific sites in the model (nasal valve, head of the inferior turbinate, head of the middle turbinate, middle of the middle turbinate, choana, and nasopharynx). Results: The AR-derived cross-sectional areas in the first 6.5 cm of the cast model nasal cavity were very close to the corresponding areas calculated from computed tomographic sections perpendicular to the presumed acoustic axis. However, AR overestimated the passage areas at locations posterior to the 6.5-cm point. Acoustic rhinometry gave an accurate indication of the passage area of the nasal valve and its distance from the nostril. The nasal valve and the choana were indicated by significant dips on the AR area-distance curve, whereas the curve was smooth throughout the region that included the head of the inferior turbinate, the head of the middle turbinate, the middle of the middle turbinate, and the nasopharynx. In other words, AR did not discretely identify these latter sites. Acoustic rhinometry detected the different-sized inserts (obstructions) more accurately at the nasal valve than at sites posterior to this location. Conclusions: The results of the study show that AR is a valuable method for assessing the anterior nasal cavity. This technique is sensitive for detecting changes in passage area at the nasal valve region; however, the sensitivity is lower at sites posterior to this. The findings suggest that when there is substantial narrowing of the nasal valve, AR will not identify an obstruction at any location posterior to the nasal valve. In such situations, AR measurements beyond the abnormal nasal valve may easily lead to misinterpretation of the patient's nasal anatomy or condition. C1 Baskent Univ, Fac Med, Dept Otorhinolaryngol, TR-06490 Ankara, Turkey. Baskent Univ, Fac Med, Dept Radiol, TR-06490 Ankara, Turkey. Hacettepe Univ, Fac Engn, Dept Phys, Ankara, Turkey. RP Cakmak, O (reprint author), Baskent Univ Hastanesi, Kulak Burun Bogaz Anabilim Dali, TR-06490 Ankara, Turkey. CR BUENTING JE, 1994, J APPL PHYSIOL, V77, P2558 Cakmak O, 2003, LARYNGOSCOPE, V113, P295 Cakmak O, 2001, LARYNGOSCOPE, V111, P587, DOI 10.1097/00005537-200104000-00007 Cakmak O, 2003, J APPL PHYSIOL, V94, P1527, DOI 10.1152/japplphysiol.01032.2002 CAKMAK O, 2001, LARYNGOSCOPE, V111, P1117 Cakmak O, 2005, AM J RHINOL, V19, P262 Cankurtaran M, 2003, J APPL PHYSIOL, V94, P2166, DOI 10.1152/japplphysiol.01146.2002 Celik H, 2004, PHYS MED BIOL, V49, P371, DOI 10.1088/0031-9155/49/3/002 Corey JP, 1997, OTOLARYNG HEAD NECK, V117, P349, DOI 10.1016/S0194-5998(97)70125-6 Corey JP, 1999, OTOLARYNG HEAD NECK, V121, P572, DOI 10.1016/S0194-5998(99)70058-6 Djupesland PG, 2001, RHINOLOGY, V39, P23 FISHER EW, 1994, ACTA OTO-LARYNGOL, V114, P647, DOI 10.3109/00016489409126120 Gilain L, 1997, ARCH OTOLARYNGOL, V123, P401 GRYMER L F, 1991, Rhinology (Utrecht), V29, P35 GRYMER LF, 1989, LARYNGOSCOPE, V99, P1180 Hamilton JW, 1997, CLIN OTOLARYNGOL, V22, P408, DOI 10.1046/j.1365-2273.1997.00044.x HAMILTON JW, 1995, ACTA OTO-LARYNGOL, V115, P811, DOI 10.3109/00016489509139406 Hilberg O, 1998, J APPL PHYSIOL, V84, P1030 Hilberg O, 2001, RHINOLOGY, V39, P119 HILBERG O, 1989, J APPL PHYSIOL, V66, P295 Hilberg O, 1996, J APPL PHYSIOL, V80, P1589 Huizing EH, 2003, RHINOLOGY, V41, P129 KASPERBAUER JL, 1987, OTOLARYNG CLIN N AM, V20, P699 Lenders Heinrich, 1994, Rhinology (Utrecht), V32, P167 LENDERS H, 1990, Rhinology (Utrecht), V28, P5 MIN YG, 1995, LARYNGOSCOPE, V105, P757, DOI 10.1288/00005537-199507000-00014 Mlynski R, 2003, LARYNGOSCOPE, V113, P290, DOI 10.1097/00005537-200302000-00017 RIECHELMANN H, 1993, CLIN OTOLARYNGOL, V18, P272, DOI 10.1111/j.1365-2273.1993.tb00846.x Terheyden H, 2000, J APPL PHYSIOL, V89, P1013 Tomkinson A, 1998, CLIN OTOLARYNGOL, V23, P20 NR 30 TC 16 Z9 24 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 949 EP 957 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100011 PM 16425563 ER PT J AU Pena, MT Aujla, PK Patel, KM Zalzal, GH Rose, MC AF Pena, MT Aujla, PK Patel, KM Zalzal, GH Rose, MC TI Immunohistochemical analyses of MUC5AC mucin expression in sinus mucosa of children with sinusitis and controls SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 107th Annual Meeting of the American-Academy-of-Otolaryngology-Head-and-Neck-Surgery CY SEP 21-24, 2003 CL ORLANDO, FL SP Amer Acad Otolaryngol Head & Neck Surg DE asthma; epithelium; goblet cell; MUC5AC; mucin; sinusitis ID GOBLET CELL HYPERPLASIA; CHRONIC MAXILLARY SINUSITIS; CHRONIC RHINOSINUSITIS; GENE-EXPRESSION; UP-REGULATION; ASTHMA; ABNORMALITIES; DISEASES; AIRWAYS; MILD AB Objectives: The purpose of this study was to analyze MUC5AC protein expression in sinus mucosal specimens of children with and without chronic sinusitis. Methods: Morphometric, histologic, and immunohistochemical analyses were carried out on sinus mucosa of 7 children with chronic sinusitis and 6 children without sinusitis. Results: MUC5AC protein was expressed in a subset of goblet cells in the surface epithelium, but not in the submucosal glands in either pediatric population. The number of goblet cells that expressed MUC5AC mucin was not significantly different in patients with and without chronic sinusitis. All specimens had similar numbers of goblet cells in the surface epithelium. Conclusions: The data demonstrate that neither goblet cell hyperplasia nor increased MUC5AC expression occurs in the sinus mucosa of children with chronic sinusitis. This suggests that in contrast to asthma, in which goblet cell hyperplasia is present in the lower respiratory tract, mucus hypersecretion in pediatric chronic sinusitis may involve other secretory cells, eg, submucosal glandular cells, and mucins secreted by these glandular cells. C1 Childrens Natl Med Ctr, Dept Otolaryngol, Washington, DC 20010 USA. Childrens Natl Med Ctr, Childrens Res Inst, Washington, DC 20010 USA. RP Pena, MT (reprint author), Childrens Natl Med Ctr, Dept Otolaryngol, 111 Michigan Ave NW, Washington, DC 20010 USA. CR AIKAWA T, 1992, CHEST, V101, P916, DOI 10.1378/chest.101.4.916 Aust MR, 1997, AM J RHINOL, V11, P293, DOI 10.2500/105065897781446685 BAROODY FM, 1995, ARCH OTOLARYNGOL, V121, P1396 Basbaum CB, 1989, LUNG CELL BIOL, P37 Burgel PR, 2000, J ALLERGY CLIN IMMUN, V106, P705, DOI 10.1067/mai.2000.109823 Fahy JV, 2002, CHEST, V122, p320S, DOI 10.1378/chest.122.6_suppl.320S Fldiss JL, 1986, DESIGN ANAL CLIN EXP GANDHI A, 1993, ALLERGY PROC, V14, P37, DOI 10.2500/108854193778816833 GOLDSTEIN NA, 1995, OPERATIVE TECHNIQUES, V6, P180, DOI 10.1016/S1043-1810(06)80010-2 Groneberg DA, 2003, LARYNGOSCOPE, V113, P520, DOI 10.1097/00005537-200303000-00023 Groneberg DA, 2002, HISTOPATHOLOGY, V40, P367, DOI 10.1046/j.1365-2559.2002.01378.x Groneberg DA, 2002, RESP MED, V96, P81, DOI 10.1053/rmed.2001.1221 HILLEMAN MR, 1981, REV INFECT DIS S, V3, P31 HO SB, 1995, GASTROENTEROLOGY, V109, P735, DOI 10.1016/0016-5085(95)90380-1 Hovenberg HW, 1996, BIOCHEM J, V318, P319 Jung HH, 2000, AM J RHINOL, V14, P163, DOI 10.2500/105065800782102690 Kim DH, 2004, ARCH OTOLARYNGOL, V130, P747, DOI 10.1001/archotol.130.6.747 LANDESMAN SH, 1981, REV INFECT DIS, V3, pS184 Lee HM, 2004, ANN OTO RHINOL LARYN, V113, P662 LUND VJ, 1995, ANN OTO RHINOL LARYN, V104, P17 Lund Valerie J., 1993, Rhinology (Utrecht), V31, P183 Lusk RP, 1997, OTOLARYNG HEAD NECK, V117, pS53, DOI 10.1016/S0194-5998(97)70008-1 Majima Y, 1997, LARYNGOSCOPE, V107, P1515, DOI 10.1097/00005537-199711000-00017 MANNING SC, 1993, OTOLARYNG CLIN N AM, V26, P623 Medina J, 1997, AM J RHINOL, V11, P203, DOI 10.2500/105065897781751857 Ordonez CL, 2001, AM J RESP CRIT CARE, V163, P517 Parsons DS, 1996, OTOLARYNG CLIN N AM, V29, P11 Rogers DF, 2004, CURR OPIN PHARMACOL, V4, P241, DOI 10.1016/j.coph.2004.01.011 ROSE MC, IN PRESS PHYSL REV ROSE MC, 1992, AM J PHYSIOL, V263, pL413 *SAS I, 1989, SAS STAT US GUID, P1195 Shinogi J, 2001, LARYNGOSCOPE, V111, P240, DOI 10.1097/00005537-200102000-00010 SPICER SS, 1971, LAB INVEST, V25, P483 STIERNA P, 1990, ACTA OTO-LARYNGOL, V110, P450, DOI 10.3109/00016489009107468 THURLBECK WM, 1975, AM REV RESPIR DIS, V112, P65 TOS M, 1984, ACTA OTO-LARYNGOL, V97, P151, DOI 10.3109/00016488409130975 NR 36 TC 9 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD DEC PY 2005 VL 114 IS 12 BP 958 EP 965 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 993IZ UT WOS:000233949100012 PM 16425564 ER PT J AU Chitkara, A Meyer, T Cultrara, A Blitzer, A AF Chitkara, A Meyer, T Cultrara, A Blitzer, A TI Dose response of topical anesthetic on laryngeal neuromuscular electrical transmission SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 85th Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE anesthesia; dose response; electromyography; larynx; lidocaine; muscle; vocal cord; vocal fold ID UPPER AIRWAY ANESTHESIA; MUSCLE AB Objectives: Our purpose was to determine the effect of a dose response to decreasing concentrations of topical anesthetic upon laryngeal neuromuscular electrical transmission. Methods: We performed a prospective study at a neurolaryngology referral center. Forty-three patients were divided into 5 groups. Each patient underwent laryngeal electromyography (EMG) of a thyroarytenoid muscle before and 60 seconds after topical laryngotracheal lidocaine hydrochloride, normal saline solution, or nothing was applied. The pretreatment and posttreatment measurements were recorded with the same indwelling EMG electrode. Group 1 (n = 12) received 4% lidocaine, group 2 (n = 9) received 2% lidocaine, and group 3 (n = 8) received 1% lidocaine. Group 4 (n 5) received topical normal saline solution instead of lidocame. A fifth group (group 5, n = 9) had 2 EMG recordings measured, each separated by 60 seconds, without topical anesthetic. Results: Groups 1, 2, and 3 showed significant decreases in the maximum peak-to-peak amplitude of the EMG recording (48.5%, 49.7%, 44.7%, respectively). Groups 4 and 5 failed to show a significant change in peak-to-peak amplitude after 60 seconds. There was no dose response change in EMG with decreasing lidocaine concentrations. Conclusions: All concentrations of lidocaine administered in this study decreased the laryngeal neuromuscular electrical transmission as measured by laryngeal EMG. This group of patients did not exhibit any dose response to anesthetic concentration. This finding is clinically significant for both diagnostic and therapeutic uses of laryngeal EMG preceded by administration of topical anesthetic. C1 New York Ctr Voice & Swallowing Disorders, New York, NY USA. RP Chitkara, A (reprint author), 29 Manor Rd, Smithtown, NY 11787 USA. EM aechitkara@yahoo.com CR Aviv JE, 2002, LARYNGOSCOPE, V112, P338, DOI 10.1097/00005537-200202000-00025 BEYDON L, 1995, INTENS CARE MED, V21, P920, DOI 10.1007/BF01712333 Fogel RB, 2000, J APPL PHYSIOL, V88, P1346 INOUE F, 1962, J PHARMACOL EXP THER, V136, P190 Nielson DW, 2000, AM J RESP CRIT CARE, V161, P147 SANTAMBROGIO G, 1983, RESP PHYSIOL, V54, P317, DOI 10.1016/0034-5687(83)90075-0 Sulica L, 2002, ANN OTO RHINOL LARYN, V111, P291 Tinazzi M, 2003, MOVEMENT DISORD, V18, P605, DOI 10.1002/mds.10398 NR 8 TC 0 Z9 0 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 819 EP 821 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300001 PM 16358599 ER PT J AU Teng, MS Malkin, BD Urken, ML AF Teng, MS Malkin, BD Urken, ML TI Prefabricated composite free flaps for tracheal reconstruction: A new technique SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE airway reconstruction; prefabricated composite free flap; tracheal reconstruction ID EAR RECONSTRUCTION; FOREARM FLAP; AUTOGRAFT; DEFECTS AB Objectives: Successful laryngotracheal reconstruction requires both structurally supported tissue that withstands airway pressure changes and well-vascularized epithelial lining to prevent granulation and stricture formation. For circumferential defects, end-to-end anastomosis achieves favorable results, but for long-segment or large noncircumferential defects, no proven methods have emerged. Several animal studies describe prefabricated soft tissue flaps wrapped around synthetic materials or cartilage. However, prefabricated flaps have had very little use in human airway reconstruction. We present a patient with laryngeal stenosis and tracheostomy dependence following chemoradiotherapy for hypopharyngeal carcinoma. Methods: In an attempt to widen the patient's laryngeal airway, a thyrotracheal autograft procedure, previously described by our institution, was performed. We transferred a segment of hemitrachea cephalad using the thyroid gland as a "vascular carrier," thus creating an 8-cm-long trough inferiorly that involved a 40% defect of the anterior tracheal circumference. Severe radiation damage to the cervical skin precluded use of traditional tracheoplasty methods. We used a technique whereby costal cartilage strips were implanted into a radial forearm free flap, designed to replicate the anterior tracheal wall. Results: Four weeks later, we harvested the prefabricated composite flap and placed it into the defect, using forearm skin as tracheal lining. The cervical skin defect was closed with an island deltopectoral flap. A soft stent was kept in the neotrachea for 3 weeks, and a tracheostomy tube was left beneath it. The tracheostomy was subsequently closed with local advancement flaps, and the patient currently maintains an excellent airway. Conclusions: Prefabricated composite free flaps are an attractive option for certain challenging cases of airway reconstruction. C1 Mt Sinai Sch Med, Dept Otolaryngol Head & Neck Surg, New York, NY USA. RP Urken, ML (reprint author), Beth Israel Med Ctr, Continuum Canc Ctr New York, Inst Head & Neck & Thyroid Canc, 10 Union Sq E,Suite 5B, New York, NY 10003 USA. CR ABBASE EA, 1995, PLAST RECONSTR SURG, V96, P1218, DOI 10.1097/00006534-199510000-00036 Akin S, 2001, J RECONSTR MICROSURG, V17, P233, DOI 10.1055/s-2001-14514 Cavadas PC, 1996, PLAST RECONSTR SURG, V98, P1052, DOI 10.1097/00006534-199611000-00020 Dal T, 2000, OTOLARYNG HEAD NECK, V123, P607, DOI 10.1067/mhn.2000.109475 Delaere PR, 2001, ANN OTO RHINOL LARYN, V110, P849 Germain M A, 1993, Chirurgie, V119, P263 ITOH Y, 1992, J RECONSTR MICROSURG, V8, P359, DOI 10.1055/s-2007-1006718 Kuriloff DB, 1996, ARCH OTOLARYNGOL, V122, P1385 Pribaz JJ, 1999, PLAST RECONSTR SURG, V104, P357, DOI 10.1097/00006534-199908000-00005 ZHOU G, 1994, MICROSURG, V15, P660, DOI 10.1002/micr.1920150912 Zur KB, 2003, LARYNGOSCOPE, V113, P1494, DOI 10.1097/00005537-200309000-00014 NR 11 TC 14 Z9 16 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 822 EP 826 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300002 PM 16358600 ER PT J AU Dauer, EH Freese, DK El-Youssef, M Thompson, DM AF Dauer, EH Freese, DK El-Youssef, M Thompson, DM TI Clinical characteristics of eosinophilic esophagitis in children SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE dysphagia; eosinophil; esophagitis; pediatrics; reflux esophagitis ID DYSPHAGIA; CORTICOSTEROIDS; STENOSIS AB Objectives: The role of eosinophilic esophagitis (EE) in aerodigestive tract disorders in children is underestimated and overlooked, primarily because of a lack of understanding of this disorder by otolaryngologists. We sought to better characterize the clinical presentation of EE in order to increase awareness among otolaryngologists. Methods: We retrospectively reviewed 71 children with biopsy-proven EE to determine the most common symptoms and laboratory findings that should increase the clinical suspicion of EE. Results: Dysphagia, food impaction, and emesis were the most common symptoms in children with EE. Asthma was the most common airway diagnosis. Rhinosinusitis was the most common otolaryngological diagnosis. Food allergy was present in 60% of the children tested. Eighty-three percent of the children with elevated immunoglobulin E levels had thick linear streaking or patchy white exudate of the esophagus seen on esophagoscopy. Other major medical comorbidities existed in more than half of the children with EE, of which psychiatric disorders and other disorders of the aerodigestive tract were the most common. Conclusions: Eosinophilic esophagitis may contribute to treatment failure in patients with common and complicated aerodigestive tract disorders. To encourage clinicians to avoid overlooking the diagnosis, we present an evaluative algorithm to increase the suspicion of this entity. C1 Mayo Clin, Dept Otorhinolaryngol, Rochester, MN 55905 USA. Mayo Clin, Dept Pediat, Div Gastroenterol & Hepatol, Rochester, MN 55905 USA. RP Thompson, DM (reprint author), Mayo Clin, Dept Otorhinolaryngol, W 5 ENT,200 1st St SW, Rochester, MN 55905 USA. CR ATTWOOD SEA, 1993, DIGEST DIS SCI, V38, P109, DOI 10.1007/BF01296781 Cheung KM, 2003, J PEDIATR GASTR NUTR, V37, P498, DOI 10.1097/00005176-200310000-00018 Faubion WA, 1998, J PEDIATR GASTR NUTR, V27, P90, DOI 10.1097/00005176-199807000-00016 FECZKO PJ, 1985, GASTROINTEST RADIOL, V10, P321, DOI 10.1007/BF01893121 Fox VL, 2002, GASTROINTEST ENDOSC, V56, P260, DOI 10.1067/mge.2002.126390 Furuta Glenn T, 2002, Curr Allergy Asthma Rep, V2, P67, DOI 10.1007/s11882-002-0042-x Furuta G T, 2001, Gastrointest Endosc Clin N Am, V11, P683 Garrett JK, 2004, J ALLERGY CLIN IMMUN, V113, P115, DOI 10.1016/j.jaci.2003.10.049 Gupta SK, 1997, GASTROINTEST ENDOSC, V45, P485, DOI 10.1016/S0016-5107(97)70178-0 Hartnick CJ, 2002, ANN OTO RHINOL LARYN, V111, P57 KELLY KJ, 1995, GASTROENTEROLOGY, V109, P1503, DOI 10.1016/0016-5085(95)90637-1 LANDRES RT, 1978, GASTROENTEROLOGY, V74, P1298 Langdon DE, 2000, AM J GASTROENTEROL, V95, P2123 LEE RG, 1985, AM J SURG PATHOL, V9, P475, DOI 10.1097/00000478-198507000-00002 Liacouras CA, 1998, J PEDIATR GASTR NUTR, V26, P380, DOI 10.1097/00005176-199804000-00004 Liacouras CA, 2003, J PEDIATR GASTR NUTR, V37, pS23, DOI 10.1097/00005176-200311001-00006 Liacouras CA, 1997, J PEDIATR SURG, V32, P1504, DOI 10.1016/S0022-3468(97)90577-7 Orenstein SR, 2001, AM J GASTROENTEROL, V96, P2290 PICUS D, 1981, AM J ROENTGENOL, V136, P1001 Siafakas CG, 2000, AM J GASTROENTEROL, V95, P1572 Spergel JM, 2002, J ALLERGY CLIN IMMUN, V109, P363, DOI 10.1067/mai.2002.121458 Teitelbaum JE, 2002, GASTROENTEROLOGY, V122, P1216, DOI 10.1053/gast.2002.32998 Vasilopoulos S, 2002, GASTROINTEST ENDOSC, V55, P99, DOI 10.1067/mge.2002.118645 NR 23 TC 32 Z9 33 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 827 EP 833 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300003 PM 16358601 ER PT J AU Wemer, RD Lee, JH Hoffman, HT Robinson, RA Smith, RJH AF Wemer, RD Lee, JH Hoffman, HT Robinson, RA Smith, RJH TI Case of progressive dysplasia concomitant with intralesional cidofovir administration for recurrent respiratory papillomatosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE antiviral; carcinogen; cidofovir; recurrent respiratory papillomatosis ID LARYNGEAL PAPILLOMATOSIS; HUMAN PAPILLOMAVIRUS; INJECTIONS; CHILDREN AB Recurrent respiratory papillomatosis (RRP) is characterized by benign wartlike growths in the larynx with occasional spread to the lungs. A broad range of therapeutic measures have been used to treat RRP; the primary treatment is laser vaporization of the lesions. Recurrences of the disease are common, and alternate methods of treatment are being used to prevent recurrence, including cidofovir. Cidofovir is a cytosine nucleotide analog with antiviral properties that is approved by the US Food and Drug Administration for treatment of cytomecalovirus retinitis and is currently being used off-label for RRP. Cidofovir has gained initial success in slowing the rate of disease recurrence when used at the time of surgery. However, the use of cidofovir lends concern to several adverse side effects, including the potential for carcinogenesis. We report here a 28-year-old woman who was treated with intralesional cidofovir at the time of surgery over the span of 27 months. The initial pathology results demonstrated benign disease with progression to severe dysplasia during the treatment time. Cidofovir's potential for carcinogenicity remains largely undefined, and thus, we are currently undertaking a project involving the evaluation of sequential paraffin-embedded samples of resections from a large cohort of patients with RRP treated at the University of Iowa Hospitals and Clinics. C1 Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. RP Hoffman, HT (reprint author), Univ Iowa, Dept Otolaryngol, 200 Hawkins Dr, Iowa City, IA 52242 USA. CR Chhetri DK, 2002, OTOLARYNG HEAD NECK, V126, P642, DOI 10.1067/mhn.2002.125604 CRISSMAN JD, 2001, DIAGNOSTIC SURG PATH, P1 DERKAY CS, 1995, ARCH OTOLARYNGOL, V121, P1386 El Hakim H, 2002, J OTOLARYNGOL, V31, P333, DOI 10.2310/7070.2002.34526 GAYLIS B, 1991, AM J OTOLARYNG, V12, P104, DOI 10.1016/0196-0709(91)90045-H Johnson JA, 1999, ANTIMICROB AGENTS CH, V43, P1198 Lalezari JP, 1997, ANN INTERN MED, V126, P257 Milczuk HA, 2003, OTOLARYNG HEAD NECK, V128, P788, DOI 10.1016/S0194-5998(03)00259-6 Pransky SM, 2000, ARCH OTOLARYNGOL, V126, P1239 Pransky SM, 2003, LARYNGOSCOPE, V113, P1583, DOI 10.1097/00005537-200309000-00032 Pransky SM, 1999, ARCH OTOLARYNGOL, V125, P1143 QUICK CA, 1979, LARYNGOSCOPE, V89, P550 Snoeck R, 1998, J MED VIROL, V54, P219, DOI 10.1002/(SICI)1096-9071(199803)54:3<219::AID-JMV13>3.0.CO;2-C STEINBERG BM, 1988, ARCH OTOLARYNGOL, V114, P27 VANCUTSEM E, 1995, J MED VIROL, V45, P230, DOI 10.1002/jmv.1890450221 Wutzler P, 2001, ANTIVIR RES, V49, P55, DOI 10.1016/S0166-3542(00)00139-X YODER MG, 1980, OTOLARYNG HEAD NECK, V88, P745 NR 17 TC 29 Z9 29 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 836 EP 839 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300005 PM 16358603 ER PT J AU Spanos, WC El-Deiry, M Lee, JH AF Spanos, WC El-Deiry, M Lee, JH TI Cidofovir incorporation into human keratinocytes with episomal HPV 16 results in nonselective cytotoxicity SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cytotoxicity; human papillomavirus; keratinocyte; recurrent respiratory papillomatosis ID RECURRENT RESPIRATORY PAPILLOMATOSIS; HUMAN-PAPILLOMAVIRUS TYPE-16; INTRALESIONAL CIDOFOVIR; NUCLEOSIDE ANALOGS; IN-VITRO; GROWTH; CYTOMEGALOVIRUS; INHIBITION; INJECTIONS; CANCER AB Objectives: Recurrent respiratory papillomatosis (RRP) is caused by human papillomavirus (HPV). Surgical excision is the mainstay of treatment; however, medical therapy including cidofovir, a cytosine analog, has been investigated. Human papillomavirus does not encode a viral DNA polymerase, which is the known target of cidofovir in cytomegalovirus infections. Methods: In an effort to better understand the usefulness of cidofovir in the treatment of HPV-related disease, we tested cidofovir's ability to inhibit growth, alter gene expression, and inhibit genome replication. Results: With the use of carbon 14-labeled cidofovir in episomal HPV 16-containing keratinocytes, there was a minimal increase in cidofovir incorporation into episomal DNA versus genomic DNA. Cidofovir decreased the copies of episomal HPV 16 in keratinocytes; however, the copies per cell returned to baseline levels once cidofovir was removed. Expression of a viral oncogene (HPV 16 E6) in transformed keratinocytes with episomal HPV 16 was not decreased by cidofovir. Cytotoxicity in head and neck squamous cell carcinoma lines exposed to cidofovir correlated with cell doubling time, and not with HPV status. Also, tonsil keratinocytes transformed with episomal HPV 16 did not exhibit greater cidofovir-mediated toxicity than did telomerase-transformed keratinocytes. Conclusions: These findings suggest that any potential in vivo benefit of cidofovir therapy results from non-viral-specific cell toxicity at the site of application. C1 Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. RP Lee, JH (reprint author), Univ Iowa, Dept Otolaryngol, 200 Hawkins Dr, Iowa City, IA 52242 USA. CR Abdulkarim B, 2002, ONCOGENE, V21, P2334, DOI 10.1038/sj/onc/1205006 Andrei G, 1998, ONCOL RES, V10, P523 Andrei G, 1998, ONCOL RES, V10, P533 Beadle JR, 2002, ANTIMICROB AGENTS CH, V46, P2381, DOI 10.1128/AAC.46.8.2381-2386.2002 Bedard J, 1999, ANTIMICROB AGENTS CH, V43, P557 Braakhuis BJM, 2004, J NATL CANCER I, V96, P998, DOI 10.1093/jnci/djh183 Christensen NB, 2000, GEOPHYS PROSPECT, V48, P1, DOI 10.1046/j.1365-2478.2000.00174.x Cihlar T, 1999, MOL PHARMACOL, V56, P570 DERKAY CS, 1995, ARCH OTOLARYNGOL, V121, P1386 Koskinen WJ, 2003, INT J CANCER, V107, P401, DOI 10.1002/ijc.11381 Lalezari JP, 1997, ANN INTERN MED, V126, P257 LAMBERT PF, 1993, P NATL ACAD SCI USA, V90, P5583, DOI 10.1073/pnas.90.12.5583 Lanham S, 2001, J CLIN PATHOL, V54, P304, DOI 10.1136/jcp.54.4.304 Lee JH, 2004, P NATL ACAD SCI USA, V101, P2094, DOI 10.1073/pnas.0308615100 Liekens S, 2001, INT J CANCER, V92, P161, DOI 10.1002/1097-0215(200102)9999:9999<::AID-IJC1183>3.0.CO;2-K Liekens S, 2001, CANCER RES, V61, P5057 MUNGER K, 1989, J VIROL, V63, P4417 Murono S, 2001, CANCER RES, V61, P7875 Penaloza-Plascencia M, 2000, ARCH OTOLARYNGOL, V126, P1119 Pransky SM, 2000, ARCH OTOLARYNGOL, V126, P1239 Pransky SM, 2003, LARYNGOSCOPE, V113, P1583, DOI 10.1097/00005537-200309000-00032 Pransky SM, 1999, ARCH OTOLARYNGOL, V125, P1143 Redondo P, 2000, BRIT J DERMATOL, V143, P741, DOI 10.1046/j.1365-2133.2000.03769.x SCHEFFNER M, 1993, CELL, V75, P495, DOI 10.1016/0092-8674(93)90384-3 Smith EM, 2000, ANN OTO RHINOL LARYN, V109, P1069 Snoeck R, 1998, J MED VIROL, V54, P219, DOI 10.1002/(SICI)1096-9071(199803)54:3<219::AID-JMV13>3.0.CO;2-C Sprague DL, 2002, VIROLOGY, V301, P247, DOI 10.1006/viro.2002.1542 *THOMPS HEALTHC, 2002, PHYS DESK REF VANCUTSEM E, 1995, J MED VIROL, V45, P230, DOI 10.1002/jmv.1890450221 Wutzler P, 2001, ANTIVIR RES, V49, P55, DOI 10.1016/S0166-3542(00)00139-X Yoshinouchi M, 2003, MOL THER, V8, P762, DOI 10.1016/j.ymthe.2003.08.004 NR 31 TC 11 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 840 EP 846 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300006 PM 16363057 ER PT J AU Berry, DA Reininger, H Alipour, F Bless, DA Ford, CN AF Berry, DA Reininger, H Alipour, F Bless, DA Ford, CN TI Influence of vocal fold scarring on phonation: Predictions from a finite element model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE mucosa; scar; simulation; viscoelasticity; vocal fold; voice ID OPTICAL COHERENCE TOMOGRAPHY; VIBRATION; TISSUES; MUCOSA AB Objectives: A systematic study of the influence of vocal fold scarring on phonation was conducted. In particular, phonatory variables such as fundamental frequency, oral acoustic intensity, and phonation threshold pressure (PTP) were investigated as a function of the size and position of the laryngeal scar. Methods: By means of a finite element model of vocal fold vibration, the viscoelastic properties of both normal and scarred vocal fold mucosae were simulated on the basis of recent rheological data obtained from rabbit and canine models. Results: The study showed that an increase in the viscoelasticity of the scarred mucosa resulted in an increase in fundamental frequency, an increase in PTP, and a decrease in oral acoustic intensity. With regard to positioning of the scar. the PTP increased most significantly when the scar was within +/- 2 min of the superior-medial junction of the vocal folds. Conclusions: The systematic data obtained in this investigation agree with the general clinical experience. In the future, these findings may be further validated on human subjects as newly emerging technologies such as linear skin rheometry and optical coherence tomography allow the histologic and viscoelastic properties of the normal and scarred vocal fold mucosae to be measured in the clinic. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Head & Neck Surg, Laryngeal Dynam Lab, Los Angeles, CA 90095 USA. Univ Iowa, Dept Speech Pathol & Audiol, Iowa City, IA 52242 USA. Univ Wisconsin, Dept Otolaryngol Head & Neck Surg, Madison, WI 53706 USA. RP Berry, DA (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Head & Neck Surg, Laryngeal Dynam Lab, 1000 Vet Ave,Suite 31-24, Los Angeles, CA 90095 USA. 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Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 847 EP 852 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300007 PM 16363058 ER PT J AU Bane, BC Van Rybroek, JM Kolker, SJ Weeks, DL Manaligod, JM AF Bane, BC Van Rybroek, JM Kolker, SJ Weeks, DL Manaligod, JM TI EYA1 expression in the developing inner ear SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 19th Annual Meeting of the American-Society-of-Pediatric-Otolaryngology CY MAY 01-03, 2004 CL Phoenix, AZ SP Amer Soc Pediat Otolaryngol DE branchio-oto-renal syndrome; confocal microscopy; EYA1; inner ear; Xenopus laevis ID EYES-ABSENT GENE; BOR SYNDROME; XENOPUS-LAEVIS; HEARING-LOSS; MANIFESTATIONS; ACTIVATION; MUTATIONS; ANOMALIES; PROTEIN AB Objectives: We sought to determine the developmental anatomy and EYA1 protein distribution in the inner ear of Xenopus laevis. Methods: Xenopus laevis embryos were stained with monoclonal antibodies and imaged with confocal microscopy. Results: At stage 27, the otocyst fully forms, with strong tubulin staining of early sensory cells at its ventromedial aspect. Neuronal ingrowth follows at stage 33/34. At stage 50, the semicircular canals are complete. EYA1 localizes to the anterior aspect of the otocyst from stages 37 to 44. By stage 50, EYA1 distribution is localized primarily to the sensory maculae and the endolymphatic duct of the developing inner ear. Conclusions: Whole mount confocal imaging of the developing Xenopus inner ear delineates the exact timing of otic development, sensory cell differentiation, and innervation. EYA1 protein expression has a distinct distribution pattern at the anterior aspect of the developing otocyst in stages 41 and 44. Later stages have a more localized pattern, in which EYA1 is detected only in the sensory epithelium and endolymphatic duct. This specific pattern of expression indicates a possible role in the determination of the anterior-posterior orientation of the inner ear, as well as a later role in sensory cell differentiation. C1 Univ Iowa, Roy J & Lucille A Carver Coll Med, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. Univ Iowa, Roy J & Lucille A Carver Coll Med, Dept Biochem, Iowa City, IA 52242 USA. RP Manaligod, JM (reprint author), Univ Iowa, Roy J & Lucille A Carver Coll Med, Dept Otolaryngol Head & Neck Surg, 200 Hawkins Dr, Iowa City, IA 52242 USA. RI Weeks, Daniel/F-6216-2010 CR Abdelhak S, 1997, HUM MOL GENET, V6, P2247, DOI 10.1093/hmg/6.13.2247 Azuma N, 2000, HUM MOL GENET, V9, P363, DOI 10.1093/hmg/9.3.363 Bever MM, 2003, DEV DYNAM, V227, P422, DOI 10.1002/dvdy.10316 Bonini NM, 1997, DEVELOPMENT, V124, P4819 BONINI NM, 1993, CELL, V72, P379, DOI 10.1016/0092-8674(93)90115-7 Dagle JM, 2003, DEV BIOL, V262, P268, DOI 10.1016/S0012-1606(03)00389-0 David R, 2001, MECH DEVELOP, V103, P189, DOI 10.1016/S0925-4773(01)00355-0 FRASER FC, 1980, AM J MED GENET, V7, P341, DOI 10.1002/ajmg.1320070316 FRASER FC, 1978, AM J MED GENET, V2, P241, DOI 10.1002/ajmg.1320020305 Graham GE, 1999, AM J MED GENET, V86, P20, DOI 10.1002/(SICI)1096-8628(19990903)86:1<20::AID-AJMG5>3.0.CO;2-H Ikeda K, 2002, MOL CELL BIOL, V22, P6759, DOI 10.1128/MCB.22.19.6759-6766.2002 Kil SH, 2001, DEV BIOL, V233, P365, DOI 10.1006/dbio.2001.0211 Kolker SJ, 2000, DEV BIOL, V218, P64, DOI 10.1006/dbio.1999.9558 Li X, 2004, NATURE, V427, P265, DOI 10.1038/nature02283 MARAZITA ML, 1993, AM J MED GENET, V46, P486, DOI 10.1002/ajmg.1320460504 NANCE WE, 2003, MENT RETARD DEV D R, V49, P109 Nieuwkoop P. D., 1994, NORMAL TABLE XENOPUS, P252 Ohto H, 1999, MOL CELL BIOL, V19, P6815 Stinckens C, 2001, INT J PEDIATR OTORHI, V59, P163, DOI 10.1016/S0165-5876(01)00473-6 Tootle TL, 2003, NATURE, V426, P299, DOI 10.1038/nature02097 Weber KM, 1999, CLIN GENET, V56, P306, DOI 10.1034/j.1399-0004.1999.560408.x Xu PX, 1999, NAT GENET, V23, P113 NR 22 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 853 EP 858 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300008 PM 16358604 ER PT J AU Ito, K Endo, A Monobe, H Ochiai, A Iwasaki, S AF Ito, K Endo, A Monobe, H Ochiai, A Iwasaki, S TI Nonsyndromic isolated unilateral cochlear nerve aplasia without narrow internal auditory meatus: A previously overlooked cause of unilateral profound deafness in childhood SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE aplasia; cochlear nerve; unilateral profound sensorineural deafness ID EVOKED MYOGENIC POTENTIALS; HEARING-LOSS; CHILDREN AB Objectives: Juvenile or adolescent unilateral profound sensorineural deafness (worldwide prevalence, 0.1% to 0.2%) has been attributed to postnatal viral infection, sudden deafness, prenatal and perinatal problems including maternal rubella and viral infections, congenital inner ear anomalies, and other factors. Herein, 2 cases are reported and another potentially important cause of unilateral profound hearing loss is proposed. Methods: Two nonsyndromic cases of a presently "very rare" cause of pediatric unilateral deafness are presented as a retrospective case study. Results: The 2 patients showed isolated aplasia of the cochlear nerve; other branches of the eighth cranial nerve, the seventh nerve, and the inner ear were spared, and there was no anomaly of the internal auditory meatus. Both functional and imaging studies confirmed the isolated lesion (absence) of the cochlear nerve. Conclusions: Because of the absence of bony abnormalities, such cases may have been overlooked. The authors would like to advocate this isolated anomaly of the cochlear nerve as an important cause of juvenile or adolescent unilateral profound deafness. C1 Univ Tokyo, Fac Med, Dept Otolaryngol, Bunkyo Ku, Tokyo 1138655, Japan. RP Ito, K (reprint author), Univ Tokyo, Fac Med, Dept Otolaryngol, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1138655, Japan. CR ANDERSON H, 1970, Acta Oto-Laryngologica, V69, P77, DOI 10.3109/00016487009123337 Casselman JW, 1997, RADIOLOGY, V202, P773 EVERBERG G, 1960, Ann Otol Rhinol Laryngol, V69, P711 EVERBERG G, 1960, Acta Otolaryngol, V52, P253, DOI 10.3109/00016486009123146 Glastonbury CM, 2002, AM J NEURORADIOL, V23, P635 Ito K, 2001, ARCH OTOLARYNGOL, V127, P275 Ito K, 1998, ARCH OTOLARYNGOL, V124, P1389 MANABE T, 1979, AUDIOL JPN, V22, P211 MARTTILA TI, 1986, INT J PEDIATR OTORHI, V11, P39, DOI 10.1016/S0165-5876(86)80026-X Murofushi T, 1998, ARCH OTOLARYNGOL, V124, P509 Nelson EG, 2001, OTOL NEUROTOL, V22, P790, DOI 10.1097/00129492-200111000-00013 SHELTON C, 1989, OTOLARYNG HEAD NECK, V100, P227 Tarkkanen J, 1966, Acta Otolaryngol, V61, P270, DOI 10.3109/00016486609127063 Thai-Van Hung, 2001, Annals of Otology Rhinology and Laryngology, V110, P388 Yates JA, 1997, INT J PEDIATR OTORHI, V41, P1, DOI 10.1016/S0165-5876(97)00044-X Zakzouk SM, 1996, ANN OTO RHINOL LARYN, V105, P882 NR 16 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 859 EP 862 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300009 PM 16358605 ER PT J AU Migirov, L Kronenberg, J AF Migirov, L Kronenberg, J TI Radiology of the cochlear aqueduct SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cochlear aqueduct; imaging ID ADULT HUMAN; ANATOMY; EAR AB Objectives: We sought to determine normative data for the radiologic presentation of the cochlear aqueduct (CA), hypothesizing that increasing the scanner's resolution could enhance detection capability. Methods: Axial sections of 502 high-resolution computed tomography (CT) images of temporal bones (488 patients) were reviewed. A type I CA was visualized on CT scans up to the vestibule, and its portion in the otic capsule segment could be seen as a thin ( < 1 mm) streak. In type 2, we were able to detect the medial two thirds of the structure, but we failed to see the whole otic capsule portion. In type 3, only the external aperture of the aqueduct and/or the medial third was seen. We defined undetectable CAs as type 4. Results: We obtained CT scans with 0.6-, 1.1-, or 1.3-mm-thick slices through the petrous bones in 9.5%, 58.8%, and 31.7% of cases, respectively. The CA was visible and bilaterally symmetric in 49% of the images, and type 2 was the most commonly detected CA type (36%). The CA was invisible on either side in 21.9% of scans, irrespective of CT resolution, and was asymmetric in 53 of the 502 images. The CA types varied with changes in resolution, although type 3 appeared unchanged independent of alterations in resolution in most cases. Conclusions: There was no significant difference in CT detection capability between CA types at different resolutions. Computed tomography failed to demonstrate any CAs >= 1 mm in width in the otic capsule segment. C1 Tel Aviv Univ, Chaim Sheba Med Ctr, Dept Otolaryngol Head & Neck Surg, IL-52621 Tel Hashomer, Israel. Tel Aviv Univ, Sackler Fac Med, IL-52621 Tel Hashomer, Israel. RP Migirov, L (reprint author), Tel Aviv Univ, Chaim Sheba Med Ctr, Dept Otolaryngol Head & Neck Surg, IL-52621 Tel Hashomer, Israel. CR ANSON BJ, 1965, LARYNGOSCOPE, V75, P1203 ARENBERG IK, 1984, LARYNGOSCOPE, V94, P1325 Arnold W, 2002, ORL J OTO-RHINO-LARY, V64, P382, DOI 10.1159/000067579 HEMMINGSSON A, 1974, ACTA RADIOL DIAGN, V15, P612 JACKLER RK, 1993, OTOLARYNG HEAD NECK, V109, P14 Krombach GA, 2002, EUR RADIOL, V12, P2770, DOI 10.1007/s00330-002-1306-5 Mukherji SK, 1998, AM J NEURORADIOL, V19, P330 MUREN C, 1986, ACTA RADIOL, V27, P11 PALVA T, 1970, ACTA OTO-LARYNGOL, V70, P83 RASKANDERSEN H, 1977, ANN OTOL RHINOL S42, V86 RITTER FN, 1965, LARYNGOSCOPE, V75, P1224 SCHUKNEC.HF, 1973, ACTA OTO-LARYNGOL, V76, P75, DOI 10.3109/00016487309121486 STRAUSS M, 1983, LARYNGOSCOPE, V93, P1341 SU WY, 1982, LARYNGOSCOPE, V92, P483 Yilmazer C, 2001, OTOL NEUROTOL, V22, P534, DOI 10.1097/00129492-200107000-00021 NR 15 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 863 EP 866 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300010 PM 16358606 ER PT J AU Elangovan, S Stuart, A AF Elangovan, S Stuart, A TI Interactive effects of high-pass filtering and masking noise on word recognition SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Auditory-Society CY MAR, 2004 CL Scottsdale, AZ SP Amer Auditory Soc DE hearing loss; temporal masking; temporal resolution; word recognition ID HEARING-IMPAIRED LISTENERS; BROAD-BAND NOISE; AUDITORY TEMPORAL RESOLUTION; AMPLITUDE-MODULATED NOISE; SPEECH RECOGNITION; INTERRUPTED NOISE; PULSED MASKING; OLDER-ADULTS; PERFORMANCE; FREQUENCY AB Objectives: This study sought to examine the word recognition performance in noise of individuals with a simulated low-frequency hearing loss. The goal was to understand how low-frequency hearing impairment affects performance on tasks that challenge temporal processing skills. Methods: Twenty-two normal-hearing young adults participated. Monosyllabic words were presented in continuous and interrupted noise at 3 signal-to-noise ratios of -10, 0, and +10 dB. High-pass filtering of the stimuli at 3 different cutoff frequencies (ie, 1,000, 1,250, and 1,500 Hz) simulated the low-frequency hearing impairment. Results: In general, performance decreased with increasing cutoff frequency, was higher for more favorable signal-to-noise ratios, and was superior in the interrupted condition relative to the continuous noise condition. One important revelation was that the magnitude of the performance superiority observed in the interrupted noise condition did not diminish with high-pass filtering; ie, the release from masking in interrupted noise was preserved. Conclusions: The results of the present study complement previous findings in which this paradigm was used with lowpass filtering to simulate a high-frequency hearing loss. That is to say, low-frequency hearing channels are inherently poorer than high-frequency channels in temporal resolution. C1 E Carolina Univ, Sch Allied Hlth Sci, Dept Commun Sci & Disorders, Greenville, NC 27858 USA. RP Stuart, A (reprint author), E Carolina Univ, Sch Allied Hlth Sci, Dept Commun Sci & Disorders, 4S-22 Brody, Greenville, NC 27858 USA. CR *AM NATL STAND I, 1999, CRIT PERM AMB NOIS A *AM SPEECH LANG HE, 1997, PAN AUD ASS GUID AUD BACON SP, 1992, J SPEECH HEAR RES, V35, P642 Bacon SP, 1998, J SPEECH LANG HEAR R, V41, P549 BACON SP, 1985, AUDIOLOGY, V24, P117 Bergman M., 1980, AGING PERCEPTION SPE Bornstein S P, 1994, J Am Acad Audiol, V5, P259 BUUS S, 1985, GAP DETECTION NORMAL, P159 de Laat J. A. P. M., 1983, HEARING PHYSL BASES, P359 DIRKS DD, 1969, J ACOUST SOC AM, V46, P898, DOI 10.1121/1.1911808 Dubno JR, 2003, J ACOUST SOC AM, V113, P2084, DOI 10.1121/1.1555611 Dubno JR, 2002, J ACOUST SOC AM, V111, P2897, DOI 10.1121/1.1480421 EGAN JP, 1946, J ACOUST SOC AM, V18, P435, DOI 10.1121/1.1916384 EISENBERG LS, 1995, J SPEECH HEAR RES, V38, P222 Festen J. M., 1987, PSYCHOPHYSICS SPEECH, P461 FESTEN JM, 1990, J ACOUST SOC AM, V88, P1725, DOI 10.1121/1.400247 FRENCH NR, 1947, J ACOUST SOC AM, V19, P90, DOI 10.1121/1.1916407 GUSTAFSSON HA, 1994, J ACOUST SOC AM, V95, P518, DOI 10.1121/1.408346 Hornsby BWY, 2003, J ACOUST SOC AM, V113, P1706, DOI 10.1121/1.1553458 HUMES LE, 1988, J ACOUST SOC AM, V83, P188, DOI 10.1121/1.396420 LOVEN FC, 1988, J SPEECH HEAR RES, V31, P681 MILLER GA, 1947, PSYCHOL BULL, V44, P105, DOI 10.1037/h0055960 MILLER GA, 1950, J ACOUST SOC AM, V22, P167, DOI 10.1121/1.1906584 MOORE B C J, 1985, British Journal of Audiology, V19, P189, DOI 10.3109/03005368509078973 Moore BC., 2003, INTRO PSYCHOL HEARIN MOORE BCJ, 1993, ANN NY ACAD SCI, V682, P119, DOI 10.1111/j.1749-6632.1993.tb22964.x MOORE BCJ, 1989, J ACOUST SOC AM, V85, P1266, DOI 10.1121/1.397457 MOORE BCJ, 1988, J ACOUST SOC AM, V83, P1102, DOI 10.1121/1.396055 NELSON DA, 1987, J ACOUST SOC AM, V81, P709, DOI 10.1121/1.395131 PHILLIPS DP, 1987, J ACOUST SOC AM, V82, P1, DOI 10.1121/1.395547 PHILLIPS DP, 1995, AM J OTOL, V16, P338 PHILLIPS DP, 1994, AM J OTOL, V15, P679 PHILLIPS DP, 1986, J ACOUST SOC AM, V80, P177, DOI 10.1121/1.394178 PLACK CJ, 1990, J ACOUST SOC AM, V87, P2178, DOI 10.1121/1.399185 PLOMP R, 1978, J ACOUST SOC AM, V63, P533, DOI 10.1121/1.381753 POLLACK I, 1948, J ACOUST SOC AM, V20, P259, DOI 10.1121/1.1906369 PUNCH JL, 1978, J AM AUDITORY SOC, V3, P245 RAPPAPORT JM, 1994, J OTOLARYNGOL, V23, P307 Scott T, 2001, J Am Acad Audiol, V12, P437 SHAILER MJ, 1987, J ACOUST SOC AM, V81, P1110, DOI 10.1121/1.394631 SHAPIRO MT, 1972, ANN OTO RHINOL LARYN, V81, P241 SHERBECOE RL, 1993, EAR HEARING, V14, P104 SOUZA PE, 1994, J SPEECH HEAR RES, V37, P655 Stuart Andrew, 2004, Am J Audiol, V13, P23, DOI 10.1044/1059-0889(2004/005) Stuart A, 1999, J COMMUN DISORD, V32, P317, DOI 10.1016/S0021-9924(99)00006-4 Stuart A, 1997, SCAND AUDIOL, V26, P112, DOI 10.3109/01050399709074983 STUART A, 1995, AM J OTOL, V16, P658 Stuart A, 1998, J Am Acad Audiol, V9, P199 Stuart Andrew, 1998, Seminars in Hearing, V19, P333, DOI 10.1055/s-0028-1082981 Stuart A, 1996, EAR HEARING, V17, P478, DOI 10.1097/00003446-199612000-00004 STUDEBAKER GA, 1993, J SPEECH HEAR RES, V36, P799 STUDEBAKER GA, 1985, J SPEECH HEAR RES, V28, P455 Summers V, 2004, J SPEECH LANG HEAR R, V47, P245, DOI 10.1044/1092-4388(2004/020) TAKAHASHI GA, 1992, J SPEECH HEAR RES, V35, P1410 TILLMAN WW, 1966, SAMTR6655 BROOKS AIR TURNER CW, 1995, J ACOUST SOC AM, V97, P2568, DOI 10.1121/1.411911 Viemeister N. F., 1993, HUMAN PSYCHOPHYSICS, P116 WAGENAAR WA, 1969, PSYCHOL BULL, V72, P384, DOI 10.1037/h0028329 WILSON RH, 1969, J ACOUST SOC AM, V46, P998, DOI 10.1121/1.1911820 WILSON RH, 1991, J SPEECH HEAR RES, V34, P1436 WILSON RH, 1990, J SPEECH HEAR DISORD, V55, P771 NR 61 TC 5 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 867 EP 878 PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300011 PM 16358607 ER PT J AU Shun, CT Lin, SK Hong, CY Kok, SH Juan, YH Wang, CC Hsu, MC Liu, CM AF Shun, CT Lin, SK Hong, CY Kok, SH Juan, YH Wang, CC Hsu, MC Liu, CM TI C-C chemokine ligand 2 gene expression in nasal polyp fibroblasts: Possible implication in the pathogenesis of nasal polyposis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE C-C chemokine ligand 2; COX-2; fibroblast; nasal polyp; tumor necrosis factor alpha ID MONOCYTE CHEMOATTRACTANT PROTEIN-1; MATRIX METALLOPROTEINASE-1; DIFFERENTIAL REGULATION; CHRONIC SINUSITIS; TISSUE INHIBITOR; PROSTAGLANDIN; CELLS; ALPHA; CYCLOOXYGENASE-2; RECRUITMENT AB Objectives: Recruitment of macrophages is essential to the pathogenesis of nasal polyps (NP), since this disease is inflammation-related. In this study, the effects of tumor necrosis factor alpha (TNF-alpha) on the expression of C-C chemokine ligand 2 (CCL2) in fibroblasts derived from nasal polyps (NPFs) were investigated. The roles of cyclooxygenase (COX) 2 and Prostaglandins in the mediation of TNF-alpha-stimulated CCL2 gene expression were also investigated. Methods: Northern blot analysis was used to study the expression of CCL2 and c-Fos in cultured NPFs. An electrophoretic mobility shift assay was used to explore the interactions between activator protein 1 (AP-1) and DNA. Immunohistochemistry was used to explore the in vivo expressions of COX-2, CCL2, and CD68 in NPs. Results: The Northern blot analysis showed that TNF-alpha stimulated the expression of CCL2 and COX-2 genes, and the synthesis of CCL2 messenger RNA was COX-2-dependent. A transient elevation of c-Fos and c-Jun messenger RNAs was induced by TNF-alpha, whereas COX-2 inhibitors NS-398 and meloxicam abolished the up-regulation of c-Fos. The electrophoretic mobility shift assay revealed that TNF-alpha triggered AP-1 and DNA binding and again, NS-398 and meloxicam inhibited this reaction via reducing c-Fos synthesis. Curcumin (AP-1 inhibitor) markedly suppressed the TNF-alpha-induced CCL2 expression. The immunohistochemical staining of NP surgical specimens also revealed an intimate alignment between CCL2-positive fibroblasts and CD-68-positive macrophages. Conclusions: These data suggest that NPFs may contribute to NP development by synthesizing CCL2 to promote macrophage recruitment. Furthermore, COX-2 facilitates CCL2 transcription in NPFs via a c-Fos and AP-1 signaling pathway. C1 Natl Taiwan Univ Hosp, Dept Otolaryngol, Taipei 10016, Taiwan. Natl Taiwan Univ Hosp, Dept Forens Med, Taipei 10016, Taiwan. Natl Taiwan Univ Hosp, Grad Inst Clin Med, Taipei 10016, Taiwan. RP Liu, CM (reprint author), Natl Taiwan Univ Hosp, Dept Otolaryngol, 1 Chang Teh St, Taipei 10016, Taiwan. CR Davidsson A, 1996, ACTA OTO-LARYNGOL, V116, P604, DOI 10.3109/00016489609137897 Ghaffar O, 1998, OTOLARYNG HEAD NECK, V118, P504, DOI 10.1016/S0194-5998(98)70209-8 HAI T, 1991, P NATL ACAD SCI USA, V88, P3720, DOI 10.1073/pnas.88.9.3720 HEMLER ME, 1980, J BIOL CHEM, V255, P6253 HICKS W, 1995, CELL BIOL INT, V19, P301, DOI 10.1006/cbir.1995.1072 HOSEMANN W, 1994, AM J OTOLARYNG, V15, P85, DOI 10.1016/0196-0709(94)90056-6 Janabi N, 1999, J IMMUNOL, V162, P1701 Kanellis J, 2003, HYPERTENSION, V41, P1287, DOI 10.1161/01.HYP.0000072820.07472.3B Karin M, 1997, CURR OPIN CELL BIOL, V9, P240, DOI 10.1016/S0955-0674(97)80068-3 Lee CH, 1998, ANN OTO RHINOL LARYN, V107, P665 Lin SK, 2001, J ENDODONT, V27, P185, DOI 10.1097/00004770-200103000-00012 Lin SK, 2004, ARTHRITIS RHEUM, V50, P785, DOI 10.1002/art.20058 Liu CM, 2002, ARCH OTOLARYNGOL, V128, P945 Liu CM, 2001, ANN OTO RHINOL LARYN, V110, P1129 MULLOL J, 1995, CLIN EXP ALLERGY, V25, P607, DOI 10.1111/j.1365-2222.1995.tb01108.x OPPENHEIM JJ, 1991, ANNU REV IMMUNOL, V9, P617 PATRIARCA G, 1991, LANCET, V337, P1488, DOI 10.1016/0140-6736(91)93185-C Rollins BJ, 1996, MOL MED TODAY, V2, P198, DOI 10.1016/1357-4310(96)88772-7 Sanchez-Segura A, 2000, LARYNGOSCOPE, V110, P1183 SEIBERT K, 1994, P NATL ACAD SCI USA, V91, P12013, DOI 10.1073/pnas.91.25.12013 van Dam H, 2001, ONCOGENE, V20, P2453, DOI 10.1038/sj.onc.1204239 Volejnikova S, 1997, AM J PATHOL, V150, P1711 Zhang YH, 1998, J IMMUNOL, V161, P3071 NR 23 TC 6 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 879 EP 885 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300012 PM 16358608 ER PT J AU Xu, L Zwolan, TA Thompson, CS Pfingst, BE AF Xu, L Zwolan, TA Thompson, CS Pfingst, BE TI Efficacy of a cochlear implant Simultaneous Analog Stimulation strategy coupled with a monopolar electrode configuration SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cochlear implant; electrode configuration; Simultaneous Analog Stimulation; speech processing strategy; speech recognition ID SPEECH-DISCRIMINATION; PATIENT PERFORMANCE; RECOGNITION; THRESHOLDS; PERCEPTION; ACTIVATION; PROSTHESES; BIPOLAR; ADULTS; MPEAK AB Objectives: The present study was performed to evaluate the efficacy and clinical feasibility of using monopolar stimulation with the Clarion Simultaneous Analog Stimulation (SAS) strategy in patients with cochlear implants. Methods: Speech recognition by 10 Clarion cochlear implant users was evaluated by means of 4 different speech processing strategy/electrode configuration combinations; ie, SAS and Continuous Interleaved Sampling (CIS) strategies were each used with monopolar (MP) and bipolar (BP) electrode configurations. The test measures included consonants, vowels, consonant-nucleus-consonant words, and Hearing in Noise Test sentences with a +10 dB signal-to-noise ratio. Additionally, subjective judgments of sound quality were obtained for each strategy/configuration combination. Results: All subjects but 1 demonstrated open-set speech recognition with the SAS/MP combination. The group mean Hearing in Noise Test sentence score for the SAS/MP combination was 31.6% (range, 0% to 92%) correct, as compared to 25.0%, 46.7%, and 37.8% correct for the CIS/BP, CIS/MP, and SAS/BP combinations, respectively. Intersubject variability was high, and there were no significant differences in mean speech recognition scores or mean preference ratings among the 4 strategy/configuration combinations tested. Individually, the best speech recognition performance was with the subject's everyday strategy/configuration combination in 72% of the applicable cases. If the everyday strategy was excluded from the analysis, the subjects performed best with the SAS/MP combination in 37.5% of the remaining cases. Conclusions: The SAS processing strategy with an NIP electrode configuration gave reasonable speech recognition in most subjects, even though subjects had minimal previous experience with this strategy/configuration combination. The SAS/MP combination might be particularly appropriate for patients for whom a full dynamic range of electrical hearing could not be achieved with a BP configuration. C1 Ohio Univ, Sch Hearing Speech & Language Sci, Athens, OH 45701 USA. Ohio Univ, Kresge Hearing Res Inst, Dept Otolaryngol, Athens, OH 45701 USA. Ohio Univ, Cochlear Implant Program, Dept Otolaryngol, Athens, OH 45701 USA. Ohio Univ, Sch Hearing Speech & Language Sci, Athens, OH 45701 USA. RP Xu, L (reprint author), Ohio Univ, Sch Hearing Speech & Language Sci, Athens, OH 45701 USA. CR *ADV BION CORP, 2000, DEV FITT MAN Battmer R D, 1999, Ann Otol Rhinol Laryngol Suppl, V177, P69 Bierer JA, 2004, JARO-J ASSOC RES OTO, V5, P32, DOI 10.1007/s10162-003-3057-7 Donaldson GS, 2000, J ACOUST SOC AM, V107, P1645, DOI 10.1121/1.428449 EDDINGTON DK, 1980, J ACOUST SOC AM, V68, P885, DOI 10.1121/1.384827 Fu QJ, 2002, J ACOUST SOC AM, V112, P1664, DOI 10.1121/1.1502901 HILLENBRAND J, 1995, J ACOUST SOC AM, V97, P3099, DOI 10.1121/1.411872 Kileny PR, 1998, AM J OTOL, V19, P313 LEHNHARDT E, 1992, ORL J OTO-RHINO-LARY, V54, P308 Loizou Philipos C., 2003, Ear and Hearing, V24, P12, DOI 10.1097/01.AUD.0000052900.42380.50 Merzenich M.M., 1985, COCHLEAR IMPLANTS, P121 NILSSON M, 1994, J ACOUST SOC AM, V95, P1085, DOI 10.1121/1.408469 Osberger MJ, 1999, ANN OTO RHINOL LARYN, V108, P74 PETERSON GE, 1962, J SPEECH HEAR DISORD, V27, P62 Pfingst BE, 1997, HEARING RES, V112, P247, DOI 10.1016/S0378-5955(97)00122-6 Pfingst BE, 2001, JARO, V2, P87 Pfingst BE, 2004, JARO-J ASSOC RES OTO, V5, P11, DOI 10.1007/s10162-003-3051-0 SHANLEY TP, 2001, MO CL BI CC, V1, P1 SKINNER MW, 1994, AM J OTOL, V15, P15 Skinner MW, 1999, EAR HEARING, V20, P443, DOI 10.1097/00003446-199912000-00001 Snyder RL, 2004, JARO-J ASSOC RES OTO, V5, P305, DOI 10.1007/s10162-004-4026-5 Stollwerck L E, 2001, Scand Audiol Suppl, P36 THORNTON AR, 1978, J SPEECH HEAR RES, V21, P507 Tyler RS, 1997, J ACOUST SOC AM, V102, P508, DOI 10.1121/1.419724 Tyler RS, 1996, EAR HEARING, V17, P528, DOI 10.1097/00003446-199612000-00008 Von Wallenberg E. L., 1995, Annals of Otology Rhinology and Laryngology, V104, P372 Wilson B. S., 2004, COCHLEAR IMPLANTS AU, P14 WILSON BS, 1991, NATURE, V352, P236, DOI 10.1038/352236a0 Xu L, 2002, J ACOUST SOC AM, V112, P247, DOI 10.1121/1.1487843 Xu L, 2005, J ACOUST SOC AM, V117, P3255, DOI 10.1121/.1.1886405 Zwolan T, 2001, OTOL NEUROTOL, V22, P844, DOI 10.1097/00129492-200111000-00022 Zwolan TA, 1996, AM J OTOL, V17, P717 NR 32 TC 6 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD NOV PY 2005 VL 114 IS 11 BP 886 EP 893 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 984DI UT WOS:000233282300013 PM 16363059 ER PT J AU Heman-Ackah, YD Sataloff, RT AF Heman-Ackah, YD Sataloff, RT TI Use of silicone hearing aid mold material in laryngotracheal reconstruction SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE airway; laryngeal stent; laryngotracheal reconstruction; larynx; relapsing polychondritis; stenosis AB Objectives: Endolaryngeal stenting in patients with irregularly shaped larynges can be challenging. In such cases, the use of a moldable yet reasonably rigid endolaryngeal stent is desirable. The purpose of this report is to describe our experience with silicone hearing aid material as a moldable endolaryngeal stent in a patient with an atypically shaped larynx. Methods: A patient with relapsing polychondritis that resulted in complete stenosis of the subglottic airway underwent laryngotracheal reconstruction. Moldable silicone, commonly used to prepare ear canal molds for hearing aids, was molded into the neo-endolarynx to serve as a custom-made endolaryngeal stent. Results: The patient tolerated the moldable silicone stent well and had a patent airway with epithelialization 8 months after removal. Conclusions: Silicone mold material is a suitable substance for endolaryngeal stenting. It conforms to the configuration of the individual's airway, is tolerated well, can be removed relatively easily, and is a useful alternative to prefabricated stents in laryngotracheal reconstruction. C1 Thomas Jefferson Univ, Dept Otolaryngol Head & Neck Surg, Philadelphia, PA USA. Grad Hosp Philadelphia, Dept Otolaryngol Head & Neck Surg, Philadelphia, PA USA. RP Heman-Ackah, YD (reprint author), Amer Inst Voice & Ear Res, 1721 Pine St, Philadelphia, PA USA. CR THOMAS GK, 1975, ARCH OTOLARYNGOL, V101, P217 NR 1 TC 0 Z9 0 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 739 EP 742 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200001 PM 16285262 ER PT J AU Leung, R Berkowitz, RG AF Leung, R Berkowitz, RG TI Decannulation and outcome following pediatric tracheostomy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE cannulation time; pediatrics; survival; tracheostomy ID INTENSIVE-CARE-UNIT; INFANT TRACHEOSTOMY; COMPLICATIONS; TRACHEOTOMIES AB Objectives: We investigated the long-term outcome of pediatric tracheostomy to identify predictive factors of early decannulation. Methods: We performed a retrospective chart review of a consecutive series of 75 patients less than 20 years of age who underwent tracheostomy between 1998 and 2003 during their admission in a tertiary pediatric institution. Complete information was available on 65 patients. Results: There were 41 male patients and 24 female patients (median age, 7 months). The indications for tracheostomy were an obstructed airway in 36 patients, prolonged mechanical ventilation in 15, and tracheobronchial toilet or aspiration risk in 14. Twelve patients (lied, and 30 of the 53 survivors were decannulated (median cannulation time, 123.5 days). Additional airway procedures were required for decarmulation in those with obstructed airways. Patients who had tracheostomy performed for tracheobronchial toilet had a significantly shorter cannulation time than those with the other two indications (log-rank test, chi(2)(2) = 47.11; p <.0000 1). Patient diagnosis was also a significant predictor of cannulation time (log-rank test, chi(2)(2) = 66.05; p <.00001). Tracheobronchial toilet as a tracheostomy indication and both trauma and neurologic conditions as admission diagnoses were statistically significant independent variables that predicted earlier decarmulation on multivariate analysis. Analysis of other group variables - age, sex, and tracheostomy insertion technique - did not reveal any significant difference in cannulation times. Conclusions: Tracheostomy indication and patient diagnosis are significant variables that predict early decannulation in pediatric patients in whom tracheostomy is required. Other variables were not shown to be significant independent predictors. C1 Royal Childrens Hosp, Dept Otolaryngol, Parkville, Vic, Australia. RP Leung, R (reprint author), 19 Clarke St, Prahran, Vic 3181, Australia. CR Carr MM, 2001, LARYNGOSCOPE, V111, P1925, DOI 10.1097/00005537-200111000-00010 Carron JD, 2000, LARYNGOSCOPE, V110, P1099, DOI 10.1097/00005537-200007000-00006 Granholm T, 2001, Respir Care Clin N Am, V7, P13, DOI 10.1016/S1078-5337(05)70020-4 HILL BP, 1990, J SPEECH HEAR DISORD, V55, P15 Kremer B, 2002, J PEDIATR SURG, V37, P1556, DOI 10.1053/jpsu.2002.36184 Lee W, 2002, ARCH OTOLARYNGOL, V128, P1249 Leung R, 2003, ANN OTO RHINOL LARYN, V112, P853 Merritt RM, 1997, LARYNGOSCOPE, V107, P868, DOI 10.1097/00005537-199707000-00006 Pereira KD, 2004, OTOLARYNG HEAD NECK, V131, P810, DOI 10.1016/j.otohns.2004.07.009 PRESCOTT CA, 1989, INT J PEDIATR OTORHI, V7, P97 SINGER LT, 1989, DEV MED CHILD NEUROL, V31, P224 *STAT, 2001, STAT STAT SOFTW TANTINIKORN W, 2000, AM J OTOLARYNG, V24, P131 TOM LWC, 1993, ARCH OTOLARYNGOL, V119, P321 Wetmore RE, 1999, ANN OTO RHINOL LARYN, V108, P695 NR 15 TC 10 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 743 EP 748 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200002 PM 16285263 ER PT J AU Windfuhr, JP Deck, JC Remmert, S AF Windfuhr, JP Deck, JC Remmert, S TI Hemorrhage following coblation tonsillectomy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE coblation tonsillectomy; complication; hemorrhage; postoperative bleeding; tonsillectomy; upper airway obstruction ID POWERED INTRACAPSULAR TONSILLECTOMY; INCREASED POSTOPERATIVE HEMORRHAGE; TONSILLAR HYPERTROPHY; ADENOIDECTOMY; ABLATION; BLIND; ELECTROSURGERY; ELECTROCAUTERY; COMPLICATIONS; CHILDREN AB Objectives: We performed a prospective study to evaluate the incidence of post-tonsillectomy hemorrhage (PTH) in adults and children who underwent Coblation tonsillectomy (CTE) under general anesthesia. Methods: The data of 63 adults and children (mean age, 21.8 years) were analyzed. Results: There were 7 episodes of considerable bleeding (11.1%) that required surgical treatment under general anesthesia in 6 patients, of whom 5 experienced secondary bleeding (>24 hours). Moreover, bleeding and massive swelling of the pharynx required surgical treatment and prolonged intubation (35 hours) in 1 patient. None of the patients received blood transfusions. There was no case with a lethal outcome. Less intense bleeding (clots; blood-tinged sputum) was observed in 17 patients (27%) who required readmission or prolonged inpatient observation, 1 of whom had previously undergone surgical treatment of PTH. However, these 17 patients had an uneventful clinical course. In total, 22 patients experienced minor or major forms of PTH (34.9%). Conclusions: At least in our hands, CTE dramatically increased the frequency of PTH. The high rate of secondary bleeding contrasts with our documented experience using conventional methods, ie, cold dissection and suture ligation, to achieve hemostasis (7.9% with CTE versus <0.8% with conventional methods). Therefore, at our institution, tonsillectomy with conventional instruments remains the method of choice. C1 St Anna Hosp, Dept Otorhinolaryngol Plast Head & Neck Surg, D-47259 Duisburg, Germany. RP Windfuhr, JP (reprint author), St Anna Hosp, Dept Otorhinolaryngol Plast Head & Neck Surg, D-47259 Duisburg, Germany. CR Arya A, 2003, CLIN OTOLARYNGOL, V28, P503, DOI 10.1046/j.1365-2273.2003.00750.x Back L, 2001, ARCH OTOLARYNGOL, V127, P1106 Belloso A, 2003, LARYNGOSCOPE, V113, P2010, DOI 10.1097/00005537-200311000-00029 Bent JP, 2004, ARCH OTOLARYNGOL, V130, P1197, DOI 10.1001/archotol.130.10.1197 Chang KW, 2005, OTOLARYNG HEAD NECK, V132, P273, DOI 10.1016/j.otohns.2004.11.002 Divi V, 2005, LARYNGOSCOPE, V115, P31, DOI 10.1097/01.mlg.0000150682.62517.0e Friedman M, 2003, LARYNGOSCOPE, V113, P882, DOI 10.1097/00005537-200305000-00020 Friedman M, 2004, LARYNGOSCOPE, V114, P441, DOI 10.1097/00005537-200403000-00011 Hall MDJ, 2004, OTOLARYNG HEAD NECK, V130, P300, DOI 10.1016/j.otohns.2003.09.024 Koltai PJ, 2002, LARYNGOSCOPE, V112, P17 Lee KC, 2002, OTOLARYNG HEAD NECK, V127, P531, DOI 10.1067/mhn.2002.129736 Brown P, 2004, LANCET, V364, P697 MEHTA D, 2004, OT RES SOC SPRING M Noon AP, 2003, J LARYNGOL OTOL, V117, P704 Plant RL, 2002, LARYNGOSCOPE, V112, P20 PLANT RL, 2003, LARYNGOSCOPE, V113, P767 Robb PJ, 2004, J LARYNGOL OTOL, V118, P247 ROSENFELD RM, 1990, ANN OTO RHINOL LARYN, V99, P187 Shah UK, 2002, ARCH OTOLARYNGOL, V128, P672 Sorin A, 2004, LARYNGOSCOPE, V114, P297, DOI 10.1097/00005537-200402000-00022 Stoker KE, 2004, OTOLARYNG HEAD NECK, V130, P666, DOI 10.1016/j.otohns.2004.02.012 Temple RH, 2001, INT J PEDIATR OTORHI, V61, P195, DOI 10.1016/S0165-5876(01)00553-5 TIMMS MS, 2003, OTOLARYNGOL HEAD NEC, V129, P78 Timms MS, 2004, J LARYNGOL OTOL, V118, P247 Timms MS, 2002, J LARYNGOL OTOL, V116, P450 Windfuhr J, 2001, J LARYNGOL OTOL, V115, P457 Windfuhr JP, 2005, OTOLARYNG HEAD NECK, V132, P281, DOI 10.1016/j.otohns.2004.09.007 Windfuhr JP, 2003, ANN OTO RHINOL LARYN, V112, P63 Woloszko J, 2000, PROC SPIE, V3907, P306, DOI 10.1117/12.386267 NR 29 TC 24 Z9 30 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 749 EP 756 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200003 PM 16285264 ER PT J AU Isaacson, G AF Isaacson, G TI Inside-out complete tonsillectomy: Extended intracapsular tonsillectomy for severe sore throat SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Eastern Section Meeting of the American-Laryngological-Rhinological-and-Otological-Society CY JAN 28-30, 2005 CL Washington, DC SP Amer Laryngol Rhinol & Otol Soc, E Sect DE bipolar scissors; electrosurgery; minimally invasive surgery; peritonsillar abscess; recurrent sore throat; tonsillectomy ID CHILDREN; ADENOIDECTOMY AB Objectives: This consecutive case series is presented to describe inside-out complete tonsillectomy and to assess its effects on postoperative pain and bleeding and its initial effectiveness in controlling recurrent sore throat and peritonsillar abscess formation. Methods: Bipolar electrosurgical scissors are used for bloodless resection of 90% of the tonsillar mass. During controlled resection, tonsil tissue is intentionally left at the superior and inferior poles and at the deepest part of the tonsillar fossa to provide coverage for nutrient arteries and the tonsillar plexus of veins. This tissue is then electrodesiccated and removed under direct vision and indirect mirror guidance to achieve complete tonsillectomy. Results: One hundred eighty-three consecutive tonsillectomies were performed by a single surgeon in a 16-month period, 47 of which were for the indication of recurrent sore throat (44) or recurrent peritonsillar abscess (3). Among these 47 children, there were 2 readmissions for dehydration. There were no immediate or delayed bleeding episodes. The average child required 4 days of narcotic pain medication. The mean annualized number of severe sore throats decreased from 5.24 before operation to 0.36 afteroperation (p <.0001, Student's paired t-test). There were no recurrent peritonsillar abscesses. Conclusions: Inside-out complete tonsillectomy achieves the surgical goal of complete tonsillectomy with the smallest possible wound and minimal injury to the surrounding tissue. The perioperative morbidity is markedly decreased compared to that of historical controls. The initial results suggest effectiveness similar to that of extracapsular tonsillectomy. C1 Temple Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Philadelphia, PA 19140 USA. Temple Univ, Childrens Med Ctr, Philadelphia, PA USA. RP Isaacson, G (reprint author), Temple Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, 3400 N Broad St, Philadelphia, PA 19140 USA. CR Ballenger WL, 1911, DIS NOSE THROAT EAR, P412 BARNES HA, 1914, TONSILS FAUCIAL LING, P128 Bent JP, 2004, ARCH OTOLARYNGOL, V130, P1197, DOI 10.1001/archotol.130.10.1197 BLUESTONE CD, 2002, SURG ATLAS PEDIAT OT, P379 Chole RA, 2003, ARCH OTOLARYNGOL, V129, P634, DOI 10.1001/archotol.129.6.634 Finkelstein Y, 2004, OTOLARYNG HEAD NECK, V131, P372, DOI 10.1016/j.otohns.2004.02.044 Hall MDJ, 2004, OTOLARYNG HEAD NECK, V130, P300, DOI 10.1016/j.otohns.2003.09.024 HOLLINSHEAD WH, 1982, ANATOMY SURGEONS, V1, P389 Hultcrantz E, 2004, LARYNGOSCOPE, V114, P871, DOI 10.1097/00005537-200405000-00016 Inci E, 2003, J INT MED RES, V31, P307 Isaacson G, 2004, ENT-EAR NOSE THROAT, V83, P704 Isaacson Glenn, 2004, Ear Nose Throat J, V83, P704 Koltai PJ, 2003, OTOLARYNG HEAD NECK, V129, P532, DOI 10.1016/S0194-5998(03)00727-7 Korolija D, 2004, SURG ENDOSC, V18, P879, DOI 10.1007/s00464-003-9263-x Kumar VV, 2004, LARYNGOSCOPE, V114, P2031, DOI 10.1097/01.mlg.0000147942.82626.1c MCKEE WJE, 1963, BRIT J PREV SOC MED, V17, P49 Moir MS, 2000, LARYNGOSCOPE, V110, P1824, DOI 10.1097/00005537-200011000-00011 Paradise Jack L, 2002, Pediatrics, V110, P7, DOI 10.1542/peds.110.1.7 PARADISE JL, 1984, NEW ENGL J MED, V310, P674, DOI 10.1056/NEJM198403153101102 POTSIC WP, 1997, SURG PEDIAT OTOLARYN, P241 ROYDHOUS.N, 1970, ARCHIV OTOLARYNGOL, V92, P611 Seitz U, 2003, ENDOSCOPY, V35, pS41 Sluder G, 1913, J AMER MED ASSOC, V60, P650 Steiner W, 2001, OTOLARYNG HEAD NECK, V124, P58, DOI 10.1067/mhn.2001.111597 Stoker KE, 2004, OTOLARYNG HEAD NECK, V130, P666, DOI 10.1016/j.otohns.2004.02.012 SUROW JB, 1989, LARYNGOSCOPE, V99, P261 von Gaudecker B, 1988, Acta Otolaryngol Suppl, V454, P28 NR 27 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 757 EP 761 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200004 PM 16285265 ER PT J AU Woodson, BT Han, JK AF Woodson, BT Han, JK TI Relationship of snoring and sleepiness as presenting symptoms in a sleep clinic population SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE obstructive sleep apnea; sleepiness symptoms; snoring ID HEART HEALTH; APNEA; OUTCOMES; RISK; QUESTIONNAIRE; DISORDERS; DISEASE AB Objectives: Sleepiness has traditionally been considered medically the cardinal symptom of obstructive sleep apnea syndrome. Snoring is perceived as a social or cosmetic complaint. Without independent medical morbidity, snoring identification and treatment is not a major focus in sleep medicine. We speculate that snoring is a major independent symptom. To evaluate how patients rated snoring symptom severity, we compared the relative significance of a sleep clinic population's presenting symptoms of snoring and sleepiness. Methods: We performed a retrospective analysis of 770 consecutive patients who completed sleep intake evaluation forms at the initial clinic visit, including standardized forms for both sleepiness and snoring using previously validated visual analog scales. Data on symptom magnitude (scale of 1 to 10), symptom importance (scale of 1 to 5), a combined symptom product score consisting of magnitude multiplied by importance (MIP; scale of 1 to 50), the Epworth Sleepiness Scale (ESS; n = 599), and the apnea-hypopnea index (AHI; n = 482; mean +/- SD, 35.6 +/- 31.9 events per hour) were collected. Results: The mean snoring measures (magnitude, importance, and MIP) were greater than those for sleepiness (MIPsnoring of 32.7 +/- 14.8 versus MIPsleepiness of 22.4 +/- 14.2, p <.001). Snoring scored higher than sleepiness in 72% of individuals. To assess whether sleep apnea or sleepiness severity affected symptom scores, we stratified the subaroup with sleep studies into quartiles by AHI and ESS score. Snoring consistently scored higher than sleepiness in most AHI and ESS quartiles (p <.01). Only in the most severe ESS quartile did any sleepiness measure (importance) score higher than the snoring measure (p <.05). Conclusions: The presenting symptoms of snoring are larger in magnitude, importance, and severity than those of sleepiness in a broad population of patients with sleep disorders and sleep-disordered breathing irrespective of severity of sleep apnea or sleepiness. Symptoms of major significance are clinically relevant to identifying, diagnosing, and treating patients. Failure of medical providers to appreciate the impact of snoring on this population may affect attempts to identify, diagnose, and treat patients with sleep-disordered breathing. C1 Med Coll Wisconsin, Dept Otolaryngol & Commu Sci, Milwaukee, WI USA. RP Woodson, BT (reprint author), Med Coll Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226 USA. CR Al-Delaimy WK, 2002, AM J EPIDEMIOL, V155, P387, DOI 10.1093/aje/155.5.387 *AM AC SLEEP MED, 1997, INT CLAS SLEEP DIS D BEARPARK H, 1995, AM J RESP CRIT CARE, V151, P1459 BRESNITZ EA, 1994, EPIDEMIOL REV, V16, P210 FERINISTRAMBI L, 1994, CHEST, V105, P1759, DOI 10.1378/chest.105.6.1759 Flemons WW, 1998, AM J RESP CRIT CARE, V158, P494 Flemons WW, 2002, AM J RESP CRIT CARE, V165, P159 Gliklich RE, 2002, ARCH OTOLARYNGOL, V128, P819 Gottlieb DJ, 2000, AM J RESP CRIT CARE, V162, P1512 Gurubhagavatula I, 2001, AM J RESP CRIT CARE, V164, P1904 HOFFSTEIN V, 1993, SLEEP, V16, P118 JOHNS MW, 1994, SLEEP, V17, P703 Kim HC, 1997, AM J RESP CRIT CARE, V156, P1813 Lindberg E, 1998, THORAX, V53, P631 Lindberg E, 2001, AM J RESP CRIT CARE, V164, P2031 MAISLIN G, 1995, SLEEP, V18, P158 Netzer NC, 1999, ANN INTERN MED, V131, P485 Piccirillo JF, 1998, OTOLARYNG HEAD NECK, V118, P833, DOI 10.1016/S0194-5998(98)70277-3 Shahar E, 2001, AM J RESP CRIT CARE, V163, P19 Urschitz MS, 2003, AM J RESP CRIT CARE, V168, P464, DOI 10.1164/rccm.200212-1397OC Weaver TE, 1997, SLEEP, V20, P835 Young T, 2002, ARCH INTERN MED, V162, P893, DOI 10.1001/archinte.162.8.893 NR 22 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 762 EP 767 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200005 PM 16285266 ER PT J AU Ceruse, P Rabilloud, M Charrie, A Dubreuil, C Disant, F AF Ceruse, P Rabilloud, M Charrie, A Dubreuil, C Disant, F TI Study of Cyfra 21-1, a tumor marker, in head and neck squamous cell carcinoma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE Cyfra 21-1; head and neck carcinoma; squamous cell carcinoma; tumor marker ID LUNG-CANCER; PROGNOSTIC VALUE; SCC; EXPRESSION; DIAGNOSIS; ANTIGEN; TESTS; CEA AB Objectives: We performed a prospective study to determine the cutoff value and the prognostic value of Cyfra 21-1, a serum tumor marker, in head and neck squamous cell carcinoma (HNSCC). Methods: The serum concentration of Cyfra 21-1 was measured in a group of 300 patients (group 1) with HNSCC, in a control group of 71 healthy subjects (group 2), and in a group of 73 patients with a nonmalignant tumor or inflammatory disease (group 3). The concentrations were compared between the various groups and subgroups; the cutoff value was calculated with a receiver operating characteristic curve. Furthermore, the serum concentrations of Cyfra 21-1 before treatment in the group of 300 patients were compared with the stage of the disease and with the evolution of the overall survival rate and the disease-free survival rate. Finally, to determine whether Cyfra 21-1 is an independent prognostic factor, we compared the concentrations, by a Cox model, with the classic prognostic factors of HNSCC. Results: At the cutoff value of 1 ng/mL, the specificity was 94% and the sensitivity was 72%. The serum concentrations of Cyfra 21-1 were statistically correlated with the stage of the disease. The overall survival rate and the disease-free survival rate were lower in patients with high serum concentrations, and these differences were statistically significant (p <.001). The Cox model allows us to conclude that Cyfra 21-1 is a prognostic marker that is independent of other classic prognostic factors. Conclusions: Cyfra 21-1 is an interesting tumor marker that could be proposed for the early detection of HNSCC with a cutoff value of 1 ng/mL. Furthermore, Cyfra 21-1 can be considered an independent prognostic marker. C1 Ctr Hosp Lyon Sud, Serv ORL & Chirug Cervico Faciale, F-69495 Pierre Benite, France. Ctr Hosp Lyon Sud, Dept Otolaryngol Head & Neck Surg, F-69495 Pierre Benite, France. Ctr Hosp Lyon Sud, Dept Radioanal, F-69495 Pierre Benite, France. Hop Edouard Herriot, Dept Otolaryngol Head & Neck Surg, Lyon, France. Hosp Civils Lyon, Dept Biostat, Lyon, France. RP Ceruse, P (reprint author), Ctr Hosp Lyon Sud, Serv ORL & Chirug Cervico Faciale, F-69495 Pierre Benite, France. 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Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 768 EP 776 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200006 PM 16285267 ER PT J AU Lin, FR Migliaccio, AA Haslwanter, T Minor, LB Carey, JP AF Lin, FR Migliaccio, AA Haslwanter, T Minor, LB Carey, JP TI Angular vestibulo-ocular reflex gains correlate with vertigo control after intratympanic gentamicin treatment for Meniere's disease SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Midwinter Meeting of the Association-for-Research-in-Otolaryngology CY JAN 27-31, 2002 CL t Petersburg, FL SP Assoc Res Otolaryngol DE angular vestibulo-ocular reflex gain; intratympanic gentamicin; Meniere's disease ID 3-DIMENSIONAL VECTOR ANALYSIS; ACCELERATION HEAD ROTATIONS; VESTIBULAR OTOTOXICITY; DARK CELLS; STREPTOMYCIN; RESPONSES; EQUILIBRIUM; STIMULATION; THERAPY; HEARING AB Objectives: The objective of our study was to determine whether angular vestibulo-ocular reflex (aVOR) gains correlated with vertigo control after intratympanic gentarnicin treatment for Meniere's disease. Methods: We conducted a prospective study of 18 subjects with unilateral Meniere's disease treated with intratympanic gentamicin injection and followed all subjects for 1 year. We measured the gain of the aVOR elicited by rapid rotary head thrusts in each of the canal planes for each subject before and after treatment with intratympanic gentamicin by using magnetic search coils to record eye movements. Results: During the follow-up period, 11 subjects ("single-treatment group"; 61%) had control of their vertigo with a single gentamicin injection. The remaining 7 subjects ("multiple-treatment group"; 39%) experienced recurrent vertigo that required a second injection of gentamicin at a mean of 6 months after the first treatment. The 11 subjects in the single-treatment group had significantly greater reduction of labyrinthine function after the first treatment, as measured by change in ipsilateral horizontal canal gain, than did the 7 subjects with vertigo recurrence. Changes in caloric asymmetry did not correlate with vertigo control. Conclusions: Our results suggest that successful treatment of Meniere's disease is closely related to attenuation of semicircular canal function as measured by horizontal canal aVOR gains. C1 Johns Hopkins Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Baltimore, MD USA. Univ Hosp Zurich, Dept Neurol, Zurich, Switzerland. Eidgenoss Tech Hochsch, Inst Theoret Phys, Zurich, Switzerland. RP Carey, JP (reprint author), Johns Hopkins Outpatient Ctr, Dept Otolaryngol Head & Neck Surg, Room 6255,601 N Caroline St, Baltimore, MD 21287 USA. RI Migliaccio, Americo/A-5791-2013 CR Alzamil KS, 2000, ANN OTO RHINOL LARYN, V109, P30 Aw ST, 1996, J NEUROPHYSIOL, V76, P4009 Aw ST, 1996, J NEUROPHYSIOL, V76, P4021 Blakley BW, 2000, LARYNGOSCOPE, V110, P236, DOI 10.1097/00005537-200002010-00009 Carey JP, 2002, JARO, V3, P430, DOI 10.1007/s101620010053 Chen JM, 1999, J OTOLARYNGOL, V28, P121 Committee on Hearing and Equilibirum, 1995, OTOLARYNGOL HEAD NEC, V113, P181 Cremer PD, 1998, BRAIN, V121, P699, DOI 10.1093/brain/121.4.699 GE XX, 1993, AM J OTOL, V14, P74 HALMAGYI GM, 1988, ARCH NEUROL-CHICAGO, V45, P737 Harner SG, 2001, OTOL NEUROTOL, V22, P210, DOI 10.1097/00129492-200103000-00016 Hellström S, 1989, Acta Otolaryngol Suppl, V457, P33 Hirvonen TP, 2005, J NEUROPHYSIOL, V93, P643, DOI 10.1152/jn.00160.2004 JONGKEES L B, 1962, Pract Otorhinolaryngol (Basel), V24, P65 Kaplan DM, 2000, LARYNGOSCOPE, V110, P1298, DOI 10.1097/00005537-200008000-00014 MINOR LB, 1990, EXP BRAIN RES, V82, P1 Minor LB, 1999, AM J OTOL, V20, P209 PAIGE GD, 1985, ACTA OTO-LARYNGOL, V100, P321, DOI 10.3109/00016488509126555 PARK JC, 1984, AM J OTOLARYNG, V5, P387, DOI 10.1016/S0196-0709(84)80053-8 PARK JC, 1982, AM J OTOLARYNG, V3, P117, DOI 10.1016/S0196-0709(82)80042-2 PARNES LS, 1993, LARYNGOSCOPE, V103, P745 PENDER DJ, 1985, AM J OTOLARYNG, V6, P358, DOI 10.1016/S0196-0709(85)80013-2 PREZANT TR, 1993, NAT GENET, V4, P289, DOI 10.1038/ng0793-289 PROCTOR L, 1975, ACTA OTO-LARYNGOL, V79, P425, DOI 10.3109/00016487509124707 Robertson DD, 1996, J OTOLARYNGOL, V25, P171 SANTOS PM, 1993, OTOLARYNG HEAD NECK, V109, P680 SCHACHERN PA, 1984, ARCH OTOLARYNGOL, V110, P15 SCHUKNECHT H F, 1956, Laryngoscope, V66, P859, DOI 10.1288/00005537-195607000-00005 Silverstein H, 1997, AM J OTOL, V18, P586 STRAUMANN D, 1995, VISION RES, V35, P3321, DOI 10.1016/0042-6989(95)00091-R Wu IC, 2003, LARYNGOSCOPE, V113, P815, DOI 10.1097/00005537-200305000-00009 NR 31 TC 10 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 777 EP 785 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200007 PM 16285268 ER PT J AU Kitahara, T Takeda, N Nishiike, S Okumura, S Kubo, T AF Kitahara, T Takeda, N Nishiike, S Okumura, S Kubo, T TI Prognosis of inner ear periphery and central vestibular plasticity in sudden deafness with vertigo SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE canal paresis; head-shaking afternystagmus; sudden deafness with vertigo; vestibular compensation; vestibular neuritis ID SENSORINEURAL HEARING-LOSS; LABYRINTHECTOMY; COMPENSATION; NEURECTOMY; NEURITIS; NERVE AB Objectives: We sought to elucidate the clinical problems and otopathology of patients with sudden deafness with vertigo (SDV). Methods: In 24 patients with SDV who had significant canal paresis (CP) at their first visit to our hospital between 1997 and 2001, we examined pure tone audiograms, caloric tests, and several questionnaires twice, at the first visit within 5 days after the onset and around 2 years after steroid therapy. Results: These examinations revealed that improvements of auditory and vestibular function in patients with SDV tended to be correlated with one another. Sixteen of the 24 patients (66.7%) still had CP. This rate in SDV was significantly worse than that reported previously for vestibular neuritis (VN). On the other hand, patients with SDV with longlasting CP had a faster reduction of head-shaking afternystagmus and of handicaps in their everyday life due to dizziness than did patients with VN and CP. Conclusions: These findings suggest that SDV may deteriorate the inner ear function more severely but accelerate the central vestibular compensation more effectively than VN after the lesion. It is well known that vestibular neurectomy causes much more severe motion-induced dizziness after surgery than does labyrinthectomy. Taken together, these findings suggest different regions of damage in SDV (mainly the labyrinth, as in labyrinthectomy) and VN (mainly the ganglion, as in vestibular neurectomy). C1 Osaka Univ, Sch Med, Dept Otolaryngol & Sensory Organ Surg, Suita, Osaka 5650871, Japan. Osaka Univ, Sch Med, Dept Otolaryngol, Suita, Osaka 565, Japan. Osaka Rosai Hosp, Dept Otolaryngol, Osaka, Japan. Univ Tokushima, Sch Med, Dept Otolaryngol, Tokushima, Japan. RP Kitahara, T (reprint author), Osaka Univ, Sch Med, Dept Otolaryngol & Sensory Organ Surg, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan. CR Badke MB, 2002, OTOL NEUROTOL, V23, P504, DOI 10.1097/00129492-200207000-00019 BROWN L A, 1957, Laryngoscope, V67, P238 CASS SP, 1991, OTOLARYNG HEAD NECK, V104, P14 Gacek RR, 1996, LARYNGOSCOPE, V106, P225, DOI 10.1097/00005537-199602000-00023 IMATE Y, 1992, EQUILIBRIUM RES S, V8, P15 KANZAKI J, 1977, ARCH OTO-RHINO-LARYN, V217, P229, DOI 10.1007/BF00665542 Kanzaki J, 2003, AURIS NASUS LARYNX, V30, P123, DOI 10.1016/S0385-8146(03)00009-9 KAWABATA A, 1990, JPN J PHARMACOL, V54, P383, DOI 10.1254/jjp.54.383 Kitahara T, 2003, NEUROL RES, V25, P287, DOI 10.1179/016164103101201364 KITAHARA T, 2000, PRACTICA OTOLOGICA J, V93, P449 Kitahara T, 1998, Acta Otolaryngol Suppl, V539, P19 MIZUKOSHI K, 1982, PRACT OTOL JPN, V75, P172 NADOL JB, 1995, OTOLARYNG HEAD NECK, V112, P162, DOI 10.1016/S0194-5998(95)70316-0 JACOBSON GP, 1990, ARCH OTOLARYNGOL, V116, P424 Nomura Y, 1988, Acta Otolaryngol Suppl, V456, P7 Okinaka Y, 1993, Acta Otolaryngol Suppl, V503, P18 Raphan T, 2002, EXP BRAIN RES, V145, P1, DOI 10.1007/s00221-002-1067-z SCHUKNECHT HF, 1986, ARCH OTO-RHINO-LARYN, V243, P1, DOI 10.1007/BF00457899 SCHUKNECHT HF, 1981, ANN OTOL RHINOL LA S, V90 Shinohara S, 2000, EUR ARCH OTO-RHINO-L, V257, P480, DOI 10.1007/s004050000236 Strupp M, 1998, J VESTIBUL RES-EQUIL, V8, P427 Takeda N, 1995, Nihon Jibiinkoka Gakkai Kaiho, V98, P951 TODA N, 2003, PRACT OTOL JPN, V96, P405 Vasama JP, 2000, ANN OTO RHINOL LARYN, V109, P527 WATANABE Y, 1993, ACTA OTO-LARYNGOL, P109 Yamashita H, 1989, B YAMAGUCHI MED SCH, V36, P37 NR 26 TC 7 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 786 EP 791 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200008 PM 16285269 ER PT J AU Hartl, DM Crevier-Buchman, L Vaissiere, J Brasnu, DF AF Hartl, DM Crevier-Buchman, L Vaissiere, J Brasnu, DF TI Phonetic effects of paralytic dysphonia SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE acoustic phonetics; larynx; paralysis; speech; voice ID VOCAL FOLD PARALYSIS; THYROPLASTY TYPE-I; VOICE; ARTICULATION; CONSONANTS; PLACE AB Objectives: This study was performed to determine whether and how unilateral vocal fold paralysis (UVFP) affects the production and perception of voiced stop consonants as compared with unvoiced stops, and to analyze the phonetic effects of UVFP on the voicing feature. Methods: Phonetic constructs pronounced by 7 male patients with UVFP and 5 normal male subjects were recorded. The 432 speech tokens consisted of intervocalic, prevocalic, and postvocalic stop consonants (/p/, /t/, /1-J, /b/, /d/, /g/) in the vowel contexts lal and /i/. Perceptual consonant identification testing was performed with 5 voice and speech professionals as listeners. The type and frequency of errors made in consonant identification were analyzed. Spectrographic analysis was used to analyze acoustic cues. Results: The rate of correct consonant identification was significantly lower for tokens pronounced by patients with UVFP (77.3% versus 97.6%, p =.0001) because of incorrect identification of the voiced consonants, frequently perceived as their unvoiced homologues. Confusion between dental and alveolar place of articulation for unvoiced stops was also noted. Conclusions: Unilateral vocal fold paralysis alters the voiced-unvoiced stop consonant distinction and the dental-palatal stop consonant distinction in an experimental nonspeech context. This finding implies the existence of a phonetic handicap for patients with UVFP. Further studies should determine the effects of UVFP on global speech intelligibility. C1 Inst Gustave Roussy, Dept Otolaryngol Head & Neck Surg, F-94805 Villejuif, France. Univ Paris 05, European Hosp Georges Pompidou, Voice Biomat & Head & Neck Oncol Res Lab, F-75270 Paris, France. Ctr Natl Rech Sci Sorbonne Nouvelle, Lab Phonet & Phonol, Paris, France. RP Hartl, DM (reprint author), Inst Gustave Roussy, Dept Otolaryngol Head & Neck Surg, 39 Rue Camille Desmoulins, F-94805 Villejuif, France. CR Adams SG, 1996, J OTOLARYNGOL, V25, P165 Bonneau A, 1996, J ACOUST SOC AM, V100, P555, DOI 10.1121/1.415866 Crevier-Buchman L, 2002, Rev Laryngol Otol Rhinol (Bord), V123, P307 CRUMLEY RL, 1989, ANN OTO RHINOL LARYN, V98, P87 Eadie TL, 2005, J VOICE, V19, P1, DOI 10.1016/j.jvoice.2004.02.002 Fant G., 1960, ACOUSTIC THEORY SPEE HAMMARBERG G, 1995, VOCAL FOLD PHYSL VOI, P283 Hartl DM, 2001, ANN OTO RHINOL LARYN, V110, P229 Hirose H, 1976, Ann Otol Rhinol Laryngol, V85, P335 Hoffman Henry T., 1996, Head and Neck, V18, P174, DOI 10.1002/(SICI)1097-0347(199603/04)18:2<174::AID-HED10>3.0.CO;2-F Kent Raymond D., 1992, ACOUSTIC ANAL SPEECH LEDER SB, 1994, LARYNGOSCOPE, V104, P275 Lisker L., 1978, HASKINS LAB STATUS R, V54, P127 MILLER GA, 1955, J ACOUST SOC AM, V27, P338, DOI 10.1121/1.1907526 Ohala J. J., 1979, SPEECH COMMUN, P89 OHDE RN, 1984, J ACOUST SOC AM, V75, P224, DOI 10.1121/1.390399 ROSINGH HJ, 1995, CLIN OTOLARYNGOL, V20, P124, DOI 10.1111/j.1365-2273.1995.tb00027.x SASAKI CT, 1990, LARYNGOSCOPE, V100, P849 Searl JP, 2001, J COMMUN DISORD, V34, P305, DOI 10.1016/S0021-9924(01)00052-1 Spector BC, 2001, OTOLARYNG HEAD NECK, V125, P176, DOI 10.1067/mhn.2001.117714 STEVENS KN, 1978, J ACOUST SOC AM, V64, P1358, DOI 10.1121/1.382102 TITZE IR, 1992, J VOICE, V6, P135, DOI 10.1016/S0892-1997(05)80127-4 WESTBURY JR, 1983, J ACOUST SOC AM, V73, P1322, DOI 10.1121/1.389236 ZEITELS SM, 1998, ANN OTOL RHINOL LARN, V107 NR 24 TC 0 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 792 EP 798 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200009 PM 16285270 ER PT J AU Ota, F Connor, NP Konopacki, R AF Ota, F Connor, NP Konopacki, R TI Alterations in contractile properties of tongue muscles in old rats SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 106th Annual Meeting of the American-Academy-of-Otolaryngology-Head-and-Neck-Surgery CY SEP 22-25, 2002 CL SAN DIEGO, CA SP Amer Acad Otolaryngol Head & Neck Surg DE aging; deglutition disorder; muscle contraction; tongue ID AGE-RELATED-CHANGES; NEUROMUSCULAR-JUNCTIONS; GENIOGLOSSUS MUSCLE; MEN; STIMULATION; PHARYNGEAL; MORPHOLOGY; FIBERS; FORCE AB Objectives: Fatigue and weakness are well-known signs of aging that are related to sarcopenia, or loss of skeletal muscle mass, organization, and strength. Sarcopenia may affect swallowing. The tongue plays a vital role in swallowing, but there is limited knowledge regarding age-related changes in lingual muscle contractile properties. Our purpose was to determine whether alterations in tongue force, temporal features of tongue muscle contraction, and fatigability are manifested as a function of aging in old rats. Methods: We evaluated tongue muscle contractile properties in young and old Fischer 344/Brown Norway rats. Contractions were elicited via bilateral electrical stimulation of the hypoglossal nerves. Results: Maximum tongue forces and fatigability were-not significantly altered in old animals, but aging was associated with significantly longer twitch contraction time and longer half-decay recovery time intervals (p <.01). Conclusions: The results indicated that old animals generated sufficient maximum tongue forces, but were slower in achieving these forces than young animals. These findings are consistent with reports of altered temporal parameters of tongue actions during swallowing in humans, and suggest that a disruption in the timing of muscle contraction onset and recovery may contribute to the altered tongue kinetics observed with aging. C1 Univ Wisconsin, Clin Sci Ctr, Madison, WI 53792 USA. Univ Wisconsin, Dept Surg, Div Otolaryngol Head & Neck Surg, Madison, WI 53792 USA. Univ Wisconsin, Dept Surg, Dept Biostat & Med Informat, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. Jikei Univ, Dept Otolaryngol Head & Neck Surg, Tokyo, Japan. RP Connor, NP (reprint author), Univ Wisconsin, Clin Sci Ctr, Room K4-711,600 Highland Ave, Madison, WI 53792 USA. CR ANIANSSON A, 1986, MUSCLE NERVE, V9, P585, DOI 10.1002/mus.880090702 Babault N, 2001, J APPL PHYSIOL, V91, P2628 Balice-Gordon R J, 1997, Muscle Nerve Suppl, V5, pS83 BAUM BJ, 1983, J DENT RES, V62, P2, DOI 10.1177/00220345830620010401 CARTEE GD, 1995, J GERONTOL A-BIOL, V50, P137 DePaul R, 1996, ACTA ANAT, V155, P29 EKBERG O, 1991, AM J ROENTGENOL, V156, P1181 Fuller D, 1998, J PHYSIOL-LONDON, V507, P265, DOI 10.1111/j.1469-7793.1998.265bu.x GILLIAM EE, 1995, J NEUROPHYSIOL, V74, P547 HELLSTRAND E, 1981, ACTA PHYSIOL SCAND, V111, P417, DOI 10.1111/j.1748-1716.1981.tb06757.x Hodges SH, 2004, ANN OTO RHINOL LARYN, V113, P175 LEXELL J, 1995, J GERONTOL A-BIOL, V50, P11 LEXELL J, 1988, J NEUROL SCI, V84, P275, DOI 10.1016/0022-510X(88)90132-3 Logemann JA, 2000, J SPEECH LANG HEAR R, V43, P1264 McHenry MA, 1999, LARYNGOSCOPE, V109, P827, DOI 10.1097/00005537-199905000-00027 McKee GJ, 1998, CLIN OTOLARYNGOL, V23, P100 Mortimore IL, 1999, EUR RESPIR J, V14, P191, DOI 10.1034/j.1399-3003.1999.14a32.x Mu LC, 1999, ANAT REC, V256, P412 Nakayama M, 1991, Nihon Jibiinkoka Gakkai Kaiho, V94, P541 Nicosia MA, 2000, J GERONTOL A-BIOL, V55, pM634 Prakash YS, 1998, MUSCLE NERVE, V21, P887, DOI 10.1002/(SICI)1097-4598(199807)21:7<887::AID-MUS6>3.0.CO;2-2 RAMIG LA, 1983, J SPEECH HEAR RES, V26, P22 ROBBINS J, 1992, GASTROENTEROLOGY, V103, P823 Rosenberg IH, 1997, J NUTR, V127, pS990 Saigusa H, 2001, ANN OTO RHINOL LARYN, V110, P779 SMITH DO, 1984, J PHYSIOL-LONDON, V347, P161 SMITH KK, 1989, ARCH ORAL BIOL, V34, P529, DOI 10.1016/0003-9969(89)90091-5 Stal P, 2003, CELLS TISSUES ORGANS, V173, P147, DOI 10.1159/000069470 Sutlive TG, 2000, MUSCLE NERVE, V23, P416, DOI 10.1002/(SICI)1097-4598(200003)23:3<416::AID-MUS14>3.0.CO;2-# Tracy J F, 1989, Dysphagia, V4, P90, DOI 10.1007/BF02407151 TURTURRO A, 1999, J GERONTOL A-BIOL, V54, P492 VANLUNTEREN E, 1995, RESP PHYSIOL, V99, P113, DOI 10.1016/0034-5687(94)00077-D NR 32 TC 14 Z9 15 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 799 EP 803 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200010 PM 16285271 ER PT J AU Hisamatsu, K Inoue, H Makiyama, K Homma, M AF Hisamatsu, K Inoue, H Makiyama, K Homma, M TI Nitrotyrosine in otitis media with effusion SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE lactic dehydrogenase; nitric oxide; nitrotyrosine; otitis media with effusion; peroxynitrite; superoxide; superoxide dismutase ID NITRIC-OXIDE SYNTHASE; NECROSIS-FACTOR-ALPHA; MIDDLE-EAR; SUPEROXIDE-DISMUTASE; PEROXYNITRITE; ENDOTOXIN; LOCALIZATION; LEUKOTRIENES; METABOLITES; EXPRESSION AB Objectives: Our purpose was to investigate mucosal cell injury due to the nitric oxide (NO)-superoxide system in otitis media with effusion. Methods: We determined the levels of nitrotyrosine (NT) and NO and the activities of superoxide dismutase (SOD) and lactic dehydrogenase (LDH) in 90 middle ear fluid samples. Results: The NT concentration was significantly higher in group A (< 16 years old) than in group C (> 50 years old; p <.05), and significantly higher in the acute group than in the chronic group (p <.05). The NO concentration did not show a significant difference among the groups. The activity of SOD showed significant correlations with the concentrations of NT and NO and with LDH activity (p <.05). The LDH activity was significantly greater in group A than in group C (p <.05). Conclusions: Our results indicate involvement of the NO-superoxide system in the pathogenesis of otitis media with effusion, showing evidence of protein and/or cell injury in the middle ear. C1 Nihon Univ, Dept Otorhinolaryngol, Tokyo 1018309, Japan. St Marianna Univ, Sch Med, Dept Plast & Reconstruct Surg, Kawasaki, Kanagawa, Japan. RP Hisamatsu, K (reprint author), Nihon Univ, Dept Otorhinolaryngol, 1-8-13 Surugadai, Tokyo 1018309, Japan. CR Ball SS, 1996, LARYNGOSCOPE, V106, P1021, DOI 10.1097/00005537-199608000-00022 Beckman JS, 1996, AM J PHYSIOL-CELL PH, V271, pC1424 Capper R, 2003, CLIN OTOLARYNGOL, V28, P51, DOI 10.1046/j.1365-2273.2003.00665.x CASTRO L, 1994, J BIOL CHEM, V269, P29409 Forseni M, 1999, ACTA OTO-LARYNGOL, V119, P577 GANBO T, 1995, ANN OTO RHINOL LARYN, V104, P231 GELLER DA, 1993, P NATL ACAD SCI USA, V90, P3491, DOI 10.1073/pnas.90.8.3491 Greenacre S, 1997, CLIN EXP PHARMACOL P, V24, P880, DOI 10.1111/j.1440-1681.1997.tb02709.x HAMAGUCHI Y, 1988, ARCH OTO-RHINO-LARYN, V245, P77, DOI 10.1007/BF00481440 HAUSLADEN A, 1994, J BIOL CHEM, V269, P29405 IGNARRO LJ, 1987, P NATL ACAD SCI USA, V84, P9265, DOI 10.1073/pnas.84.24.9265 Inoue H, 2002, NITRIC OXIDE-BIOL CH, V7, P11, DOI 10.1016/S1089-8603(02)00005-8 John EO, 2001, INT J PEDIATR OTORHI, V60, P55, DOI 10.1016/S0165-5876(01)00509-2 JUNG TTK, 1988, LARYNGOSCOPE, V98, P980 KOOY NW, 1995, AM J RESP CRIT CARE, V151, P1250 Kruidenier L, 2003, J PATHOL, V201, P28, DOI 10.1002/path.1409 Lee DH, 2001, LARYNGOSCOPE, V111, P728, DOI 10.1097/00005537-200104000-00030 Li WM, 2000, INT J PEDIATR OTORHI, V55, P91, DOI 10.1016/S0165-5876(00)00372-4 LUNDBERG JO, 1996, ACTA PHYSL SCAND S MARSDEN PA, 1993, J BIOL CHEM, V268, P17478 OVESEN T, 1992, ACTA OTO-LARYNGOL, V112, P1017, DOI 10.3109/00016489209137504 Rose AS, 1997, OTOLARYNG HEAD NECK, V116, P308, DOI 10.1016/S0194-5998(97)70265-1 SAKAKURA K, 1990, ANN OTO RHINOL LARYN, V99, P379 Sampson JB, 1996, METHOD ENZYMOL, V269, P210 Schousboe LP, 2001, LARYNGOSCOPE, V111, P297, DOI 10.1097/00005537-200102000-00020 Shigemi H, 1998, ANN OTO RHINOL LARYN, V107, P327 Strand OA, 2000, CRIT CARE MED, V28, P2779 Willett DN, 1998, ANN OTO RHINOL LARYN, V107, P28 ZHU L, 1992, ARCH BIOCHEM BIOPHYS, V298, P452, DOI 10.1016/0003-9861(92)90434-X Zhu XY, 2004, CIRCULATION, V109, P2109, DOI 10.1161/01.CIR.0000125742.65841.8B NR 30 TC 0 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 804 EP 808 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200011 PM 16285272 ER PT J AU Hunter, EJ Titze, IR AF Hunter, EJ Titze, IR TI Individual subject laryngeal dimensions of multiple mammalian species for biomechanical models SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE arytenoid cartilage; cricoid cartilage; geometric measure; laryngeal skeleton; ovine larynx; thyroid cartilage ID FRAMEWORK; HEMILARYNX; SURGERY AB Objectives: This report provides a detailed knowledge base of individual subject laryngeal cartilage dimensions across multiple species to assist researchers in creating subject-specific biomechanical laryngeal models. Methods: The raw data from previous laryngeal cartilage studies were grouped by species (for human, canine, and ovine) and by cartilage (arytenoid, thyroid, and cricoid) by means of a previously reported labeling scheme. No animals were sacrificed specifically for the present study. Results: More than 1,500 measurements from 37 subjects are presented in 15 tables. No comparisons of the average measures were attempted, as they were done in previous studies. Conclusions: By means of a database of individual subject dimensions, a laryngeal model could be designed and tested to morph from one subject to the next, predicting subject-specific results of laryngeal function. Eventually,. this would lead to modeling patient-specific laryngeal disorders and the prediction of therapeutic outcomes. An electronic downloadable version of the database is made available to assist in this effort. C1 Denver Ctr Performing Arts, Natl Ctr Voice & Speech, Denver, CO USA. Univ Iowa, Natl Ctr Voice & Speech, Dept Speech Pathol & Audiol, Iowa City, IA USA. RP Hunter, EJ (reprint author), 1245 Champa St, Denver, CO 80204 USA. CR Alipour F, 2000, J VOICE, V14, P443, DOI 10.1016/S0892-1997(00)80002-8 Alipour F, 1997, J VOICE, V11, P187, DOI 10.1016/S0892-1997(97)80077-X Alipour F, 2001, ANN OTO RHINOL LARYN, V110, P550 Berry DA, 1996, J VOICE, V10, P129, DOI 10.1016/S0892-1997(96)80039-7 Berry DA, 2001, J ACOUST SOC AM, V110, P2539, DOI 10.1121/1.1408947 DOLLINGER M, IN PRESS J BIOMECHAN ECKEL HE, 1995, AM J OTOLARYNG, V16, P40, DOI 10.1016/0196-0709(95)90008-X ECKEL HE, 1994, SURG RADIOL ANAT, V16, P31, DOI 10.1007/BF01627918 Gunter HE, 2004, J BIOMECH, V37, P1119, DOI 10.1016/j.jbiomech.2003.11.007 Hunter EJ, 2005, ACOUST RES LETT ONL, V6, P112, DOI 10.1121/1.1899723 HUNTER EJ, 2005, 09 NCVS Isshiki N, 2000, ACTA OTO-LARYNGOL, V120, P120, DOI 10.1080/000164800750000748 Kim MJ, 2004, ANN OTO RHINOL LARYN, V113, P60 MAUE WM, 1971, ARCHIV OTOLARYNGOL, V94, P432 MEITELES LZ, 1992, OTOLARYNG HEAD NECK, V106, P235 Peretti G, 2000, OTOLARYNG HEAD NECK, V123, P124, DOI 10.1067/mhn.2000.104523 Sprinzl GM, 1999, HEAD NECK-J SCI SPEC, V21, P743, DOI 10.1002/(SICI)1097-0347(199912)21:8<743::AID-HED10>3.3.CO;2-# Tayama N, 2001, ANN OTO RHINOL LARYN, V110, P1154 ZRUNEK M, 1989, ACTA OTO-LARYNGOL, V108, P311, DOI 10.3109/00016488909125533 NR 19 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD OCT PY 2005 VL 114 IS 10 BP 809 EP 818 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 972AW UT WOS:000232427200012 PM 16285273 ER PT J AU Poetker, DM Kerschner, JE Patel, NJ Bauman, NM Sandler, AD AF Poetker, DM Kerschner, JE Patel, NJ Bauman, NM Sandler, AD TI Immune stimulation for the treatment of papilloma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE cottontail rabbit; CpG; immune system; papillomavirus ID RECURRENT RESPIRATORY PAPILLOMATOSIS; DNA AB Objectives: There is no curative therapy for recurrent respiratory papillomatosis. Unmethylated dinucleotides of cytosine and guanine (CpG) are potent immune stimulants that have shown efficacy against tumors as monotherapy, as vaccine adjuvants, and in combination with chemotherapies. We examined the therapeutic effect of CpG oligodeoxynucleotides in the treatment of papillomavirus in a cottontail rabbit model (CRPV). Methods: Twenty rabbits were infected with CRPV; 10 were treated with I I weekly CpG inoculations while treatment control rabbits received intralesional saline solution. Eight rabbits (4 treatment, 4 control) were rechallenged with CRPV 17 weeks after the initial viral challenge and monitored for new papilloma development. Results: Papillomas developed in all 20 rabbits (100%) within 4 weeks of infection. The diagnosis was confirmed histologically. There was no difference in the average tumor burden between the treatment and control groups after I I weeks of CpG treatments or after 9 additional weeks of observation. There was no difference between the groups in papilloma size at the site of the injections, nor was there eradication of papillomas at remote sites in either group. No new papillomas developed in any of the 8 animals that were rechallenged. Conclusions: We have reproduced an effective mammalian papilloma model for preclinical immunotherapeutic testing. Despite the potency of CpG in triggering host immunity, CpG oligodeoxynucleotide did not show a therapeutic effect against the large papilloma burdens tested in this study. The lack of effect suggests that either enhanced papilloma antigen presentation or targeting of immune-evasive mechanisms used by the papillomas is needed to treat bulky disease with an immunotherapeutic strategy. C1 Univ Iowa, Carver Coll Med, Dept Surg, Div Pediat Surg, Iowa City, IA 52242 USA. Univ Iowa, Carver Coll Med, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Milwaukee, WI 53226 USA. RP Sandler, AD (reprint author), Univ Iowa, Carver Coll Med, Dept Surg, Div Pediat Surg, 200 Hawkins Dr, Iowa City, IA 52242 USA. CR Derkay CS, 2001, LARYNGOSCOPE, V111, P57, DOI 10.1097/00005537-200101000-00011 DERKAY CS, 1995, ARCH OTOLARYNGOL, V121, P1386 Green GE, 2000, OTOLARYNG CLIN N AM, V33, P187, DOI 10.1016/S0030-6665(05)70215-2 KREIDER JW, 1995, J VIROL METHODS, V55, P233, DOI 10.1016/0166-0934(95)00062-Y Krieg AM, 2001, CURR OPIN MOL THER, V3, P15 KRIEG AM, 1995, NATURE, V374, P546, DOI 10.1038/374546a0 Sandler AD, 2003, CANCER RES, V63, P394 SCOTT D, 2000, SURG FORUM, V53, P534 NR 8 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 657 EP 661 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900001 PM 16240926 ER PT J AU Hansen, JK Thibeault, SL Walsh, JF Shu, XZ Prestwich, GD AF Hansen, JK Thibeault, SL Walsh, JF Shu, XZ Prestwich, GD TI In vivo engineering of the vocal fold extracellular matrix with injectable hyaluronic acid hydrogels: Early effects on tissue repair and biomechanics in a rabbit model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Laryngol Assoc DE hyaluronic acid hydrogel; prophylaxis; scarring; tissue engineering; vocal fold ID VISCOELASTIC PROPERTIES; INSUFFICIENCY; DRESSINGS; MUCOSA; FLOW AB Objectives: A prospective, controlled animal study was performed to determine whether the use of injectable. chemically modified hyaluronic acid (HA) derivatives at the time of intentional vocal fold resection might facilitate wound repair and preserve the unique viscoelastic properties of the vocal fold extracellular matrix. Methods: We performed bilateral vocal fold biopsies on 33 rabbits. Two groups of rabbits were unilaterally treated with 2 different HA derivatives - Carbylan-SX and HA-DTPH-PEGDA - at the time of resection, Saline was injected as a control into the contralateral fold. The animals were painlessly sacrificed 3 weeks after biopsy and injection. The outcomes measured included histologic fibrosis level, tissue HA level. and tissue viscosity and elasticity. Results: The Carbylan-SX-treated vocal folds were found to have significantly less fibrosis than the saline-treated controls. The levels of HA in the treated vocal folds were not significantly different from those in the controls at 3 weeks as measured by enzyme-linked immunosorbent assay. The Carbylan-SX-treated vocal folds had significantly improved biomechanical properties of elasticity and viscosity. The HA-DTPH-PEGDA injections yielded significantly improved viscosity, but not elasticity. Conclusions: Prophylactic in vivo manipulation of the extracellular matrix with in injectable Carbylan-SX hydrogel appears to induce vocal fold tissue regeneration to yield optimal tissue composition and biomechanical properties favorable for phonation. C1 Univ Utah, Div Otolaryngol Head & Neck Surg, Sch Med, Dept Surg, Salt Lake City, UT 84132 USA. Univ Utah, Ctr Therapeut Biomat, Salt Lake City, UT 84132 USA. Univ Utah, Dept Bioengn, Salt Lake City, UT 84132 USA. Univ Utah, Dept Med Chem, Salt Lake City, UT 84132 USA. RP Thibeault, SL (reprint author), Univ Utah, Div Otolaryngol Head & Neck Surg, Sch Med, Dept Surg, 3C120,30 N 1900 E, Salt Lake City, UT 84132 USA. CR BALAZS EA, 2000, SCARLESS WOUND HEALI, P143 Benninger MS, 1996, OTOLARYNG HEAD NECK, V115, P474, DOI 10.1016/S0194-5998(96)70087-6 Chan RW, 1999, LARYNGOSCOPE, V109, P1142, DOI 10.1097/00005537-199907000-00026 Chan RW, 2001, OTOLARYNG HEAD NECK, V124, P607, DOI 10.1067/mhn.2001.115906 Chan RW, 1999, J ACOUST SOC AM, V106, P2008, DOI 10.1121/1.427947 Hallen L, 1999, ACTA OTO-LARYNGOL, V119, P107 Hallen L, 1998, LARYNGOSCOPE, V108, P393, DOI 10.1097/00005537-199803000-00015 Hertegard S, 2003, OTOLARYNG HEAD NECK, V128, P401, DOI 10.1067/mhn.2003.96 Kirker KR, 2002, BIOMATERIALS, V23, P3661, DOI 10.1016/S0142-9612(02)00100-X Kirker KR, 2004, J BURN CARE REHABIL, V25, P276, DOI 10.1097/01.BCR.0000124790.69026.3D Klemuk SA, 2004, LARYNGOSCOPE, V114, P1597, DOI 10.1097/00005537-200409000-00018 LONGAKER MT, 1991, ANN SURG, V213, P292, DOI 10.1097/00000658-199104000-00003 MA L, 1995, J FOOD ENG, V25, P409, DOI 10.1016/0260-8774(94)00010-7 Pal R, 2000, COLLOID SURFACE A, V162, P55, DOI 10.1016/S0927-7757(99)00239-3 RODEN L, 1989, CIBA F SYMP, V143, P60 Sanchez-Reyes J, 2003, LANGMUIR, V19, P3304, DOI 10.1021/la0265326 Shu XZ, 2004, CHEMISTRY AND BIOLOGY OF HYALURONAN, P475 Shu XZ, 2002, BIOMACROMOLECULES, V3, P1304, DOI 10.1021/bm025603c Shu XZ, 2004, BIOMATERIALS, V25, P1339, DOI 10.1016/j.biomaterials.2003.08.014 Thibeault SL, 2004, LARYNGOSCOPE, V114, P760, DOI 10.1097/00005537-200404000-00031 Thibeault SL, 2004, CHEMISTRY AND BIOLOGY OF HYALURONAN, P339 Thibeault SL, 2002, J VOICE, V16, P96, DOI 10.1016/S0892-1997(02)00078-4 Ward PD, 2002, J VOICE, V16, P303, DOI 10.1016/S0892-1997(02)00101-7 WEIGEL PH, 1986, J THEOR BIOL, V119, P219, DOI 10.1016/S0022-5193(86)80076-5 YOSHIMURA A, 1988, J RHEOL, V32, P53, DOI 10.1122/1.549963 NR 25 TC 56 Z9 57 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 662 EP 670 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900002 PM 16240927 ER PT J AU Burns, JA Zeitels, SM Anderson, RR Kobler, JB Pierce, MC de Boer, JF AF Burns, JA Zeitels, SM Anderson, RR Kobler, JB Pierce, MC de Boer, JF TI Imaging the mucosa of the human vocal fold with optical coherence tomography SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE glottis; imaging technique; larynx; optical coherence tomography; vocal fold ID FEASIBILITY; BIREFRINGENCE; TISSUE AB Objectives: Discerning the layered microstructure of the vocal folds is critical for effective phonomicrosurgery. Optical coherence tomography (OCT), a noncontact, noninvasive technology that provides cross-sectional images by means of backscattered light, offers the potential for delineating these layers in vivo. Methods: The glottal mucosa of 3 human cadaver larynges was imaged with conventional OCT and polarization-sensitive OCT (PS-OCT). Images were obtained through the epithelium and lamina propria. Results: Although the superficial layer of the lamina propria appeared quite homogeneous, the outer surface of the superficial lamina propria was correlated with an increase in backscatter with OCT. The superficial lamina propria and vocal ligament were correlated with a marked increase in tissue birefringence with PS-OCT. Conclusions: This preliminary study demonstrates the capacity of OCT and PS-OCT for visualizing the layered microstructure of the vocal fold mucosa. We believe that these imaging techniques will have applications in the exploration of solutions to vocal fold scarring and in imaging vocal fold disorders in the clinic and operating room. C1 Harvard Univ, Sch Med, Wellman Ctr Photomed, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Surg, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Dermatol, Boston, MA 02114 USA. Massachusetts Gen Hosp, Wellman Ctr Photomed, Boston, MA 02114 USA. Massachusetts Gen Hosp, Dept Surg, Boston, MA 02114 USA. Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rahabil, Boston, MA 02114 USA. RP de Boer, JF (reprint author), Harvard Univ, Sch Med, Wellman Ctr Photomed, 50 Blossom St,Bar 724, Boston, MA 02114 USA. RI de Boer, Johannes/B-7590-2012 OI de Boer, Johannes/0000-0003-1253-4950 CR Bibas AG, 2003, P SOC PHOTO-OPT INS, V4956, P95, DOI 10.1117/12.477886 BISHOP J, 1836, EXPT RESERCHES PHYS Bouma BE, 2002, ACAD RADIOL, V9, P942, DOI 10.1016/S1076-6332(03)80465-8 Chan RC, 2004, OPT EXPRESS, V12, P4558, DOI 10.1364/OPEX.12.004558 de Boer JF, 2002, J BIOMED OPT, V7, P359, DOI 10.1117/1.1483879 deBoer JF, 1997, OPT LETT, V22, P934, DOI 10.1364/OL.22.000934 Gladkova ND, 2002, HANDBOOK OF OPTICAL COHERENCE TOMOGRAPHY, P705 Hammond TH, 2000, ANN OTO RHINOL LARYN, V109, P913 Hirano M., 1975, OTOLOGIA FUKUOKA S1, V21, P239 Hirano M., 1981, P C ASSESSMENT VOCAL, P11 Hirano M, 1991, PHONOSURGERY ASSESSM, P25 HUANG D, 1991, SCIENCE, V254, P1178, DOI 10.1126/science.1957169 Park BH, 2003, OPT EXPRESS, V11, P782, DOI 10.1364/OE.11.000782 Pierce MC, 2002, OPT LETT, V27, P1534, DOI 10.1364/OL.27.001534 Pitris C, 2001, ARCH OTOLARYNGOL, V127, P637 Pitris C, 1998, AM J RESP CRIT CARE, V157, P1640 PRESSMAN J, 1956, Ann Otol Rhinol Laryngol, V65, P963 PRESSMAN J J, 1960, Trans Am Acad Ophthalmol Otolaryngol, V64, P628 Reinke F, 1897, ANAT HEFTE, V9, P103 Shakhov AV, 2001, J SURG ONCOL, V77, P253, DOI 10.1002/jso.1105 TITZE IR, 1994, PRINCIPLES VOICE PRO, P17 White BR, 2003, OPT EXPRESS, V11, P3490, DOI 10.1364/OE.11.003490 Wong BJF, 2000, J BIOMED OPT, V5, P367, DOI 10.1117/1.1310165 Yun SH, 2003, OPT EXPRESS, V11, P3598, DOI 10.1364/OE.11.003598 Zeitels SM, 2002, ANN OTO RHINOL LARYN, V111, P21 ZEITELS SM, 1995, LARYNGOSCOPE S67, V105 NR 26 TC 27 Z9 29 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 671 EP 676 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900003 PM 16240928 ER PT J AU Andrews, BT Trask, DK AF Andrews, BT Trask, DK TI Oral melanoacanthoma: A case report, a review of the literature and a new treatment option SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Middle Section Meeting of the Triological-Society CY JAN 21-23, 2005 CL Chicago, IL SP Triol Soc DE argon plasma coagulation; melanoacanthoma; oral melanoacanthoma ID INTRAORAL MELANOACANTHOMA; MELANOCYTIC HYPERPLASIA; MUCOSA; BENIGN; CELLS; LIP AB Objectives: Oral melanoacanthoma is a rare condition that presents as a pigmented, painful lesion, most commonly on the buccal mucosa. Argon plasma coagulation is a new treatment option for benign oral lesions and is hypothesized to be efficacious for this rare mucosal disorder. Methods: Treatment of a case and a review of the English-language literature were performed. Results: One patient received a diagnosis of oral melanoacanthoma, and argon plasma coagulation treatment resulted in ablation of the lesion with excellent mucosal healing. A review of the literature demonstrated that this lesion is most commonly associated with black (90.9%), adult female (69.7%) patients and is most commonly located on the buccal mucosa (64.7%). Conclusions: Oral melanoacanthoma is a rare, benign mucosal lesion that may require surgical intervention for symptomatic relief. Argon plasma coagulation is a relatively safe and effective means of treating this lesion. Argon plasma coagulation treatment may be expanded to include other benign, superficial lesions of the oral mucosa. C1 Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. RP Trask, DK (reprint author), Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, 21272 Pomerantz Pavil,200 Hawkins Dr, Iowa City, IA 52242 USA. CR Bloch B, 1927, ARCH DERMATOL SYPH-G, V153, P20, DOI 10.1007/BF01828960 BUCHNER A, 1991, ORAL SURG ORAL MED O, V71, P58, DOI 10.1016/0030-4220(91)90522-E Chandler K, 1997, ORAL SURG ORAL MED O, V84, P492, DOI 10.1016/S1079-2104(97)90264-X Fatahzadeh M, 2002, ORAL SURG ORAL MED O, V94, P54, DOI 10.1067/moe.2002.122337 Flaitz CM, 2000, AM J DENT, V13, P162 Fornatora ML, 2003, AM J DERMATOPATH, V25, P12, DOI 10.1097/00000372-200302000-00003 FREY VM, 1984, J SURG ONCOL, V27, P93, DOI 10.1002/jso.2930270208 GOODE RK, 1983, ORAL SURG ORAL MED O, V56, P622, DOI 10.1016/0030-4220(83)90080-4 Heine Brian Tory, 1996, General Dentistry, V44, P451 HORLICK HP, 1988, J AM ACAD DERMATOL, V19, P786, DOI 10.1016/S0190-9622(88)70235-2 MATSUOKA LY, 1979, ARCH DERMATOL, V115, P1116, DOI 10.1001/archderm.115.9.1116 MISHIMA Y, 1960, ARCH DERMATOL, V81, P539 SCHNEIDER LC, 1981, ORAL SURG ORAL MED O, V52, P284, DOI 10.1016/0030-4220(81)90267-X SEXTON FM, 1987, AM J DERMATOPATH, V9, P438, DOI 10.1097/00000372-198710000-00012 TOMICH CE, 1990, J DERMATOL SURG ONC, V16, P231 TOMICH CE, 1978, 32 ANN M AM AC OR PA WRIGHT JM, 1988, J AM DENT ASSOC, V117, P620 WRIGHT JM, 1988, J PERIODONTOL, V59, P53 WRIGHT JM, 1983, J PERIODONTOL, V54, P107 WRIGHT JM, 1989, J AM DENT ASSOC, V118, P412 ZEMTSOV A, 1989, J CUTAN PATHOL, V16, P365, DOI 10.1111/j.1600-0560.1989.tb00587.x NR 21 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 677 EP 680 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900004 PM 16240929 ER PT J AU Mosier, K Liu, WC Behin, B Lee, C Baredes, S AF Mosier, K Liu, WC Behin, B Lee, C Baredes, S TI Cortical adaptation following partial glossectomy with primary closure: Implications for reconstruction of the oral tongue SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE adaptation; functional magnetic resonance imaging; functional outcome; partial glossectomy; primary closure ID PRIMARY MOTOR CORTEX; FUNCTIONAL-PROPERTIES; BLOOD OXYGENATION; REPRESENTATION; REORGANIZATION; AMPUTATION; MOVEMENT; FEATURES; NEURONS; OBJECTS AB Objectives: The considerable variability in functional outcomes for speech and swallowing with different reconstruction techniques following partial glossectomy may reflect the ability of patients to adapt to altered tongue structure. The purpose of this study was to determine mechanisms of cortical adaptation in swallowing to partial glossectomy reconstructed with primary closure. Methods: Four patients treated with partial glossectomy and primary closure underwent functional magnetic resonance imaging at a mean of 6 months after operation, and the data were compared to those from 8 healthy controls. Results: Statistically significant increases in activity occurred predominately in the parietal cortices and the cerebellum. The volume of the resection was most highly correlated with activity in the premotor and parietal cortices and cerebellum. Conclusions: The adaptive changes in the cortex following partial glossectomy with primary closure reflect adaptation to the biomechanics of tongue movement during swallowing, and not altered sensation in the tongue. C1 Univ Med & Dent New Jersey, Div Otolaryngol Head & Neck Surg, Dept Radiol, New Jersey Med Sch, Newark, NJ 07103 USA. Univ Med & Dent New Jersey, Div Otolaryngol Head & Neck Surg, Dept Surg, New Jersey Med Sch, Newark, NJ 07103 USA. RP Mosier, K (reprint author), Indiana Univ, Sch Med, Dept Radiol, R2 E124,950 W Walnut St, Indianapolis, IN 46202 USA. 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Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 681 EP 687 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900005 PM 16240930 ER PT J AU Numa, WA Desai, U Gold, DR Heher, KL Annino, DJ AF Numa, WA Desai, U Gold, DR Heher, KL Annino, DJ TI Silent sinus syndrome: A case presentation and comprehensive review of all 84 reported cases SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the Eastern Section of the American-Laryngological-Rhinological-and Otological-Society CY JAN 24-26, 2004 CL New York, NY SP Amer Laryngol Rhinol & Otol Soc, Eastern Sect DE chronic maxillary atelectasis; chronic maxillary sinusitis; enophthalmos; hypoglobus; ostiomeatal complex; silent sinus syndrome ID CHRONIC MAXILLARY ATELECTASIS; SPONTANEOUS ENOPHTHALMOS; VERTICAL DIPLOPIA; SECONDARY; PRESSURE; MUCOCELE AB Objectives: The term silent sinus syndrome has been used to describe the constellation of progressive enophthalmos and hypoglobus due to gradual collapse of the orbital floor with opacification of the maxillary Sinus. in the presence of subclinical chronic maxillary sinusitis. Currently, it is believed to occur as a result of the sequence of events Following maxillary sinus hypoventilation due to the obstruction of the ostiomeatal complex. Methods. In this study, we present a case of true silent sinus syndrome. In addition. we highlight the previously published cases of silent sinus syndrome, as well as provide a review of the etiology, pathophysiology, radiologic diagnosis, surgical treatment, and pitfalls to avoid in the management of patients with silent sinus syndrome. Results: Eighty-three previously published cases of silent sinus syndrome were reported in the literature and are summarized in this review. Conclusions: A well-defined set of criteria is needed to classify a patient under the diagnosis of silent sinus syndrome, which include enophthalmos and/or hypoglobus in the absence of clinically evident sinonasal inflammatory disease. C1 Tufts Univ, Sch Med, New England Med Ctr, Dept Otolaryngol Head & Neck Surg, Boston, MA 02111 USA. Tufts Univ, Sch Med, New England Med Ctr,New England Eye Ctr, Dept Ophthalmol,Div Oculoplast & Reconstruct Surg, Boston, MA 02111 USA. RP Annino, DJ (reprint author), Tufts Univ, Sch Med, New England Med Ctr, Dept Otolaryngol Head & Neck Surg, 750 Washington St,NEMC 850, Boston, MA 02111 USA. CR ANTONELLI PJ, 1992, ANN OTO RHINOL LARYN, V101, P977 Boyd JH, 1998, ANN OTO RHINOL LARYN, V107, P34 Burroughs JR, 2003, OPHTHAL PLAST RECONS, V19, P449, DOI 10.1097/01.IOP.0000096161.78346.AB CASTELEIN S, 2002, REV LARYNGOL OTOL RH, V1123, P99 CHIDYLLO SA, 1994, PLAST RECONSTR SURG, V93, P1264, DOI 10.1097/00006534-199405000-00025 CLINE RA, 1984, OPHTHALMOLOGY, V91, P229 Dailey RA, 1995, OPHTHALMIC PLAST REC, V11, P261, DOI 10.1097/00002341-199512000-00007 Davidson JK, 1999, ARCH OPHTHALMOL-CHIC, V117, P1653 Durig J, 1998, KLIN MONATSBL AUGENH, V212, P397, DOI 10.1055/s-2008-1034917 Ende K, 2002, ANN OTO RHINOL LARYN, V111, P759 ETO RT, 1995, AM J NEURORADIOL, V16, P939 Garber PF, 1995, OPHTHALMIC PLAST REC, V11, P254, DOI 10.1097/00002341-199512000-00006 Gillman GS, 1999, AM J RHINOL, V13, P459, DOI 10.2500/105065899781329629 GOLDHAMMER Y, 1998, J LARYNGOL OTOL, V95, P643 HAYES EJ, 1987, ANN OTO RHINOL LARYN, V96, P351 Hira Neelu K, 2004, Optometry, V75, P589, DOI 10.1016/S1529-1839(04)70191-8 Hobbs CGL, 2004, J LARYNGOL OTOL, V118, P310 HUNT SM, 2000, EAR NOST THROAT J, V576, P579 Illner A, 2002, AM J ROENTGENOL, V178, P503 Iseli HP, 2003, OPHTHALMOLOGICA, V217, P308, DOI 10.1159/000070641 KALTREIDER SA, 1988, ARCH OPHTHALMOL-CHIC, V106, P1398 Kass ES, 1997, ANN OTO RHINOL LARYN, V106, P109 Kass ES, 1996, LARYNGOSCOPE, V106, P1255, DOI 10.1097/00005537-199610000-00017 Kim SA, 2002, ARCH OTOLARYNGOL, V128, P81 KUMAR BU, 1994, J LARYNGOL OTOL, V108, P74 MARTELLI A, 1984, J CLIN NEURO-OPHTHAL, V4, P167 Michielsens A, 1999, J FR OPHTALMOL, V22, P451 MONTGOMERY W W, 1964, Eye Ear Nose Throat Mon, V43, P41 Ong Lorraine, 2003, Orbit, V22, P161, DOI 10.1076/orbi.22.3.161.15623 Raghavan U, 2001, BRIT J OPHTHALMOL, V85, P118 Rapidis AD, 2004, J ORAL MAXIL SURG, V62, P1028, DOI 10.1016/j.joms.2004.01.021 Roach HD, 2003, BRIT J RADIOL, V76, P577, DOI 10.1259/bjr/58320420 Rose GE, 2003, OPHTHALMOLOGY, V110, P1475 Rose T P, 1998, J Am Optom Assoc, V69, P236 SCHARF KE, 1995, LARYNGOSCOPE, V105, P570, DOI 10.1288/00005537-199506000-00002 Soparkar CNS, 2004, OPHTHALMOLOGY, V111, P414, DOI 10.1016/j.ophtha.2003.12.018 SOPARKAR CNS, 1994, OPHTHALMOLOGY, V101, P772 Thomas RD, 2003, AM J RHINOL, V17, P97 TRAUSTASON OI, 1983, AM J OPHTHALMOL, V95, P838, DOI 10.1016/0002-9394(83)90077-6 Vander Meer J B, 2001, Laryngoscope, V111, P975, DOI 10.1097/00005537-200106000-00008 Wan M K, 2000, J Neuroophthalmol, V20, P207, DOI 10.1097/00041327-200020030-00010 WHITE JE, 1994, CAN J OPHTHALMOL, V29, P90 WILKINS RB, 1981, OPHTHALMOLOGY, V88, P981 NR 43 TC 26 Z9 27 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 688 EP 694 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900006 PM 16240931 ER PT J AU Shpitzer, T Keller, N Wolf, M Goldschmied-Reouven, A Bahar, G Bahar, I Kronenberg, J Feinmesser, R Talmi, YP AF Shpitzer, T Keller, N Wolf, M Goldschmied-Reouven, A Bahar, G Bahar, I Kronenberg, J Feinmesser, R Talmi, YP TI Seasonal variations in rhino-cerebral Mucor infection SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE fungus; hematologic malignancy; mucormycosis; season ID MUCORMYCOSIS; AIR; FUNGI; PREVALENCE; DOGS AB Objectives: Rhino-orbito-cerebral mucormycosis (ROCM) is an uncommon, potentially lethal infection that occurs mostly in immunocompromised hosts. The seasonal occurrence of ROCM was studied in two of Israel's largest medical centers. Methods: A total of 36 patients were seen during a 25-year period in this retrospective bi-institutional cohort study. Meteorologic data were obtained and analyzed for a possible linkage of infection with precipitation and temperature. Results: Twenty-one of the 36 patients (58%) presented between the months of August and October, and 27 patients (75%) presented between the months of August and December. A peak incidence of ROCM was noted in the month of September (13/36 patients; 36%). No association was noted between meteorologic conditions and the incidence of ROCM infection. Conclusions: A consistent seasonal peak was observed in ROCM. Heightened awareness is important for early recognition and treatment of this disease. C1 Chaim Sheba Med Ctr, Dept Otolaryngol Head & Neck Surg, IL-52621 Tel Hashomer, Israel. Chaim Sheba Med Ctr, Dept Microbiol, IL-52621 Tel Hashomer, Israel. Tel Aviv Univ, Sackler Sch Med, IL-69978 Tel Aviv, Israel. Rabin Med Ctr, Dept Otolaryngol Head & Neck Surg, Petah Tiqwa, Israel. Rabin Med Ctr, Dept Ophthalmol, Petah Tiqwa, Israel. RP Talmi, YP (reprint author), Chaim Sheba Med Ctr, Dept Otolaryngol Head & Neck Surg, IL-52621 Tel Hashomer, Israel. CR BARTZOKAS CA, 1975, MYCOPATHOLOGIA, V57, P35, DOI 10.1007/BF00431176 BEAUMONT F, 1985, ALLERGY, V40, P173, DOI 10.1111/j.1398-9995.1985.tb00213.x Cabanes FJ, 1996, MYCOPATHOLOGIA, V133, P1, DOI 10.1007/BF00437092 Corey JP, 1997, OTOLARYNG HEAD NECK, V117, P516, DOI 10.1016/S0194-5998(97)70024-X DRAKOS PE, 1993, BONE MARROW TRANSPL, V12, P203 ENGLAND AC, 1981, AM REV RESPIR DIS, V124, P497 FERRY AP, 1983, OPHTHALMOLOGY, V90, P1096 Ghazifard A, 2001, WASTE MANAGE RES, V19, P257 HERRERO B, 1997, ALLERGOL CLIN IMMUNO, V7, P611 JAND SK, 1989, MYCOSES, V32, P104 Mancianti F., 2002, Mycopathologia, V156, P13, DOI 10.1023/A:1021361001794 MORDUCHOWICZ G, 1986, REV INFECT DIS, V8, P441 MORRISON VA, 1993, BONE MARROW TRANSPL, V11, P383 MULLINS J, 1984, CLIN ALLERGY, V14, P351, DOI 10.1111/j.1365-2222.1984.tb02215.x OGUNLANA EO, 1975, APPL MICROBIOL, V29, P458 Panagopoulou P, 2002, J HOSP INFECT, V52, P185, DOI 10.1053/jhin.2002.1298 Ren P, 1999, J EXPO ANAL ENV EPID, V9, P560, DOI 10.1038/sj.jea.7500061 ROSEN PP, 1976, NEW ENGL J MED, V295, P1319 SHPITZER T, 1995, CLIN OTOLARYNGOL, V20, P374, DOI 10.1111/j.1365-2273.1995.tb00064.x SUGAR AM, 1992, CLIN INFECT DIS, V14, pS126 Talmi YP, 2002, OTOLARYNG HEAD NECK, V127, P22, DOI 10.1067/mhn.2002.126587 YOHAI RA, 1994, SURV OPHTHALMOL, V39, P3, DOI 10.1016/S0039-6257(05)80041-4 NR 22 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 695 EP 698 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900007 PM 16240932 ER PT J AU Pomerantz, J Dutton, JM AF Pomerantz, J Dutton, JM TI Platelet gel for endoscopic sinus surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 49th Annual Fall Meeting of the American-Rhinologic-Society CY SEP 20, 2003 CL Orlando, FL SP Amer Rhinol Soc DE autologous platelet gel; endoscopic sinus surgery; packing; paranasal sinus; platelet-poor plasma; platelet-rich plasma; wound healing ID PARANASAL SINUSES; NASAL PACKING AB Objectives: New techniques are being utilized to improve outcomes for endoscopic sinus surgery, including newer forms of packing. Platelet gel is an innovative technique that holds many advantages, including comfort, hemostasis, and growth factors that may improve wound healing. This report discusses the theoretical advantages of this packing material and describes the initial results in a cohort of patients who underwent endoscopic sinus surgery. Methods: A cohort of patients who underwent endoscopic sinus surgery were interviewed and evaluated after the placement of platelet gel. A quality of life study was also administered for further understanding. Results: None of the patients in the study had postoperative epistaxis that required additional packing, and there were no instances of synechia formation or exuberant granulation tissue. Although not statistically significant because of a small population, the quality of life scores did show improvement over the control group. Conclusions: Platelet gel used as a packing material after endoscopic sinus surgery offers efficient hemostatic properties, as well as growth factors that can advance the healing process. The quality of life of the patient may be improved by the use of platelet gel packing. C1 Rush Univ, Med Ctr, Dept Otolaryngol & Bronchoesophagol, Chicago, IL 60612 USA. RP Dutton, JM (reprint author), 1725 W Harrison St,Suite 340, Chicago, IL 60612 USA. CR Anderson ER, 1999, OTOLARYNG HEAD NECK, V121, P702, DOI 10.1053/hn.1999.v121.a100114 Bhanot Sumeet, 2002, Facial Plast Surg, V18, P27, DOI 10.1055/s-2002-19824 Chandra RK, 2003, AM J RHINOL, V17, P51 HOSEMANN W, 1991, HNO, V39, P111 HOSEMANN W, 1991, EUR ARCH OTO-RHINO-L, V248, P390, DOI 10.1007/BF01463560 Maccabee MS, 2003, AM J RHINOL, V17, P203 MAUSNER P, 2003, SUMMARY PRESENTATION Orlandi RR, 2004, LARYNGOSCOPE, V114, P1541, DOI 10.1097/00005537-200409000-00007 ROSENBERG L, 2002, WOUND HEALING GROWTH TOWNSEND CM, 2001, SABISTON TXB SURG, P78 VONSCHOENBERG M, 1993, J LARYNGOL OTOL, V107, P902 Weber R, 1996, LARYNGO RHINO OTOL, V75, P208, DOI 10.1055/s-2007-997564 Weber R, 2001, AM J OTOLARYNG, V22, P306, DOI 10.1053/ajot.2001.26499 Whitman DH, 1997, J ORAL MAXIL SURG, V55, P1294, DOI 10.1016/S0278-2391(97)90187-7 NR 14 TC 22 Z9 23 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 699 EP 704 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900008 PM 16240933 ER PT J AU Sennes, LU Fortes, FSG Butugan, O Saldiva, PH Bernardi, FC AF Sennes, LU Fortes, FSG Butugan, O Saldiva, PH Bernardi, FC TI Tissue maturation correlating to clinical manifestations in juvenile angiofibroma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE clinical manifestation; histology; juvenile nasopharyngeal angiofibroma; maturation ID NASOPHARYNGEAL ANGIOFIBROMA; GROWTH AB Objectives: Juvenile nasopharyngeal angiofibroma is a rare benign tumor that affects young male patients and shows a characteristic development from its origin. It is not a true neoplasm, but shows features of vascular processes, developing into a more fibrous condition. The aim of this study was to correlate the clinical manifestations and the histologic findings of the tumor. Methods: Thirty-six patients without previous treatment were studied. We correlated the incidence and duration of the clinical manifestations (nasal obstruction, epistaxis, nasal and/or pharyngeal tumor, and facial deformity) and morphometric histologic analyses of the central region of the tumor (number, caliber, and presence of muscle cells in the vessel wall, and tissue maturity and cellularity). Results: The duration of nasal obstruction, the presence of nasal and/or pharyngeal tumor, and facial deformity were significantly correlated with the number of vessels, the tissue maturation, and the cellularity of the tumor. Epistaxis showed a strong correlation with the presence of muscle fibers in the vessels. Conclusions: There are correlations between the duration of the clinical manifestations and histologic maturation in the central portion of the tumor. C1 Univ Sao Paulo, Dept Otolaryngol, Sch Med, Sao Paulo, Brazil. Univ Sao Paulo, Dept Pathol, Sch Med, Sao Paulo, Brazil. RP Sennes, LU (reprint author), Av Padre Pereira Andrade 545,Ap 174F, BR-05469900 Sao Paulo, Brazil. RI Sennes, Luiz/E-6815-2012 CR Beham A, 2000, ADV ANAT PATHOL, V7, P36, DOI 10.1097/00125480-200007010-00006 BRENTANI MM, 1989, LARYNGOSCOPE, V99, P398, DOI 10.1288/00005537-198904000-00007 Coutinho-Camillo CM, 2003, DIAGN MOL PATHOL, V12, P57, DOI 10.1097/00019606-200303000-00008 HARRISON DFN, 1987, ARCH OTOLARYNGOL, V113, P936 KUMAGAMI H, 1993, AM J RHINOL, V7, P101, DOI 10.2500/105065893781976393 Liang JG, 2000, OTOLARYNG HEAD NECK, V123, P475, DOI 10.1067/mhn.2000.105061 Lloyd G, 1999, J LARYNGOL OTOL, V113, P127 MARTIN H, 1948, ANN SURG, V127, P513, DOI 10.1097/00000658-194803000-00012 Nagai MA, 1996, LARYNGOSCOPE, V106, P190, DOI 10.1097/00005537-199602000-00016 Radkowski D, 1996, ARCH OTOLARYNGOL, V122, P122 SCHIFF M, 1959, Laryngoscope, V69, P981 SCHIFF M, 1992, LARYNGOSCOPE, V102, P940, DOI 10.1288/00005537-199208000-00016 Sennes LU, 2003, RHINOLOGY, V41, P235 Sennes LU, 2004, ANN OTO RHINOL LARYN, V113, P34 STANSBIE JM, 1986, J LARYNGOL OTOL, V100, P599, DOI 10.1017/S0022215100099722 WANG HW, 1994, EUR ARCH OTO-RHINO-L, V251, P123 WEPRIN LS, 1991, ARCH OTOLARYNGOL, V117, P796 NR 17 TC 5 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 705 EP 708 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900009 PM 16240934 ER PT J AU Naumann, IC Porcellini, B Fisch, U AF Naumann, IC Porcellini, B Fisch, U TI Otosclerosis: Incidence of positive findings on high-resolution computed tomography and their correlation to audiological test data SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 25th Meeting of the Politzer-Society CY APR 22-25, 2004 CL Saas Fee, SWITZERLAND SP Politzer Soc DE audiometry; computed tomography; otosclerosis ID DRINKING-WATER FLUORIDATION; SENSORINEURAL HEARING-LOSS; COCHLEAR OTOSCLEROSIS; CT ANALYSIS AB Objectives: Computed tomographic (CT) scanning with slices of 1 mm. or more has not been sufficient to demonstrate otosclerotic foci in most cases to date. Methods: We investigated the validity of CT scans with a 0.5-mm cubical scan technique, with and without planar reconstruction, and correlated these findings with audiological data. Forty-four temporal bone CT scans from 30 patients with conductive or mixed hearing loss were evaluated. Results: Otosclerotic foci were visualized in 74% of the cases. With reconstruction at the workstation, the sensitivity increased to 85%. Whereas in fenestral otosclerosis a correlation was found between the size of the focus and the air-bone gap, no correlation was seen between the size of the focus and bone conduction thresholds with cochlear involvement. Otosclerotic foci in patients treated with sodium fluoride were smaller than those in patients without treatment. This finding may indicate a beneficial effect of sodium fluoride on otosclerotic growth. Conclusions: High-resolution CT scans are a valid tool that can be used to confirm, localize, and determine the size of clinically suspected otosclerotic foci. C1 Klin Hirslanden, ORL Zentrum, CH-8029 Zurich, Switzerland. Klin Hirslanden, Dept Radiol, CH-8029 Zurich, Switzerland. Indiana Univ, Dept Otolaryngol Head & Neck Surg, Indianapolis, IN 46204 USA. RP Fisch, U (reprint author), Klin Hirslanden, ORL Zentrum, Witellikerstr 40, CH-8029 Zurich, Switzerland. CR Grayeli AB, 2004, ACTA OTO-LARYNGOL, V124, P1136, DOI 10.1080/00016480410018188 Cherukupally SR, 1998, ANN OTO RHINOL LARYN, V107, P319 Derks W, 2001, ACTA OTO-LARYNGOL, V121, P174 Guneri EA, 1996, ANN OTO RHINOL LARYN, V105, P659 Kiyomizu K, 2004, AURIS NASUS LARYNX, V31, P125, DOI 10.1016/j.anl.2004.01.006 MAFEE MF, 1985, RADIOLOGY, V156, P709 MAFEE MF, 1985, RADIOLOGY, V156, P703 Nelson EG, 2004, LARYNGOSCOPE, V114, P1214, DOI 10.1097/00005537-200407000-00016 SCHUKNECHT HF, 1985, LARYNGOSCOPE, V95, P1307 Shin YJ, 2001, OTOL NEUROTOL, V22, P461, DOI 10.1097/00129492-200107000-00008 SWARTZ JD, 1985, RADIOLOGY, V155, P147 SWARTZ JD, 1984, RADIOLOGY, V151, P703 Van Den Bogaert K, 2002, BONE, V30, P624, DOI 10.1016/S8756-3282(02)00679-8 Vartiainen E, 1997, J LARYNGOL OTOL, V111, P20 Vartiainen E, 1996, ACTA OTO-LARYNGOL, V116, P747, DOI 10.3109/00016489609137918 NR 15 TC 28 Z9 30 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 709 EP 716 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900010 PM 16240935 ER PT J AU Kuo, SW Yang, TH Young, YH AF Kuo, SW Yang, TH Young, YH TI Changes in vestibular evoked myogenic potentials after Meniere attacks SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 18th International Congress of the Barany-Society CY JUL 09, 2004 CL Paris, FRANCE SP Barany Soc DE Meniere attack; Meniere's disease; vestibular evoked myogenic potential ID ENDOLYMPHATIC HYDROPS; DISEASE; STIMULATION AB Objectives: The aim of this study was to apply videonystagmography (VNG) and vestibular evoked myogenic potential (VEMP) tests to patients with Meniere attacks, to explore the mechanics of where saccular disorders may affect the semicircular canals. Methods: From January 2001 to December 2003, 12 consecutive patients with unilateral definite Meniere's disease with vertiginous attacks underwent VNG for recording spontaneous nystagmus, as well as VEMP tests. Results: At the very beginning of the Meniere attack, the spontaneous nystagmus beat toward the lesion side in 5 patients (42%) and toward the healthy side in 7 patients (58%). Twenty-four hours later, only 6 patients (50%) showed spontaneous nystagmus beating toward the healthy side. Nevertheless, spontaneous nystagmus subsided in all patients within 48 hours. The VEMP test was performed within 24 hours of a Meniere attack; the VEMPs were normal in 4 patients and abnormal in 8 patients (67%). After 48 hours, 4 patients with initially abnormal VEMPs had resolution and return to normal VEMPs, and the other 4 patients still had absent VEMPs. Conclusions: Most patients (67%) with Meniere attacks revealed abnormal VEMPs, indicating that the saccule participates in a Meniere attack. This is an important idea that stimulates consideration of the mechanism of Meniere attacks. C1 Natl Taiwan Univ Hosp, Dept Otolaryngol, Taipei, Taiwan. Far Eastern Mem Hosp, Dept Otolaryngol, Taipei, Taiwan. Natl Taiwan Univ, Coll Med, Taipei 10764, Taiwan. RP Young, YH (reprint author), Natl Taiwan Univ Hosp, Dept Otolaryngol, 1 Chang Te St, Taipei, Taiwan. CR BANCE M, 1991, LARYNGOSCOPE, V101, P197 COHEN B, 1964, ANN OTO RHINOL LARYN, V73, P153 COLEBATCH JG, 1994, J NEUROL NEUROSUR PS, V57, P190, DOI 10.1136/jnnp.57.2.190 Committee on Hearing and Equilibirum, 1995, OTOLARYNGOL HEAD NEC, V113, P181 DOHLMANN GF, 1977, ARCH OTORHINOLARYNGO, V212, P301 FRAYSSE BG, 1980, ANN OTOL RHINOL S76, V89 Guillemant P, 1995, Acta Otolaryngol Suppl, V520 Pt 2, P288 OKUNO T, 1987, ANN OTO RHINOL LARYN, V96, P438 SCHUKNECHT HF, 1976, ARCH OTO-RHINO-LARYN, V212, P253, DOI 10.1007/BF00453673 TONNDORF J, 1975, OTOLARYNG CLIN N AM, V8, P303 Wang SJ, 2003, HEARING RES, V185, P43, DOI 10.1016/S0378-5955(03)00256-9 Young YH, 2002, LARYNGOSCOPE, V112, P509, DOI 10.1097/00005537-200203000-00019 Young YH, 2003, ARCH OTOLARYNGOL, V129, P815, DOI 10.1001/archotol.129.8.815 NR 13 TC 19 Z9 20 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 717 EP 721 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900011 PM 16240936 ER PT J AU Blau, PA Schwade, N Roland, P AF Blau, PA Schwade, N Roland, P TI Diazepam tolerance effects on vestibular function testing, Part II: Vestibulo-ocular reflex parameters during rotational testing SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE diazepam; rotational testing; sinusoidal harmonic acceleration; tolerance; vestibular function test ID SINUSOIDAL HARMONIC ACCELERATION; GABA(A)-RECEPTOR SUBTYPES; OCULAR REFLEX; EYE-MOVEMENTS; BRAIN AB Objectives: The purpose of this prospective study was to determine whether clinical doses of diazepam (DZ: 10 mg/d) administered for 14 days result in tolerance as measured by the sinuosidal harmonic acceleration (SHA) rotational test. It has been shown that repeated dosing with DZ leads to accumulation and tolerance in outcome measures that assess memory, sedation, and psychomotor tasks. Methods: In a double-blinded, repeatedmeasures design, 30 normal male subjects who ranged in age from 20 to 36 years were randomly assigned to a placebo group or a DZ group and participated in 6 SHA rotational sessions over a 2 week period. Analysis of drug-placebo differences in percent change from baseline was performed with a 1 -way analysis of variance. Results: Vestibulo-ocular reflex gain and phase frequencies at 0,01, 0.02, 0.04. and 0.08 Hz were significant (p < .05) for treatment group. No significant effect was observed for gain and phase frequency at 0.16 Hz - a finding that indicates selective effects on different central nervous system mechanisms. There was no statistical significance for time. Conclusions: Clinically, the DZ subjects' scores remained within the normal ranges for vestibulo-ocular phase and gain. suggesting that patients in whom drug cessation is problematic may not have to discontinue DZ before testing with the SHA rotational system. C1 Univ Texas, SW Med Ctr Dallas, Dept Otorhinolaryngol, Dallas, TX 75390 USA. RP Blau, PA (reprint author), Univ Texas, SW Med Ctr Dallas, Dept Otorhinolaryngol, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. CR *AM SPEECH LANG HE, 1996, SPEC AUD ANSI S3 6 1 BALOH RW, 1984, ANN NEUROL, V16, P222, DOI 10.1002/ana.410160209 BARMACK NH, 1980, ARCH NEUROL-CHICAGO, V37, P718 BLAIR SM, 1979, ARCH OTOLARYNGOL, V105, P698 Blau PA, 2005, ANN OTO RHINOL LARYN, V114, P621 BUTTNERENNEVER JA, 1992, ANN NY ACAD SCI, V656, P363, DOI 10.1111/j.1749-6632.1992.tb25222.x FRITSCHY JM, 1995, J COMP NEUROL, V359, P154, DOI 10.1002/cne.903590111 HENRY DF, 1993, OTOLARYNG HEAD NECK, V109, P975 HIRSCH BE, 1986, EAR HEARING, V7, P198, DOI 10.1097/00003446-198606000-00013 HONRUBIA V, 1995, OTOLARYNG HEAD NECK, V112, P64, DOI 10.1016/S0194-5998(95)70304-7 Honrubia V, 1994, VESTIBULAR REHABILIT, P113 ISHIKAWA K, 1984, ARCH OTO-RHINO-LARYN, V240, P49, DOI 10.1007/BF00464344 Jenkins H A, 1988, Adv Otorhinolaryngol, V41, P190 KORTTILA K, 1976, ANAESTHESIA, V31, P724, DOI 10.1111/j.1365-2044.1976.tb11862.x LEIGH RJ, 1991, NEUROLOGY EYE MOVEM Matsunaga T, 1983, Acta Otolaryngol Suppl, V393, P33 McKernan RM, 1996, TRENDS NEUROSCI, V19, P139, DOI 10.1016/S0166-2236(96)80023-3 MCLEOD DR, 1988, J CLIN PSYCHOPHARM, V8, P310 MCLEOD DR, 1988, J CLIN PSYCHOPHARM, V8, P83 MEGIGHIAN D, 1984, ARCH OTO-RHINO-LARYN, V241, P23, DOI 10.1007/BF00457913 METTENS P, 1994, J NEUROPHYSIOL, V72, P785 MOHLER H, 1995, ADV BIOCHEM PSYCHOPH, V48, P41 MOHLER H, 1997, GABA RECEPTORS, P11 Padoan S, 1990, J Vestib Res, V1, P97 ROTHENBERG SJ, 1981, PSYCHOPHARMACOLOGY, V74, P232, DOI 10.1007/BF00427100 RYU JH, 1974, AEROSPACE MED, V45, P1177 Sharpe James A., 1993, P15 Stockwell C. W., 1993, HDB BALANCE FUNCTION, P237 Vidal PP, 1999, ADV OTO-RHINO-LARYNG, V55, P26 WALL C, 1990, NEUROL CLIN, V8, P269 WESTERMAN ST, 1981, LARYNGOSCOPE, V91, P1536 WOLFE JW, 1982, NYSTAGMUS VERTIGO CL, P95 ZORUMSKI CF, 1991, AM J PSYCHIAT, V148, P162 NR 33 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 722 EP 729 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900012 PM 16240937 ER PT J AU Derkay, CS Smith, RJH McClay, J van Burik, JAH Wiatrak, BJ Arnold, J Berger, B Neefe, JR AF Derkay, CS Smith, RJH McClay, J van Burik, JAH Wiatrak, BJ Arnold, J Berger, B Neefe, JR TI HspE7 treatment of pediatric recurrent respiratory papillomatosis: Final results of an open-label trial SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 21st International Papillomavirus Conference (HPV 2004) CY FEB 26, 2004 CL Mexico City, MEXICO DE HspE7; recurrent respiratory papillomatosis ID HUMAN-PAPILLOMAVIRUS INFECTION; JUVENILE-ONSET; LARYNGEAL PAPILLOMATOSIS; INTRALESIONAL CIDOFOVIR; NATIONAL REGISTRY; IMMUNOTHERAPY; INJECTIONS; REMISSION; CHILDREN; SEQUENCE AB Objectives: We sought to evaluate the effectiveness of HspE7, a recombinant fusion protein of Hsp65 from Mycobacterium bovis BCG and E7 protein from human papillomavirus 16, to improve the clinical course of pediatric patients with recurrent respiratory papillomatosis. Methods: An open-label, single-arm intervention study was conducted in 8 university-affiliated medical centers, Twenty-seven mate and female patients with recurrent respiratory papillomatosis, ages 2 to 18 years. were enrolled and followed up to 60 weeks. Before enrollment, these patients required surgery on average every 55 days, After a baseline debulking surgery, the patients received HspE7 500 mu g subcutaneously monthly, for 3 doses over 60 days. The primary end point was the length of the interval from the last surgery during the treatment period until the first debulking surgery in the posttreatment period, compared with the median intersurgical interval (ISI) of the 4 surgeries before the treatment. Results: The mean of the first posttreatment ISI increased 93% (from 55 days to 106 days; p < .02). The median ISI for all surgeries after treatment was similarly prolonged (mean, 107 days. p < .02), indicating a sustained treatment effect. and was associated with a significant decrease in the number of required surgeries (p < .003). Unexpectedly, the treatment effect was most striking in the 13 female patients, who had statistically significant increases in both the first posttreatment ISI (142%; p < .03) and the median ISI (147% p < .03). The most common adverse events were mild -to- moderate injection site reactions. Conclusions: Treatment with HspE7 appears to significantly improve the clinical course in pediatric patients with RRP insofar as it reduces the frequency of required surgeries. These results warrant a confirmatory phase III trial. C1 Eastern Virginia Med Sch, Dept Otolaryngol Head & Neck Surg, Norfolk, VA 23501 USA. Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. Univ Texas, SW Med Ctr, Dept Otolaryngol, Dallas, TX 75230 USA. Univ Minnesota, Fairvew Univ Med Ctr, Div Infect Dis, Dept Med, Minneapolis, MN USA. Childrens Hosp Alabama, Dept Pediat Otolaryngol, Birmingham, AL USA. Rainbow Babies & Childrens Hosp, Dept Pediat Otolaryngol, Cleveland, OH 44106 USA. Stressgen Biotechnol Inc, Collegeville, PA USA. RP Derkay, CS (reprint author), Childrens Hosp Kings Daughters, Dept Otolaryngol Head & Neck Surg, 601 Childrens Lane, Norfolk, VA 23507 USA. RI Young, Jo-Anne/G-2617-2013 OI Young, Jo-Anne/0000-0003-4182-341X CR Aaltonen LM, 2002, LARYNGOSCOPE, V112, P700, DOI 10.1097/00005537-200204000-00020 Abramson AL, 2004, J MED VIROL, V72, P473, DOI 10.1002/jmv.20013 ABRAMSON AL, 1987, LARYNGOSCOPE, V97, P678 Armbruster C, 2002, EXPERT OPIN INV DRUG, V11, P1139, DOI 10.1517/13543784.11.8.1139 Armstrong LR, 1999, ARCH OTOLARYNGOL, V125, P743 Chu NR, 2000, CLIN EXP IMMUNOL, V121, P216, DOI 10.1046/j.1365-2249.2000.01293.x Derkay CS, 1998, LARYNGOSCOPE, V108, P935, DOI 10.1097/00005537-199806000-00026 DERKAY CS, 1995, ARCH OTOLARYNGOL, V121, P1386 GOLDSTONE SE, 2002, 20 INT PAP C PAR FRA Goldstone SE, 2002, DIS COLON RECTUM, V45, P502, DOI 10.1007/s10350-004-6229-6 KASHIMA HK, 1992, LARYNGOSCOPE, V102, P9 LINDEBERG H, 1986, CLIN OTOLARYNGOL, V11, P423, DOI 10.1111/j.1365-2273.1986.tb00146.x MARICH JE, 1992, VIROLOGY, V186, P770 MORGAN A H, 1986, Ear Nose and Throat Journal, V65, P22 MOUNTS P, 1982, P NATL ACAD SCI-BIOL, V79, P5425, DOI 10.1073/pnas.79.17.5425 NEEDLEMA.SB, 1970, J MOL BIOL, V48, P443, DOI 10.1016/0022-2836(70)90057-4 PFISTER H, 1990, PAPILLOMAVIRUSES HUM, P1 Pransky SM, 2000, ARCH OTOLARYNGOL, V126, P1239 Pransky SM, 2003, LARYNGOSCOPE, V113, P1583, DOI 10.1097/00005537-200309000-00032 Pransky SM, 1999, ARCH OTOLARYNGOL, V125, P1143 Reeves WC, 2003, ARCH OTOLARYNGOL, V129, P976, DOI 10.1001/archotol.129.9.976 Ruparelia S, 2003, ARCH OTOLARYNGOL, V129, P1275, DOI 10.1001/archotol.129.12.1275 Schraff S, 2004, ARCH OTOLARYNGOL, V130, P1039, DOI 10.1001/archotol.130.9.1039 SMITH EM, 1993, ARCH OTOLARYNGOL, V119, P554 Snoeck R, 1998, J MED VIROL, V54, P219, DOI 10.1002/(SICI)1096-9071(199803)54:3<219::AID-JMV13>3.0.CO;2-C Snowden RT, 2001, LARYNGOSCOPE, V111, P404, DOI 10.1097/00005537-200103000-00007 Steinberg BM, 1996, CANCER METAST REV, V15, P91, DOI 10.1007/BF00049489 STEINBERG BM, 1983, NEW ENGL J MED, V308, P1261, DOI 10.1056/NEJM198305263082104 TERRY RM, 1987, J PATHOL, V153, P245, DOI 10.1002/path.1711530308 NR 29 TC 37 Z9 41 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD SEP PY 2005 VL 114 IS 9 BP 730 EP 737 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 964NN UT WOS:000231887900013 PM 16240938 ER PT J AU Peretti, G Piazza, C Mensi, MC Magnoni, L Bolzoni, A AF Peretti, G Piazza, C Mensi, MC Magnoni, L Bolzoni, A TI Endoscopic treatment of cT2 glottic carcinoma: Prognostic impact of different pT subcategories SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE carbon dioxide laser; endoscopic surgery; T2 glottic carcinoma; TNM of larynx ID SQUAMOUS-CELL CARCINOMA; SUPRACRICOID PARTIAL LARYNGECTOMY; TRANSORAL LASER-SURGERY; VOCAL CORD CARCINOMA; ANTERIOR COMMISSURE; PARAGLOTTIC SPACE; STAGE-II; FRONTOLATERAL LARYNGECTOMY; CURATIVE RADIOTHERAPY; CONSERVATION SURGERY AB Objectives: The cT2 glottic squamous cell carcinomas are a heterogeneous group of lesions in terms of superficial and deep extension. As a consequence, they differ greatly in treatment indications and prognosis. The aim of the present study was to divide cT2 glottic tumors into subcategories according to radiologic and postoperative histopathologic information, in order to identify risk factors connected with determinate survival, local-regional control, and laryngeal preservation rates. Methods: We retrospectively analyzed 55 cT2 glottic lesions treated at a single institution by carbon dioxide laser with at least 2 years of follow-up. Clinical, radiologic, surgical, and histopathologic data were reviewed, and the tumors were accordingly divided into 5 subcategories: I, or pT2 with lateral supraglottic extension (19 patients); 11, or pT2 with lateral subglottic extension (6 patients); III, or pT2 with supracommissural and/or subcommissural extension (10 patients); IV, or pT2 with deep vocal muscle infiltration (14 patients); and V, or pT3, for superior and/or inferior paraglottic space invasion lateral to the thyroarytenoid muscle not detected before operation by computed tomographic scan (6 patients). Results: The disease-free survival, ultimate local control with laser alone, and laryngeal preservation rates were compared for each subcategory. Statistically significant differences were found only for the pT3 subgroup (2-year rates of 16.7%, 16.7%, and 16.7% for pT3 versus 5-year rates of 80.5%, 84.7%, and 93.3% for the entire pT2 group). Conclusions: Endoscopic treatment of cT2 glottic tumors can be considered effective when the pT2 stage has been confirmed. In cT2/pT3 patients, after the first endoscopic resection that allows the correct pT staging, additional treatment should always be considered. C1 Univ Brescia, Dept Otolaryngol, I-25123 Brescia, Italy. RP Peretti, G (reprint author), Univ Brescia, Dept Otolaryngol, Piazza Spedali Civili 1, I-25123 Brescia, Italy. 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Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 579 EP 586 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800001 PM 16190089 ER PT J AU Yang, GS Bishop, WP Smith, BJ Goudy, SL Sato, Y Bauman, NM AF Yang, GS Bishop, WP Smith, BJ Goudy, SL Sato, Y Bauman, NM TI Radiographic and endoscopic measurements of esophageal length in pediatric patients SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 13-14, 2005 CL Boca Raton, FL SP Amer Broncho Esophagol Assoc DE esophageal length; extraesophageal reflux disease; intraluminal impedance study; lower esophageal sphincter; pediatric patient; upper esophageal sphincter ID GASTROESOPHAGEAL-REFLUX DISEASE; TUTTLE TEST; MANIFESTATIONS; MANOMETRY; CHILDREN AB Objectives: Knowledge of the length between the upper esophageal sphincter (UES) and the lower esophageal sphincter (LES) in pediatric patients is essential for intraluminal impedance and dual pH probe recordings. Methods: We measured the vertical distance between the true vocal cords (TVCs) and the LES in chest x-rays (CXRs) of 118 children (ages, 6 weeks to 13 years) and measured the vertical distance between the UES and the LES during endoscopy in 31 patients (ages, 14 months to 17 years) and correlated the measurements to height, weight, and age. Results: Esophageal length correlated best with patient height (R = 0.96 by CXR, R = 0.88 byendoscopy) and less well with weight (R = 0.87, R = 0.67) and age (R = 0.94, R = 0.86). Linear regression analyses using radiographic measurements revealed that esophageal length (TVC to LES) can be estimated from a patient ' s height by the following equation: 1.048 + 0.167 x height (in centimeters). With the upper pH probe placed in the hypopharynx at the TVC level and the inferior probe placed in the esophagus 3 to 6 cm above the LES, the patients were divided into 6 groups corresponding to the currently available number of sizes of dual pH-impedance probes. With the patients ' heights between 71.5 and 161.3 cm, 64.7% to 100% of patients were within 1 cm of the desired location with preselected probes. Confirmation of placement was performed with CXR. Conclusions: A pediatric patient ' s height can be used to estimate the esophageal length (TVC to LES) and facilitate the selection of dual pH-impedance probes. Our method decreases the risk of morbidity while increasing the accuracy of the study of extraesophageal reflux disease. C1 Univ Iowa, Dept Otorhinolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. Univ Iowa, Dept Pediat, Iowa City, IA 52242 USA. Univ Iowa, Dept Biostat, Iowa City, IA 52242 USA. Univ Iowa, Dept Radiol, Iowa City, IA 52242 USA. RP Bauman, NM (reprint author), Univ Iowa, Dept Otorhinolaryngol Head & Neck Surg, 200 Hawkins Dr, Iowa City, IA 52242 USA. CR Bagucka B, 2000, J PEDIATR GASTR NUTR, V31, P244, DOI 10.1097/00005176-200009000-00008 Bauman NM, 2000, ANN OTO RHINOL LARYN, V109, P18 Bauman NM, 1996, ANN OTO RHINOL LARYN, V105, P23 EULER AR, 1977, PEDIATRICS, V60, P65 Johnson PE, 2001, LARYNGOSCOPE, V111, P1970, DOI 10.1097/00005537-200111000-00019 KALLOOR GJ, 1976, THORAX, V31, P284, DOI 10.1136/thx.31.3.284 Marshall REK, 1999, DIS ESOPHAGUS, V12, P297 McCollough M, 2004, DIGEST DIS SCI, V49, P1607, DOI 10.1023/B:DDAS.0000043372.98660.82 Pope CE, 1997, AM J MED, V103, p19S, DOI 10.1016/S0002-9343(97)00315-X PUTNAM PE, 1991, J PEDIATR GASTR NUTR, V13, P354, DOI 10.1097/00005176-199111000-00004 Rabinowitz SS, 2003, INT J PEDIATR OTORHI, V67, P621, DOI 10.1016/S0165-5876(03)00072-7 Sivarao D. V., 2000, American Journal of Medicine, V108, p27S STROBEL CT, 1979, J PEDIATR-US, V94, P81, DOI 10.1016/S0022-3476(79)80361-3 Wenzl TG, 2002, J PEDIATR GASTR NUTR, V34, P519, DOI 10.1097/00005176-200205000-00009 NR 14 TC 7 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 587 EP 592 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800002 PM 16190090 ER PT J AU Moonis, G Dyce, O Loevner, LA Mirza, N AF Moonis, G Dyce, O Loevner, LA Mirza, N TI Magnetic resonance imaging of micronized dermal graft in the larynx SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE magnetic resonance imaging; micronized dermal graft; vocal fold augmentation ID INJECTION; ALLOGRAFT; FAT; AUGMENTATION AB Objectives: This study was conducted to evaluate magnetic resonance imaging (MRI) as an objective measure of survival of micronized acellular human dermal graft (Cymetra, LifeCell Corporation) injected into the thyroarytenoid muscle for augmentation of unilateral vocal fold paralysis. Methods: We performed a retrospective review of MRI scans obtained in 6 patients in whom Cymetra was injected into the thyroarytenoid muscle. Gadolinium-enhanced MRI of the larynx was performed 3 days, 1 month, 8 months, 11 months, 15 months, and 21 months after injection. The survival of injected Cymetra was assessed according to information obtained from the MRI scan. Images were also obtained for 1 cm(3) of reconstituted Cymetra paste. Results: The identification of Cymetra in the larynx is based on its proteinaceous content. T1 -weighted images of the injected material in the true vocal fold showed hyperintense foci corresponding to injected Cymetra. Hyperintense signal was also present on the T2-weighted images. Persistence of the injected Cymetra was readily detectable by MRI for as long as 11 months. Conclusions: Cymetra is a viable treatment option for vocal fold augmentation. The duration of survival of Cymetra (as long as 11 months) makes it a good option in cases in which longer survival of the injectable material is needed. C1 Hosp Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. Hosp Univ Penn, Dept Radiol, Philadelphia, PA 19104 USA. RP Mirza, N (reprint author), Hosp Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, 5 Ravdin,3400 Spruce St, Philadelphia, PA 19104 USA. CR AROLD R, 1986, LARYNGO RHINO OTOL, V65, P5, DOI 10.1055/s-2007-998768 Brandenburg JH, 1996, LARYNGOSCOPE, V106, P174, DOI 10.1097/00005537-199602000-00013 Brunings W., 1911, VERHANDL VER DTSCH L, V19, P93 Dejonckere P H, 1998, Rev Laryngol Otol Rhinol (Bord), V119, P265 Hsiung MW, 2000, LARYNGOSCOPE, V110, P1026, DOI 10.1097/00005537-200006000-00026 KOUFMAN JA, 1991, OTOLARYNG CLIN N AM, V24, P1151 Kridel RWH, 1998, ARCH OTOLARYNGOL, V124, P73 Rhee PH, 1998, ARCH OTOLARYNGOL, V124, P1201 Rihkanen H, 1998, LARYNGOSCOPE, V108, P51, DOI 10.1097/00005537-199801000-00010 Sclafani A P, 2000, Arch Facial Plast Surg, V2, P130, DOI 10.1001/archfaci.2.2.130 Shindo ML, 1996, ANN OTO RHINOL LARYN, V105, P602 SOM PM, 1989, RADIOLOGY, V172, P515 Youssef AM, 1999, LARYNGOSCOPE, V109, P1832, DOI 10.1097/00005537-199911000-00020 NR 13 TC 4 Z9 5 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 593 EP 598 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800003 PM 16190091 ER PT J AU Olthoff, A Zeiss, D Laskawi, R Kruse, E Steiner, W AF Olthoff, A Zeiss, D Laskawi, R Kruse, E Steiner, W TI Laser microsurgical bilateral posterior cordectomy for the treatment of bilateral vocal fold paralysis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Annual Scientific Meeting of the German-Society-of-Phoniatrics and Pedaudiology CY OCT 06-08, 2000 CL Tubingen, GERMANY SP German Soc Phoniat Pedaudiol DE laryngeal paralysis; laser surgery; respiratory function; voice quality ID RECURRENT LARYNGEAL NERVE; CORD PARALYSIS; ARYTENOIDECTOMY; MANAGEMENT; REINNERVATION; IMMOBILITY; CHORDECTOMY; FIXATION; GLOTTIS; VOICES AB Objectives: We performed a prospective study to assess respiratory function and voice quality before and after laser microsurgical bilateral posterior cordectonly performed for chronic airway obstruction in patients with bilateral vocal fold paralysis. Methods: In 17 patients a laser microsurgical posterior cordectomy was performed as an immediate bilateral approach. Roughness, breathiness, hoarseness, and dyspnea were evaluated both subjectively (on a scale from 0 to 3) and objectively (body plethysmography, computerized voice analysis: Gottingen Hoarseness Diagram). Results: After laser surgery, the patients ' respiratory function was significantly increased and was sufficient for all activities of daily living. The body plethysmographic measure of airway resistance had superior descriptive power and correlated significantly with the clinical degree of dyspnea (scale 0 to 3). Pretreatment and posttreatment impairment of voice quality was objectively documented with the Gottingen Hoarseness Diagram; the phonatory results measured with it correlated significantly with the subjective clinical evaluation of hoarseness. Aphonia did not occur. Conclusions: A bilateral approach for laser microsurgical posterior cordectomy combines excellent airway improvement and satisfactory voice preservation. In bilateral vocal fold paralysis, pretreatment and posttreatment clinical data should be evaluated by objective measures. C1 Univ Gottingen, Dept Phoniatr & Pedaudiol, D-37075 Gottingen, Germany. Univ Gottingen, Dept Gen Surg, D-37075 Gottingen, Germany. Univ Gottingen, Dept Otorhinolaryngol, D-37075 Gottingen, Germany. RP Olthoff, A (reprint author), Univ Gottingen, Dept Phoniatr & Pedaudiol, Robert Koch Str 40, D-37075 Gottingen, Germany. CR BENNINGER MS, 1994, OTOLARYNG HEAD NECK, V111, P497 CRUMLEY RL, 1993, ANN OTO RHINOL LARYN, V102, P81 CRUMLEY RL, 1989, ANN OTO RHINOL LARYN, V98, P87 DENNIS DP, 1989, ANN OTO RHINOL LARYN, V98, P930 Echeverri A, 1998, AM SURGEON, V64, P328 ECKEL HE, 1994, ANN OTO RHINOL LARYN, V103, P852 Eckel HE, 2003, ANN OTO RHINOL LARYN, V112, P103 ECKEL HE, 1995, ANN OTO RHINOL LARYN, V104, P119 EJNELL H, 1984, LARYNGOSCOPE, V94, P954 Frohlich M, 2000, J SPEECH LANG HEAR R, V43, P706 HOLINGER LD, 1976, ANN OTO RHINOL LARYN, V85, P428 KASHIMA HK, 1991, ANN OTO RHINOL LARYN, V100, P717 KLEINSASSER O, 1981, LARYNG RHINOL OTOL V, V60, P397, DOI 10.1055/s-2007-1008753 Leitersdorfer S, 2002, EUR ARCH OTO-RHINO-L, V259, P57, DOI 10.1007/s004050100414 Lichtenberger G, 1999, EUR ARCH OTO-RHINO-L, V256, P407, DOI 10.1007/s004050050176 Michaelis D, 1998, J ACOUST SOC AM, V103, P1628, DOI 10.1121/1.421305 MIEHLKE A, 1973, ARCH KLIN EXP OHR, V203, P241, DOI 10.1007/BF00344935 Olthoff A, 2003, ARCH OTOLARYNGOL, V129, P994, DOI 10.1001/archotol.129.9.994 Pedersen OF, 1997, J APPL PHYSIOL, V83, P1721 Pia F, 1999, EUR ARCH OTO-RHINO-L, V256, P403, DOI 10.1007/s004050050175 Postma GN, 1998, ANN OTO RHINOL LARYN, V107, P236 Reker U, 1998, LARYNGO RHINO OTOL, V77, P213, DOI 10.1055/s-2007-996963 Remacle M, 1996, ANN OTO RHINOL LARYN, V105, P438 RODRIQUEZ AA, 1990, ARCH PHYS MED REHAB, V71, P587 Rovo L, 2001, EUR ARCH OTO-RHINO-L, V258, P509, DOI 10.1007/s004050100378 Steiner W, 2000, ENDOSCOPIC LASER SUR Szmeja Z, 1999, EUR ARCH OTO-RHINO-L, V256, P388, DOI 10.1007/s004050050170 TUCKER HM, 1989, ANN OTO RHINOL LARYN, V98, P674 TUCKER HM, 1976, LARYNGOSCOPE, V86, P769, DOI 10.1288/00005537-197606000-00004 WOODMAN D, 1976, ANN OTO RHINOL LARYN, V85, P437 WOODSON GE, 1993, LARYNGOSCOPE, V103, P1227 Yin SS, 1997, AM J OTOLARYNG, V18, P9, DOI 10.1016/S0196-0709(97)90042-9 NR 32 TC 8 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 599 EP 604 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800004 PM 16190092 ER PT J AU Gruen, PM Carranza, A Karmody, CS Bachor, E AF Gruen, PM Carranza, A Karmody, CS Bachor, E TI Anomalies of the ear in the Pierre Robin triad SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anomaly; auricle; branchial arch; child; development; histopathology; Meckel's cartilage; Pierre Robin triad; Reichert's cartilage; stapes; temporal bone; vestibular aqueduct ID AIDED 3-DIMENSIONAL RECONSTRUCTION; ROBIN-SEQUENCE; CONGENITAL-ANOMALIES; CLEFT-PALATE; OTITIS-MEDIA; INNER-EAR; MIDDLE; INFANTS; COCHLEA AB Objectives: The Pierre Robin triad (PRT) consists of micrognathia-retrognathia, glossoptosis, and an oval or cleft palate. The goal of this study was to identify patterns of similarity to and differences from the two previous temporal bone studies of the PRT. Methods: Seven children with the PRT (ages, 45 minutes to 2 years; gestational ages, 41 to 43 weeks) were studied. Thirteen temporal bones were decalcified, sectioned at a thickness of 20 gm, and studied by light microscopy. Results: Our study demonstrated multiple architectural anomalies involving the entire ear, including abnormal auricles, and anomalies of the ossicles, including abnormal stapes footplates (6/13). All children showed signs of middle ear infection (12/13). Anomalies of the inner ear included aplasia of the lateral semicircular canals (5/13), a large vestibular aqueduct (2/13), and unusually large otoconia (1/13). In the mastoid process there were islands of cartilage in the expected position of Reichert ' s cartilage (9/13) and dehiscence of the fallopian canal (11/13). Loss of cochlear hair cells was seen in children who had antemortem hypoxia. Conclusions: Although the PRT is caused by various genes, most anomalies can be traced to the development of the first and second branchial arches. C1 Univ Ulm, Dept Otorhinolaryngol, D-89069 Ulm, Germany. Univ Costa Rica, Hosp Nacl Ninos, Dept Pathol, San Jose, Costa Rica. Tufts Univ, Sch Med, Dept Otolaryngol, Medford, MA 02155 USA. Tufts Univ New England Med Ctr, Boston, MA 02111 USA. RP Bachor, E (reprint author), SRH Zentralklinikum Suhl, Dept Otolaryngol, Albert Schweitzer Str 2, D-98527 Suhl, Germany. EM ebmail@web.de CR Amatuzzi MG, 2001, ARCH OTOLARYNGOL, V127, P629 BAST TH, 1949, AUDITORY OSSICLES, P337 Cantos R, 2000, P NATL ACAD SCI USA, V97, P11707, DOI 10.1073/pnas.97.22.11707 CAREY JC, 1982, J PEDIATR-US, V101, P858, DOI 10.1016/S0022-3476(82)80348-X Cohen MM, 1999, AM J MED GENET, V84, P311 Fekete DM, 1999, TRENDS NEUROSCI, V22, P263, DOI 10.1016/S0166-2236(98)01366-6 GOLDMAN JL, 1993, SOUTHERN MED J, V86, P1236 HandzicCuk J, 1996, J LARYNGOL OTOL, V110, P830 Houdayer C, 2001, AM J MED GENET, V102, P219, DOI 10.1002/ajmg.1448 IGARASHI M, 1976, LARYNGOSCOPE, V86, P1679, DOI 10.1288/00005537-197611000-00009 Ikui A, 1997, ANN OTO RHINOL LARYN, V106, P33 JARVIS BL, 1990, OTOLARYNG HEAD NECK, V102, P391 JONES KL, 1997, ROBIN SEQUENCE P ROB, P234 Li HY, 2002, INT J PEDIATR OTORHI, V65, P45, DOI 10.1016/S0165-5876(02)00131-3 Nomura Y., 1984, ADV OTORHINOLARYNGOL, V33, P38 Nomura Y, 1983, Adv Otorhinolaryngol, V31, P50 Orita Y, 2002, OTOL NEUROTOL, V23, P34, DOI 10.1097/00129492-200201000-00009 Palva T, 2001, OTOL NEUROTOL, V22, P433, DOI 10.1097/00129492-200107000-00003 Robin P, 1934, AM J DIS CHILD, V48, P541 ROBINSON PJ, 1993, INT J PEDIATR OTORHI, V25, P13, DOI 10.1016/0165-5876(93)90005-N Ross SA, 2000, PHYSIOL REV, V80, P1021 Rother T, 2003, HEARING RES, V185, P22, DOI 10.1016/S0378-5955(03)00255-7 Sando I, 1990, ANN OTOL RHINOL S148, V148, P13 SANDO I, 1988, INT J PEDIATR OTORHI, V16, P1, DOI 10.1016/0165-5876(88)90095-X Sheahan P, 2003, INT J PEDIATR OTORHI, V67, P785, DOI 10.1016/S0165-5876(03)00098-3 SHEFFIELD LJ, 1987, AM J MED GENET, V28, P25, DOI 10.1002/ajmg.1320280105 Tahayato A, 2003, GENE EXPR PATTERNS, V3, P449, DOI 10.1016/S1567-133X(03)00066-8 TAKAHASHI H, 1989, OTOLARYNG HEAD NECK, V101, P517 VONTROLTSCH A, 1967, ANATOMIE AUSSEREN OH, V2, P24 YAMAGUCHI N, 1990, ANN OTO RHINOL LARYN, V99, P984 NR 30 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 605 EP 613 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800005 PM 16190093 ER PT J AU Roh, JL Lee, YW AF Roh, JL Lee, YW TI Prediction of difficult laryngeal exposure in patients undergoing microlaryngosurgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE classification; difficult laryngeal exposure; physical examination; predictor; suspension laryngoscopy ID OBSTRUCTIVE SLEEP-APNEA; TRACHEAL INTUBATION; LARYNGOSCOPIC EXPOSURE; CLINICAL PREDICTORS AB Objectives: Although difficult laryngeal exposure (DLE) is a common problem encountered during microlaryngosurgery, reliable predictors of DLE and grading systems of laryngeal exposure have been scarcely suggested in the field of laryngology. We propose a new classification of laryngeal exposure focusing on the extent of glottic visualization. Methods: We investigated physical parameters that could predict DLE; 73 patients underwent a physical examination including 15 parameters. During endotracheal intubation and suspension laryngoscopy, Cormack-Lehane and laryngeal exposure scores were obtained for each patient and compared with the parameters. Results: The patients ' ages ranged from 23 to 77 years. The laryngeal exposure score was correlated with the Cormack-Lehane score (p <.001, r = 0.469). Of all parameters, body mass index, neck circumference, thyroid-mental distance, and horizontal thyroid-mental distance showed significant correlation with the laryngeal exposure score (p <.05). From analysis of the candidate parameters in 13 patients with DLE and the non-DLE group, we found that the cutoff values for predicting DLE were a body mass index of > 25.0 kg/m(2), a neck circumference of > 39.5 cm, a thyroid-mental distance of < 5.5 cm, and a horizontal thyroid-mental distance of < 4.0 cm. Conclusions: According to the proposed classification of laryngeal exposure, patients with obesity, a muscular neck, or retrognathia are likely to present DLE, and preoperative measurement of the predictors may be useful in preparing for microlaryngosurgery. C1 Chungnam Natl Univ Hosp, Canc Res Inst, Dept Otorhinolaryngol Head & Neck Surg, Taejon 301040, South Korea. RP Roh, JL (reprint author), Chungnam Natl Univ Hosp, Canc Res Inst, Dept Otorhinolaryngol Head & Neck Surg, 640 Daesa Dong, Taejon 301040, South Korea. CR CORMACK RS, 1984, ANAESTHESIA, V39, P1105, DOI 10.1111/j.1365-2044.1984.tb08932.x ElGanzouri AR, 1996, ANESTH ANALG, V82, P1197, DOI 10.1097/00000539-199606000-00017 Friedman M, 1999, LARYNGOSCOPE, V109, P1901, DOI 10.1097/00005537-199912000-00002 Hiremath AS, 1998, BRIT J ANAESTH, V80, P606 Hochman II, 1999, ANN OTO RHINOL LARYN, V108, P715 Hsiung MW, 2004, LARYNGOSCOPE, V114, P358, DOI 10.1097/00005537-200402000-00033 Juvin P, 2003, ANESTH ANALG, V97, P595, DOI 10.1213/01.ANE.0000072547.75928.B0 Kawaida M, 2001, J VOICE, V15, P305, DOI 10.1016/S0892-1997(01)00032-7 Kikkawa YS, 2004, LARYNGOSCOPE, V114, P776, DOI 10.1097/00005537-200404000-00036 MALLAMPATI SR, 1985, CAN ANAESTH SOC J, V32, P429, DOI 10.1007/BF03011357 SAMSOON GLT, 1987, ANAESTHESIA, V42, P487, DOI 10.1111/j.1365-2044.1987.tb04039.x WEED DT, 1994, OTOLARYNG HEAD NECK, V110, P247 Yeh ARM, 1999, ANN OTO RHINOL LARYN, V108, P165 ZEITELS SM, 1994, ANN OTO RHINOL LARYN, V103, P669 NR 14 TC 11 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 614 EP 620 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800006 PM 16190094 ER PT J AU Blau, PA Schwade, N Roland, P AF Blau, PA Schwade, N Roland, P TI Diazepam tolerance effects on vestibular function testing, part I: Saccadic parameters during electronystagmography SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE diazepam; saccadic eye movement; sedation; tolerance; vestibular function test; visual analog scale ID EYE-MOVEMENTS; PHARMACODYNAMIC INTERACTIONS; PSYCHOMOTOR PERFORMANCE; BENZODIAZEPINES; SENSITIVITY; TEMAZEPAM; WOMEN AB Objectives: Benzodiazepines, particularly diazepam (DZ), are used in clinical practice to suppress acute vestibular symptoms. There have been limited studies looking at the effects of tolerance to DZ on parameters designed to measure the integrity of the vestibular system and its interaction with the oculomotor and balance systems. Methods: In a double-blinded, repeated-measures design, we randomized 30 young healthy men into one of two treatment groups (diazepam and placebo) and assessed with electro-oculography the effects of clinical divided doses of DZ on saccadic eye movements and sedation over 16 days. Results: Only sedation and saccadic latency were significant (p <.05) for treatment group, indicating selective effects on different central nervous system mechanisms. No significant effect for time was seen in any of the variables measured. Bonferroni t-test comparisons of the DZ group among 3 days were significant (p <.017) between baseline and day 3 for saccadic latency and accuracy and between day 3 and day 16 for self-ratings of sedation. Conclusions: Saccadic latency and accuracy and sedation ratings appear to be more sensitive to changes over time and less affected by subject variability than saccadic eye velocity. It remains questionable whether patients who have been on DZ for acute or extended periods of time need to discontinue the drug 48 hours before testing. C1 Univ Texas, SW Med Ctr, Dept Otorhinolaryngol, Dallas, TX 75390 USA. RP Blau, PA (reprint author), Univ Texas, SW Med Ctr, Dept Otorhinolaryngol, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. 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Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 621 EP 628 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800007 PM 16190095 ER PT J AU Doi, K Nibu, K Ishida, H Okado, H Terashima, T AF Doi, K Nibu, K Ishida, H Okado, H Terashima, T TI Adenovirus-mediated gene transfer in olfactory epithelium and olfactory bulb: A long-term study SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE adenoviral vector; beta-galactosidase; gene transfer; LacZ; olfactory pathway ID RECEPTOR NEURONS; RECOMBINANT ADENOVIRUS; IN-VIVO; PROLIFERATION; RETROGRADE; EXPRESSION; DELIVERY; CELLS AB Objectives: We sought to study the spatiotemporal gene expression mediated by adenoviral vector in the olfactory pathways. Methods: The replication-defective adenoviral vector AxCALacZ, which encodes the enzyme Escherichia coli P-galactosidase, was applied to mouse olfactory epithelium by intranasal instillation. Results: The LacZ gene product, beta-galactosidase, was expressed not only in the olfactory receptor neurons and their axons, but also in the olfactory bulbs. The first evidence of anterograde labeling was observed at postinfection day (PID) 2. At PID 3, beta-galactosidase was strongly expressed in olfactory nerve axons, as well as their terminal glomeruli, in the olfactory bulbs. beta-Galactosidase expression persisted up to PID 90, and there was a significant decrease in the number of labeled neurons at PID 30. Conclusions: These results suggest possible long-term effects of adenovirus-mediated gene transfer on the olfactory neurons, as well as the olfactory bulbs. C1 Kobe Univ, Grad Sch Med, Dept Otorhinolaryngol Head & Neck Surg, Chuo Ku, Kobe, Hyogo 6500017, Japan. Kobe Univ, Grad Sch Med, Dept Anat, Chuo Ku, Kobe, Hyogo 6500017, Japan. Kobe Univ, Grad Sch Med, Dept Dev Neurobil, Chuo Ku, Kobe, Hyogo 6500017, Japan. 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Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 629 EP 633 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800008 PM 16190096 ER PT J AU Shah, RK Rebeiz, EE AF Shah, RK Rebeiz, EE TI Tracheoesophageal voice restoration following laryngotracheal separation procedure SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 12th World Congress of Bronchology and Bronchoesophagology CY JUN 19-22, 2002 CL Boston, MA DE aspiration; Blom-Singer valve; Lindeman procedure; speech pathology ID INTRACTABLE ASPIRATION; DIVERSION AB Objectives: Laryngeal dysfunction leading to incompetence and intractable aspiration can be a life-threatening problem. Laryngotracheal separation (LTS) can be used to prevent aspiration, but results in aphonia. The options for alaryngeal speech following LTS are limited. Methods: We performed tracheoesophageal puncture (TEP) and insertion of a Blom-Singer valve in 3 patients in an attempt to restore their voice after LTS for chronic aspiration. Results: Two patients had intractable aspiration (5 and 14 years) after full-course radiotherapy for laryngeal cancer, and I patient had aspiration after a stroke. In the first patient TEP was done as a secondary procedure, and in the other 2 patients it was done at the time of the LTS. The TEP was successful in providing these patients with phonation ability after their LTS procedure. There was no morbidity from these procedures. Conclusions: Creation of a TEP after an LTS procedure is relatively simple and relatively safe, and allows for the control of aspiration while maintaining vocal function. C1 Tufts Univ New England Med Ctr, Dept Otorhinolaryngol Head & Neck Surg, Boston, MA 02111 USA. RP Rebeiz, EE (reprint author), Tufts Univ New England Med Ctr, Dept Otorhinolaryngol Head & Neck Surg, 750 Washington St,NEMC 850, Boston, MA 02111 USA. CR Aviv JE, 2000, LARYNGOSCOPE, V110, P563, DOI 10.1097/00005537-200004000-00008 Broniatowski M, 2001, LARYNGOSCOPE, V111, P2032, DOI 10.1097/00005537-200111000-00031 DARROW DH, 1994, LARYNGOSCOPE, V104, P1163 EIBLING DE, 1995, LARYNGOSCOPE, V105, P83, DOI 10.1288/00005537-199501000-00018 EISELE DW, 1988, ANN OTO RHINOL LARYN, V97, P471 EISELE DW, 1989, AM J SURG, V157, P230, DOI 10.1016/0002-9610(89)90534-5 LAWLESS ST, 1995, LARYNGOSCOPE, V105, P198, DOI 10.1288/00005537-199502000-00017 SINGER MI, 1983, J OTOLARYNGOL, V12, P329 Takano Y, 1999, CHEST, V116, P1251, DOI 10.1378/chest.116.5.1251 NR 9 TC 0 Z9 0 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 634 EP 637 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800009 PM 16190097 ER PT J AU Georgalas, C Thomas, K Owens, C Abramovich, S Lack, G AF Georgalas, C Thomas, K Owens, C Abramovich, S Lack, G TI Medical treatment for rhinosinusitis associated with adenoidal hypertrophy in children: An evaluation of clinical response and changes on magnetic resonance imaging SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE adenoidal hypertrophy; amoxicillin-clavulanate potassium; loratadine; magnetic resonance imaging; sinusitis; steroids ID OBSTRUCTIVE SLEEP-APNEA; ADENOTONSILLAR HYPERTROPHY; AIRWAY-OBSTRUCTION; ALLERGIC RHINITIS; OTITIS-MEDIA; NASAL SPRAY; ADENOIDECTOMY; INFECTIONS; EFFICACY; NOSE AB Objectives: The association between adenoidal hypertrophy and rhinosinusitis with upper airway inflammation is increasingly recognized; however, no study has used magnetic resonance imaging (MRI) to assess the changes in adenoid size after medical treatment of rhinosinusitis. Methods: Thirteen children referred to a tertiary allergy clinic with symptoms of rhinosinusitis received medical treatment over a 4-month period. All underwent MRI before and after treatment. The medical treatment regimen comprised a short course of oral antibiotics and oral steroids and a longer course of oral antihistamines and intranasal steroids. Results: The pretreatment MRI demonstrated enlarged adenoids and rhinosinusitis in all 13 children, with evidence of extensive rhinosinusitis in 9 of the 13. The treatment resulted in an improvement in overall symptom score; the most significant improvement was seen in mouth breathing. The posttreatment MRI showed a statistically significant reduction in adenoid size and adenoid/nasopharynx ratio, which was associated with a significant decrease in sinus involvement on MRI. Conclusions: There is a high association between adenoidal hypertrophy and rhinosinusitis in the context of an allergy clinic. Magnetic resonance imaging can document the changes in adenoid size associated with resolution of rhinosinusitis. Further studies are necessary to validate these pilot data and further assess the effects of medical treatment and the role of MRI in adenoidal hypertrophy. C1 Great Ormond St Hosp Children, Dept Radiol, London WC1N 3JH, England. St Marys Hosp, Dept Otolaryngol, London, England. St Marys Hosp, Dept Pediat Allergy, London, England. RP Georgalas, C (reprint author), Whipps Cross Hosp & Chest Clin, Dept Otolaryngol, Whipps Cross Rd,Leytonstone, London E11 1NR, England. CR AlGhamdi SA, 1997, LARYNGOSCOPE, V107, P1382, DOI 10.1097/00005537-199710000-00017 Arens R, 2001, AM J RESP CRIT CARE, V164, P698 BECKER S, 1991, HNO, V39, P182 Bernstein JM, 2001, OTOLARYNG HEAD NECK, V125, P593, DOI 10.1067/mhn.2001.120232 Brenner DJ, 2001, AM J ROENTGENOL, V176, P289 BRODSKY L, 1988, LARYNGOSCOPE, V98, P1055 Brooks CN, 2001, RESTOR ECOL, V9, P1, DOI 10.1046/j.1526-100x.2001.009001001.x Brouillette RT, 2001, J PEDIATR-US, V138, P838, DOI 10.1067/mpd.2001.114474 Casselbrant ML, 1999, INT J PEDIATR OTORHI, V49, pS133 Clement PAR, 1999, INT J PEDIATR OTORHI, V49, pS95, DOI 10.1016/S0165-5876(99)00141-X DEMAIN JG, 1995, PEDIATRICS, V95, P355 GRUNDFAST KM, 1982, LARYNGOSCOPE, V92, P650 Gryczynska D, 1999, INT J PEDIATR OTORHI, V49, pS275 Huang SW, 2001, ANN ALLERG ASTHMA IM, V87, P350 Jaw Twei-Shiun, 1999, Kaohsiung Journal of Medical Sciences, V15, P12 Lack G, 2001, J ALLERGY CLIN IMMUN, V108, pS9, DOI 10.1067/mai.2001.115562 Lipworth BJ, 2000, THORAX, V55, P878, DOI 10.1136/thorax.55.10.878 MANDEL W, 1955, JAMA-J AM MED ASSOC, V158, P1021 MAURIZI M, 1984, INT J PEDIATR OTORHI, V8, P31, DOI 10.1016/S0165-5876(84)80023-3 McColley SA, 1997, CHEST, V111, P170, DOI 10.1378/chest.111.1.170 RAPHAEL G, 1987, OTOLARYNG CLIN N AM, V20, P295 Schenkel EJ, 2000, PEDIATRICS, V105, part. no., DOI 10.1542/peds.105.2.e22 Sclafani AP, 1998, PEDIATRICS, V101, P675, DOI 10.1542/peds.101.4.675 SINGER LP, 1990, OTOLARYNG CLIN N AM, V23, P665 TERESI L, 1988, COMPUT MED IMAG GRAP, V12, P165, DOI 10.1016/0895-6111(88)90028-6 TOMONAGA K, 1989, AM J OTOLARYNG, V10, P204, DOI 10.1016/0196-0709(89)90064-1 VANCAUWENBERGE PB, 1995, INT J PEDIATR OTORHI, V32, pS71, DOI 10.1016/0165-5876(94)01146-O Vandenberg SJ, 1997, ARCH OTOLARYNGOL, V123, P675 Vogler RC, 2000, CLIN OTOLARYNGOL, V25, P392, DOI 10.1046/j.1365-2273.2000.00381.x WORMALD PJ, 1992, J LARYNGOL OTOL, V106, P342, DOI 10.1017/S0022215100119449 1999, UK DEP HLTH FIGURES NR 31 TC 11 Z9 12 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 638 EP 644 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800010 PM 16190098 ER PT J AU Isaacson, G Buttaro, BA Mazeffa, V Li, GM Frenz, DA AF Isaacson, G Buttaro, BA Mazeffa, V Li, GM Frenz, DA TI Oxymetazoline solutions inhibit middle ear pathogens and are not ototoxic SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 108th Annual Meeting of the American-Academy-of-Otolaryngology-Head-and-Neck-Surgery CY SEP 19-22, 2004 CL New York, NY SP Amer Acad Otolaryngol Head & Neck Surg DE antimicrobial activity; otorrhea; ototopical drops; ototoxicity; oxymetazoline ID TYMPANOSTOMY TUBE OBSTRUCTION; POSTTYMPANOSTOMY OTORRHEA; POSTOPERATIVE OTORRHEA; ANTIBIOTIC DROPS; CIPROFLOXACIN; PROPHYLAXIS AB Objectives: This study was performed to explore the antimicrobial activity of two commercially available oxymetazoline hydrochloride preparations against the common pathogens of otitis media and to demonstrate the lack of ototoxicity of these agents and of United States Pharmacopeia (USP) oxymetazoline in a standard animal model. Methods: Disc diffusion assays and minimum inhibitory concentration studies against American Type Culture Collection reference strains of common middle ear pathogens were used to evaluate the antimicrobial activity of oxymetazoline solutions and fluoroquinolone drops, and outer hair cell counts were performed on scanning electron micrographs of guinea pig basal cochlear segments after chronic exposure to oxymetazoline solutions and positive and negative controls. Results: Oxymetazoline nasal spray and eyedrops had activity against all species tested except Haemophilus influenzae and Pseudomonas aeruginosa. The USP oxymetazoline had limited antimicrobial activity. Oxymetazoline nasal spray, oxymetazoline eyedrops, and USP oxymetazoline had ototoxicity profiles indistinguishable from that of the saline solution control. Conclusions: Commercially available oxymetazoline solutions are active against several of the common pathogens of otitis media. This antimicrobial activity is not due to oxymetazoline, and is more likely due to preservatives present in the solutions. The solutions tested are not ototoxic to guinea pig outer hair cells. Oxymetazoline solutions are potential substitutes for broad-spectrum antibiotic drops after tympanostomy tube placement. C1 Temple Univ, Sch Med, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19140 USA. Temple Univ, Sch Med, Dept Microbiol & Immunol, Philadelphia, PA 19140 USA. Albert Einstein Coll Med, Dept Otolaryngol, Bronx, NY 10467 USA. Albert Einstein Coll Med, Dept Anat & Struct Biol, Bronx, NY 10467 USA. RP Isaacson, G (reprint author), Temple Univ, Sch Med, Dept Otorhinolaryngol Head & Neck Surg, 3400 N Broad St, Philadelphia, PA 19140 USA. CR Altman JS, 1998, ARCH OTOLARYNGOL, V124, P1233 Charnock D R, 1997, Ear Nose Throat J, V76, P870 François M, 2001, Ann Otolaryngol Chir Cervicofac, V118, P278 HESTER TO, 1995, ARCH OTOLARYNGOL, V121, P445 Isaacson G, 1996, PEDIATR CLIN N AM, V43, P1183, DOI 10.1016/S0031-3955(05)70513-7 JAMAL TS, 1995, LARYNGOSCOPE, V105, P833, DOI 10.1288/00005537-199508000-00012 Jang CH, 2004, CLIN OTOLARYNGOL, V29, P321, DOI 10.1111/j.1365-2273.2004.00835.x Johnson PE, 2003, ANN OTO RHINOL LARYN, V112, P14 Kite P, 2004, J CLIN MICROBIOL, V42, P3073, DOI 10.1128/JCM.42.7.3073-3076.2004 Kruszewska Hanna, 2002, Acta Pol Pharm, V59, P436 Kumar VV, 2005, LARYNGOSCOPE, V115, P363, DOI 10.1097/01.mlg.0000154746.55937.4d Matz G, 2004, OTOLARYNG HEAD NECK, V130, pS79, DOI 10.1016/j.otohns.2003.12.007 Meyer DR, 2000, OPHTHALMIC PLAST REC, V16, P201, DOI 10.1097/00002341-200005000-00006 Morpeth JF, 2001, INT J PEDIATR OTORHI, V61, P99, DOI 10.1016/S0165-5876(01)00552-3 Myer Charles M 3rd, 2004, Ear Nose Throat J, V83, P9 RIEGLE EV, 1992, LARYNGOSCOPE, V102, P820, DOI 10.1288/00005537-199207000-00012 Rutala WA, 2000, INFECT CONT HOSP EP, V21, P33, DOI 10.1086/501694 Schrader N, 2003, PEDIATRICS, V111, P1123, DOI 10.1542/peds.111.5.1123 SCHRADER N, 2004, E SECT M TRIOL SOC N SCOTT BA, 1992, OTOLARYNG HEAD NECK, V106, P34 Shinkwin CA, 1996, J LARYNGOL OTOL, V110, P531 Staecker H, 1996, NEUROREPORT, V7, P889, DOI 10.1097/00001756-199603220-00011 Thorp MA, 1998, J LARYNGOL OTOL, V112, P925 Zipfel TE, 1999, AM J OTOL, V20, P416 NR 24 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 645 EP 651 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800011 PM 16190099 ER PT J AU Yildirim, A Erdem, H Kilic, S Yetiser, S Pahsa, A AF Yildirim, A Erdem, H Kilic, S Yetiser, S Pahsa, A TI Effect of climate on the bacteriology of chronic suppurative otitis media SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE chronic suppurative otitis media; climate ID CHILDREN AB Objectives: We evaluated the correlation between the microbial content of chronic suppurative otitis media (CSOM) and regional climatic parameters. Methods: We assessed the interrelations between monthly mean records of temperature, maximum temperature, atmospheric pressure, and humidity and the aerobic microbial flora in CSOM. Results: Forty-three bacteria of Enterobacteriaceae, 67 staphylococcal spp, 51 Pseudomonas aeruginosa, 9 Streptococcus pneunioniae, 1 alpha-hemolytic Streptococcus, 1 Enterococcus sp, and 2 Edwardsiella tarda strains were recovered from 173 patients with CSOM. There was a good relationship between enteric bacteria and monthly mean temperature (r = 0.501) and significant colonization rates due to increasing monthly mean temperature (p =.040) and monthly mean maximum temperature values (p =.048). Conclusions: When the weather warmed, the frequency of isolation of enteric bacteria increased significantly. Temperature changes may affect the enteric bacterial colonization of CSOM. C1 Cumhuriyet Univ, Fac Med, Dept Otorhinolaryngol Head & Neck Surg, TR-58140 Sivas, Turkey. Gulhane Mil Med Acad, Dept Infect Dis, Ankara, Turkey. Gulhane Mil Med Acad, Dept Otorhinolaryngol Head & Neck Surg, Ankara, Turkey. GATA Mil Med Acad, Dept Publ Hlth, Ankara, Turkey. RP Yildirim, A (reprint author), Cumhuriyet Univ, Fac Med, Dept Otorhinolaryngol Head & Neck Surg, TR-58140 Sivas, Turkey. RI erdem, hakan/O-2462-2013 CR Castagno LA, 2002, INT J PEDIATR OTORHI, V62, P129, DOI 10.1016/S0165-5876(01)00607-3 CHRISTOPHER AO, 2004, INFECT DIS, P1703 Danielides V, 2002, ACTA OTO-LARYNGOL, V122, P655, DOI 10.1080/000164802320396358 DAWSON B, 2001, BUS L TODAY JAN, P51 Douglas AS, 1997, SCOT MED J, V42, P166 Dowell SF, 2001, EMERG INFECT DIS, V7, P369 EINSTEIN BI, 1995, PRINCIPLES PRACTICE, P1964 Harvell CD, 2002, SCIENCE, V296, P2158, DOI 10.1126/science.1063699 HAWLEY HB, 1973, JAMA-J AM MED ASSOC, V226, P33, DOI 10.1001/jama.226.1.33 JOHANSEN HK, 1992, THORAX, V47, P109, DOI 10.1136/thx.47.2.109 KENNA MA, 1986, LARYNGOSCOPE, V96, P146 Koneman EW AS, 1997, COLOR ATLAS TXB DIAG, P171 Mcmichael A., 1996, CLIMATE CHANGE HUMAN Monge R, 1996, REV BIOL TROP, V44, P369 Patz JA, 2000, ANNU REV PUBL HEALTH, V21, P271, DOI 10.1146/annurev.publhealth.21.1.271 ROBINSBROWNE RM, 1984, AM J EPIDEMIOL, V119, P350 NR 16 TC 8 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD AUG PY 2005 VL 114 IS 8 BP 652 EP 655 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 955MA UT WOS:000231228800012 PM 16190100 ER PT J AU Lindman, JP Lewis, LS Accortt, N Wiatrak, BJ AF Lindman, JP Lewis, LS Accortt, N Wiatrak, BJ TI Use of the Pediatric Quality of Life Inventory to assess the health-related quality of life in children with recurrent respiratory papillomatosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE adolescent; child; health-related quality of life; pediatrics; recurrent respiratory papillomatosis ID GENERIC CORE SCALES; EMOTIONAL-PROBLEMS; RELIABILITY; VALIDITY; PEDSQL(TM); POPULATION; CANCER; MODULE AB Objectives: The objective of this study was to use the Pediatric Quality of Life Inventory (PedsQL), a 23-question modular instrument designed to measure the health-related quality of life (HRQOL) in children and adolescents, to compare the HRQOL in children with recurrent respiratory papillomatosis (RRP) with the HRQOLs reported for healthy children and children with other chronic medical conditions. Methods: The PedsQL version 4.0 Generic Core Scales consist of 23 questions in 4 subscales (Physical, Emotional, Social, and School Functioning) for parent-proxy reporting on the HRQOL in children ages 2 to 4 years, parent reporting for children 5 to 18 years, and child self-reporting for ages 5 to 7 years (age-adjusted questions and rating scales) and 8 to 18 years. The questionnaires were administered in person or by telephone to 22 children with RRP and (or, for children 2 to 4 years of age) one parent recruited from a tertiary pediatric otolaryngology practice. The results were compared with validated norms for healthy children and scores for children whose parents reported a chronic medical condition. Results: Compared with healthy controls, the children 5 to 18 years of age with RRP self-reported a significantly (p <.05) worse HRQOL as measured by the PedsQL Total Score, Psychosocial Health score (a combination of Emotional, Social, and School Functioning Scores), and Social Functioning and School Functioning scores. Self-reported scores for the children 5 to 18 years of age with RRP compared with children with other chronic illnesses followed the same trend, and the difference approached statistical significance (p =.05) for the School Functioning Subscale scores. The parent-proxy report (for children 2 to 18 years of age) scores for children with RRP were significantly lower (p <.000 1) on every scale and in total compared with scores for healthy children. Compared with scores of children with other chronic medical conditions, the parent-proxy report scores were significantly lower for psychosocial health (p =.005) and school functioning (p <.0001). Conclusions: Children with RRP report a lower quality of life than do those who are healthy, and a quality of life similar to that of those who have other chronic medical problems. The parent reports also reflect a lower quality of life for children affected by this disease, as compared with healthy children. The PedsQL demonstrated a statistically significant low HRQOL in children with RRP; however, the clinical implications of this finding appear trivial. A distinct, disease-specific survey for RRP, if developed, would have enhanced responsiveness and sensitivity to change (due to the natural course of the disease and/or surgical treatments). C1 Univ Alabama, Dept Surg, Div Otolaryngol, Birmingham, W Midlands, England. Univ Alabama, Med Stat Sect, Dept Med, Birmingham, W Midlands, England. Childrens Hosp Alabama, Dept Pediat Otolaryngol, Birmingham, AL USA. RP Wiatrak, BJ (reprint author), Pediat ENT Associates Childrens S, 1940 Elmer J Bissell Rd, Birmingham, AL 35243 USA. CR ACHENBACH TM, 1987, PSYCHOL BULL, V101, P213, DOI 10.1037/0033-2909.101.2.213 [Anonymous], 1995, WEBSTERS NEW AM DICT Armstrong LR, 1999, ARCH OTOLARYNGOL, V125, P743 Bishai D, 2000, ARCH OTOLARYNGOL, V126, P935 CZYZEWSKI DI, 1994, MED CARE, V32, P965, DOI 10.1097/00005650-199409000-00007 Derkay CS, 2001, LARYNGOSCOPE, V111, P57, DOI 10.1097/00005537-200101000-00011 Guyatt GH, 1997, PEDIATRICS, V99, P165, DOI 10.1542/peds.99.2.165 Hill DS, 2000, CLIN OTOLARYNGOL, V25, P153, DOI 10.1046/j.1365-2273.2000.00345.x Kay DJ, 2003, OTOLARYNG HEAD NECK, V128, P17, DOI 10.1067/mhn.2003.41 Roberts G, 2003, J ALLERGY CLIN IMMUN, V111, P491, DOI 10.1067/mai.2003.138 Sohn H, 2003, OTOLARYNG HEAD NECK, V128, P344, DOI 10.1067/mhn.2003.4 STEIN REK, 1993, J PEDIATR-US, V122, P342, DOI 10.1016/S0022-3476(05)83414-6 Varni JW, 2002, ARTHRITIS RHEUM, V46, P714, DOI 10.1002/art.10095 Varni JW, 2003, DIABETES CARE, V26, P631, DOI 10.2337/diacare.26.3.631 Varni JW, 2001, MED CARE, V39, P800, DOI 10.1097/00005650-200108000-00006 Varni JW, 1999, MED CARE, V37, P126, DOI 10.1097/00005650-199902000-00003 Varni JW, 1998, J BEHAV MED, V21, P179, DOI 10.1023/A:1018779908502 Varni JW, 2002, CANCER, V94, P2090, DOI 10.1002/cncr.10427 Varni JW, 2003, AMBUL PEDIATR, V3, P329, DOI 10.1367/1539-4409(2003)003<0329:TPAAPP>2.0.CO;2 VARNI JW, 1992, AM J DIS CHILD, V146, P103 *WHO, 1948, CONS WORLD HLTH ORG NR 21 TC 17 Z9 17 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 499 EP 503 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900001 PM 16134343 ER PT J AU Hockstein, NG Thaler, ER Lin, YQ Lee, DD Hanson, CW AF Hockstein, NG Thaler, ER Lin, YQ Lee, DD Hanson, CW TI Correlation of pneumonia score with electronic nose signature: A prospective study SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE biosensing technique; biosensor; breath test; electronic nose; pneumonia; smell ID VENTILATOR-ASSOCIATED PNEUMONIA; PARTIAL LEAST-SQUARES; PULMONARY INFECTION SCORE; FLUID AB Objectives: Ventilator-associated pneumonia (VAP) is a frequent complication in patients in surgical intensive care units. Pneumonia scores, chest radiography, and bronchoscopy are all employed, but there is no gold standard test for the diagnosis of VAP The electronic nose, a sensor of volatile molecules, is well suited to testing the breath of mechanically ventilated patients. Our objective was to determine the potential use of an electronic nose as a diagnostic adjunct in the detection of VAR. Methods: We performed a prospective study of mechanically ventilated patients in a surgical intensive care unit. Clinical data, including temperature, white blood cell count, character and quantity of tracheal secretions, ratio of partial pressure of arterial oxygen to fraction of inspired oxygen, and chest radiographs, were collected, and a pneumonia score between 0 and 10 was calculated. Exhaled gas was sampled from the expiratory limb of the ventilator circuit. The gases were assayed with a commercially available electronic nose. Multidimensional data reduction analysis was used to analyze the results. Results: Forty-four patients were studied. Fifteen patients had pneumonia scores of 7 or greater, and 29 patients had scores of 6 or less. With Fisher discriminant analysis and K-nearest neighbor analysis, the electronic nose was able to discriminate between the two groups. Conclusions: The electronic nose is a new technology that is inexpensive, noninvasive, and portable. W demonstrate its ability to predict pneumonia, based on a well-recognized scoring system. This technology promises to serve as a diagnostic adjunct in the management of VAP. C1 Univ Penn Hlth Syst, Dept Anesthesia, Philadelphia, PA 19104 USA. Univ Penn Hlth Syst, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. Univ Penn, Dept Elect Engn, Philadelphia, PA 19104 USA. RP Hanson, CW (reprint author), Univ Penn Hlth Syst, Dept Anesthesia, 5th Floor Founders,3400 Spruce St, Philadelphia, PA 19104 USA. RI Lee, Daniel/B-5753-2013 CR BACK AD, 2003, CLASSIFICATION USING BOARDMAN AE, 1981, COMMUN STAT A-THEOR, V10, P613, DOI 10.1080/03610928108828062 Collard HR, 2003, ANN INTERN MED, V138, P494 Fartoukh M, 2003, AM J RESP CRIT CARE, V168, P173, DOI 10.1164/rccm.200212-1449OC Grossman RF, 2000, CHEST, V117, p177S, DOI 10.1378/chest.117.4_suppl_2.177S Lai SY, 2002, LARYNGOSCOPE, V112, P975, DOI 10.1097/00005537-200206000-00007 Luna CM, 2003, CRIT CARE MED, V31, P676, DOI 10.1097/01.CCM.0000055380.86458.1E Malthouse EC, 1997, COMPUT CHEM ENG, V21, P875, DOI 10.1016/S0098-1354(96)00311-0 Nagle HT, 1998, IEEE SPECTRUM, V35, P22, DOI 10.1109/6.715180 Pearce TC, 1997, BIOSYSTEMS, V41, P43, DOI 10.1016/S0303-2647(96)01661-9 PUGIN J, 1991, AM REV RESPIR DIS, V143, P1121 *STATS INC, 2005, KNEAREST NEIGHBORS Thaler ER, 2001, AM J RHINOL, V15, P291 Thaler ER, 2000, ARCH OTOLARYNGOL, V126, P71 Warren DK, 2003, CRIT CARE MED, V31, P1312, DOI 10.1097/01.CCM.0000063087.93157.06 West D, 2000, INT J MED INFORM, V57, P41, DOI 10.1016/S1386-5056(99)00059-3 WOLD S, 1984, SIAM J SCI STAT COMP, V5, P735, DOI 10.1137/0905052 NR 17 TC 30 Z9 31 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 504 EP 508 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900002 PM 16134344 ER PT J AU Heman-Ackah, YD AF Heman-Ackah, YD TI Determinants of fatal apnea responses to acid stimulation of the larynx in piglets SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY MAY 02-03, 2003 CL NASHVILLE, TN SP Amer Laryngol Assoc DE airway reflex; carbon dioxide; hypoxia; infant; laryngeal chemoreflex; respiration; respiratory drive; ventilatory drive ID SUDDEN-INFANT-DEATH; CHEMOREFLEX SEVERITY; PROLONGED APNEA; PRETERM INFANTS; RECEPTORS; WATER; LAMB AB Objectives: This study explores the physiological determinants of laryngeal chemoreflex (LCR) response severity under hypoxic conditions. Methods: Thirty-four piglets underwent hypoxic laryngeal stimulation. Physiologic data were collected, and responses were graded as mild, moderate, or profound. Results: Prestimulation hypoxia caused respiratory depression and carbon dioxide retention in profound responders and respiratory stimulation in mild and moderate responders (p <.05). Resumption of respiration occurred in all animals when the PaCO2 rose by a mean +/- SD of 15.1 +/- 6.5 mm Hg (p >.05). There was a significant difference between mild, moderate, and severe responders in change in arterial PaO2 and hydrogenated hemoglobin saturation during the LCR-induced response (p <.001 for both). Conclusions: Resumption of respiration is associated with accumulation of arterial PaCO2. The respiratory response to hypoxia predicts the severity of the LCR response. The severity of the LCR-induced response is associated with changes in arterial PaO2 and hydrogenated hemoglobin saturation during the LCR-induced apnea. C1 Univ Illinois, Dept Otolaryngol Head & Neck Surg, Chicago, IL USA. RP Heman-Ackah, YD (reprint author), Amer Inst Voice & Ear Res, 1721 Pine St, Philadelphia, PA 19103 USA. CR DAVIES AM, 1989, AM REV RESPIR DIS, V139, P668 DAVIES AM, 1988, J APPL PHYSIOL, V64, P1412 DOWNING SE, 1975, PEDIATRICS, V55, P640 Goding GS, 1998, LARYNGOSCOPE, V108, P863, DOI 10.1097/00005537-199806000-00015 Goding GS, 1996, OTOLARYNG HEAD NECK, V114, P84, DOI 10.1016/S0194-5998(96)70288-7 GROGAARD J, 1982, Journal of Developmental Physiology (Eynsham), V4, P353 HARDING R, 1976, J PHYSIOL-LONDON, V256, P35 HARDING R, 1978, J PHYSIOL-LONDON, V277, P409 HARNED HS, 1978, PEDIATR RES, V12, P1003, DOI 10.1203/00006450-197810000-00011 Heman-Ackah YD, 2000, ANN OTO RHINOL LARYN, V109, P921 Heman-Ackah YD, 2000, OTOLARYNG HEAD NECK, V123, P157, DOI 10.1067/mhn.2000.106710 KOVAR I, 1979, PEDIATR RES, V13, P1444 LANIER B, 1983, OTOLARYNG HEAD NECK, V91, P597 PERKETT EA, 1982, ACTA PAEDIATR SCAND, V71, P969, DOI 10.1111/j.1651-2227.1982.tb09558.x PICKENS DL, 1988, AM REV RESPIR DIS, V137, P113 STOREY AT, 1975, EXP NEUROL, V47, P42, DOI 10.1016/0014-4886(75)90235-6 WETMORE RF, 1993, LARYNGOSCOPE, V103, P1242 WOODSON GE, 1992, OTOLARYNG HEAD NECK, V107, P775 NR 18 TC 5 Z9 5 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 509 EP 516 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900003 PM 16134345 ER PT J AU Sato, K Nakashima, T AF Sato, K Nakashima, T TI Vitamin A-storing stellate cells in the human newborn vocal fold SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE extracellular matrix; growth of vocal fold; larynx; newborn; stellate cell; vocal fold ID AGE-RELATED-CHANGES; MACULA FLAVA; FIBERS; MUCOSA; FIBROBLASTS; TISSUE AB Objectives: Vocal fold stellate cells (VFSCs) in the newborn vocal fold were examined and compared with VFSCs in the adult vocal fold. Methods: Light and electron microscopic investigation of VFSCs was carried out on 5 human newborn larynges. Results: The VFSCs were distributed in human newborn maculae flavae. They were stellate or oval in shape, and possessed cytoplasmic processes. The VFSCs in some cells formed a gap junction with each other. A few lipid droplets were present in the cytoplasm, but they were much fewer than those of an adult. The nucleus-cytoplasm ratio was high, and the intracellular organelles were not very well developed. Free ribosomes were well developed in the cytoplasm. The VFSCs in some cells showed strong cytoplasm staining with periodic acid-Schiff stain and type III collagen. There were vesicles along the periphery of the cytoplasm of the VFSCs, and newly released amorphous materials were seen, but fewer were observed on the cell surface. The newborn VFSCs had started to synthesize extracellular matrices such as collagenous fibers, reticular fibers, elastic fibers, and glycosaminoglycan. Conclusions: The VFSCs in the newborn maculae flavae were immature, but had already started the synthesis of extracellular matrices essential for the viscoelastic properties of the vocal fold mucosa. C1 Kurume Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Kurume, Fukuoka 8300011, Japan. RP Sato, K (reprint author), Kurume Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, 67 Asahi Machi, Kurume, Fukuoka 8300011, Japan. CR DELUCA L, 1968, ARCH BIOCHEM BIOPHYS, V123, P1, DOI 10.1016/0003-9861(68)90097-0 Hirano M., 1975, OTOLOGIA FUKUOKA S1, V21, P239 HIRANO M, 1993, HIST COLOR ATLAS HUM Hirano M, 2000, ACTA OTO-LARYNGOL, V120, P336 Hirano M, 1999, ACTA OTO-LARYNGOL, V119, P271 HIRANO M, 1989, ACTA OTO-LARYNGOL, V107, P428, DOI 10.3109/00016488909127535 Hirano M., 1983, VOCAL FOLD PHYSL CON, P22 KANNO Y, 1985, JPN J PHYSIOL, V35, P693, DOI 10.2170/jjphysiol.35.693 LEVI AS, 1968, BIOCHEM J, V109, P69 Sato K, 1997, ANN OTO RHINOL LARYN, V106, P44 SATO K, 2003, PRACT OTOL KYOTO, V96, P567 Sato K, 2003, ACTA OTO-LARYNGOL, V123, P106, DOI 10.1080/0036554021000028077 Sato K, 2004, ANN OTO RHINOL LARYN, V113, P108 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P138 Sato K, 2002, ANN OTO RHINOL LARYN, V111, P15 Sato K, 2001, ANN OTO RHINOL LARYN, V110, P319 Sato K, 1998, ANN OTO RHINOL LARYN, V107, P1023 Sato K, 1992, LARYNX JPN, V4, P84 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P556 Sato K, 2003, ACTA OTO-LARYNGOL, V123, P269, DOI 10.1080/00016480310001123 Sato K, 2000, ANN OTO RHINOL LARYN, V109, P136 Sato K, 2001, ANN OTO RHINOL LARYN, V110, P417 Sato K, 1997, Nihon Jibiinkoka Gakkai Kaiho, V100, P479 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P839 SUNDARES.PR, 1966, BIOCHIM BIOPHYS ACTA, V113, P95 NR 25 TC 14 Z9 14 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 517 EP 524 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900004 PM 16134346 ER PT J AU Melker, JS Gabrielli, A AF Melker, JS Gabrielli, A TI Melker Cricothyrotomy Kit: An alternative to the surgical technique SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE alternative; cricothyrotomy; technique AB Emergent cricothyrotomy is a potentially lifesaving procedure central to acute airway algorithms. In most cases in which cricothyrotomy is indicated, the acuteness of the airway precludes subspecialty consultation before performance of the procedure. The academic environment is an exception, in which the responsibility of securing a "difficult" cricothyroid airway may fall upon junior otolaryngology residents. Described here is the use of the Melker Emergency Cricothyrotomy Kit, a prepackaged kit that uses a wire-guided percutaneous dilational technique (the Seldinger technique) and a procedure-specific polyvinyl chloride airway catheter. The wire-guided technique may add a margin of safety for a relatively inexperienced resident performing cricothyrotomy. Furthermore, a newly released version of the kit includes instrumentation for insertion of the Melker airway catheter by the classic surgical technique in addition to that required for the Seldinger technique, which may enable even a seasoned surgeon to secure the airway faster and more safely. C1 Univ Florida, Coll Med, Dept Otolaryngol, Gainesville, FL USA. Univ Florida, Coll Med, Dept Anesthesiol, Gainesville, FL USA. Univ Florida, Coll Med, Dept Surg, Gainesville, FL USA. RP Melker, JS (reprint author), Gainesville Otolaryngol Grp, 6821 NW 11th Pl, Gainesville, FL 32605 USA. CR Chan TC, 1999, J EMERG MED, V17, P957, DOI 10.1016/S0736-4679(99)00123-7 Vadodaria BS, 2004, ANAESTHESIA, V59, P73, DOI 10.1111/j.1365-2044.2004.03456.x NR 2 TC 12 Z9 12 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 525 EP 528 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900005 PM 16134347 ER PT J AU Chang, CY Furdyna, JA AF Chang, CY Furdyna, JA TI Bilateral pharyngoceles (branchial cleft anomalies?) and endoscopic surgical considerations SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE branchial region; diverticulum; dysphagia; laryngocele; pharyngocele ID PHARYNGEAL POUCH; ZENKERS DIVERTICULUM; SINUS; MANAGEMENT AB A case report of bilateral pharyngoceles without a history of elevated intrapharyngeal pressures is used to support the hypothesis that pharyngoceles may be an adult manifestation of an internal branchial sinus anomaly. The development of a pharyngocele from a branchial sinus origin would suggest a predictable relationship to the hypoglossal, glossopharyngeal, and superior laryngeal nerves, which may influence the choice of surgical approach (open versus endoscopic) and the counseling of patients who are considering surgical correction. C1 Asheville Vet Adm Med Ctr, Div Otolaryngol Head & Neck Surg, Asheville, NC 28805 USA. Duke Univ, Med Ctr, Div Otolaryngol Head & Neck Surg, Durham, NC USA. RP Furdyna, JA (reprint author), Asheville Vet Adm Med Ctr, Div Otolaryngol Head & Neck Surg, Asheville, NC 28805 USA. CR Chang CY, 2003, LARYNGOSCOPE, V113, P957, DOI 10.1097/00005537-200306000-00009 Chevallier P, 2000, J CLIN ULTRASOUND, V28, P101, DOI 10.1002/(SICI)1097-0096(200002)28:2<101::AID-JCU9>3.0.CO;2-P CHOI SS, 1995, LARYNGOSCOPE, V105, P909, DOI 10.1288/00005537-199509000-00007 GODIN MS, 1990, LARYNGOSCOPE, V100, P174 Huang PC, 1999, ANN OTO RHINOL LARYN, V108, P408 Lin CJ, 2003, ARCH OTOLARYNGOL, V129, P356 LISTON SL, 1981, OTOLARYNG HEAD NECK, V89, P520 MEEHAN T, 1992, J LARYNGOL OTOL, V106, P1002, DOI 10.1017/S0022215100121607 NORRIS CW, 1979, LARYNGOSCOPE, V89, P1788 OSTFELD E, 1985, LARYNGOSCOPE, V95, P1114 Restrepo Santiago, 2003, Ear Nose Throat J, V82, P494 VANDEVEN PM, 1995, J LARYNGOL OTOL, V109, P247 Westrin KM, 1996, ACTA OTO-LARYNGOL, V116, P351, DOI 10.3109/00016489609137857 NR 13 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 529 EP 532 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900006 PM 16134348 ER PT J AU Halpin, C Owen, G Gutierez-Espeleta, GA Sims, K Rehm, HL AF Halpin, C Owen, G Gutierez-Espeleta, GA Sims, K Rehm, HL TI Audiologic features of Norrie disease SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE audiometry; NDP gene; Norrie disease; speech intelligibility; stria vascularis ID MISSENSE MUTATIONS; ND GENE; CARRIERS; DEAFNESS; MODEL AB Objectives: Norrie disease is an X-linked recessive disorder in which patients are born blind and develop sensory hearing loss in adolescence. The hearing loss associated with Norrie disease has been shown in a genetically altered knockout mouse to involve dysfunction of the stria vascularis; most other structures are preserved until the later stages of the disease. The objective of this study was to characterize the audiologic phenotype of Norrie disease for comparison with the pathophysiologic mechanism. Methods: The design combined two series of clinical audiologic evaluations, with special attention to speech intelligibility. Results: The audiologic results for 12 affected individuals and 10 carriers show that patients with Norrie disease retain high speech intelligibility scores even when the threshold loss is severe. Conclusions: The cochlear mechanism - failure of the stria vascularis - accounts for some of the higher values in the wide distribution of speech scores in cases with similar pure tone audiograms. C1 Massachusetts Eye & Ear Infirm, Dept Audiol, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Otol & Laryngol, Cambridge, MA 02138 USA. Harvard Univ, Sch Med, Massachusetts Gen Hosp, Dept Neurol, Cambridge, MA 02138 USA. Harvard Univ, Sch Med, Dept Pathol, Boston, MA USA. Univ Costa Rica, Escuela Biol, Inst Invest Salud, San Jose, Costa Rica. RP Halpin, C (reprint author), Massachusetts Eye & Ear Infirm, Dept Audiol, 243 Charles St, Boston, MA 02114 USA. CR *AM NATL STAND I, 1969, METH CALC ART IND *AM NATL STAND I, 1978, METH MAN PUR TON THR BERGER W, 1992, NAT GENET, V2, P84 Berger W, 1996, HUM MOL GENET, V5, P51, DOI 10.1093/hmg/5.1.51 BLODI FC, 1969, DOC OPHTHALMOL, V26, P434, DOI 10.1007/BF00944002 CHEN ZY, 1992, NAT GENET, V1, P204, DOI 10.1038/ng0692-204 De Cardenas M, 1994, CUADERNO LOGOAUDIOME FUENTES JJ, 1993, HUM MOL GENET, V2, P1953, DOI 10.1093/hmg/2.11.1953 Halpin Chris, 2002, Am J Audiol, V11, P56, DOI 10.1044/1059-0889(2002/016) HALPIN C, 1994, EAR HEARING, V15, P71, DOI 10.1097/00003446-199402000-00008 HALPIN C, 1995, CURR OPIN OTOLARYNGO, V3, P325 HOLMES LB, 1971, J PEDIATR-US, V79, P89, DOI 10.1016/S0022-3476(71)80063-X MEINDL A, 1995, HUM MOL GENET, V4, P489, DOI 10.1093/hmg/4.3.489 Moore BCJ, 1999, J ACOUST SOC AM, V106, P2761, DOI 10.1121/1.428133 NADOL JB, 1990, AM J OTOLARYNG, V11, P112, DOI 10.1016/0196-0709(90)90007-I PARVING A, 1978, AUDIOLOGY, V17, P293 PARVING A, 1977, AUDIOLOGY, V16, P124 PARVING A, 1991, INT J PEDIATR OTORHI, V21, P103, DOI 10.1016/0165-5876(91)90140-7 Perez-Vilar J, 1997, J BIOL CHEM, V272, P33410, DOI 10.1074/jbc.272.52.33410 Rehm HL, 2002, J NEUROSCI, V22, P4286 Rehm HL, 1997, HUM MUTAT, V9, P402 Schuknecht HF, 1993, PATHOLOGY EAR Sims KB, 1997, ARCH OPHTHALMOL-CHIC, V115, P517 THORNTON A, 1994, HARVARD AUDIOMETER O THORNTON A, 1988, QMASS, V1 THORNTON AR, 1978, J SPEECH HEAR RES, V21, P507 WARBURG M, 1986, T OPHTHAL SOC UK, V105, P88 WARBURG M, 1966, ACTA OPHTHALMOL S NR 28 TC 9 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 533 EP 538 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900007 PM 16134349 ER PT J AU Semple, CW Mahadevan, M Berkowitz, RG AF Semple, CW Mahadevan, M Berkowitz, RG TI Extensive acquired cholesteatoma in children: When the penny drops SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE acquired cholesteatoma; diagnosis; otitis media; otorrhea ID MIDDLE-EAR CHOLESTEATOMA; CHRONIC OTITIS-MEDIA; COMPUTED-TOMOGRAPHY; LONG-TERM; SURGERY; EPIDEMIOLOGY; DISEASE; SCAN AB Objectives: To determine the factors associated with the diagnosis of acquired cholesteatoma (AC) in children, we performed a retrospective chart review at a tertiary care center. Methods: We reviewed children with a diagnosis of AC that extended beyond the mesotympanum in the presence of a nonintact tympanic membrane who underwent surgical treatment over a 14-year period. Results: There were 116 children (78 male, 38 female) between 3 and 18 years of age (mean, 9.5 years). Their average period of management in a specialist otolaryngology clinic before the diagnosis of cholesteatoma was made was 3.2 years, and 68% of the children had previously undergone insertion of tympanostomy tubes. Symptoms and signs included chronic otorrhea (59%), recurrent acute otitis media (58%), and conductive hearing loss (51%). The diagnosis of AC was eventually made after office otoscopy (26%), temporal bone computed tomography (24%), or examination under anesthesia (17%). In 33% of children, the diagnosis was made only after surgical exploration of the middle ear and mastoid. Conclusions: Our data underscore the importance of maintaining a high index of suspicion for AC in managing children with long-standing otologic symptoms, and considering otomicroscopy, computed tomographic scanning, or tympanomastoid exploration if medical treatment fails. C1 Royal Childrens Hosp, Dept Otolaryngol, Parkville, Vic 3052, Australia. RP Berkowitz, RG (reprint author), Royal Childrens Hosp, Dept Otolaryngol, Flemington Rd, Parkville, Vic 3052, Australia. CR Banerjee A, 2003, J LARYNGOL OTOL, V117, P454 Bluestone CD, 1983, PEDIATRIC OTOLARYNGO, P513 BORDLEY JE, 1986, EAR NOSE THROAT DISO BUCKINGHAM RA, 1981, LARYNGOSCOPE, V91, P1450 Chee N. W. C., 2001, SMJ Singapore Medical Journal, V42, P155 El-Bitar MA, 2003, INT J PEDIATR OTORHI, V67, P231, DOI 10.1016/S0165-5876(02)00373-7 GARBER LZ, 1994, J OTOLARYNGOL, V23, P121 GLASSCOCK ME, 1981, LARYNGOSCOPE, V91, P1743 HERDMAN R, 1988, J LARYNGOL OTOL, V102, P1000, DOI 10.1017/S002221510010711X Kay DJ, 2001, OTOLARYNG HEAD NECK, V124, P374, DOI 10.1067/mhn.2001.113941 Kemppainen HO, 1999, ACTA OTO-LARYNGOL, V119, P568 PALVA A, 1977, ARCH OTOLARYNGOL, V103, P74 Rakover Y, 2000, INT J PEDIATR OTORHI, V56, P41, DOI 10.1016/S0165-5876(00)00407-9 SADE J, 1988, J LARYNGOL OTOL, V102, P1003, DOI 10.1017/S0022215100107121 SHEEHY JL, 1978, CLIN OTOLARYNGOL, V3, P393, DOI 10.1111/j.1365-2273.1978.tb00720.x SNEYERS W, 1991, Acta Oto-Rhino-Laryngologica Belgica, V45, P369 TEELE DW, 1989, J INFECT DIS, V160, P83 TOS M, 1983, AM J OTOL, V4, P189 TWEMLOW S, 1991, RADIOGR TODAY, V55, P22 VARTIAINEN E, 1986, J LARYNGOL OTOL, V100, P515, DOI 10.1017/S0022215100099606 VARTIAINEN E, 1992, INT J PEDIATR OTORHI, V24, P201, DOI 10.1016/0165-5876(92)90017-J Walshe P, 2002, CLIN OTOLARYNGOL, V27, P95, DOI 10.1046/j.1365-2273.2002.00538.x WETMORE RF, 1987, INT J PEDIATR OTORHI, V14, P101, DOI 10.1016/0165-5876(87)90020-6 NR 23 TC 3 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 539 EP 542 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900008 PM 16134350 ER PT J AU Cervera-Paz, FJ Linthicum, FH AF Cervera-Paz, FJ Linthicum, FH TI Cochlear wall erosion after cochlear implantation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE inner ear; pathology; surgery; temporal bone ID INSERTIONAL TRAUMA; HISTOPATHOLOGY; ELECTRODES AB Objectives: Cochlear implantation is a clinically satisfactory procedure, but it is associated with a variable degree of histologic intracochlear trauma. We report a new histologic finding in a cochlear implant specimen from the House Ear Institute collection. Methods: An analysis of 34 temporal bones with single-channel (n = 23) or multichannel (n = 11) cochlear implants was performed. All temporal bones had been fixed for a month in 10% buffered formalin, progressively decalcified in ethylenediaminetetraacetic acid, and embedded in celloidin. After electrode removal, the bones were cut into 20-mu m sections and stained. Results: In I specimen, the implanted electrode had caused erosion of the bone through the endosteum into the marrow spaces, at the superior-anterior portion of the basal turn. This area showed an intense lymphocytic infiltration surrounded by some new bone formation. Conclusions: Trauma may provoke an inflammatory reaction due to the presence of the foreign body after violation of the endosteum. C1 House Ear Res Inst, Dept Histopathol, Los Angeles, CA USA. RP Cervera-Paz, FJ (reprint author), Univ Navarra, Clin Univ, Dept Otorrinolaringol, Av Pio 12 Nr 36, Pamplona 31008, Spain. CR Eshraghi AA, 2003, LARYNGOSCOPE, V113, P415, DOI 10.1097/00005537-200303000-00005 FAYAD J, 1991, ANN OTO RHINOL LARYN, V100, P807 Gstoettner W, 1997, ACTA OTO-LARYNGOL, V117, P274, DOI 10.3109/00016489709117786 Gstoettner WK, 2001, ACTA OTO-LARYNGOL, V121, P216 KENNEDY DW, 1987, LARYNGOSCOPE, V97, P42 LINTHICUM FH, 1991, AM J OTOL, V12, P245 Nadol JB, 1997, OTOLARYNG HEAD NECK, V117, P220, DOI 10.1016/S0194-5998(97)70178-5 Nadol JB, 2001, ANN OTO RHINOL LARYN, V110, P883 SCHUKNECHT HF, 1993, PATHOLOGY EAR, P25 SHEPHERD RK, 1995, AM J OTOL, V16, P186 Tien HC, 2002, OTOLARYNG HEAD NECK, V127, P260, DOI 10.1067/mhn.2002.128555 WELLING DB, 1993, LARYNGOSCOPE, V103, P995 NR 12 TC 9 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 543 EP 546 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900009 PM 16134351 ER PT J AU Lee, IK Liu, JW AF Lee, IK Liu, JW TI Tuberculous parotitis: Case report and literature review SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cytology; fine-needle aspiration; histopathology; tuberculous parotitis ID MYCOBACTERIUM-BOVIS; GLAND; INFECTION; TUMOR AB Objectives: Our aim was to better understand the rarely encountered tuberculous (TB) parotitis. Methods: A case of TB parotitis is reported, and the literature is reviewed. Results: Forty-nine patients (27 men, 22 women; mean age, 38.3 +/- 16.4 years) were enrolled. The median duration of symptoms before these patients sought medical help was 6 months. Except for I patient with bilateral TB parotitis, all had unilateral involvement; complications included draining sinuses in 4 patients (8%) and facial palsy in 2 patients (4%). Twenty-one of 36 patients (58%) had a painless parotid mass, 12 of 19 (63%) had cervical lymphadenitis, 8 of 11 (73%) had fever, and I I of 44 (25%) had pulmonary tuberculosis (4 active and 7 inactive cases). Neoplasm was the most common presumptive diagnosis. The diagnosis of TB parotitis in most cases was made on the basis of cytologic analysis of the fine-needle aspirate or histopathologic analysis of the excised tissue. Forty-six patients with TB parotitis who had a traceable outcome survived after 6 to 10 months of antituberculosis chemotherapy. Conclusions: Physicians should have a high index of suspicion for TB parotitis in patients with a chronic parotid lump, even if the chest radiographs appear normal. Fine-needle aspiration should be performed first for diagnosis, and TB parotitis should be medically treated. C1 Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Internal Med, Div Infect Dis, Kaohsiung 833, Taiwan. RP Liu, JW (reprint author), Chang Gung Mem Hosp, Kaohsiung Med Ctr, Dept Internal Med, Div Infect Dis, 123 Ta Pei Rd, Kaohsiung 833, Taiwan. 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Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 547 EP 551 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900010 PM 16134352 ER PT J AU Goding, GS Al-Sharif, KI McLoon, LK AF Goding, GS Al-Sharif, KI McLoon, LK TI Myonuclear addition to uninjured laryngeal myofibers in adult rabbits SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE larynx; muscle; myofiber; satellite cell ID MYOSIN HEAVY-CHAIN; SATELLITE CELL-PROLIFERATION; SKELETAL-MUSCLE FIBERS; EXTRAOCULAR-MUSCLES; MOTOR UNITS; EXPRESSION; REGENERATION; MOUSE; RAT; IDENTIFICATION AB Objectives: In normal mature limb skeletal muscle, satellite cells are quiescent and myonuclei do not divide after formation of their associated myofibers in the absence of injury. The possibility of myonuclear addition in uninjured laryngeal myofibers of adult rabbits was investigated in an immunohistochemical pilot study. Methods: Bromodeoxyuridine (brdU), a marker for cell division, was administered by intraperitoneal injection over a 12-hour period in rabbits. The number of brdU-positive myonuclei per myofiber was determined on cross sections through the thyroarytenoid (TA) and posterior cricoarytenoid (PCA) muscles. Results: In the TA muscle, 0.13% +/- 0.03% (mean +/- SEM) of the myofibers counted had a brdU-positive nucleus. In the PCA muscle, 0.13% 0.01 % of the myofibers counted had a brdU-positive nucleus. Approximately 0.2% and 0.3% of the myofibers of the TA and PCA muscles, respectively, had brdU-positive satellite cells associated with them. Tibialis anterior and pectoralis major muscle controls were negative for brdU-positive myonuclei. Conclusions: These data support the possibility of continuous remodeling in uninjured adult laryngeal myofibers and accentuate the distinct nature of laryngeal muscle relative to limb skeletal muscle in the rabbit model. C1 Univ Minnesota, Dept Otolaryngol, Minneapolis, MN 55455 USA. Univ Minnesota, Dept Ophthalmol, Minneapolis, MN 55455 USA. Univ Minnesota, Dept Neurosci, Minneapolis, MN 55455 USA. RP Goding, GS (reprint author), Univ Minnesota, Dept Otolaryngol, 420 Delaware St, Minneapolis, MN 55455 USA. CR ALLEN DL, 1995, J APPL PHYSIOL, V78, P1969 ALLEN RE, 1989, J CELL PHYSIOL, V138, P311, DOI 10.1002/jcp.1041380213 Bain NL, 2001, J MED SPEECH-LANG PA, V9, P157 Baroffio A, 1996, DIFFERENTIATION, V60, P47, DOI 10.1046/j.1432-0436.1996.6010047.x Charge SBP, 2004, PHYSIOL REV, V84, P209, DOI 10.1152/physrev.00019.2003 Cooper RN, 1999, J CELL SCI, V112, P2895 CRUMLEY RL, 1991, LARYNGOSCOPE, V101, P384 Decary S, 1997, HUM GENE THER, V8, P1429, DOI 10.1089/hum.1997.8.12-1429 DELGAUDIO JM, 1995, ANN OTO RHINOL LARYN, V104, P237 Goldberg SJ, 1999, PROG BRAIN RES, V123, P221, DOI 10.1016/S0079-6123(08)62859-9 GOLDBERG SJ, 1976, ACTA PHYSIOL SCAND, V96, P58, DOI 10.1111/j.1748-1716.1976.tb10170.x GROUNDS MD, 1992, CELL TISSUE RES, V267, P99, DOI 10.1007/BF00318695 HALLCRAG.EC, 1974, J ANAT, V117, P171 Hawke TJ, 2001, J APPL PHYSIOL, V91, P534 HIROSE H, 1969, ANN OTO RHINOL LARYN, V78, P297 LENNERST.G, 1974, ACTA PHYSIOL SCAND, V91, P458, DOI 10.1111/j.1748-1716.1974.tb05702.x Li ZB, 2004, OTOLARYNG HEAD NECK, V130, P217, DOI 10.1016/j.otohns.2003.09.009 LUCAS CA, 1995, J MUSCLE RES CELL M, V16, P368, DOI 10.1007/BF00114502 Lucas CA, 1997, INVEST OPHTH VIS SCI, V38, P2817 Malmgren LT, 2000, ARCH OTOLARYNGOL, V126, P851 MAURO A, 1961, J BIOPHYS BIOCHEM CY, V9, P493, DOI 10.1083/jcb.9.2.493 McLoon LK, 2004, MUSCLE NERVE, V29, P707, DOI 10.1002/mus.20012 McLoon Linda K, 2002, Trans Am Ophthalmol Soc, V100, P119 McLoon LK, 2002, MUSCLE NERVE, V25, P348, DOI 10.1002/mus.10056 McLoon LK, 2003, INVEST OPHTH VIS SCI, V44, P1927, DOI 10.1167/iovs.02-0673 MONTARRAS D, 1991, NEW BIOL, V3, P592 Nomoto M, 1993, Acta Otolaryngol Suppl, V506, P71 Perie S, 1999, ANN OTO RHINOL LARYN, V108, P683 Perie S, 2000, ANN OTO RHINOL LARYN, V109, P216 PORTER JD, 1989, INVEST OPHTH VIS SCI, V30, P1894 Putman CT, 2000, AM J PHYSIOL-CELL PH, V279, pC682 SADEH M, 1981, CELL MOL BIOL, V27, P643 SALPETER MM, 1974, ANAT REC, V179, P201, DOI 10.1002/ar.1091790205 SKOGLUND C R, 1964, Acta Physiol Scand, V60, P318 Smith HK, 2001, J APPL PHYSIOL, V90, P1407 Tatsumi R, 1998, DEV BIOL, V194, P114, DOI 10.1006/dbio.1997.8803 TUCKER HM, 1978, LARYNGOSCOPE, V88, P598 WIECZOREK DF, 1985, J CELL BIOL, V101, P618, DOI 10.1083/jcb.101.2.618 NR 38 TC 17 Z9 17 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 552 EP 557 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900011 PM 16134353 ER PT J AU Roh, JL AF Roh, JL TI Prevention of posterior glottic stenosis by mitomycin C SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE larynx; mitomycin C; posterior commissure; posterior glottic stenosis; rabbit ID LARYNGEAL AB Objectives: Posterior glottic stenosis (PGS) is a disabling disease commonly induced by endolaryngeal injury from intubation or surgery. Few experiments on PGS prevention, however, have been performed. The purpose of this study was to investigate the preventive effect of mitomycin C (MMC) on PGS in a randomized, controlled animal study. Methods: Twenty-six rabbits underwent laser injury of 6 W, continuous-focus mode on the posterior glottis. There were 6 uninjured controls. Thirteen animals were treated by a single topical use of 0.4 mg/mL MMC solution on the injured posterior glottis for 5 minutes, and 13 were sham-treated controls. The posterior glottis of all groups was blindly evaluated by telescopic examination under direct laryngoscopy 2 months after injury and was harvested for histologic analyses. Results: Scar, granulation tissue, and synechia formation of the posterior glottis were clearly induced by laser injury. Microscopic examination showed increased collagen content and fibroblast proliferation in the region. The use of MMC significantly decreased the incidence of such gross and microscopic changes of the posterior glottis (p <.05). Conclusions: This study suggests that topical MMC can be helpful in preventing the progression of PGS from mucosal injury of the posterior glottis. C1 Chungnam Natl Univ, Coll Med, Canc Res Inst, Dept Otolaryngol Head & Neck Surg, Taejon, South Korea. RP Roh, JL (reprint author), Chungnam Natl Univ Hosp, Dept Otolaryngol Head & Neck Surg, Chung Gu, 640 Daesa Dong, Taejon 301040, South Korea. CR BOGDASARIAN RS, 1980, OTOLARYNG HEAD NECK, V88, P765 Bradner WT, 2001, CANCER TREAT REV, V27, P35, DOI 10.1053/ctrv.2000.0202 Chung JH, 2002, OTOLARYNG HEAD NECK, V126, P468, DOI 10.1067/mhn.2002.124705 Courey MS, 1998, ANN OTO RHINOL LARYN, V107, P839 DEBRUIJN EA, 1992, INT J CANCER, V51, P359, DOI 10.1002/ijc.2910510305 Estrem SA, 1999, OTOLARYNG HEAD NECK, V120, P794, DOI 10.1016/S0194-5998(99)70316-5 Ferguson B, 2005, LARYNGOSCOPE, V115, P110, DOI 10.1097/01.mlg.0000150694.08259.80 Hoasjoe DK, 1997, LARYNGOSCOPE, V107, P675, DOI 10.1097/00005537-199705000-00022 IRVING RM, 1993, INT J PEDIATR OTORHI, V28, P11, DOI 10.1016/0165-5876(93)90142-P KHAW PT, 1993, ARCH OPHTHALMOL-CHIC, V111, P263 MIYAMURA S, 1967, J ANTIBIOT, V20, P72 MONTGOME.WW, 1973, ARCH OTOLARYNGOL, V98, P170 Perkins JA, 1998, ARCH OTOLARYNGOL, V124, P281 Rahbar R, 2001, ANN OTO RHINOL LARYN, V110, P1 Spector JE, 1999, LARYNGOSCOPE, V109, P1125, DOI 10.1097/00005537-199907000-00022 WEYMULLER EA, 1988, LARYNGOSCOPE S45, V98 WHITED RE, 1983, LARYNGOSCOPE, V93, P1314 NR 17 TC 16 Z9 17 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 558 EP 562 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900012 PM 16134354 ER PT J AU Zealear, DL Swelstad, MR Fortune, S Rodriguez, RJ Chung, SM Valyi-Nagy, K Billante, MJ Billante, CR Garren, K AF Zealear, DL Swelstad, MR Fortune, S Rodriguez, RJ Chung, SM Valyi-Nagy, K Billante, MJ Billante, CR Garren, K TI Evoked electromyographic technique for quantitative assessment of the innervation status of laryngeal muscles SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE denervation; evoked electromyography; laryngeal muscle; recurrent laryngeal nerve; reinnervation; vocal fold paralysis ID PERIPHERAL-NERVES; PARALYSIS; ELECTRODE; RAT; ELECTRONEUROGRAPHY; CONSEQUENCES; SYNKINESIS AB Objectives: The purpose of this study was to develop a minimally invasive, noninjurious evoked electromyographic technique that could accurately quantitate the level of innervation of laryngeal muscles with recurrent laryngeal nerve stimulation. Methods: A four-phase study was conducted in 24 canines, including 1) identification of the best stimulation-recording configuration, 2) statistical analysis of sensitivity and accuracy, 3) evaluation of safety, and 4) identification of the laryngeal muscle(s) that contribute to the evoked response. Results: The results demonstrated that an entirely noninvasive technique is not feasible. The stimulating cathode must be invasive to ensure discrete activation of the recurrent laryngeal nerve, whereas both recording electrodes should remain on the surface with one overlying the thyroid ala. This configuration proved to be highly accurate, with an error rate of only 6% to 7%, and with sensitivity sufficient to detect a signal in a nerve with fewer than 1% of the axons intact. There was no evidence of nerve injury in any animal over the course of 350 stimulus needle penetrations. By use of neuromuscular blockade to identify those muscles generating the surface response, the thyroarytenoid muscle was found to be the primary contributor, whereas the posterior cricoarytenoid muscle was uninvolved. Conclusions: This evoked electromyographic technique could provide quantitative information regarding the extent of muscle innervation during denervation and regeneration in case of laryngeal paralysis. C1 Vanderbilt Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Nashville, TN 37232 USA. RP Zealear, DL (reprint author), Vanderbilt Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Med Ctr N S2100, Nashville, TN 37232 USA. CR COKER NJ, 1992, LARYNGOSCOPE, V102, P747, DOI 10.1288/00005537-199207000-00004 CRUMLEY RL, 1989, ANN OTO RHINOL LARYN, V98, P87 Damrose EJ, 2001, ANN OTO RHINOL LARYN, V110, P815 DYCK PJ, 1993, PERIPHERAL NEUROPATH, P544 ESSLEN E, 1977, FACIAL NERVE SURG FISCH U, 1984, AM J OTOL, V5, P494 FISCH U, 1977, P SHAMB 5 INT WORKSH FLINT PW, 1991, ANN OTO RHINOL LARYN, V100, P797 HILLEL AD, 2001, LARYNGOSCOPE S97, V111 Khan A, 1997, AM J OTOLARYNG, V18, P99, DOI 10.1016/S0196-0709(97)90095-8 KUNA ST, 1988, J APPL PHYSIOL, V65, P1332 LUDLOW CL, 1994, ANN OTO RHINOL LARYN, V103, P16 RASLAN WF, 1988, LARYNGOSCOPE, V98, P891 Rea JL, 1998, LARYNGOSCOPE, V108, P1418, DOI 10.1097/00005537-199809000-00032 RICE ASC, 1994, PAIN, V59, P385, DOI 10.1016/0304-3959(94)90025-6 RICE ASC, 1993, BRAIN RES, V631, P221, DOI 10.1016/0006-8993(93)91538-4 SATALOFF RF, 2003, LARYNGEAL ELECTROMYO, P67 SATOH I, 1978, LARYNGOSCOPE, V88, P2022 Sims H. Steven, 1996, Otolaryngology - Head and Neck Surgery, V114, P761, DOI 10.1016/S0194-5998(96)70099-2 THUMFART W, 1980, LARYNG RHINOL OTOL V, V59, P727, DOI 10.1055/s-2007-1008921 Thumfart W F, 1986, Acta Otorhinolaryngol Belg, V40, P358 THUMFART WF, 1992, ANN OTO RHINOL LARYN, V101, P629 Zealear DL, 2004, OTOLARYNG CLIN N AM, V37, P1, DOI 10.1016/S0030-6665(03)00165-8 ZEALEAR DL, 1988, LARYNGOSCOPE, V98, P568 NR 24 TC 8 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 563 EP 572 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900013 PM 16134355 ER PT J AU Brook, I Foote, PA Frazier, EH AF Brook, I Foote, PA Frazier, EH TI Microbiology of acute exacerbation of chronic sinusitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anaerobic bacteria; antimicrobial resistance; chronic sinusitis; exacerbation; Haemophilus influenzae ID OTITIS-MEDIA; PENICILLIN-RESISTANT; ANAEROBIC-BACTERIA; CHILDREN AB Objectives: We undertook to evaluate the microbiology of acute exacerbation of chronic sinusitis (AECS). Methods: Repeated aspirations of maxillary sinus secretions by endoscopy were performed in 7 patients over a period of 125 to 242 days. Results: Bacteria were recovered for all 22 aspirates, and the number of isolates was between 2 and 4. A total of 54 isolates were isolated: 16 aerobic and facultative bacteria and 38 anaerobic bacteria. The aerobic bacteria were Haemophilus influenzae (7 isolates), Streptococcus pneumoniae (3), Moraxella catarrhalis (3), Staphylococcus aureus (2), and Klebsiella pneumoniae (1). The anaerobic bacteria included pigmented Prevotella and Porphyromonas spp (19), Peptostreptococcus spp (9), Fusobacterium spp (8), and Propionibacterium acnes (2). A change in the types of isolates was noted in all consecutive cultures obtained from the same patients as different organisms emerged and previously isolated bacteria were no longer recovered. An increase in antimicrobial resistance was noted in 6 instances. Conclusions: This study illustrates the microbial dynamics of AECS in which anaerobic and aerobic bacteria prevail, and highlights the importance of obtaining cultures from patients with AECS for guidance in selection of proper antimicrobial therapy. C1 Georgetown Univ, Sch Med, Dept Pediat, Washington, DC USA. Alachua Gen Hosp, Gainesville, FL USA. RP Brook, I (reprint author), 4431 Albemarle St NW, Washington, DC 20016 USA. CR Brook I, 1999, ACTA OTO-LARYNGOL, V119, P832, DOI 10.1080/00016489950180504 Brook I, 1996, CLIN INFECT DIS, V22, P143 Brook I, 1996, J PEDIATR-US, V128, P237, DOI 10.1016/S0022-3476(96)70397-9 BROOK I, 1981, JAMA-J AM MED ASSOC, V246, P967, DOI 10.1001/jama.246.9.967 BROOK I, 1984, CLIN PEDIATR, V23, P338, DOI 10.1177/000992288402300608 Brook I, 1999, ANN OTO RHINOL LARYN, V108, P645 Clement PAR, 1998, ARCH OTOLARYNGOL, V124, P31 Ednie LM, 1997, ANTIMICROB AGENTS CH, V41, P1033 Finegold SM, 1999, INT J ANTIMICROB AG, V12, pS9, DOI 10.1016/S0924-8579(99)00086-2 JOUSIMIESSOMER HR, 1988, J CLIN MICROBIOL, V26, P1919 *NATL COMM CLIN LA, 1995, METH DIL ANT SUSC TE NORD CE, 1995, CLIN INFECT DIS, V20, P1512 OCALLAGH.CH, 1972, ANTIMICROB AGENTS CH, V1, P283 NR 13 TC 13 Z9 14 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUL PY 2005 VL 114 IS 7 BP 573 EP 576 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 946KL UT WOS:000230570900014 PM 16134356 ER PT J AU Orgill, RD Pasic, TR Peppler, WW Hoffman, MD AF Orgill, RD Pasic, TR Peppler, WW Hoffman, MD TI Radiographic evaluation of aspirated metallic foil foreign bodies SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE aluminum; bronchoscopy; bronchus; candy wrapper; differential diagnosis; foreign body; nonradiopaque material; thoracic radiography; trachea; tracheobronchial tree ID PENNIES; ESOPHAGUS; CHILDREN AB Objectives: Aspirated objects generally represent items accessible to children. When metallic candy wrapper aspiration is questioned, radiographic studies may aid diagnosis. An infant with repeated chest radiographs negative for a metallic foreign body was found to have a multi-layer metallic candy wrapper in the left main bronchus. The purpose of this study was-to determine whether conventional and dual-energy radiographic techniques exclude the presence of aspirated metallic foil wrappers. Methods: Single-layer and multi-layer metallic candy wrappers were radiographically studied with conventional and dual-energy radiographic techniques in 3 tissue models. Results: No single-layer metallic samples were detectable with conventional or dual-energy radiography. The multilayer samples were not detectable at less than 8 layers (pulmonary tissue model) or 16 layers (mediastinal model) by either conventional or dual-energy radiography. Conclusions: Conventional and dual-energy chest radiographic techniques do not reliably exclude the presence of aspirated metallic foil wrappers. C1 Univ Wisconsin, Ctr Clin Sci 54 712, Dept Surg Orgill Pas, Div Otolaryngol Head & Neck Surg, Madison, WI 53792 USA. Univ Wisconsin, Dept Radiol, Madison, WI 53792 USA. RP Pasic, TR (reprint author), Univ Wisconsin, Ctr Clin Sci 54 712, Dept Surg Orgill Pas, Div Otolaryngol Head & Neck Surg, 600 Highland Ave, Madison, WI 53792 USA. CR ABDULMAJID O, 1976, THORAX, V31, P635, DOI 10.1136/thx.31.6.635 BANKS LM, 2001, GRAINGER ALLISONS DI, P185 BURRINGTON JD, 1976, JAMA-J AM MED ASSOC, V235, P2614, DOI 10.1001/jama.235.24.2614 Cantu S, 2001, CLIN PEDIATR, V40, P677, DOI 10.1177/000992280104001206 CASSELBRANT ML, 2003, PEDIAT OTOLARYNGOLOG, P1379 Darrow DH, 2003, PEDIAT OTOLARYNGOLOG, P1543 Dyleski RA, 2004, PEDIATRICS, V113, P176, DOI 10.1542/peds.113.1.176 HELLER RM, 1974, PEDIATRICS, V54, P684 HOLINGER LD, 2004, NELSON TXB PEDIAT, P1410 Hunter TB, 2003, RADIOGRAPHICS, V23, P731, DOI 10.1148/rg.233025137 Jefferson T, 1999, JAMA-J AM MED ASSOC, V281, P122, DOI 10.1001/jama.281.2.122 LOSEK JD, 1990, AM J EMERG MED, V8, P348, DOI 10.1016/0735-6757(90)90094-G MU LC, 1991, LARYNGOSCOPE, V101, P657 ROGERS LF, 1975, JAMA-J AM MED ASSOC, V233, P345, DOI 10.1001/jama.233.4.345 Silva AB, 1998, ANN OTO RHINOL LARYN, V107, P834 THOMAS SH, 2002, ROSENS EMERGENCY MED, P752 Younger RM, 2001, ARCH OTOLARYNGOL, V127, P1371 NR 17 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 419 EP 424 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900001 PM 16042097 ER PT J AU Halum, SL Patel, N Smith, TL Jaradeh, S Toohill, RJ Merati, AL AF Halum, SL Patel, N Smith, TL Jaradeh, S Toohill, RJ Merati, AL TI Laryngeal electromyography for adult unilateral vocal fold immobility: A survey of the American broncho-esophagological association SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE laryngeal electromyography; vocal fold immobility; vocal fold paralysis AB Objectives: Diagnostic and management strategies for adult unilateral vocal fold immobility (UVFI) vary among oto-laryngologists. The aim of this study was to determine the current attitudes and practices regarding laryngeal electromyography (LEMG) for the management of adult UVFI within a cohort of subspecialty laryngologists. Methods: A 19-item instrument focused on diagnosis and management of adult UVFI was mailed to active members (n = 249) of the American Broncho-Esophagological Association (ABEA). The subset of questions related to LEMG is reviewed in this report. Statistical analysis using a X-2 test was performed. Results: The survey response rate was 34% (n = 84), with 8 surveys returned incomplete because of pediatric-limited practices. Of the respondents, 75% (n = 57) rely on LEMG for evaluation of UVFI, whereas 25% (n = 19) do not use LEMG. Of those who use LEMG, 54% place their own electrodes and 44% interpret the LEMG results themselves. Monopolar electrodes are used by 57% (n = 25), bipolar electrodes by 27% (n = 12), and hooked-wire electrodes by 17% (n = 7). Muscles evaluated by LEMG include the thyroarytenoid (100%), cricothyroid (94%), posterior cricoarytenoid (70%), lateral cricoarytenoid (43%), cricopharyngeus (27%), and interarytenoid (17%). The LEMG is performed in an unblinded fashion by most respondents (85%), and many (66%) feel a more accurate result is obtained when clinical information is known. There was no statistically significant difference in use of LEMG, placement of electrodes, and interpretation of LEMG according to percentage of laryngology practice. Conclusions: The survey results demonstrate congruence among ABEA members in the utility of LEMG in the management of adult UVFI. Some variability was noted in the methods by which LEMG is performed and interpreted. C1 Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Milwaukee, WI 53226 USA. Med Coll Wisconsin, Dept Neurol, Milwaukee, WI 53226 USA. RP Merati, AL (reprint author), Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, 9200 W Wisconsin Ave, Milwaukee, WI 53226 USA. CR DEDO HH, 1969, ANN OTO RHINOL LARYN, V78, P172 HILLEL AD, 2001, LARYNGOSCOPE S97, V111 Hirano M, 1987, NEUROLARYNGOLOGY REC, P232 Kimura J, 1989, ELECTRODIAGNOSIS DIS Koufman JA, 1998, PHONOSCOPE, V1, P57 Koufman JA, 2001, OTOLARYNG HEAD NECK, V124, P603, DOI 10.1067/mhn.2001.115856 LUDLOW CL, 1994, ANN OTO RHINOL LARYN, V103, P16 Woo P, 1998, ARCH OTOLARYNGOL, V124, P472 NR 8 TC 15 Z9 15 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 EI 1943-572X J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 425 EP 428 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900002 PM 16042098 ER PT J AU Omori, K Nakamura, T Kanemaru, S Asato, R Yamashita, M Tanaka, S Magrufov, A Ito, J Shimizu, Y AF Omori, K Nakamura, T Kanemaru, S Asato, R Yamashita, M Tanaka, S Magrufov, A Ito, J Shimizu, Y TI Regenerative medicine of the trachea: The first human case SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE airway reconstruction; in situ tissue engineering; regenerative medicine; trachea ID COLLAGEN SPONGE; SUBGLOTTIC STENOSIS; PROSTHESIS; RECONSTRUCTION; REPAIR AB Objectives: The objective of the present study was to demonstrate regenerative medicine of the tracheal tissue by using an in situ tissue engineering technique for airway reconstruction. Methods: Based on the previous successful experimental animal studies, the current regenerative technique was applied to repair of the trachea of a 78-year-old woman with thyroid cancer. A Marlex mesh tube covered by collagen sponge was used as a tissue scaffold. The operative intervention included right hemithyroidectomy, resection of the trachea, and tracheoplasty using the scaffold. The right half of three rings of the trachea was resected, and the scaffold material was sutured to the defect of the trachea. Results: After 2 weeks, the mesh collagen structure of the artificial material could be seen with endoscopy in most of the implanted area. The artificial material was covered with epithelial growth after 2 months. Epithelialization continued to cover the artificial material completely for 2 years without any complications. Conclusions: The current regenerative technique avoided tracheotomy, a second operation, and deformity. Good epithelialization has been observed on the tracheal luminal surface without any complications for 2 years. Although long-term observation is required, regenerative medicine of the tracheal tissue appears feasible for airway reconstruction. C1 Fukushima Med Univ, Dept Otolaryngol, Sch Med, Fukushima 9601295, Japan. Kyoto Univ, Dept Bioartificial Organs, Inst Frontier Med Sci, Kyoto, Japan. Kyoto Univ, Dept Otolaryngol Head & Neck Surg, Postgrad Med Sch, Kyoto, Japan. RP Omori, K (reprint author), Fukushima Med Univ, Dept Otolaryngol, Sch Med, 1 Hikarigaoka, Fukushima 9601295, Japan. RI Yamashita, Masaru/B-2411-2009 CR Bianco P, 2001, NATURE, V414, P118, DOI 10.1038/35102181 Breuing K, 1997, PLAST RECONSTR SURG, V100, P657, DOI 10.1097/00006534-199709000-00018 CAPUTO V, 1961, J THORAC CARDIOV SUR, V41, P594 Cotton RT, 2000, OTOLARYNG CLIN N AM, V33, P111, DOI 10.1016/S0030-6665(05)70210-3 Hori Y, 2001, ASAIO J, V47, P206, DOI 10.1097/00002480-200105000-00008 Hori Y, 2001, INT J ARTIF ORGANS, V24, P50 Nakamura T, 2000, INT J ARTIF ORGANS, V23, P718 NEVILLE WE, 1990, J THORAC CARDIOV SUR, V99, P604 Omori K, 2004, ANN OTO RHINOL LARYN, V113, P623 RUOSLAHTI E, 1985, ARTERIOSCLEROSIS, V5, P581 TERAMACHI M, 1995, ASAIO J, V41, pM306, DOI 10.1097/00002480-199507000-00019 Teramachi M, 1997, J THORAC CARDIOV SUR, V113, P701, DOI 10.1016/S0022-5223(97)70227-7 Teramachi M, 1997, ANN THORAC SURG, V64, P965, DOI 10.1016/S0003-4975(97)00755-8 Yamamoto Y, 1999, J THORAC CARDIOV SUR, V118, P276, DOI 10.1016/S0022-5223(99)70218-7 NR 14 TC 81 Z9 88 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 429 EP 433 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900003 PM 16042099 ER PT J AU Cantarella, G Fasano, V Bucchioni, E Maraschi, B Cesana, BM AF Cantarella, G Fasano, V Bucchioni, E Maraschi, B Cesana, BM TI Variability of specific airway resistance in patients with laryngeal hemiplegia SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE breathiness; laryngeal hemiplegia; plethysmography; specific airway resistance; spirometry; upper airway obstruction ID FLOW-VOLUME LOOP; OBSTRUCTION; DISEASE AB Objectives: This study was designed to analyze whether respiratory flows and specific airway resistance (sRaw) depend on the degree of breathiness and on the position of the paralyzed vocal fold in laryngeal hemiplegia. Methods: We performed a prospective study involving 55 patients affected by laryngeal hemiplegia. Results: The paralyzed fold was in an intermediate position in 18 cases and in a paramedian position in 37. Breathiness was estimated with the GRBAS scale, and the patients were divided into four groups: Bo (12 patients), B 1 (14), 132 (16) and B-3 (13). Spirometry was used to measure the flow-volume loop, and body plethysmography was used to measure the sRaw at increasing respiratory frequencies (30 5, 60 5, and 90 5 breaths per minute). The mean inspiratory flows (PIF, FIF50) were lower than predicted (< 80%) in all four groups; there was no significant intergroup difference. In all four groups, the mean FEF50/FIF50 ratio was > 1, as is typical of variable extrathoracic obstruction. The mean sRaw values increased with respiratory frequency, and the increase was higher in group B-3, although the values varied widely. The frequency-dependent increase in the sRaw value was not significantly related to the degree of breathiness, nor to the position of the paralyzed fold. Furthermore, Spearman's coefficient did not reveal any correlation between the sRaw values and inspiratory flows, showing that plethysmography and spirometry explore different aspects of airway function. Conclusions: Respiratory flows and sRaw are not significantly influenced by either the degree of breathiness or the position of the paralyzed vocal fold. C1 Osped Maggiore Policlin, Dept Otolaryngol, Fdn IRCCS, Ist Ricovero & Cura & Carattere Sci, Milan, Italy. Osped Maggiore Policlin, Dept Resp Dis, Fdn IRCCS, Ist Ricovero & Cura & Carattere Sci, Milan, Italy. Univ Brescia, Sect Med Stat & Biometry, Brescia, Cesana, Italy. RP Cantarella, G (reprint author), Osped Maggiore, UO Otorinolaringoiatria, Via F Sforza 35, I-20122 Milan, Italy. CR BARTER CE, 1973, RESPIRATION, V30, P1 BASS H, 1973, CHEST, V63, P171, DOI 10.1378/chest.63.2.171 Cantarella G, 2003, ANN OTO RHINOL LARYN, V112, P1014 DUBOIS AB, 1956, J CLIN INVEST, V35, P327, DOI 10.1172/JCI103282 ENGLAND SJ, 1982, J APPL PHYSIOL, V52, P780 Fasano V, 2001, EUR RESPIR J, V18, P1003, DOI 10.1183/09031936.01.00061501 Hirano M., 1981, CLIN EXAMINATION VOI, P81 HOGG JC, 1969, J CLIN INVEST, V48, P421, DOI 10.1172/JCI105999 KASHIMA HK, 1984, LARYNGOSCOPE, V94, P923 KRELL WS, 1984, J APPL PHYSIOL, V57, P1917 Macklem PT, 1998, AM J RESP CRIT CARE, V157, pS181 MACKLEM PT, 1967, J APPL PHYSIOL, V22, P395 Quanjer P H, 1993, Eur Respir J Suppl, V16, P5 SCHIRATZKI H, 1965, ACTA OTOLARYNGOL STO, V59, P474 STANESCU DC, 1972, J APPL PHYSIOL, V32, P460 TATTERSFIELD AE, 1979, BRIT J CLIN PHARMACO, V8, P307 NR 16 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 434 EP 438 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900004 PM 16042100 ER PT J AU Har-El, G AF Har-El, G TI Combined endoscopic transmaxillary-transnasal approach to the pterygoid region, lateral sphenoid sinus, and retrobulbar orbit SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE encephalocele; orbit; pterygopalatine fossa; sphenoid sinus ID PTERYGOPALATINE FOSSA AB Objectives: The sublabial transmaxillary approach to the pterygoid region was a popular one during the Caldwell-Luc, pre-endoscopic era. It was the procedure of choice for management of lesions of the pterygopalatine space, for internal maxillary artery ligation, and for vidian neurectomy. With the introduction of endoscopic instrumentation and techniques, the Caldwell-Luc procedure is rarely performed today. Also, because vidian neurectomy is performed less frequently, and because internal maxillary artery ligation for severe epistaxis has been replaced with transnasal endoscopic sphenopalatine artery ligation, the sublabial transmaxillary route is rarely used. We have found that combining the use of endoscopes via the sublabial approach and the transnasal endoscopic approach is very helpful for management of extreme lateral lesions of the sphenoid sinus, as well as the pterygoid region and the posterior orbit. Methods: The records of patients who underwent a combined endoscopic transmaxillary-transnasal approach between 1994 and 2002 were reviewed. Indications for the procedure included extreme lateral sphenoid and pterygoid encephalocele (3 patients), pterygoid mucocele (2 patients), orbital apex lesion (2 patients), and pterygopalatine tumor (2 patients). Results: Nine patients underwent the above-mentioned procedure. Wide and comfortable exposure of the involved region was achieved in all cases. Compared with the transnasal approach, the working distance, working comfort, and maneuverability of instruments were significantly enhanced. There were no major complications related to the approach. Because the maxillary wall opening is very small, infraorbital hypoesthesia is very limited and of short duration. Conclusions: Combining the transmaxillary and transnasal approaches for endoscopic management of pterygoid, lateral sphenoid, and retrobulbar orbit lesions provides excellent exposure and avoids the limited working angle and surgical struggle that may be associated with the use of the transnasal approach alone. C1 SUNY Hlth Sci Ctr, Dept Otolaryngol, Brooklyn, NY 11203 USA. SUNY Hlth Sci Ctr, Dept Neurosurg, Brooklyn, NY 11203 USA. Othmer Canc Ctr, Brooklyn, NY 11203 USA. RP Har-El, G (reprint author), Long Isl Coll Hosp, Dept Otolaryngol, 134 Atlantic Ave, Brooklyn, NY 11201 USA. CR Bolger WE, 1999, ENT-EAR NOSE THROAT, V78, P36 DelGaudio JM, 2003, ARCH OTOLARYNGOL, V129, P441, DOI 10.1001/archotol.129.4.441 HAREL G, 2004, SKULL BASE S1, V14, P10 Klossek J. M., 1994, Rhinology (Utrecht), V32, P208 Lane AP, 2003, OP TECH OTOLARYNGOL, V14, P212, DOI 10.1016/S1043-1810(03)90028-5 Lane AP, 2002, AM J RHINOL, V16, P109 Pasquini E, 2002, AM J RHINOL, V16, P113 NR 7 TC 34 Z9 35 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 439 EP 442 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900005 PM 16042101 ER PT J AU Speyer, R Wieneke, GH Kersing, W Dejonckere, PH AF Speyer, R Wieneke, GH Kersing, W Dejonckere, PH TI Accuracy of measurements on digital videostroboscopic images of the vocal folds SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE accuracy; digitized image; laryngostroboscopy; measurement error; vocal fold ID THYROPLASTY TYPE-I; RELIABILITY; SYSTEM; VOCIM AB Objectives: The reliability of objective measurements on digital laryngeal images was investigated. Methods: The magnitude of the error of measurement of surface areas by visually tracing the outline was determined for three different areas: the area of the lesion and, during vibration, the glottal area on maximal opening of the vocal folds and the glottal area on maximal closing of the vocal folds. Results: The errors in these areas were 10% to 30%. The results suggest that the error is mainly due to the uncertainty of the real outline of areas with a vague boundary. Correction for differences in magnification between two images (posttherapy and pretherapy) is of importance in about 25% to 65% of cases, depending on the area measured. Conclusions: Only when the magnification ratio is small (less than about 10% from 1.0) may a correction not be necessary. C1 Univ Utrecht, Ctr Med, Inst Phoniatr, Utrecht, Netherlands. RP Speyer, R (reprint author), Univ Hosp Maastrciht, Dept Otorhinolaryngol Head & Neck Surg, POB 5800, NL-6202 AZ Maastricht, Netherlands. RI Speyer, Renee/H-1104-2013 CR BJORCK G, 1999, LOGOPEDICS PHONIATRI, V24, P127, DOI 10.1080/140154399435075 COLTON R H, 1989, Journal of Voice, V3, P132, DOI 10.1016/S0892-1997(89)80139-0 DANTONIO LL, 1995, LARYNGOSCOPE, V105, P256, DOI 10.1288/00005537-199503000-00007 Goncalves MI, 1998, J VOICE, V12, P143, DOI 10.1016/S0892-1997(98)80033-7 Hanson DG, 1998, J VOICE, V12, P78 Hibi SR, 1988, J VOICE, V2, P168, DOI 10.1016/S0892-1997(88)80073-0 Jeannon JP, 1998, CLIN OTOLARYNGOL, V23, P351 Johnson IJM, 1996, CLIN OTOLARYNGOL, V21, P308, DOI 10.1111/j.1365-2273.1996.tb01076.x Omori K, 1997, ANN OTO RHINOL LARYN, V106, P544 Omori K, 1996, ANN OTO RHINOL LARYN, V105, P280 PEPPARD RC, 1990, J VOICE, V4, P280, DOI 10.1016/S0892-1997(05)80023-2 Poburka BJ, 1999, J VOICE, V13, P403, DOI 10.1016/S0892-1997(99)80045-9 POBURKA BJ, 1998, J VOICE, V4, P513 Rosenberger D. A., 2003, Plant Health Progress, P1, DOI 10.1094/PHP-2003-0826-01-RV Schuberth S, 2002, LARYNGOSCOPE, V112, P1043, DOI 10.1097/00005537-200206000-00020 SERCARZ JA, 1991, ARCH OTOLARYNGOL, V117, P871 SHROUT PE, 1979, PSYCHOL BULL, V86, P420, DOI 10.1037//0033-2909.86.2.420 Speyer R, 2002, ANN OTO RHINOL LARYN, V111, P902 SPEYER R, 2003, THESIS U UTRECHT Sulter AM, 1996, J VOICE, V10, P175, DOI 10.1016/S0892-1997(96)80045-2 WOO P, 1996, LARYNGOSCOPE S79, V106 NR 21 TC 5 Z9 5 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 443 EP 450 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900006 PM 16042102 ER PT J AU Hahn, MS Kobler, JB Zeitels, SM Langer, R AF Hahn, MS Kobler, JB Zeitels, SM Langer, R TI Midmembranous vocal fold lamina propria proteoglycans across selected species SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE animal model; human; lamina propria; proteoglycan; vocal fold ID FIBROBLAST-GROWTH-FACTOR; MONOCLONAL-ANTIBODIES; EXTRACELLULAR-MATRIX; LUNG FIBROBLASTS; SULFATE; GLYCOSAMINOGLYCANS; EXPRESSION; CARTILAGE; HYALURONAN; MODULATION AB Objectives: We examined the proteoglycan (PG) and associated sulfated glycosaminoglycan (GAG) content of the midmembranous vocal fold lamina propria (LP) of humans, dogs, pigs, and ferrets. Methods: The LP PG levels were assessed indirectly by quantifying the associated sulfated GAGs, and immunohistochemical analyses of specific PGs and/or GAGs (PGs/GAGs) were conducted. Results: Sulfated GAGs constituted approximately (average SEM) 14.7 +/- 2.1 mu g per milligram of tissue total protein in the human LP - similar to levels in canine, porcine, and ferret LPs (p >.05). Immunohistochemical analysis identified versican, chondroitin 4- and 6-sulfate, and heparan sulfate in the LP extracellular matrix - PGs/GAGs previously believed to be localized only intracellularly and in the basement membrane. Observations of PG/GAG staining patterns resulted in identification of micro structurally based subdivisions of canine, porcine, and ferret LPs. Conclusions: The sulfated GAG concentration in human LP was similar to that of dermis. In contrast to the interspecies similarity in LP sulfated GAG levels, immurohistochemical analysis indicated notable interspecies differences in specific PG/GAG distributions. Moreover, spatial variations in the presence of several PGs/GAGs were observed - variations that may be integral in maintaining normal LP physiology. Finally, the noted canine, porcine, and ferret LP subdivisions may yield insight into the adaptation of LP microstructure to the phonatory needs of each species. C1 Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Dept Thorac Surg, Boston, MA 02114 USA. MIT, Dept Elect Engn & Comp Sci, Cambridge, MA 02139 USA. MIT, Dept Chem Engn, Cambridge, MA 02139 USA. RP Zeitels, SM (reprint author), Massachusetts Gen Hosp, Ctr Laryngeal Surg & Voice Rehabil, Dept Thorac Surg, 1 Bowdoin Sq,11th Floor, Boston, MA 02114 USA. CR Ashikari-Hada S, 2004, J BIOL CHEM, V279, P12346, DOI 10.1074/jbc.M313523200 BOAK AM, 1994, AM J RESP CELL MOL, V11, P751 BRETTELL LM, 1994, AM J RESP CELL MOL, V10, P306 CATERSON B, 1985, FED PROC, V44, P386 CATERSON B, 1983, J BIOL CHEM, V258, P8848 CATERSON B, 1990, J CELL SCI, V97, P411 CHAKRAVARTI S, 2003, GLYCOCONJ J, V19, P287 Costell M, 1999, J CELL BIOL, V147, P1109, DOI 10.1083/jcb.147.5.1109 COUCHMAN JR, 1984, NATURE, V307, P650, DOI 10.1038/307650a0 DAVID G, 1992, J CELL BIOL, V119, P961, DOI 10.1083/jcb.119.4.961 DAVIDSON JM, 1993, J CELL PHYSIOL, V155, P149, DOI 10.1002/jcp.1041550119 Dennissen MABA, 2002, J BIOL CHEM, V277, P10982, DOI 10.1074/jbc.M104852200 Erickson AC, 2001, MATRIX BIOL, V19, P769, DOI 10.1016/S0945-053X(00)00126-8 Garg HG, 1996, CARBOHYD RES, V284, P223, DOI 10.1016/0008-6215(95)00403-3 Garrett CG, 2000, LARYNGOSCOPE, V110, P814, DOI 10.1097/00005537-200005000-00011 Goldsmith LA, 1991, PHYSL BIOCH MOL BIOL Gray SD, 1999, LARYNGOSCOPE, V109, P845, DOI 10.1097/00005537-199906000-00001 Hirano M, 1985, SPEECH SCI, P1 HIRANO M, 1974, FOLIA PHONIATR, V26, P89 Hirano S, 2003, ANN OTO RHINOL LARYN, V112, P617 Hocking AM, 1998, MATRIX BIOL, V17, P1 Iozzo RV, 1998, ANNU REV BIOCHEM, V67, P609, DOI 10.1146/annurev.biochem.67.1.609 Kielty CM, 2002, J CELL SCI, V115, P2817 LAURENT TC, 1992, FASEB J, V6, P2397 MADSEN K, 1979, ARCH BIOCHEM BIOPHYS, V196, P192, DOI 10.1016/0003-9861(79)90566-6 Miserocchi G, 2001, NEWS PHYSIOL SCI, V16, P66 Pawlak AS, 1996, ANN OTO RHINOL LARYN, V105, P6 POOLE AR, 1986, BIOCHEM J, V236, P1 Redaelli A, 2003, J BIOMECH, V36, P1555, DOI 10.1016/S0021-9290(03)00133-7 Sato K, 1998, ANN OTO RHINOL LARYN, V107, P1023 Seibel MJ, 1999, DYNAMICS BONE CARTIL Theocharis AD, 2003, INT J BIOCHEM CELL B, V35, P376, DOI 10.1016/S1357-2725(02)00264-9 Thibeault SL, 2002, ANN OTO RHINOL LARYN, V111, P8 WIGHT TN, 1991, PROTEOGLYCANS STRUCT NR 34 TC 28 Z9 29 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 451 EP 462 PG 12 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900007 PM 16042103 ER PT J AU Gerein, V Rastorguev, E Gerein, J Jecker, P Pfister, H AF Gerein, V Rastorguev, E Gerein, J Jecker, P Pfister, H TI Use of interferon-alpha in recurrent respiratory papillomatosis: 20-year follow-up SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE adjuvant therapy; human papillornavirus; interferon-alpha; multicenter study; recurrent respiratory papillomatosis ID JUVENILE LARYNGEAL PAPILLOMATOSIS; HUMAN-PAPILLOMAVIRUS; LEUKOCYTE INTERFERON; CLINICAL-COURSE; THERAPY; CIDOFOVIR; ASSOCIATION; IFN; DNA AB Objectives: The aim of this study was analysis of the results of use of interferon-alpha (IFN-alpha) in patients with recurrent respiratory papillomatosis (RRP) and correlation of the results with human papillomavirus (HPV) type. Methods: A multicenter prospective series (42 patients from 22 hospitals) yielded 20 years of follow-up of patients with RRP and HPV typing who were treated with IFN-a in doses of 3 MU/m(2) 3 times per week. Results: During long-term follow-up (mean SD, 172 +/- 36.8 months), the rate of event-free survival evaluated by Kaplan-Meier analysis was 42.8%, and the overall survival rate was 82.6%. The HPV typing revealed an association of HPV 11 with a more aggressive disease course (64% of HPV I I patients versus 24% of HPV 6 patients), a lower incidence of long-term response to IFN-alpha therapy (14% of HPV 11 patients versus 64% of HPV 6 patients), and a higher incidence of malignant transformation and mortality during follow-up (36% and 24%, respectively, of HPV I I patients versus 0% of HPV 6 patients). Conclusions: The obtained results revealed maximal effectiveness of IFN-alpha therapy in RRP patients with HPV 6 as compared with HPV 11. The association of HPV I I with a worse long-term response to IFN-alpha therapy and a higher incidence of malignant transformation and mortality is clinically important and indicates the necessity of HPV typing in RRP patients after the first biopsy. C1 Univ Mainz, Dept Pediat Pathol, Inst Pathol, D-55101 Mainz, Germany. Univ Mainz, Sch Med, Dept Otorhinolaryngol Head & Neck Surg, D-55101 Mainz, Germany. Univ Frankfurt, Pediat Clin, D-6000 Frankfurt, Germany. Univ Cologne, Inst Virol, Cologne, Germany. RP Gerein, V (reprint author), Univ Mainz, Dept Pediat Pathol, Inst Pathol, Langenbeckstr 1, D-55101 Mainz, Germany. CR Aaltonen LM, 2002, LARYNGOSCOPE, V112, P700, DOI 10.1097/00005537-200204000-00020 Armbruster C, 2001, EUR RESPIR J, V17, P830, DOI 10.1183/09031936.01.17408300 Armstrong LR, 1999, ARCH OTOLARYNGOL, V125, P743 Bergler WF, 2000, EUR ARCH OTO-RHINO-L, V257, P263, DOI 10.1007/s004050050236 Cook JR, 2000, MODERN PATHOL, V13, P914, DOI 10.1038/modpathol.3880164 Dedo HH, 2001, LARYNGOSCOPE, V111, P1639, DOI 10.1097/00005537-200109000-00028 Deunas L, 1997, J LARYNGOL OTOL, V111, P134 Gabbott M, 1997, J CLIN MICROBIOL, V35, P3098 Garcia-Milian R, 1999, CYTOKINES CELL MOL T, V5, P79 GEREIN V, 1986, BLUT, V53, P230 GEREIN V, 1989, KURZ 60 JAHR DTSCH G, P96 GEREIN V, 1987, KLIN PADIATR, V199, P224, DOI 10.1055/s-2008-1026794 GISSMANN L, 1984, J INVEST DERMATOL, V83, P26 GISSMANN L, 1983, P NATL ACAD SCI-BIOL, V80, P560, DOI 10.1073/pnas.80.2.560 GLANZ H, 1997, INT CONGR SER, V1128, P3 HAGLUND S, 1981, ARCH OTOLARYNGOL, V107, P327 HEALY GB, 1988, NEW ENGL J MED, V319, P401, DOI 10.1056/NEJM198808183190704 Hester RP, 2003, INT J PEDIATR OTORHI, V67, P505, DOI 10.1016/S0165-5876(03)00007-7 Johnson JA, 2003, ANTIMICROB AGENTS CH, V47, P2022, DOI 10.1128/AAC.47.6.2022-2026.2003 Johnson T, 2003, APMIS, V111, P398, DOI 10.1034/j.1600-0463.2003.t01-1-1110204.x KASHIMA H, 1985, PAPILLOMAVIRUSES MOL, P125 Kimberlin David W, 2002, Expert Opin Pharmacother, V3, P1091, DOI 10.1517/14656566.3.8.1091 KORNHUBER B, 1983, MONATSSCHR KINDERH, V131, P680 LEVENTHAL BG, 1991, NEW ENGL J MED, V325, P613, DOI 10.1056/NEJM199108293250904 LODEMANN E, 1984, J INTERFERON RES, V4, P283, DOI 10.1089/jir.1984.4.283 MOUNTS P, 1984, LARYNGOSCOPE, V94, P28 Naiman AN, 2004, LARYNGOSCOPE, V114, P1151, DOI 10.1097/00005537-200407000-00004 Pransky SM, 2003, LARYNGOSCOPE, V113, P1583, DOI 10.1097/00005537-200309000-00032 Rabah R, 2001, PEDIATR DEVEL PATHOL, V4, P68, DOI 10.1007/s100240010105 Rady PL, 1998, LARYNGOSCOPE, V108, P735, DOI 10.1097/00005537-199805000-00021 Rimell FL, 1997, LARYNGOSCOPE, V107, P915, DOI 10.1097/00005537-199707000-00015 SCHOUTEN TJ, 1982, LARYNGOSCOPE, V92, P686 Schraff S, 2004, ARCH OTOLARYNGOL, V130, P1039, DOI 10.1001/archotol.130.9.1039 Shykhon M, 2002, CLIN OTOLARYNGOL, V27, P237, DOI 10.1046/j.1365-2273.2002.00555.x Tóthová E, 2002, Vnitr Lek, V48, P380 Worle H, 1999, EUR J PEDIATR, V158, P344, DOI 10.1007/s004310051089 NR 36 TC 35 Z9 36 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 463 EP 471 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900008 PM 16042104 ER PT J AU Chandarana, S Parnes, L Agrawal, S Fung, K AF Chandarana, S Parnes, L Agrawal, S Fung, K TI Quality of life following small fenestra stapedotomy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE otosclerosis; quality of life; questionnaire; stapes surgery ID HEARING HANDICAP INVENTORY; TOTAL STAPEDECTOMY; PSYCHOSOCIAL IMPACT; OTOSCLEROSIS; SURGERY AB Objectives: A cross-sectional observational study was designed to evaluate patient satisfaction after stapedotomy. Methods: Two validated questionnaires, the Psychosocial Impact of Assistive Devices Scale (PIADS) and the Hearing Handicap Inventory (HHI), were used to assess patients for whom audiometric data were available. Results: The response rate was 79%. The PIADS score showed that 96% of patients reported an improvement in quality of life. The HHI score, however, showed that 32% of patients still experienced a marked degree of handicap after surgery. The HHI scores correlated positively with postoperative audiometric data, and the PIADS scores correlated positively with the degree of change in audiometric data. Conclusions: The results of this study support the role of small fenestra stapedotomy as a primary treatment for otosclerosis. The study also identifies a certain subpopulation of patients with residual handicap who may require further aural rehabilitation. C1 Univ Western Ontario, Dept Otolaryngol, London Hlth Sci Ctr, London, ON N6A 5A5, Canada. RP Parnes, L (reprint author), Univ Western Ontario, Dept Otolaryngol, London Hlth Sci Ctr, Univ Campus,339 Windermere Rd, London, ON N6A 5A5, Canada. CR Agrawal S, 2002, J OTOLARYNGOL, V31, P112, DOI 10.2310/7070.2002.19069 BESS FH, 1989, J SPEECH HEAR RES, V32, P795 CAUSSE JB, 1985, AM J OTOL, V6, P68 COLLETTI V, 1988, AM J OTOL, V9, P136 CREMERS CWRJ, 1991, ANN OTO RHINOL LARYN, V100, P959 Day H, 2002, DISABIL REHABIL, V24, P31, DOI 10.1080/09638280110066343 Day H, 1996, CANADIAN J REHABILIT, V9, P159 De Bruijn AJG, 1998, CLIN OTOLARYNGOL, V23, P123 DORNHOFFER JL, 1994, AM J OTOL, V15, P674 ELLWOOD PM, 1988, NEW ENGL J MED, V318, P1549, DOI 10.1056/NEJM198806093182329 FISCH U, 1982, AM J OTOL, V4, P112 HODDINOTT SN, 1986, CAN FAM PHYSICIAN, V32, P2366 Jutai J, 2000, ASSIST TECHNOL, V12, P123 KURSTEN R, 1994, AM J OTOL, V15, P804 Laitakari K, 1997, Acta Otolaryngol Suppl, V529, P50 MCGEE TM, 1981, ANN OTO RHINOL LARYN, V90, P633 MEYER SE, 2000, EAR NOSE THROAT J, V79, P854 Meyer S E, 2000, Ear Nose Throat J, V79, P846 MEYER SE, 2000, EAR NOSE THROAT J, V79, P851 Newman CW, 1997, ANN OTO RHINOL LARYN, V106, P210 NEWMAN CW, 1991, EAR HEARING, V12, P355, DOI 10.1097/00003446-199110000-00009 Noble W., 1978, ASSESSMENT IMPAIRED Persson P, 1997, ACTA OTO-LARYNGOL, V117, P94, DOI 10.3109/00016489709117998 Ramsay H, 1997, AM J OTOLARYNG, V18, P23, DOI 10.1016/S0196-0709(97)90044-2 Saunders Gabrielle H, 2004, J Am Acad Audiol, V15, P238, DOI 10.3766/jaaa.15.3.6 SHEA JJ, 1988, J LARYNGOL OTOL, V102, P14, DOI 10.1017/S0022215100103846 STEWART MG, 2000, LARYNGOSCOPE S94, V110 VENTRY IM, 1982, EAR HEARING, V3, P128, DOI 10.1097/00003446-198205000-00006 WEINSTEIN BE, 1984, AUDIOLOGY, V9, P91 NR 29 TC 5 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 472 EP 477 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900009 PM 16042105 ER PT J AU Van Daele, DJ McCulloch, TM Palmer, PM Langmore, SE AF Van Daele, DJ McCulloch, TM Palmer, PM Langmore, SE TI Timing of glottic closure during swallowing: A combined electromyographic and endoscopic analysis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE deglutition; electromyography; endoscopy; larynx ID LARYNGEAL; PHARYNGEAL; MUSCLES; COORDINATION; DEGLUTITION; CONSTRICTOR AB Objectives: We performed a case series to enhance our understanding of the coupling between neuromuscular events and glottic closure. Methods: We performed combined flexible video laryngoscopy and electromyography in 4 healthy human subjects. Hooked-wire electrodes were placed in the superior pharyngeal constrictor, longitudinal pharyngeal, cricopharyngeus, thyroarytenoid, genioglossus, suprahyoid, and posterior cricoarytenoid muscles. A flexible endoscope tip was positioned in the oropharyngeal-hypopharyngeal region. The subjects performed multiple trials each of 10-mL normal and super- supraglottic liquid swallows. Results: Arytenoid movement consistently preceded full glottic closure and was associated with cessation of activity of the posterior cricoarytenoid muscle. In 89% of normal swallows, the glottis was partially open in the video frame before bolus passage. The maximum amount of thyroarytenoid electromyographic activity occurred during endoscopic white-out. When subjects executed a super- supraglotti c swallow, early thyroarytenoid activity coincided with arytenoid contact. Conclusions: The initial medialization of the arytenoids is due to a decrease in motor tone of the posterior cricoarytenoid muscle. Full glottic closure typically occurs late in the process of swallowing, with activation of the thyroarytenoid muscle. Shifting of arytenoid medialization and glottic closure earlier in the super- supraglottic swallow indicates that glottic closure is under significant voluntary control. C1 Univ Iowa, Dept Otolaryngol Head & Neck Surg, Roy J & Lucille A Carver Coll Med, Iowa City, IA 52242 USA. RP Van Daele, DJ (reprint author), Univ Iowa, Dept Otolaryngol Head & Neck Surg, Roy J & Lucille A Carver Coll Med, 200 Hawkins Dr,21165 PFP, Iowa City, IA 52242 USA. RI Palmer, Phyllis/C-5921-2009 CR ANDERSON STP, 1891, P ROY SOC MED, V50, P323 ARDRAN GM, 1952, BRIT J RADIOL, V25, P406 ARDRAN GM, 1956, BRIT J RADIOL, V29, P205 Broniatowski M, 1997, DYSPHAGIA, V12, P93, DOI 10.1007/PL00009525 Cook I J, 1989, Dysphagia, V4, P8, DOI 10.1007/BF02407397 DOTY RW, 1956, J NEUROPHYSIOL, V19, P44 Dua KS, 1997, GASTROENTEROLOGY, V112, P73, DOI 10.1016/S0016-5085(97)70221-X EKBERG O, 1982, ACTA OTO-LARYNGOL, V93, P123, DOI 10.3109/00016488209130862 ELIDAN J, 1990, ANN OTO RHINOL LARYN, V99, P466 FINK B R, 1956, Trans Am Acad Ophthalmol Otolaryngol, V60, P117 FLAHERTY RF, 1995, GASTROENTEROLOGY, V109, P843, DOI 10.1016/0016-5085(95)90393-3 GAY T, 1994, LARYNGOSCOPE, V104, P341 HIRANO M, 1969, J SPEECH HEAR RES, V12, P362 HIROSE J, 1981, VOCAL FOLD PHYSL CON, P253 Johnstone AS, 1942, J ANAT, V77, P97 Martin Bonnie J. W., 1993, Dysphagia, V8, P11, DOI 10.1007/BF01351472 McCulloch T. M., 1997, Dysphagia, V12, P111 McCulloch TM, 1996, LARYNGOSCOPE, V106, P1351, DOI 10.1097/00005537-199611000-00009 McCulloch TM, 1997, LARYNGOSCOPE, V107, P146 MENDELSOHN MS, 1993, ANN OTO RHINOL LARYN, V102, P941 Ohmae Y, 1996, ANN OTO RHINOL LARYN, V105, P123 Ohmae Y, 1998, ANN OTO RHINOL LARYN, V107, P344 OHMAE Y, 1995, HEAD NECK-J SCI SPEC, V17, P394, DOI 10.1002/hed.2880170506 Palmer PM, 1999, J SPEECH LANG HEAR R, V42, P1378 Perlman AL, 1999, J APPL PHYSIOL, V86, P1663 PERLMAN AL, 1989, J SPEECH HEAR RES, V32, P749 Perlman AL, 1993, J MED SPEECH-LANG PA, V11, P223 RAMSEY GH, 1955, RADIOLOGY, V64, P498 SHAKER R, 1990, GASTROENTEROLOGY, V98, P1478 NR 29 TC 17 Z9 17 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 478 EP 487 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900010 PM 16042106 ER PT J AU Fleischer, S Schade, G Hess, MM AF Fleischer, S Schade, G Hess, MM TI Office-based laryngoscopic observations of recurrent laryngeal nerve paresis and paralysis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 31st Annual Voice-Foundation Symposium on Care of the Professional Voice CY JUN, 2002 CL Philadelphia, PA SP Voice Fdn DE arytenoid cartilage; recurrent laryngeal nerve disorder; videolaryngoscopy; vocal fold paralysis; vocal fold paresis; vocal process ID CONFIGURATION; INNERVATION; STROBOSCOPY; ANATOMY; GLOTTIS; MUSCLE AB Objectives: To evaluate the endoscopic criteria of recurrent laryngeal nerve disorders, we performed a retrospective evaluation of videolaryngoscopic recordings from 50 patients with recurrent laryngeal nerve disorders. Methods: The videolaryngoscopic examination was performed with rigid and flexible endoscopes. The range of motion of three laryngeal structures was assessed: the vocal ligament, the vocal process, and the arytenoid "hump" (mainly the corniculate region). Results: Comparison of movement of these three structures revealed discrepancies. In 16 of 45 patients (36%) rigid endoscopy showed movements of the arytenoid hump associated with absence of any mobility of the vocal process and vocal ligament. In 5 patients the extent of movement of the vocal process and vocal ligament was less than that of the arytenoid hump. Only in 24 of 45 cases were the ratings for the vocal process, vocal ligament, and arytenoid hump identical. The findings of fiberscopy were comparable. Conclusions: In assessing recurrent laryngeal nerve disorders via laryngoscopy, sole judgment of the arytenoid hump movement can mislead. Our interpretation suggests that visible movement of the mucosa covering the arytenoid and accessory cartilages is not always paralleled by movement of the arytenoid cartilage itself. It was shown that the best criterion to rely on in endoscopy is movement of the vocal process or the vocal ligament. C1 Univ Hamburg, Hosp Eppendorf, Dept Phoniatr & Pediat Audiol, D-20246 Hamburg, Germany. RP Fleischer, S (reprint author), Univ Hamburg, Hosp Eppendorf, Dept Phoniatr & Pediat Audiol, Martinistr 52, D-20246 Hamburg, Germany. CR BAKEN RJ, 1977, FOLIA PHONIATR, V29, P206 BRAUS H, 1954, ANATOMIE MENSCHEN, V1 Dursun G, 1996, J VOICE, V10, P206, DOI 10.1016/S0892-1997(96)80048-8 Eckel HE, 2001, HNO, V49, P166, DOI 10.1007/s001060050729 Fleischer S, 2003, HNO, V51, P160, DOI 10.1007/s00106-002-0796-4 MELLER SM, 1984, OTOLARYNG CLIN N AM, V17, P3 Nasri S, 1997, ANN OTO RHINOL LARYN, V106, P594 OLTHOFF A, 2002, AKT PHONIATR PADAUDI, V10, P99 Pinho SMR, 1999, J VOICE, V13, P36, DOI 10.1016/S0892-1997(99)80059-9 Reidenbach MM, 1998, EUR ARCH OTO-RHINO-L, V255, P365, DOI 10.1007/s004050050078 RETHI A, 1952, Folia Phoniatr (Basel), V4, P201 SANDERS I, 1993, ARCH OTOLARYNGOL, V119, P934 Sanders I, 1998, ANAT REC, V252, P646, DOI 10.1002/(SICI)1097-0185(199812)252:4<646::AID-AR15>3.0.CO;2-E Sanudo JR, 1999, LARYNGOSCOPE, V109, P983 Schade G, 2001, HNO, V49, P562, DOI 10.1007/s001060170084 VONLEDEN H, 1961, ARCHIV OTOLARYNGOL, V73, P541 WOODSON GE, 1993, LARYNGOSCOPE, V103, P1227 WOODSON GE, 1993, LARYNGOSCOPE, V103, P1235 NR 18 TC 4 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 488 EP 493 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900011 PM 16042107 ER PT J AU Berkowitz, RG Sun, QJ Pilowsky, PM AF Berkowitz, RG Sun, QJ Pilowsky, PM TI Congenital bilateral vocal cord paralysis and the role of glycine SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE glycine; larynx; motoneuron; strychnine; vocal cord paralysis ID INSPIRATORY ACTIVATION; VENTROLATERAL MEDULLA; RESPIRATORY NEURONS; INHIBITION; RAT; HYPEREKPLEXIA; ADDUCTOR; CAT; PATTERNS; MAMMALS AB Objectives: We sought to modify normal laryngeal constrictor (LC) motoneuron activity to induce a pattern of aberrant LC muscle function that may serve as a model of congenital bilateral vocal cord paralysis. Methods: Single unit extracellular recordings of functionally identified LC motoneurons were made in anesthetized Sprague-Dawley rats, and the response to both intravenous and iontophoretic application of the glycine antagonist strychnine was studied. Results: The postinspiratory firing pattern of LC motoneurons became inspiratory after intravenous injection of strychnine (4 of 5 rats), but no change was recorded in response to strychnine iontophoresis (7 of 8 rats). Conclusions: Blockade of glycinergic inhibitory neurotransmission by strychnine, acting above the level of the LC motoneuron, causes LC motoneurons to fire during inspiration rather than after inspiration. This observation suggests that impaired glycine neurotransmission may be an underlying mechanism that explains the clinical manifestations of congenital bilateral vocal cord paralysis. C1 Royal Childrens Hosp, Dept Otolaryngol, Parkville, Vic 3161, Australia. Royal Childrens Hosp, Dept Paediat, Parkville, Vic 3161, Australia. Univ Sydney, Dept Physiol, Hypertens & Stroke Res Labs, Sydney, NSW 2006, Australia. RP Berkowitz, RG (reprint author), Royal Childrens Hosp, Dept Otolaryngol, Flemington Rd, Parkville, Vic 3161, Australia. RI Pilowsky, Paul/G-7514-2011 CR BARILLOT JC, 1990, BRAIN RES, V509, P99, DOI 10.1016/0006-8993(90)90314-2 Berkowitz RG, 1996, ANN OTO RHINOL LARYN, V105, P207 Berkowitz RG, 2003, ANN OTO RHINOL LARYN, V112, P764 Berkowitz RG, 1998, ANN OTO RHINOL LARYN, V107, P75 Berkowitz RG, 2001, ANN OTO RHINOL LARYN, V110, P624 Busselberg D, 2001, PFLUG ARCH EUR J PHY, V441, P444, DOI 10.1007/s004240000453 DREIFUSS FE, 1982, ANTIEPILEPTIC DRUGS, P737 Dutschmann M, 2002, AM J PHYSIOL-REG I, V282, pR999, DOI 10.1152/ajpregu.00502.2001 Dutschmann M, 2002, RESP PHYSIOL NEUROBI, V131, P57, DOI 10.1016/S1569-9048(02)00037-X Dutschmann M, 2002, J PHYSIOL-LONDON, V543, P643, DOI 10.1113/jphysiol.2002.013466 Ezure K, 2003, J NEUROSCI, V23, P8941 GRUNDFAST KM, 1989, OTOLARYNG CLIN N AM, V22, P569 HAJI A, 1990, J NEUROPHYSIOL, V63, P955 HOLINGER LD, 1976, ANN OTO RHINOL LARYN, V85, P428 Lapena JF, 2001, ANN OTO RHINOL LARYN, V110, P952 Lieske SP, 2000, NAT NEUROSCI, V3, P600 NIGRO MA, 1992, PEDIATR NEUROL, V8, P221, DOI 10.1016/0887-8994(92)90073-8 Paton JFR, 2002, J ANAT, V201, P319, DOI 10.1046/j.1469-7580.2002.00101.x PILOWSKY PM, 1990, J COMP NEUROL, V301, P604, DOI 10.1002/cne.903010409 Ramirez JM, 1997, RESP PHYSIOL, V110, P71, DOI 10.1016/S0034-5687(97)00074-1 SCHMID K, 1991, RESP PHYSIOL, V84, P351, DOI 10.1016/0034-5687(91)90129-7 Sekita Y, 2004, LARYNGOSCOPE, V114, P376, DOI 10.1097/00005537-200402000-00037 SHIANG R, 1993, NAT GENET, V5, P351, DOI 10.1038/ng1293-351 Shiba K, 2004, LARYNGOSCOPE, V114, P372, DOI 10.1097/00005537-200402000-00036 TIJSSEN MAJ, 1995, ARCH NEUROL-CHICAGO, V52, P578 Tijssen MAJ, 1997, J NEUROL SCI, V149, P63, DOI 10.1016/S0022-510X(97)05378-1 Wood DM, 2002, CRIT CARE, V6, P456, DOI 10.1186/cc1549 NR 27 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JUN PY 2005 VL 114 IS 6 BP 494 EP 498 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 935OZ UT WOS:000229792900012 PM 16042108 ER PT J AU Richtsmeier, WJ AF Richtsmeier, WJ TI Myotomy length determinants in endoscopic staple-assisted esophagodiverticulostomy for small Zenker's diverticula SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE endoscopic staple-assisted esophagodiverticulostomy; myotomy; Zenker's diverticulum ID SURGERY; CHOICE AB A small Zenker's pouch is a major challenge for endoscopic staple-assisted esophagodiverticulostomy (ESED). This study tested the stapler dimensions so as to identify limitations they impose on ESED. Combining ESED with additional endoscopic suturing could extend the incision and consequently the myotomy. Zenker's diverticulum residual pouch measurements were performed with a previously reported latex glove model and in patients undergoing surgery. Two stapler designs were compared by measuring the residual pouch length for both the stock and modified staplers. One other stapler model cannot be modified without damaging the mechanism. The Endostitch was used to place an additional suture at the apex of the staple line, allowing cutting between the staples while leaving a closed distal incision. All three staplers suitable for ESED leave a residual pouch of 1.5 cm when unmodified. The modified anvil staplers gave a smaller residual pouch by 4 to 5 turn. An additional septal reduction can be accomplished by suturing the area distal to the staple line and incising the party wall beyond the stapler cut. The absolute amount of residual pouch with an additional myotomy is 3 mm. The combined staple-suture technique has proven relatively safe thus far. To provide a maximally efficient myotomy in a patient with a short pouch, the surgeon needs to be aware of the stapler differences. Modifications of the staplers may decrease the depth of the residual pouch, but may carry an added liability. A minimum residual pouch can be achieved with a combination of stapler and suture techniques, but is more technically demanding than the original ESED description. C1 Dept Otolaryngol Head & Neck Surg, Cooperstown, NY 13326 USA. RP Richtsmeier, WJ (reprint author), Dept Otolaryngol Head & Neck Surg, 1 Atwell Rd, Cooperstown, NY 13326 USA. CR Cook RD, 2000, LARYNGOSCOPE, V110, P2020, DOI 10.1097/00005537-200012000-00008 DOHLMAN G, 1960, ARCHIV OTOLARYNGOL, V71, P744 Kelly JH, 1996, LARYNGOSCOPE, V106, P713, DOI 10.1097/00005537-199606000-00009 Narne S, 1999, ANN OTO RHINOL LARYN, V108, P810 Peracchia A, 1998, ARCH SURG-CHICAGO, V133, P695, DOI 10.1001/archsurg.133.7.695 Philippsen LP, 2000, LARYNGOSCOPE, V110, P1283, DOI 10.1097/00005537-200008000-00011 Richtsmeier WJ, 2002, ARCH OTOLARYNGOL, V128, P137 Richtsmeier WJ, 2002, LARYNGOSCOPE, V112, P1230, DOI 10.1097/00005537-200207000-00016 Richtsmeier WJ, 2003, AM J MED, V115, p175S, DOI 10.1016/S0002-9343(03)00220-1 Scher RL, 1996, LARYNGOSCOPE, V106, P951, DOI 10.1097/00005537-199608000-00007 Scher RL, 1998, LARYNGOSCOPE, V108, P200, DOI 10.1097/00005537-199802000-00008 VANOVERBEEK JJ, 2003, ANN OTO RHINOL LARYN, V122, P583 NR 12 TC 16 Z9 17 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 341 EP 346 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100002 PM 15966519 ER PT J AU Altman, JI Genden, EM Moche, J AF Altman, JI Genden, EM Moche, J TI Fiberoptic endoscopic-assisted diverticulotomy. A novel technique for the management of Zenker's diverticulum SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE diverticulotomy; esophageal diverticulum; fiberoptic diverticulotomy; Zenker's diverticulum ID STAPLED DIVERTICULOTOMY; PHARYNGEAL POUCHES; HYPOPHARYNGEAL DIVERTICULA; PATIENT SATISFACTION; ESOPHAGODIVERTICULOSTOMY; EXPERIENCE; CHOICE AB Endoscopic diverticulotomy is rapidly becoming the procedure of choice for treatment of Zenker's diverticulum. The endoscopic approach has resulted in significant decreases in patient morbidity, time to resumption of oral intake, and overall cost as compared with open treatment. However, a small but significant patient population is unable to accommodate the rigid laryngoscope and therefore requires open treatment. We present a novel technique, flexible fiberoptic endoscopic-assisted diverticulotomy, for the management of patients who are unable to undergo rigid endoscopy. C1 CUNY Mt Sinai Sch Med, Dept Otolaryngol Head & Neck Surg, New York, NY 10029 USA. RP Altman, JI (reprint author), CUNY Mt Sinai Sch Med, Dept Otolaryngol Head & Neck Surg, Box 1189,1 Gustave L Levy Pl, New York, NY 10029 USA. CR Adams J, 2001, SURG ENDOSC-ULTRAS, V15, P34, DOI 10.1007/s004640000323 Baldwin DL, 1998, CLIN OTOLARYNGOL, V23, P244 Burstin PP, 1998, AUST NZ J SURG, V68, P532, DOI 10.1111/j.1445-2197.1998.tb04816.x Chang CY, 2003, LARYNGOSCOPE, V113, P957, DOI 10.1097/00005537-200306000-00009 COLLARD JM, 1993, ANN THORAC SURG, V56, P573 Cook RD, 2000, LARYNGOSCOPE, V110, P2020, DOI 10.1097/00005537-200012000-00008 Counter PR, 2002, ANN ROY COLL SURG, V84, P89 DOHLMAN G, 1960, ARCHIV OTOLARYNGOL, V71, P744 ISHIOKA S, 1995, ENDOSCOPY, V27, P433, DOI 10.1055/s-2007-1005736 Jaramillo MJ, 2001, J LARYNGOL OTOL, V115, P462 Koay CB, 1996, CLIN OTOLARYNGOL, V21, P371, DOI 10.1111/j.1365-2273.1996.tb01091.x Lüscher M S, 2000, Acta Otolaryngol Suppl, V543, P235 Manni JJ, 2004, EUR ARCH OTO-RHINO-L, V261, P68, DOI 10.1007/s00405-003-0589-8 MARTINHIRSCH DP, 1993, J LARYNGOL OTOL, V107, P723 Mattinger C, 2002, DYSPHAGIA, V17, P34, DOI 10.1007/s00455-001-0099-z Mosher HP, 1917, SURG GYNECOL OBSTET, V25, P175 MULDER CJJ, 1995, ENDOSCOPY, V27, P438, DOI 10.1055/s-2007-1005737 Narne S, 1999, ANN OTO RHINOL LARYN, V108, P810 Nguyen HC, 1997, LARYNGOSCOPE, V107, P1436, DOI 10.1097/00005537-199711000-00003 Omote K, 1999, SURG ENDOSC-ULTRAS, V13, P535, DOI 10.1007/s004649901031 Peracchia A, 1998, ARCH SURG-CHICAGO, V133, P695, DOI 10.1001/archsurg.133.7.695 Philippsen LP, 2000, LARYNGOSCOPE, V110, P1283, DOI 10.1097/00005537-200008000-00011 Raut VV, 2002, OTOLARYNG HEAD NECK, V127, P225, DOI 10.1067/mhn.2002.127605 Scher RL, 1996, LARYNGOSCOPE, V106, P951, DOI 10.1097/00005537-199608000-00007 Scher RL, 1998, LARYNGOSCOPE, V108, P200, DOI 10.1097/00005537-199802000-00008 Smith SR, 2002, ARCH OTOLARYNGOL, V128, P141 Sood S, 2000, J LARYNGOL OTOL, V114, P853 Stoeckli SJ, 2002, SURGERY, V131, P158, DOI 10.1067/msy.2002.119491 Thaler ER, 2001, LARYNGOSCOPE, V111, P1506, DOI 10.1097/00005537-200109000-00002 VANOVERBEEK JJM, 1994, ANN OTO RHINOL LARYN, V103, P178 van Eeden S, 1999, J LARYNGOL OTOL, V113, P237 Westrin KM, 1996, ACTA OTO-LARYNGOL, V116, P351, DOI 10.3109/00016489609137857 Zenker FA vZH, 1878, CYCLOPAEDIA PRACTICE, V3, P46 NR 33 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 347 EP 351 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100003 PM 15966520 ER PT J AU Nagai, H Ota, F Connor, NP AF Nagai, H Ota, F Connor, NP TI Effect of deficits in laryngeal sensation on laryngeal muscle biochemistry SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE cricothyroid muscle; lateral cricoarytenoid muscle; lateral thyroarytenoid muscle; myosin heavy chain; posterior cricoarytenoid muscle ID HEAVY-CHAIN ISOFORMS; NEUROMUSCULAR-JUNCTION; RAT LARYNX; AGED RATS; NERVE; DENERVATION; EXPRESSION; REINNERVATION; REGENERATION; ADULT AB Swallowing deficits in elderly people are significant clinical problems and may be associated with impaired pharyngolaryngeal sensation. However, the extent to which sensory innervation affects the motor system is unclear. Our purpose was to examine differences in biochemical properties of laryngeal muscles following sensory nerve ablation. We used sodium dodecyl sulfate-polyacrylamide gel electrophoresis to evaluate laryngeal muscles of young and old Fischer 344/Brown Norway rats, and rats that underwent sensory ablation via bilateral section of the superior laryngeal nerve, internal branch (SLNi), or mixed sensory-motor nerve ablation via left-sided recurrent laryngeal nerve (RLN) section. In lateral thyroarytenoid muscle, a reduction was found in the proportion of the most rapidly contracting myosin heavy chain isoform (type 2B) with SLNi section, RLN section, and aging. Section of the SLNi did not alter the proportion of any myosin heavy chain isoform within the lateral cricoarytenoid or posterior cricoarytenoid muscles, but RLN section resulted in a reduction in the proportion of type 2B. Accordingly, alteration in biochemical properties of the lateral thyroarytenoid muscle alone was demonstrated following sensory ablation. We conclude that sensory changes may affect properties of laryngeal muscles, and may thus have an impact on motor control during critical functions, such as airway protection during swallowing. C1 Univ Wisconsin, Sci Ctr, Madison, WI 53792 USA. RP Connor, NP (reprint author), Univ Wisconsin, Sci Ctr, K4-711,600 Highland Ave, Madison, WI 53792 USA. CR Ameredes BT, 1998, AGING-CLIN EXP RES, V10, P112 Andersen JL, 2003, SCAND J MED SCI SPOR, V13, P40, DOI 10.1034/j.1600-0838.2003.00299.x MARTIN JH, 1994, ANN OTO RHINOL LARYN, V103, P749 Bamman MM, 1999, ELECTROPHORESIS, V20, P466, DOI 10.1002/(SICI)1522-2683(19990301)20:3<466::AID-ELPS466>3.0.CO;2-7 Connor NP, 2002, ANN OTO RHINOL LARYN, V111, P579 DelGaudio JM, 1997, ANN OTO RHINOL LARYN, V106, P1076 EKBERG O, 1991, AM J ROENTGENOL, V156, P1181 GOLDSPINK G, 1979, J PHYSIOL-LONDON, V296, P453 Inagi K, 1998, LARYNGOSCOPE, V108, P1048, DOI 10.1097/00005537-199807000-00018 Inagi K, 1999, OTOLARYNG HEAD NECK, V120, P876, DOI 10.1016/S0194-5998(99)70330-X Jafari S, 2003, J PHYSIOL-LONDON, V550, P287, DOI 10.1113/jphysiol.2003.039966 JAKUBIECPUKA A, 1990, EUR J BIOCHEM, V193, P623, DOI 10.1111/j.1432-1033.1990.tb19379.x Kerezoudi E, 1999, GERONTOLOGY, V45, P301, DOI 10.1159/000022109 Liu Y, 2003, J APPL PHYSIOL, V94, P2282, DOI 10.1152/japplphysiol.00830.2002 Maranillo E, 2003, LARYNGOSCOPE, V113, P525, DOI 10.1097/00005537-200303000-00024 Pette D, 1999, MUSCLE NERVE, V22, P666, DOI 10.1002/(SICI)1097-4598(199906)22:6<666::AID-MUS3>3.0.CO;2-Z ROSENHEIMER JL, 1990, NEUROSCIENCE, V38, P763, DOI 10.1016/0306-4522(90)90069-G WU BL, 1994, ARCH OTOLARYNGOL, V120, P1321 Sanders I, 1998, ANAT REC, V252, P646, DOI 10.1002/(SICI)1097-0185(199812)252:4<646::AID-AR15>3.0.CO;2-E Sanudo JR, 1999, LARYNGOSCOPE, V109, P983 Schindler JS, 2002, LARYNGOSCOPE, V112, P589, DOI 10.1097/00005537-200204000-00001 SHINDO ML, 1992, LARYNGOSCOPE, V102, P663, DOI 10.1288/00005537-199206000-00012 Shiotani A, 2001, LARYNGOSCOPE, V111, P472, DOI 10.1097/00005537-200103000-00017 Shiotani A, 1998, LARYNGOSCOPE, V108, P1225, DOI 10.1097/00005537-199808000-00023 SMITH DO, 1984, J PHYSIOL-LONDON, V347, P161 Son YJ, 1996, TRENDS NEUROSCI, V19, P280, DOI 10.1016/S0166-2236(96)10032-1 SON YJ, 1995, NEURON, V14, P125, DOI 10.1016/0896-6273(95)90246-5 STERNBERG SS, 1992, HIST PATHOLOGISTS, P184 Sulica L, 2002, ANN OTO RHINOL LARYN, V111, P291 Sulica L, 2000, LARYNGOSCOPE, V110, P1777, DOI 10.1097/00005537-200010000-00040 Sultan KR, 2001, AM J PHYSIOL-CELL PH, V280, pC239 Suzuki T, 2002, ANN OTO RHINOL LARYN, V111, P684 Suzuki T, 2002, ANN OTO RHINOL LARYN, V111, P962 TALMADGE RJ, 1993, J APPL PHYSIOL, V75, P2337 NR 34 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 352 EP 360 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100004 PM 15966521 ER PT J AU Butler, AP O'Rourke, AK Wood, BP Porubsky, ES AF Butler, AP O'Rourke, AK Wood, BP Porubsky, ES TI Acute external laryngeal trauma: Experience with 112 patients SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE deglutition; fracture; laryngeal cartilage; larynx; nonpenetrating wound; penetrating wound; tracheotomy; voice disorder ID LARYNGOTRACHEAL TRAUMA; ACUTE MANAGEMENT; INJURIES; TRACHEA; PROTOCOL AB The purpose of this report is to promote early recognition, expeditious evaluation, and judicious management of acute external laryngeal trauma. A retrospective chart review was performed of 112 cases that were managed at a Medical College of Georgia tertiary care hospital by the senior author (E.S.P.). Patients were classified by the time of their presentation, the severity of their injury, and the treatment protocol followed. The clinical outcomes of airway, voice quality, and deglutition were retrospectively reviewed. For voice outcomes, in the delayed treatment group, only 27.7% of patients had a good result, as compared to a 78.3% good result in the early treatment group. Similar differences were demonstrated regarding the airway. In the delayed treatment group, only 73.3% had good airway function, as compared to 93.3% who had good airway function in the early treatment group. Ninety-nine percent of all patients had a good result for deglutition. We conclude that expeditious diagnosis and intervention reduce the incidence of suboptimal clinical outcomes, and with timely and appropriate application of diagnostic and management protocols, the majority of patients will be successfully decannulated (97%) with functional speech (100%) and normal deglutition (99%). C1 Med Coll Georgia, Dept Otolaryngol Head & Neck Surg, Augusta, GA 30912 USA. RP Porubsky, ES (reprint author), Med Coll Georgia, Dept Otolaryngol Head & Neck Surg, BP 4596,1120 15th St, Augusta, GA 30912 USA. CR BENT JP, 1993, OTOLARYNG HEAD NECK, V109, P441 COHN AM, 1976, ARCH OTOLARYNGOL, V102, P166 FUHRMAN GM, 1990, J TRAUMA, V30, P87, DOI 10.1097/00005373-199001000-00014 GUSSACK GS, 1986, LARYNGOSCOPE, V96, P660 HARRIS HH, 1970, LARYNGOSCOPE, V80, P1376, DOI 10.1288/00005537-197009000-00005 Jewett BS, 1999, ARCH OTOLARYNGOL, V125, P877 KOUFMAN JA, 1991, LARYNGOSCOPE S53, V101 LEOPOLD DA, 1983, ARCH OTOLARYNGOL, V109, P106 LUCENTE FE, 1985, EAR NOSE THROAT J, V64, P406 NAHUM AM, 1967, ANN OTO RHINOL LARYN, V76, P781 Offiah CJ, 1997, J LARYNGOL OTOL, V111, P1079 OGURA JH, 1973, CAN J OTOLARYNGOL, V2, P112 OLSON NR, 1971, ANN OTO RHINOL LARYN, V80, P704 PENNINGT.CL, 1972, ANN OTO RHINOL LARYN, V81, P546 POTTER CR, 1978, OTOLARYNG HEAD NECK, V86, P909 REECE GP, 1988, SOUTHERN MED J, V81, P1542 SCHAEFER SD, 1992, ARCH OTOLARYNGOL, V118, P598 SCHAEFER SD, 1989, ANN OTO RHINOL LARYN, V98, P98 SCHAEFER SD, 1983, LARYNGOSCOPE, V93, P1473 SCHAEFER SD, 1991, ARCH OTOLARYNGOL, V117, P35 SCHILD JA, 1989, HEAD NECK-J SCI SPEC, V11, P491, DOI 10.1002/hed.2880110603 STANLEY RB, 1984, J TRAUMA, V24, P359, DOI 10.1097/00005373-198404000-00015 TRONE T H, 1980, Otolaryngology - Head and Neck Surgery, V88, P257 NR 23 TC 11 Z9 11 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 361 EP 368 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100005 PM 15966522 ER PT J AU Sulica, L AF Sulica, L TI Laryngeal thrush SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE Candida; fluticasone; larynx; steroid inhaler; thrush; vocal fold ID INHALED FLUTICASONE THERAPY; CANDIDIASIS; LARYNGITIS; INFECTION; STEROIDS AB Superficial fungal infection of the mucous membranes (thrush) isolated to the larynx is neither widely reported nor well recognized clinically. Therefore, it is often associated with ineffective treatment and delay in diagnosis, and sometimes associated with unneeded surgical intervention. Eight cases of thrush isolated to the larynx, with no oral or oropharyngeal manifestations, are presented. Four of these were isolated to the vocal folds alone. All patients were adults, and 4 were smokers. Hoarseness was always present. Pain was present inconsistently, and there was no dysphagia or odynophagia, in contrast to other forms of upper aerodigestive tract candidiasis. On average, diagnosis was not made until 6 months after the onset of symptoms. Possible causative factors included use of systemic steroids (3 cases), broad-spectrum antibiotics (1 case), or inhaled steroids (5 cases); diabetes (2 cases); and neutropenia (1 case). In 3 cases, all with thrush isolated to the vocal folds, inhaled steroids were the only causative factor identifiable - a feature reported only twice previously. Three patients underwent surgical procedures that might have been avoided had an accurate diagnosis been made. All patients responded readily to oral fluconazole and removal of predisposing factors where possible. The signs, symptoms, predisposing factors, and treatment are compared to those of 14 cases reported in the literature over 35 years. C1 Beth Israel Med Ctr, Dept Otolaryngol, New York, NY 10003 USA. RP Sulica, L (reprint author), Beth Israel Med Ctr, Dept Otolaryngol, 10 Union Sq, New York, NY 10003 USA. CR De Pasquale Kalpana, 2003, Ear Nose Throat J, V82, P419 DelGaudio JM, 2002, ARCH OTOLARYNGOL, V128, P677 Fairfax AJ, 1999, THORAX, V54, P860 Forrest LA, 1998, J VOICE, V12, P91, DOI 10.1016/S0892-1997(98)80080-5 Fukushima C, 2003, ANN ALLERG ASTHMA IM, V90, P646 Gemci T, 2002, AEROSOL SCI TECH, V36, P18, DOI 10.1080/027868202753339050 HABERMAN RS, 1983, ARCH OTOLARYNGOL, V109, P770 Hanania NA, 2003, CHEST, V124, P834, DOI 10.1378/chest.124.3.834 HICKS JN, 1982, LARYNGOSCOPE, V92, P644 Lavy JA, 2000, J VOICE, V14, P581, DOI 10.1016/S0892-1997(00)80014-4 Makitie AA, 2003, ARCH OTOLARYNGOL, V129, P124 Mathur Kevin K, 2004, Ear Nose Throat J, V83, P13 Mirza N, 2004, LARYNGOSCOPE, V114, P1566, DOI 10.1097/00005537-200409000-00012 Neuenschwander M C, 2001, Ear Nose Throat J, V80, P138 Pabuccuoglu U, 2002, PATHOL RES PRACT, V198, P675, DOI 10.1078/0344-0338-00319 Roland NJ, 2004, CHEST, V126, P213, DOI 10.1378/chest.126.1.213 SELKIN SG, 1985, OTOLARYNG HEAD NECK, V93, P661 TASHJIAN LS, 1984, ARCH OTOLARYNGOL, V110, P806 TEDESCHI LG, 1968, ARCH OTOLARYNGOL, V87, P82 Toogood J H, 1998, Can Respir J, V5 Suppl A, p50A TOOGOOD JH, 1984, EUR J RESPIR DIS, V65, P35 WILLIAMS AJ, 1983, THORAX, V38, P813, DOI 10.1136/thx.38.11.813 WILLIAMSON IJ, 1995, EUR RESPIR J, V8, P590 YONKERS AJ, 1973, ANN OTO RHINOL LARYN, V82, P812 Zhang SZ, 2000, ARCH OTOLARYNGOL, V126, P672 NR 25 TC 5 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 369 EP 375 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100006 PM 15966523 ER PT J AU Junquera, L Torre, A Vicente, JC Garcia-Consuegra, L Fresno, MF AF Junquera, L Torre, A Vicente, JC Garcia-Consuegra, L Fresno, MF TI Complete spontaneous regression of Merkel cell carcinoma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE immunohistochemistry; Merkel cell carcinoma; spontaneous regression ID NEUROENDOCRINE CARCINOMA; SKIN; TUMOR; MANAGEMENT; PROGNOSIS AB Merkel cell carcinoma (MCC) is a very aggressive primary cutaneous neoplasm most often occurring on the head and neck of the elderly. Spontaneous regression of MCC was first described in 1986. A 79-year-old woman with MCC on the right cheek underwent spontaneous regression of the malignancy, documented by photographic follow-up, computed tomography, and histologic studies. A review of the literature is presented. Complete clinical and histologic regression of MCC was observed in the present case. Although the literature documents 11 similar cases, only 6 can be regarded as complete spontaneous regressions following exclusive performance of a biopsy (primary complete spontaneous regression). Primary complete spontaneous regression of MCC is infrequent, and most case reports describe this phenomenon in women with MCC on the cheek. The reasons underlying regression are unknown. C1 Univ Oviedo, Cent Hosp Astruias, Dept Oral & Maxillofacial Surg, Oviedo, Spain. Univ Oviedo, Cent Hosp Astruias, Dept Pathol, Oviedo, Spain. RP Junquera, L (reprint author), Univ Oviedo, Escuela Estomatol, Catedratico Jose Serrano S-N, E-33006 Oviedo, Spain. CR BAYROU O, 1991, J AM ACAD DERMATOL, V24, P198, DOI 10.1016/0190-9622(91)70027-Y Brissett AE, 2002, HEAD NECK-J SCI SPEC, V24, P982, DOI 10.1002/hed.10153 Brown TJ, 1999, DERMATOL SURG, V25, P23, DOI 10.1046/j.1524-4725.1999.08142.x Connelly TJ, 2000, DERMATOL SURG, V26, P853, DOI 10.1046/j.1524-4725.2000.00054.x Connelly TJ, 1997, DERMATOL SURG, V23, P588 DJILALIBOUZINA F, 1992, NOUV DERMATOL, V11, P767 DUNCAN WC, 1993, J AM ACAD DERMATOL, V29, P653 GOULD VE, 1985, LAB INVEST, V52, P334 Halata Z, 2003, ANAT REC PART A, V271A, P225, DOI 10.1002/ar.a.10029 Inoue T, 2000, J DERMATOL SCI, V24, P203, DOI 10.1016/S0923-1811(00)00103-1 KAYASHIMA K, 1991, ARCH DERMATOL, V127, P550, DOI 10.1001/archderm.127.4.550 MARKS ME, 1990, CANCER, V65, P60, DOI 10.1002/1097-0142(19900101)65:1<60::AID-CNCR2820650113>3.0.CO;2-5 Maruo K, 2000, BRIT J DERMATOL, V142, P1184, DOI 10.1046/j.1365-2133.2000.03546.x MELAND NB, 1986, PLAST RECONSTR SURG, V77, P632, DOI 10.1097/00006534-198604000-00021 OROURKE MGE, 1986, J DERMATOL SURG ONC, V12, P994 Pan D, 2002, PLAST RECONSTR SURG, V110, P1259, DOI 10.1097/01.PRS.0000025287.96915.88 Sais G, 2002, J EUR ACAD DERMATOL, V16, P82, DOI 10.1046/j.1468-3083.2002.374_2.x SHAW JHF, 1991, BRIT J SURG, V78, P138, DOI 10.1002/bjs.1800780205 SIBLEY RK, 1985, AM J SURG PATHOL, V9, P95, DOI 10.1097/00000478-198502000-00004 Smith P D, 2001, Am J Clin Pathol, V115 Suppl, pS68 Takenaka H, 1997, AM J DERMATOPATH, V19, P614, DOI 10.1097/00000372-199712000-00012 TOKER C, 1972, ARCH DERMATOL, V105, P107, DOI 10.1001/archderm.105.1.107 Yanguas I, 1997, BRIT J DERMATOL, V137, P296, DOI 10.1046/j.1365-2133.1997.18251927.x YIENGPRUKSAWAN A, 1991, ARCH SURG-CHICAGO, V126, P1514 NR 24 TC 16 Z9 16 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 376 EP 380 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100007 PM 15966524 ER PT J AU Khan, AM Handzel, O Eddington, DK Damian, D Nadol, JB AF Khan, AM Handzel, O Eddington, DK Damian, D Nadol, JB TI Effect of cochlear implantation on residual spiral. ganglion cell count as determined by comparison with the contralateral nonimplanted inner ear in humans SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cochlear implant; spiral ganglion cell ID DEAFENED GUINEA-PIG; SENSORINEURAL HEARING-LOSS; ELECTRICAL-STIMULATION; SURVIVAL; HISTOPATHOLOGY; PATIENT AB It is generally assumed that at least a minimal number of spiral ganglion cells is essential for successful speech perception with a cochlear implant. Although the insertion of a multichannel cochlear implant frequently results in loss of residual hearing in the implanted ear, this outcome does not imply that significant damage to residual populations of spiral ganglion cells has occurred. The purpose of the current study was to compare spiral ganglion cell counts in implanted and nonimplanted cochleas in 11 patients for whom both temporal bones were available and in whom a multichannel cochlear implant had been placed unilaterally. The temporal bones were processed for light microscopy by standard techniques. The cochleas were reconstructed by 2-dimensional methods. Spiral ganglion cell counts of the implanted and nonimplanted sides were compared by a paired t-test (2-tailed). The mean spiral ganglion cell counts for implanted and nonimplanted ears were not statistically different in the most basal three segments of the cochlea. However, the mean spiral ganglion cell count in segment 4 (apical segment) and the mean total spiral ganglion cell count were lower in the implanted cochleas than in the nonimplanted cochleas (p < .01 ). The results of this study suggest a modest decrease in the total spiral ganglion cell count in the implanted ears as compared to the nonimplanted ears, principally in the apical segment. Possible interpretations of this finding are discussed. C1 Massachusetts Eye & Ear Infirm, Dept Otolaryngol, Boston, MA 02114 USA. Harvard Univ, Sch Med, Dept Otol & Laryngol, Cambridge, MA 02138 USA. RP Nadol, JB (reprint author), Massachusetts Eye & Ear Infirm, Dept Otolaryngol, 243 Charles St, Boston, MA 02114 USA. 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Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 381 EP 385 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100008 PM 15966525 ER PT J AU Wei, CY Fang, SY AF Wei, CY Fang, SY TI Tissue-specific immunoglobulin E in human nasal polyps SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE allergy; CAP; immunoglobulin E; nasal polyp ID SKIN-TESTS; ALLERGY; IGE; DIAGNOSIS; RHINITIS; RAST; CAP AB Allergy is generally believed to be an underlying cause of nasal polyps. The objective of this study was to define allergic nasal polyps. We investigated specific immunoglobulin E (sIgE) in polyp tissue. Thirty pieces of polyp tissue were taken from patients with positive allergic symptoms, and 30 from patients without allergic symptoms. Nasal polyp tissue homogenate and serum from these patients were prepared for detecting sIgE by a CAP method. For patients with allergic symptoms and/or positive serum CAP test results, the rates of positive tissue CAP tests were low: 36.7% and 35.7%, respectively. However, nearly all of the tissue CAP-positive subjects had allergic symptoms and positive serum CAP tests. We conclude that the local tissue slgE profile reflects more specifically the allergic status of patients with nasal polyps than does the systemic serum test or the presentation of allergic symptoms. Thus, polyp tissue CAP tests might be performed in patients with positive allergic symptoms and positive serum CAP tests to define an allergy-induced polyp precisely. Then, specific antiallergic treatment could be administered to prevent polyp recurrence. C1 Natl Cheng Kung Univ Hosp, Dept Otolaryngol, Tainan 70428, Taiwan. RP Fang, SY (reprint author), Natl Cheng Kung Univ Hosp, Dept Otolaryngol, 138,Sheng Li Rd, Tainan 70428, Taiwan. 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Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 386 EP 389 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100009 PM 15966526 ER PT J AU Ximenes, JA De Melo, ECM Tsuji, DH Carneiro, CDG Sennes, LU AF Ximenes, JA De Melo, ECM Tsuji, DH Carneiro, CDG Sennes, LU TI Length of the human vocal folds: Proposal of mathematical equations as a function of gender and body height SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 3rd Sao-Paulo-University Otolaryngology Meeting CY AUG 07-09, 2003 CL Sao Paulo, BRAZIL SP Sao Paulo Univ HO Sao Paulo Univ DE body height; larynx; vocal fold anatomy; vocal fold histology AB To obtain a mathematical equation that could estimate the length of the intermembranous part of the vocal fold as a function of body height and gender, we removed the larynges from 39 cadavers (22 men and 17 women) after recording the subject's height, age, and cause of death. The dimensions of the vocal folds were determined with a digital pachymeter. The following equations were obtained: y = 0.18x - 15.8 for men and y = 0.24x - 28.1 for women, where y is the length of the intermembranous part of the vocal folds in millimeters and x is the height of the individual in centimeters. We conclude that it is possible to estimate the normal expected length of the intermembranous portion of the male and female vocal folds on the basis of body height. C1 Univ Sao Paulo, Sch Med, Dept Otorhinolaryngol, Sao Paulo, Brazil. RP Ximenes, JA (reprint author), 700-1202,Rua Paula Ney, BR-60140200 Fortaleza, Ceara, Brazil. 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PD MAY PY 2005 VL 114 IS 5 BP 390 EP 392 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100010 ER PT J AU Jeon, SY Kim, JP Ahn, SK Kim, EA Kim, BG AF Jeon, SY Kim, JP Ahn, SK Kim, EA Kim, BG TI Rat model of platelet-activating factor-induced rhinosinusitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE histology; inducible nitric oxide synthase; platelet-activating factor; rat; rhinosinusitis ID NITRIC-OXIDE SYNTHASE; NASAL EPITHELIAL-CELLS; BACTERIAL RHINOSINUSITIS; MOUSE MODEL; SINUSITIS; EXPRESSION; RABBITS; DISEASE; MUCOSA AB Platelet-activating factor (PAF) is known to be a potent inflammatory mediator, especially in allergic inflammation. However, the exact role of PAF in the pathogenesis of rhinosinusitis has not been clearly established. To understand the role of PAF in the pathogenesis of rhinosinusitis, it is necessary to develop an animal model of PAF-induced rhinosinusitis. The aim of this study was to develop a rat model of rhinosinusitis induced by intranasally applied PAR Fifty microliters of 16 mu g/mL PAF was applied intranasally through each naris in 4-week-old Sprague-Dawley rats, and the same amount of vehicle was applied in control rats. At 1, 3, or 5 days, the animals were painlessly sacrificed, and the nasal cavity and sinuses were prepared for histologic investigation. The histologic sections were examined in a blind manner for the appearance of neutrophil clusters in the sinonasal air space, and the numbers of eosinophils, areas of epithelial loss, goblet cells, and inducible nitric oxide synthase (iNOS)-positive inflammatory cells in the mucosa. Neutrophil clusters were observed in the air space, and the number of eosinophils, areas of epithelial loss, goblet cells, and iNOS-positive inflammatory cells in the mucosa were increased significantly in the PAF-applied rats. The amount of inflammation varied according to the time interval, showing a peak at day 3. We conclude that intranasally applied PAF induces rhinosinusitis in rats. The histologic evidence of rhinosinusitis revealed the appearance of neutrophil clusters in the sinonasal air space, infiltration of eosinophils and iNOS-positive inflammatory cells in the mucosa, areas of epithelial loss, and goblet cell hyperplasia in the epithelium. This rat model of PAF-induced rhinosinusitis may be applied for better understanding of the role of PAF in the pathogenesis of rhinosinusitis. C1 Gyeongsang Natl Univ, Dept Otolaryngol, Chinju 660702, South Korea. RP Jeon, SY (reprint author), Gyeongsang Natl Univ, Dept Otolaryngol, Chinju 660702, South Korea. 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Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 393 EP 398 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100011 PM 15966528 ER PT J AU Zhang, L Han, DM Sanderson, MJ AF Zhang, L Han, DM Sanderson, MJ TI Effect of isoproterenol on the regulation of rabbit airway ciliary beat frequency measured with high-speed digital and fluorescence microscopy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE calcium; cilia; epithelium; protein kinase A; trachea ID TRACHEAL EPITHELIAL-CELLS; NITRIC-OXIDE; INTRACELLULAR CALCIUM; MOTILITY; PATHWAY; MODULATION; DYNEINS; KINASES; PKA AB To investigate how isoproterenol, a P-adrenergic agonist, regulates airway ciliary beat frequency (CBF), we simultaneously quantified changes in rabbit airway CBF and intracellular calcium concentration ([Ca2+](i)) in response to isoproterenol (100 mu mol/L) by using high-speed (240 frames per second) and fluorescence microscopy. At approximately 30 degrees C, isoproterenol induced a change in CBF that could be separated into two parts. First, isoproterenol induced a moderate increase in the basal CBF that was calcium-independent. This response was unaffected by buffering the [Ca2+](i) with 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid tetrapotassium salt (BAPTA). Second, isoproterenol induced a transient increase in CBF that was superimposed on the increased basal CBF and correlated with a simultaneous transient increase in [Ca2+](i). This transient increase in CBF was abolished by BAPTA. We conclude that isoproterenol initially increases CBF through a calcium-independent mechanism, probably via protein kinase A, and subsequently through a calcium-dependent mechanism mediated by an increase in [Ca2+](i). C1 Univ Massachusetts, Sch Med, Dept Physiol, Worcester, MA 01655 USA. Beijing Inst Otolaryngol, Dept Otolaryngol Head & Neck Surg, Beijing, Peoples R China. Capital Univ Med Sci, Beijing TongRen Hosp, Beijing, Peoples R China. RP Sanderson, MJ (reprint author), Univ Massachusetts, Sch Med, Dept Physiol, Worcester, MA 01655 USA. 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Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 399 EP 403 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100012 PM 15966529 ER PT J AU Tatsumi, A Watanabe, K AF Tatsumi, A Watanabe, K TI Fixation of soft tissue surrounded by bone with microwave irradiation: Electron microscopic observation of guinea pig inner ear SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE electron microscope; inner ear morphology; microwave irradiation ID POSTEMBEDDING IMMUNOGOLD TECHNIQUE; STRIA VASCULARIS; ENERGY FIXATION; MAST-CELLS; ANTIGENS; ULTRASTRUCTURE; CYTOCHEMISTRY; PRESERVATION; LOCALIZATION; PERMEABILITY AB When electron microscopy is performed on organs such as the inner ear that cannot be removed immediately after decapitation of animals, it is necessary to fix the target organ or tissue by systemic or regional perfusion fixation. However, such methods of fixation can increase vascular pressure or perilymphatic pressure, making it difficult to perform precise morphological observation of the vascular endothelial cells and membranous labyrinth. We recently attempted fixation of the cochlea by microwave irradiation. Guinea pigs were decapitated. The bullas were then removed from each animal and fixed in a mixture of 2% paraformaldehyde and 0.5% glutaraldehyde. Microwave (300 W) irradiation was then applied to the specimen for I minute. The fixative was immediately replaced with new fixative (4 degrees C). This sequence of manipulations was repeated 10 times, for a cumulative microwave irradiation time of 10 minutes. During the microwave irradiation period, the fixative temperature was kept at about 30 degrees C. After the last round of irradiation, the specimens were kept immersed in the fixative for I hour. After a small slit was created in the bone on the lateral wall of the cochlea, the specimens were post-fixed in osmic acid and embedded in Epon 812. Each specimen was cut into halves along the plane containing the modiolus of the cochlea. After the bone on the lateral wall of the cochlea was cut off under a stereoscopic microscope, ultrathin sections were prepared for observation under a transmission electron microscope. With this technique, the stria vascularis and the organ of Corti were fixed to a degree comparable to or better than that achieved with the conventional method of fixation. Fixation with microwave irradiation is relatively simple and can solve the problems associated with perfusion fixation, and thus provides an excellent means of fixation. This technique appears to be particularly promising for fixation for soft tissue surrounded by bone. C1 Dokkyo Univ, Sch Med, Dept Otorhinolaryngol, Koshigaya, Saitama 3438555, Japan. 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Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 404 EP 410 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100013 PM 15966530 ER PT J AU Dias, NH Braz, JRC Martins, RHG Carvalho, LR AF Dias, NH Braz, JRC Martins, RHG Carvalho, LR TI Larynx and cervical trachea in humidification and heating of inhaled gases SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cervical trachea; conditioning of air; dog; larynx ID AIRWAY; TEMPERATURE; HUMIDITY; DOGS AB To evaluate the participation of the larynx and cervical trachea in conditioning inspired gases, we randomly allocated 16 mixed-breed dogs to two groups: group TT (tracheal tube; n = 8) and group LMA (laryngeal mask airway; n = 8). The dogs were anesthetized with pentobarbital sodium and mechanically ventilated for 3 hours. The parameters studied were temperature and absolute humidities of ambient, inhaled, and tracheal air. There was a small increase in tracheal air temperature compared to inhaled air temperature, but no significant difference between groups. The absolute humidity of tracheal air was greater in group LMA than in group TT (23 mg H2O center dot L-1 and 14 mg H2O center dot L-1, respectively; p < .0001). The difference in absolute humidity between the tracheal air and the inhaled air was higher in group LMA at all times (p < .0001). We conclude that the larynx and cervical trachea of the dog participate in humidification and heating of inhaled air by means of air contact with mucosa in this airway segment. C1 Univ Estadual Paulista Julio Mesquita Filho, Fac Med Botucatu, Dept Oftalmol Otorrinolaringol & Cirurg Cabeca &, BR-18618970 Botucatu, SP, Brazil. RP Dias, NH (reprint author), Univ Estadual Paulista Julio Mesquita Filho, Fac Med Botucatu, Dept Oftalmol Otorrinolaringol & Cirurg Cabeca &, BR-18618970 Botucatu, SP, Brazil. RI Cerqueira Braz, Jose Reinaldo/D-2267-2012 CR Bisinotto FMB, 1999, CAN J ANAESTH, V46, P897 CHALON J, 1972, ANESTHESIOLOGY, V37, P338, DOI 10.1097/00000542-197209000-00010 CHALON J, 1979, ANESTHESIOLOGY, V50, P195, DOI 10.1097/00000542-197903000-00005 DEVITT JH, 1994, ANESTHESIOLOGY, V80, P550, DOI 10.1097/00000542-199403000-00011 GUYTON AC, 2002, TRATADO FISIOLOGIA M, P406 Hare W.C.D., 1986, ANATOMIA ANIMAIS DOM, P1465 HIRSCH JA, 1975, J APPL PHYSIOL, V39, P242 Keck T, 2000, LARYNGOSCOPE, V110, P651, DOI 10.1097/00005537-200004000-00021 MCFADDEN ER, 1983, J APPL PHYSIOL, V54, P331 MCFADDEN ER, 1992, AM REV RESPIR DIS, V146, P8 Thomachot L, 2002, CRIT CARE MED, V30, P232, DOI 10.1097/00003246-200201000-00033 TUBELIS A, 1980, METEREOLOGIA DESCRIT, P94 Widdicombe J, 1997, ALLERGY, V52, P7 Wilkes AR, 2000, ANAESTHESIA, V55, P685, DOI 10.1046/j.1365-2044.2000.01469.x Williams R, 1996, CRIT CARE MED, V24, P1920, DOI 10.1097/00003246-199611000-00025 NR 15 TC 7 Z9 7 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAY PY 2005 VL 114 IS 5 BP 411 EP 415 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 927BJ UT WOS:000229167100014 PM 15966531 ER PT J AU Lee, B Woo, P AF Lee, B Woo, P TI Chronic cough as a sign of laryngeal sensory neuropathy: Diagnosis and treatment SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE chronic cough; laryngospasm; paradoxical cord; sensory neuropathy; vocal cord dysfunction ID GABAPENTIN; PAIN AB Chronic cough is often attributed to reflux, postnasal drip, or asthma. We present 28 patients who had chronic cough or throat-clearing as a manifestation of sensory neuropathy involving the superior or recurrent laryngeal nerve. They had been identified as having sudden-onset cough. laryngospasm, or throat-clearing after viral illness, surgery, or an unknown trigger. Cough and laryngospasm were the most common complaints. Seventy-one percent of the patients had concomitant superior laryngeal nerve or recurrent laryngeal nerve motor neuropathy documented by laryngeal electromyography or videostroboscopy. After a negative workup for reflux. asthma. or postnasal drip, these patients were treated with gabapentin at 100 to 900 mg/d. Symptomatic relief was achieved in 68% of the patients. Sensory, neuropathy of the recurrent laryngeal nerve or superior laryngeal nerve should be considered in the workup for chronic cough or larynx irritability. Symptomatic management of patients with cough and laryngospasm due to a suspected sensory neuropathy may include the use of antiseizure medications such as gabapentin. C1 CUNY Mt Sinai Sch Med, Dept Otolaryngol Head & Surg, Grabscheid Voice Ctr, New York, NY 10029 USA. RP Lee, B (reprint author), CUNY Mt Sinai Sch Med, Dept Otolaryngol Head & Surg, Grabscheid Voice Ctr, 1 Gustave L Levy Pl, New York, NY 10029 USA. CR Altman KW, 2002, OTOLARYNG HEAD NECK, V127, P501, DOI 10.1067/mhn.2002.127589 Andrianopoulos MV, 2000, J VOICE, V14, P607, DOI 10.1016/S0892-1997(00)80016-8 Backonja M, 2003, CLIN THER, V25, P81, DOI 10.1016/S0149-2918(03)90011-7 Cheshire WP, 2002, J PAIN, V3, P137, DOI 10.1054/jpai.2002.122944 Ford CE, 1998, ARCH OTOLARYNGOL, V124, P476 Irwin RS, 2000, NEW ENGL J MED, V343, P1715, DOI 10.1056/NEJM200012073432308 Jensen TS, 2002, EUR J PAIN, V6, P61, DOI 10.1053/eujp.2001.0324 Lawler WR, 1998, AM FAM PHYSICIAN, V58, P2015 Morrison M, 1999, J VOICE, V13, P447, DOI 10.1016/S0892-1997(99)80049-6 Woo P, 1998, ARCH OTOLARYNGOL, V124, P472 NR 10 TC 64 Z9 65 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 253 EP 257 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600001 PM 15895778 ER PT J AU Thompson, DM Rutter, MJ Rudolph, CD Willging, JP Cotton, RT AF Thompson, DM Rutter, MJ Rudolph, CD Willging, JP Cotton, RT TI Altered laryngeal sensation: A potential cause of APNEA of infancy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE apnea; infant; laryngeal adductor reflex; laryngeal chemoreflex ID PRETERM INFANTS; SENSORY DISCRIMINATION; SLEEPING INFANTS; PROLONGED APNEA; DEATH-SYNDROME; CHEMOREFLEX; REFLEX; PHARYNGEAL; MICE; AUTORESUSCITATION AB Delayed maturation of respiratory control of breathing and the laryngeal adductor reflex (LAR) are commonly implicated in infant apnea. A swallow response occurs to remove the stimulus from the pharynx to prevent aspiration once the glottis reopens. Induction of apnea by poorly cleared endogenous upper airway secretions has been postulated to be a potential cause of infant apnea. Our purpose was to determine whether alteration in the LAR, an indicator of laryngeal sensation, and the presence of secretions influenced the responsiveness of the LAR in infants with apnea. The LAR was induced in 20 infants with apnea (median gestational age, 36.5 weeks) by application of air pulses of controlled duration (50 ms) and intensity (2.5 to 10 mm Hg) to the aryepiglottic fold. Twenty infants evaluated for upper respiratory tract anomalies were used as a comparison group (median gestational age, 39 weeks). The infants with apnea required higher-intensity stimuli (p < .001) to induce the LAR (6.2 +/- 1.6 mm Hg) than did the comparison group (4.3 +/- 1.0 mm Hg) and demonstrated poorer clearance of secretions (p < .001). These findings were significant even when we adjusted for postconceptional age at the time of the test (p = .007). The findings of this study suggest that decreased laryngeal sensitivity results in poor endogenous secretion clearance and that it may induce a prolonged glottic closure event to prevent aspiration. This closure may play a role in infant apnea. C1 Univ Cincinnati, Coll Med, Cincinnati Childrens Hosp, Ctr Med,Dept Pediat Otolaryngol, Cincinnati, OH USA. Mayo Clin & Mayo Eugenio Litta Childrens Hosp, Div Pediat Otolaryngol, Dept Otolaryngol Head & Neck Surg, Rochester, MN USA. RP Thompson, DM (reprint author), MS,200 1st St SW, Rochester, MN 55905 USA. CR ABUOSBA YK, 1981, PEDIATRICS, V68, P796 Aviv JE, 1999, ANN OTO RHINOL LARYN, V108, P725 Aviv JE, 1997, AM J MED, V103, p74S, DOI 10.1016/S0002-9343(97)00327-6 Aviv Jonathan E., 1993, Annals of Otology Rhinology and Laryngology, V102, P777 Aviv JE, 1997, OTOLARYNG HEAD NECK, V116, P331, DOI 10.1016/S0194-5998(97)70268-7 Aviv JE, 1996, ANN OTO RHINOL LARYN, V105, P92 BOGGS DF, 1982, J APPL PHYSIOL, V53, P455 DAVIES AM, 1988, J APPL PHYSIOL, V64, P1412 DOWNING SE, 1975, PEDIATRICS, V55, P640 DRANSFIELD DA, 1983, AM J DIS CHILD, V137, P441 GERSHAN WM, 1992, J APPL PHYSIOL, V72, P677 GODING GS, 1987, OTOLARYNG HEAD NECK, V97, P28 Goding GS, 1998, LARYNGOSCOPE, V108, P863, DOI 10.1097/00005537-199806000-00015 HENDERSONSMART DJ, 1981, AUST PAEDIATR J, V17, P273 HENDERSONSMART DJ, 1984, J DEV PHYSIOL, V6, P83 HENDERSONSMART DJ, 1983, NEW ENGL J MED, V308, P353, DOI 10.1056/NEJM198302173080702 JACOBI MS, 1991, J APPL PHYSIOL, V71, P1098 Khurana A, 1996, J APPL PHYSIOL, V80, P472 LEE JC, 1977, AM J PHYSIOL, V233, P30 Link DT, 2000, ANN OTO RHINOL LARYN, V109, P899 LUCIER GE, 1978, EXP NEUROL, V62, P200, DOI 10.1016/0014-4886(78)90051-1 LUCIER GE, 1979, BIOL NEONATE, V35, P82 MARTIN RJ, 1986, J PEDIATR-US, V109, P733, DOI 10.1016/S0022-3476(86)80685-0 MENON AP, 1984, AM REV RESPIR DIS, V130, P969 MENON AP, 1985, J PEDIATR-US, V106, P625, DOI 10.1016/S0022-3476(85)80091-3 PICKENS DL, 1988, AM REV RESPIR DIS, V137, P113 PICKENS DL, 1989, J APPL PHYSIOL, V66, P1164 PLAXICO DT, 1981, AM J DIS CHILD, V135, P793 STOREY AT, 1975, EXP NEUROL, V47, P42, DOI 10.1016/0014-4886(75)90235-6 THACH BT, 1989, J APPL PHYSIOL, V66, P1599 Thach BT, 1997, AM J MED, V103, p120S, DOI 10.1016/S0002-9343(97)00336-7 WETMORE RF, 1993, LARYNGOSCOPE, V103, P1242 NR 32 TC 9 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 258 EP 263 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600002 PM 15895779 ER PT J AU Kearney, PR Poletto, CJ Mann, EA Ludlow, CL AF Kearney, PR Poletto, CJ Mann, EA Ludlow, CL TI Suppression of thyroarytenoid muscle responses during repeated air pressure stimulation of the laryngeal mucosa in awake humans SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE air pressure; conditioning; laryngeal adductor reflex; larynx; sensation; spasmodic dysphonia; thyroarytenoid muscle ID SPASMODIC DYSPHONIA; NERVE-STIMULATION; REFLEX; CAT AB Repeated stimulation of the laryngeal mucosa occurs during speech. Single stimuli, however, can elicit the laryngeal adductor response (LAR). Our hypothesis was that the LAR to repeated rapid air pressure stimuli is centrally suppressed in humans. Hooked-wire electrodes were inserted into the thyroarytenoid and cricothyroid muscles on both sides and into the posterior cricoarytenoid muscle on one side. Pairs of air puff stimuli were presented to the mucosa over the arytenoids at pressure levels three times threshold with interstimulus intervals from 250 to 5,000 ms. Bilateral thyroarytenoid responses occurred at around 150 ms to more than 70% of the initial stimuli. With repeated presentation at intervals of 2 seconds or less, the percent occurrence decreased to less than 40% and response amplitudes were reduced by 50%. Central suppression of adductor responses to repeated air puff stimuli may allow speakers to produce voice without eliciting reflexive spasms that could disrupt speech. C1 NINDS, LSS, NIH, Bethesda, MD 20892 USA. RP Ludlow, CL (reprint author), NINDS, LSS, NIH, Bldg 10,Room 5D38, Bethesda, MD 20892 USA. CR Ambalavanar R, 2004, J NEUROPHYSIOL, V92, P2920, DOI 10.1152/jn.00064.2004 Andreatta RD, 2002, J APPL PHYSIOL, V93, P1622, DOI 10.1152/japplphysiol.00417.2002 Aviv JE, 1999, ANN OTO RHINOL LARYN, V108, P725 Aviv Jonathan E., 1993, Annals of Otology Rhinology and Laryngology, V102, P777 Bhabu P, 2003, ANN OTO RHINOL LARYN, V112, P834 BLITZER A, 1992, LARYNGOSCOPE, V102, P163 BOUSHEY HA, 1974, J PHYSIOL-LONDON, V240, P153 DAVIS PJ, 1987, J PHYSIOL-LONDON, V388, P467 Davis PJ, 1993, VOCAL FOLD PHYSL FRO, P189 Deleyiannis FWB, 1999, ANN OTO RHINOL LARYN, V108, P612 Esteban A, 1999, NEUROPHYSIOL CLIN, V29, P7, DOI 10.1016/S0987-7053(99)80039-2 Hertegård Stellan, 2003, Logoped Phoniatr Vocol, V28, P133, DOI 10.1080/14015430310015246 HIRANO M, 1969, J SPEECH HEAR RES, V12, P362 Larsson H, 2000, LARYNGOSCOPE, V110, P2117, DOI 10.1097/00005537-200012000-00028 LUDLOW CL, 1995, ANN OTO RHINOL LARYN, V104, P928 LUDLOW CL, 1971, J SPEECH HEAR RES, V14, P535 LUDLOW CL, 1992, ANN OTO RHINOL LARYN, V101, P127 LUDLOW CL, 1996, CONTROLLING COMPLEXI, P201 MURAKAMI Y, 1972, ANN OTO RHINOL LARYN, V81, P59 SANES JN, 1983, BEHAV NEUROSCI, V97, P833, DOI 10.1037//0735-7044.97.5.833 SANTAMBROGIO G, 1986, RESP PHYSIOL, V64, P45, DOI 10.1016/0034-5687(86)90059-9 Sims H. Steven, 1996, Otolaryngology - Head and Neck Surgery, V114, P761, DOI 10.1016/S0194-5998(96)70099-2 Yumoto E, 1998, ARCH OTOLARYNGOL, V124, P897 NR 23 TC 13 Z9 13 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 264 EP 270 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600003 PM 15895780 ER PT J AU Sasaki, CT Hundal, JS Kim, YH AF Sasaki, CT Hundal, JS Kim, YH TI Protective glottic closure: Biomechanical effects of selective laryngeal denervation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Laryngological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Laryngol Assoc DE aspiration; glottic closing force; vocal cord paralysis ID VOCAL CORD PARALYSIS; CENTRAL FACILITATION; CLOSING FORCE; PIG MODEL; ASPIRATION; NERVE; THYROPLASTY; DYSPHAGIA; REFLEX AB Glottic closure constitutes the primary mechanism for prevention of intradeglutitive and postdeglutitive aspiration. Laryngeal paralysis therefore exerts a considerable impact on deglutition, yet little is understood regarding the biomechanical effects of selective denervation on the laryngeal protective function. We measured the glottic closing force (GCF) in each of 6 male, 40-kg Yorkshire pigs 1) after selective unilateral Superior laryngeal nerve (SLN) section; 2) after selective unilateral recurrent laryngeal nerve (RLN) section: and/or 3) after combined SLN-RLN section as both right and left SLNs were simultaneously stimulated to evoke the glottic closure response. Stimulation was provided through an oscilloscope with bipolar platinum-iridium electrodes, and the GCF was measured with a pressure transducer positioned between the vocal cords. Six repetitive measures of GCF were obtained before nerve section. and 6 after nerve section, in each subject. Unilateral SLN section reduced the GCF to 54.14% of control, RLN section reduced the GCF to 23.39% of control, and combined SLN-RLN section reduced the GCF to 22.67% of control. These findings underscore the profound differential effects exerted by isolated lesions on the glottic closure function. C1 Yale Univ, Sch Med, Dept Surg, Otolaryngol Sect, New Haven, CT 06520 USA. RP Sasaki, CT (reprint author), Yale Univ, Sch Med, Dept Surg, Otolaryngol Sect, 333 Cedar St POB 208041, New Haven, CT 06520 USA. CR Bhattacharyya N, 2002, ANN OTO RHINOL LARYN, V111, P672 COHEN S, 1993, ANN OTO RHINOL LARYN, V102, P28 Flint PW, 1997, OTOLARYNG HEAD NECK, V116, P349, DOI 10.1016/S0194-5998(97)70272-9 GODING GS, 1987, OTOLARYNG HEAD NECK, V97, P28 Heitmiller RF, 2000, DYSPHAGIA, V15, P184, DOI 10.1007/s004550000026 HIRANO M, 1993, ANN OTO RHINOL LARYN, V102, P182 Jafari S, 2003, J PHYSIOL-LONDON, V550, P287, DOI 10.1113/jphysiol.2003.039966 Kim YH, 2001, ACTA OTO-LARYNGOL, V121, P310 Medda BK, 2003, AM J PHYSIOL-GASTR L, V284, pG933, DOI 10.1152/ajpgi.00395.2002 Sasaki CT, 2001, ANN OTO RHINOL LARYN, V110, P401 Sasaki CT, 2004, ANN OTO RHINOL LARYN, V113, P93 SHIN T, 1989, OTOLARYNG HEAD NECK, V100, P187 Sulica L, 2002, ANN OTO RHINOL LARYN, V111, P291 NR 13 TC 8 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 271 EP 275 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600004 PM 15895781 ER PT J AU Kumar, VV Amin, MR AF Kumar, VV Amin, MR TI Evaluation of middle and distal esophageal diverticuli with transnasal esophagoscopy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE dysphagia; esophageal diverticulum; office procedure; transnasal esophagoscopy ID BARIUM SWALLOW AB To emphasize the utility of office-based transnasal esophagoscopy (TNE) in the evaluation of patients with swallowing complaints, we present 2 case reports and a review of the literature. The 2 patients both presented with complaints of chronic dysphagia, globus sensation, and a sensation of "food sticking" with swallowing. The patients were counseled to undergo esophagoscopy. Informed consent was obtained. The nasal cavities and pharynx were anesthetized with topical 4% lidocaine hydrochloride solution. Transnasal esophagoscopy was performed. The procedure was well tolerated by the patients. Esophagoscopy revealed diverticuli in various segments of the esophagus, including the midesophageal and distal areas. The cause of the patients' complaints could be well attributed to the endoscopic findings. No morbidity was associated with the TNE examination. A review of the literature concerning office-based TNE was performed. We found no published reports of middle or distal esophageal diverticuli detected on routine office TNE. We conclude that transnasal esophagoscopy is a relatively safe and efficient tool that can be used in the office setting for evaluation of swallowing complaints. C1 Drexel Univ, Coll Med, Dept Otolaryngol Head & Neck Surg, Philadelphia, PA 19103 USA. RP Amin, MR (reprint author), Drexel Univ, Coll Med, Dept Otolaryngol Head & Neck Surg, 219 N Broad St,10th Floor, Philadelphia, PA 19103 USA. CR Aviv JE, 2001, OTOLARYNG HEAD NECK, V125, P170, DOI 10.1067/mhn.2001.117873 Back GW, 2000, J LARYNGOL OTOL, V114, P951 Belafsky PC, 2001, OTOLARYNG HEAD NECK, V125, P588, DOI 10.1067/mhn.2001.120427 Enzinger PC, 2003, NEW ENGL J MED, V349, P2241, DOI 10.1056/NEJMra035010 Hajioff D, 2004, INT J CLIN PRACT, V58, P86, DOI 10.1111/j.1368-5031.2003.0096.x Logemann JA, 1997, OTOLARYNG HEAD NECK, V116, P335, DOI 10.1016/S0194-5998(97)70269-9 Postma GN, 2002, LARYNGOSCOPE, V112, P2242, DOI 10.1097/00005537-200212000-00020 NR 7 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 276 EP 278 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600005 PM 15895782 ER PT J AU Genden, EM Govindaraj, S Chaboki, H Cleven, H Fedorova, E Bromberg, JS Mayer, L AF Genden, EM Govindaraj, S Chaboki, H Cleven, H Fedorova, E Bromberg, JS Mayer, L TI Reepithelialization of orthotopic tracheal allografts prevents rejection after withdrawal of immunosuppression SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE immunosuppression withdrawal; rejection; trachea; transplant ID INHIBITS CYTOKINE PRODUCTION; RENAL-TRANSPLANT RECIPIENTS; OBLITERATIVE BRONCHIOLITIS; INTRATRACHEAL DELIVERY; REGULATORY CELLS; GRAFT ACCEPTANCE; ANIMAL-MODEL; CHIMERISM; IL-10; TOLERANCE AB Prior Work has demonstrated that immunosuppressed orthotopic tracheal allografts undergo progressive reepithelialization over a 48-day period with recipient-derived tracheal epithelium. We hypothesized that reepithelialization of tracheal allografts Would prevent rejection after withdrawal of immunosuppression. BALB/c murine tracheal grafts were transplanted orthotopically into either syngeneic or allogeneic C57/B16 recipients. The recipients were either not immunosuppressed, immunosuppressed with cyclosporine A (10 mg/kg per day) continuously, or immunosuppressed for 48 days and then withdrawn from immunosuppression. The grafts were assessed for acute and chronic rejection 10 days and 50 days after immunosuppression withdrawal. The immunosuppressed allograft recipients maintained a ciliated epithelium acutely and chronically after immunosuppression withdrawal. Ten days after immunosuppression Withdrawal. there Was a mild cellular infiltrate, which resolved 50 days after withdrawal. Electron microscopy. lymphocyte subpopulation assays. and lamina propria analysis demonstrated that immunosuppression withdrawal did not result in tracheal allograft rejection. In vitro and in vivo assessments did not demonstrate evidence of systemic or local immune tolerance. We Conclude that reepithelialization of orthotopic tracheal allo.-rafts with recipient-derived mucosa prevents rejection of allograft segments. Tracheal transplantation may require only transient immunosuppression, which can be withdrawn after tracheal reepithelialization. C1 CUNY Mt Sinai Sch Med, Dept Otolaryngol Head & Neck Surg, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Microbiol, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Recanti Miller Transplantat Inst, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Inst Gene Therapy & Mol Med, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Immunobiol Ctr, New York, NY 10029 USA. RP Genden, EM (reprint author), CUNY Mt Sinai Sch Med, Dept Otolaryngol Head & Neck Surg, 1 Gustave L Levy Pl, New York, NY 10029 USA. 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Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 279 EP 288 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600006 PM 15895783 ER PT J AU Rahbar, R Vargas, SO Folkman, J McGill, TJ Healy, GB Tan, XL Brown, LF AF Rahbar, R Vargas, SO Folkman, J McGill, TJ Healy, GB Tan, XL Brown, LF TI Role of vascular endothelial growth factor-A in recurrent respiratory papillomatosis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE angiogenesis; recurrent respiratory papillomatosis; vascular endothelial growth factor-A ID FIBRIN-GEL INVESTMENT; PERMEABILITY FACTOR; BREAST-CARCINOMA; FACTOR VPF/VEGF; FACTOR RECEPTOR; CELLS SECRETE; TUMOR-GROWTH; EXPRESSION; ANGIOGENESIS; ADENOCARCINOMAS AB Vascular endothelial growth factor A (VEGF-A) is known to play an important role in the angiogenic response essential for tumor growth in a variety of human and experimental tumors. This study was designed to investigate whether VEGF-A may play a role in he pathogenesis of recurrent respiratory papillomatosis (RRP). A retrospective study with institutional review board approval was performed at a tertiary care medical center on 12 patients with a history of laryngeal RRP. Their ages at the time of initial diagnosis ranged from 19 to 96 months (mean, 56 months). All patients had involvement of right and left true vocal cords. All patients required multiple endoscopic procedures (range, 4 to 66; mean, 12). Normal pediatric larynx samples from 5 autopsy patients were used as controls. Formalin-fixed, paraffin-embedded sections of laryngeal squamous papillomas from the 12 patients with a diagnosis of RRP and the 5 control patients were examined by in situ hybridization for the presence of messenger RNA (mRNA) for VE64F-A and vascular endothelial growth factor receptor I (VEGFR-1) and vascular endothelial growth factor receptor 2 (VEGFR-2). The biopsy specimens were from the true vocal cord (N = 10) or subglottis (N = 2) in the patients with RRP and consisted of large sections of larynx including the true vocal cord in the control patients (N = 5). Strong expression of VEGF-A mRNA was noted in the squamous epithelium of papillomas of all 12 patients. Strong expression of VEGFR-1 and VEGFR-2 was noted in the endothelial cells of the underlying vessels in all 12 patients. Neither strong labeling of VEGF-A mRNA nor labeling of its receptors was noted in the control patients. We conclude that the angiogenic growth factor VEGF-A is strongly expressed in the epithelium of squamous papillomas in RRP. Also. VEGFR-1 and VEGFR-2 mRNAs are strongly expressed by Underlying vascular endothelial cells, suggesting an important role in the pathogenesis of RRP. C1 Childrens Hosp, Dept Otolaryngol & Commun Disorders, Boston, MA 02115 USA. Childrens Hosp, Dept Pathol, Boston, MA 02115 USA. Childrens Hosp, Dept Surg, Boston, MA 02115 USA. Harvard Univ, Sch Med, Dept Otol & Laryngol, Boston, MA USA. Beth Israel Deaconess Med Ctr, Dept Pathol, Boston, MA USA. RP Rahbar, R (reprint author), Childrens Hosp, Dept Otolaryngol & Commun Disorders, Boston, MA 02115 USA. 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Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 289 EP 295 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600007 PM 15895784 ER PT J AU Cohen, SM Huang, S Garrett, CG Courey, MS AF Cohen, SM Huang, S Garrett, CG Courey, MS TI Acute histologic effects of extraesophageal reflux on vocal fold healing SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE gastroesophageal reflux; vocal fold; wound healing ID GASTROESOPHAGEAL REFLUX; SUBGLOTTIC STENOSIS; CANINE MODEL; FIBRONECTIN; DISEASE; LARYNX; ACID; PATHOGENESIS; SECONDARY AB This study evaluates how extraesophageal reflux affects membranous vocal fold healing in a canine model. We created membranous vocal fold injuries in the animals and randomly assigned them to topical application of acid and pepsin at pH 2 or pH 6 or of normal saline solution every other day for 12 days. The experimental vocal folds were compared to uninjured, control vocal folds from animals painlessly sacrificed for other reasons. Hematoxylin and eosin, fibronectin, and procollagen I staining were performed for histologic analysis. The injured specimens had three times greater cellular infiltrate (p <= .001, analysis of variance) and twice as much fibronectin and procollagen I (p <= .001, analysis of variance) as did the specimens from the control animals. No significant differences or trends were identified for cellular infiltrate, fibronectin, or procollagen I within the injured groups (p > .05, Bonferroni t-test). Acute wound healing did not appear to be influenced by the presence of acid and pepsin at pH 2 or 6 as compared to saline solution. C1 Univ Calif San Francisco, Voice Ctr, San Francisco, CA 94115 USA. Vanderbilt Univ, Ctr Med, Dept Otolaryngol Head & Neck Surg, San Francisco, CA USA. RP Courey, MS (reprint author), Univ Calif San Francisco, Voice Ctr, 2330 Post St,5th Floor, San Francisco, CA 94115 USA. 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Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 296 EP 303 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600008 PM 15895785 ER PT J AU Hirano, S Nagai, H Tateya, I Tateya, T Ford, CN Bless, DM AF Hirano, S Nagai, H Tateya, I Tateya, T Ford, CN Bless, DM TI Regeneration of aged vocal folds with basic fibroblast growth factor in a rat model: A preliminary report SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE aged vocal fold; basic fibroblast growth factor; collagen; growth factor therapy; hyaluronic acid ID AGING VOICE; ELASTIN AB Aged vocal folds have been reported to have dense collagen deposition and decreased hyaluronic acid (HA) in the lamina propria. These characteristics are thought to contribute to vocal problems that occur with age (presbyphonia). To restore better viscoelasticity to aged vocal folds, an intervention that might increase HA and decrease collagen production from aged vocal fold fibroblasts would appear to be a potentially useful approach. Our previous in vitro study has revealed that basic fibroblast growth factor (bFGF) consistently stimulates HA production and decreases collagen production from aged rat vocal fold fibroblasts. The present in vivo study examined the effects of intracordal injection of bFGF into aged rats' vocal folds in terms of restoration of HA and collagen distribution in the lamina propria. We injected bFGF transorally into the lamina propria of (unilateral) vocal folds. The injection was repeated 4 times weekly, and rats were painlessly sacrificed I week, I month, and 2 months after the final injection. Histologic examination revealed that bFGF significantly increased the HA content of the lamina propria up to 2 months, but showed no effect on collagen, even after 2 months. Because it might take longer for excessive collagen to be degraded, further studies are necessary to clarify the long-term effect on collagen. A drug delivery system for bFGF also needs to be developed to maximize its effect in the future. The present study suggested at least a positive effect of bFGF in restoring the HA content in the aged vocal fold lamina propria. C1 Univ Wisconsin, Div Otolaryngol Head & Neck Surg, Dept Surg, Madison, WI USA. RP Hirano, S (reprint author), Kyoto Med Ctr, Dept ENT Bronchoesophagol, Kyoto 6128555, Japan. CR BIEVER D M, 1989, Journal of Voice, V3, P120, DOI 10.1016/S0892-1997(89)80138-9 Bloch I, 2001, LARYNGOSCOPE, V111, P2022, DOI 10.1097/00005537-200111000-00029 Butler JE, 2001, LARYNGOSCOPE, V111, P907, DOI 10.1097/00005537-200105000-00029 Ehrlich HP, 2000, SCARLESS WOUND HEALI, P99 Gray SD, 1999, LARYNGOSCOPE, V109, P845, DOI 10.1097/00005537-199906000-00001 Hammond TH, 1998, OTOLARYNG HEAD NECK, V119, P314, DOI 10.1016/S0194-5998(98)70071-3 HELDIN P, 1989, BIOCHEM J, V258, P919 Hirano S, 2004, LARYNGOSCOPE, V114, P2161, DOI 10.1097/01.mlg.0000149450.37640.db Hong HH, 2002, J PERIODONTOL, V73, P145, DOI 10.1902/jop.2002.73.2.145 Ramig LO, 2001, FOLIA PHONIATR LOGO, V53, P252, DOI 10.1159/000052680 Sato K, 2002, ANN OTO RHINOL LARYN, V111, P15 SATO K, 1995, ANN OTO RHINOL LARYN, V104, P839 Woo P, 1992, Laryngoscope, V102, P139 NR 13 TC 31 Z9 32 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 304 EP 308 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600009 PM 15895786 ER PT J AU Kubba, H Gibson, D Bailey, M Hartley, B AF Kubba, H Gibson, D Bailey, M Hartley, B TI Techniques and outcomes of laryngeal cleft repair: An update to the Great Ormond Street Hospital series SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE congenital anomaly; laryngeal cleft ID LARYNGOTRACHEOESOPHAGEAL CLEFTS; POSTERIOR LARYNGEAL; SURGICAL REPAIR; MANAGEMENT; DIAGNOSIS; CHILDREN; GRAFT AB We present an update to the Great Ormond Street Hospital series of laryngeal clefts, describing a further 35 clefts of Benjamin-Inglis types I through 3 treated between 1992 and 2003. Associated congenital anomalies were common. Most type I and smaller type 2 clefts were repaired endoscopically, whereas larger clefts were repaired through an anterior approach. Increasing use was made recently of a 3-layer repair with an interposition graft of temporalis fascia. The rates of complication, revision Surgery, and death were 54%, 26%, and 6%, respectively. Most of the children are now orally fed, and 9 still have a tracheotomy. C1 Great Ormond St Hosp Children, Dept Paediat Otolaryngol, London, England. RP Kubba, H (reprint author), Royal Hosp Sick Children, Dept Pediat Otolaryngol, Glasgow G3 8SJ, Lanark, Scotland. 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Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 309 EP 313 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600010 PM 15895787 ER PT J AU Brumund, KT Gutierrez-Fonseca, R Garcia, D Babin, E Hans, S Laccourreye, O AF Brumund, KT Gutierrez-Fonseca, R Garcia, D Babin, E Hans, S Laccourreye, O TI Frontolateral vertical partial laryngectomy without tracheotomy for invasive squamous cell carcinoma of the true vocal cord: A 25-year experience SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE partial laryngectomy; squamous cell carcinoma; vocal cord ID SUPRACRICOID PARTIAL LARYNGECTOMY; EARLY GLOTTIC CARCINOMA; PROGNOSTIC-FACTORS; LOCAL RECURRENCE; RECONSTRUCTION; CRICOHYOIDOEPIGLOTTOPEXY AB On the basis of an inception cohort of 270 patients with a previously untreated invasive squamous cell carcinoma of the true vocal cord (232 T1N0M0, 35 T2N0M0, and 3 T3N0M0) and a minimum of 3 years of follow-up, the authors analyze the oncological and functional outcomes following frontolateral vertical partial laryngectomy without tracheotomy. The 5-year Kaplan-Meier actuarial survival estimate ranged from 83.1% for T I tumors to 67.2% for T2 tumors (p = .005). On univariate analysis, a significant statistical relationship was noted between reduced survival and the following variables: increased age, increased Charlson comorbidity index score over grade 0, increased tobacco intake, increased alcohol intake, increased T stage, local failure, nodal failure, and development of a metachronous second primary cancer. The hospital mortality rate was 0.4%. A significant postoperative surgical complication was noted in 49 patients (18.1%). The predominant significant surgical complication was wound infection (19 patients; 7%), followed by seroma and major subcutaneous emphysema. No significant statistical relationship was noted in a comparison of each significant postoperative complication (including postoperative death) with the variables under analysis. The incidence of secondary tracheotomy was 0.4%. The incidence of completion laryngectomy due to functional problems was 0%. The 5-year Kaplan-Meier actuarial local control estimate was 91% for T1 tumors and 68.7% for T2 tumors (p < .0001). Within the T1 tumors, the 5-year Kaplan-Meier actuarial local control estimate ranged from 96.2% for tumors without anterior commissure involvement to 74.7% for tumors with anterior commissure involvement (p = .0002). On univariate analysis, a significant statistical relationship was noted between an increase in local recurrence and the following variables: increased T stage, anterior commissure involvement, and pathological margin involvement. The overall disease control rate and laryngeal preservation rate were 92.9% and 93.3%, respectively. C1 Hop Europeen Georges Pompidou, Dept Otolaryngol Head & Neck Surg, F-75015 Paris, France. Univ Paris 05, Assistance Publ Hop Paris, Paris, France. RP Laccourreye, O (reprint author), Hop Europeen Georges Pompidou, Dept Otolaryngol Head & Neck Surg, 20-40 Rue Leblanc, F-75015 Paris, France. 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Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 314 EP 322 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600011 PM 15895788 ER PT J AU Lahav, J Handzel, O Gertler, R Yehuda, M Halperin, D AF Lahav, J Handzel, O Gertler, R Yehuda, M Halperin, D TI Postauricular needle aspiration of subperiosteal abscess in acute mastoiditis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE mastoidectomy; mastoiditis; subperiosteal abscess drainage ID CHILDREN; EXPERIENCE; MANAGEMENT AB To test the hypothesis that subperiosteal abscess, a complication of acute mastoiditis, can be treated equally well by needle aspiration as by cortical mastoidectomy, we performed a retrospective analysis of 78 pediatric patients hospitalized between 1995 and 2003 and performed an analysis of published data on types and outcomes of treatment approaches for acute mastoiditis. Postauricular pus aspiration resolved the subperiosteal abscess in 14 of 17 patients. The length of the hospital stay of patients who underwent aspiration was shorter than that of patients who underwent cortical mastoidectomy. We conclude that postauricular pus aspiration, a simple and minimally invasive procedure, is an effective treatment modality for subperiosteal abscess. Mastoidectomy should be reserved for nonresponsive cases or those with more serious complications. Broad-spectrum antibiotics, myringotomy with daily toilet of the ear. and postauricular aspiration, when required, minimize the indications for surgery and reduce the hospital stay. C1 Kaplan Med Ctr, Dept Otolaryngol Head & Neck Surg, Rehovot, Israel. Hebrew Univ Jerusalem, Hadassah Med Sch, Jerusalem, Israel. RP Lahav, J (reprint author), Kaplan Med Ctr, Dept Otolaryngol Head & Neck Surg, POB 1, Rehovot, Israel. 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Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 323 EP 327 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600012 PM 15895789 ER PT J AU Williams, GB Kun, LE Thompson, JW Gould, HJ Stocks, RMS AF Williams, GB Kun, LE Thompson, JW Gould, HJ Stocks, RMS TI Hearing loss as a late complication of radiotherapy in children with brain tumors SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE asymmetric hearing loss; delayed sensorineural hearing loss; postirradiation hearing loss ID NASOPHARYNGEAL CARCINOMA; IONIZING-RADIATION; TEMPORAL BONE; IRRADIATION; EAR; THERAPY; IMPAIRMENT AB Late postirradiation hearing loss has been well described in the adult population. Few reports exist on the pediatric population. We conducted a retrospective review of 157 consecutive children with brain tumors treated exclusively with irradiation at St Jude Children's Research Hospital. Twenty-six patients developed a hearing loss, 74 did not, and 57 were excluded because of incomplete records. We report a statistically significant 27.41% cumulative risk of a stringent 20-dB hearing loss in the voice frequency range by the fifth year after radiotherapy. The right side demonstrated a significant frequency effect, with a higher incidence of loss in the higher-frequency region. We found no difference in cumulative incidence of hearing shift between the low-, middle-, and high-frequency ranges for either ear. This risk should be anticipated and managed as part of the treatment plan for radiotherapy for the treatment of malignancies. Radiation-induced hearing loss is important to acknowledge so that techniques of hyperfractionation, total dose, ports, preservative infusion medical therapy, or prolonged medical intervention (such as anticoagulants) can be developed that might reduce this disabling problem of postirradiation sensorineural hearing loss in future patients. C1 Univ Tennessee, Dept Otolaryngol, Memphis, TN 38163 USA. St Jude Childrens Res Hosp, Dept Radiol Sci, Memphis, TN USA. Univ Memphis, Dept Speech & Hearing, Memphis, TN USA. RP Thompson, JW (reprint author), Univ Tennessee, Dept Otolaryngol, 956 Court Ave,Suite B226, Memphis, TN 38163 USA. 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Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 328 EP 331 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600013 PM 15895790 ER PT J AU Dikkers, FG Verheij, JBGM van Mechelen, M AF Dikkers, FG Verheij, JBGM van Mechelen, M TI Hereditary congenital unilateral deafness: A new disorder? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE congenital deafness; congenital hearing loss; hereditary deafness; hereditary hearing loss; unilateral deafness; unilateral hearing loss ID SENSORINEURAL HEARING-LOSS; EAR AB Congenital unilateral deafness is a rare disorder. The prevalence rates are unknown. The prevalence of children with severe to profound hearing losses that are congenital (or acquired before the development of speech and language) is 0.5 to 3 per 1,000 live births. Evidently, congenital unilateral deafness must have a lower prevalence. The purpose of this research was to present a new disorder, hereditary congenital unilateral deafness. A pedigree is presented in which both male and female members display symptoms of congenital unilateral deafness. Two affected persons and a normal-hearing member of the family have vestibular abnormalities without dysequilibrium. The inheritance pattern of this new syndrome is not clear. We hypothesize that the disorder might be new. A family like this has never before been presented in the medical literature. C1 Univ Groningen, Ctr Med, Dept Otorhinolaryngol, NL-9700 RB Groningen, Netherlands. Univ Groningen, Ctr Med, Dept Clin Genet, NL-9700 RB Groningen, Netherlands. RP Dikkers, FG (reprint author), Univ Groningen, Ctr Med, Dept Otorhinolaryngol, POB 30-001, NL-9700 RB Groningen, Netherlands. CR BROOKHOUSER PE, 1991, LARYNGOSCOPE, V101, P1264 CARGILL EJ, 2001, P 4 C MOL BIOL HEAR, P115 EVERBERG G, 1957, Acta Otolaryngol, V47, P303, DOI 10.3109/00016485709130346 EVERBERG G, 1960, Acta Otolaryngol, V51, P615, DOI 10.3109/00016486009124539 GRAF K, 1992, LARYNGO RHINO OTOL, V71, P242, DOI 10.1055/s-2007-997288 GREWEL F, 1959, Acta Genet Med Gemellol (Roma), V8, P99 JACKLER RK, 1987, LARYNGOSCOPE, V97, P2 LINAGRANADE G, 1995, ACTA OTO-LARYNGOL, V115, P196, DOI 10.3109/00016489509139291 PARNES LS, 1990, ANN OTO RHINOL LARYN, V99, P957 Niparko JK, 2000, COCHLEAR IMPLANTS, P88 POPPER AN, 1987, BRAIN BEHAV EVOLUT, V30, P43, DOI 10.1159/000118637 Smith AB, 1939, LANCET, V2, P1172 Strain GM, 1999, VET CLIN N AM-SMALL, V29, P895 Yu KK, 2003, OTOLARYNG HEAD NECK, V129, P637, DOI 10.1016/S0194-5998(03)01593-6 NR 14 TC 5 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD APR PY 2005 VL 114 IS 4 BP 332 EP 337 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 916UL UT WOS:000228411600014 PM 15895791 ER PT J AU Aviv, JE Murry, T Zschommler, A Cohen, M Gartner, C AF Aviv, JE Murry, T Zschommler, A Cohen, M Gartner, C TI Flexible endoscopic evaluation of swallowing with sensory testing: Patient characteristics and analysis of safety in 1,340 consecutive examinations SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagolog Assoc DE deglutition; endoscopy; FEESST; safety; swallowing ID LARYNGEAL ADDUCTOR REFLEX; ASPIRATION; DYSPHAGIA; DEFICITS AB Flexible endoscopic evaluation of swallowing with sensory testing (FEESST) is a comprehensive endoscopic assessment of the sensory and motor components of a swallow. Previous studies addressing patient safety issues with respect to FEESST included relatively small numbers of patients and paid almost no attention to patient characteristics. The purpose of this study was to determine the incidence of FEESST-related complications in the outpatient and inpatient settings and to analyze patient diagnoses that led to the performance of FEESST. We performed a prospective study of FEESST complications in 1,340 consecutive evaluations performed over a 41/2-year period. The primary outcome variables were incidence of epistaxis and airway compromise. The secondary outcome variable was underlying patient diagnoses. The incidence of epistaxis was 1 in 1,340 (0.07%). There were no instances of airway compromise. Stroke was the most common reason for the performance of FEESST (343; 25.6%), followed by cardiac-related dysphagia (298; 22.2%) following open heart surgery (169/298; 56.7%), heart attack, congestive heart failure, or new arrhythmia. The remaining causes were head and neck cancer (207; 15.4%), pulmonary disease (141; 10.5%), chronic neurologic disease (124; 9.3%), and acid reflux disease (80; 6.0%). We conclude that FEESST is a relatively safe procedure for the sensory and motor assessment of dysphagia in a cohort of patients with a wide variety of underlying diagnoses. The emergence of cardiac surgery as a common cause of dysphagia warrants further study. C1 Columbia Univ, Med Ctr, Coll Phys & Surg,New York Presbyterian Hosp, Voice & Swallowing Ctr,Dept Otolaryngol Head & Ne, New York, NY USA. RP Aviv, JE (reprint author), Dept Otolaryngol Head & Neck Surg, 180 Ft Washington Ave,Harkness Pavil HP 8-812, New York, NY 10032 USA. 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PD MAR PY 2005 VL 114 IS 3 BP 173 EP 176 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800001 PM 15825564 ER PT J AU Toohill, RJ Lim, HJ Ulualp, SO Toohill, RJ AF Toohill, RJ Lim, HJ Ulualp, SO Toohill, RJ TI Meta-analysis of upper probe measurements in normal subjects and patients with laryngopharyngeal reflux SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagolog Assoc DE laryngopharyngeal reflux; upper probe measurements ID PHARYNGEAL ACID REFLUX; GASTROESOPHAGEAL-REFLUX; POSTERIOR LARYNGITIS; LARYNGEAL REFLUX; PROXIMAL PROBE; PH PARAMETERS; NORMAL VALUES; REPRODUCIBILITY; SYMPTOMS; TRIALS AB We report a meta-analysis of a series of studies in which 24-hour ambulatory pH monitoring was performed in 1) normal subjects, 2) the normal control subjects in studies of laryngopharyngeal reflux (LPR), and 3) the patients with LPR in these controlled studies. The statistical analysis utilized the fixed-effects model by Mantel-Haenszel and the random-effects mixed model. There were 16 studies from the past 12 years that fulfilled the inclusion criteria. They involved 793 subjects (264 normal and 529 with LPR). The numbers of positive pharyngeal reflux events for normal subjects and for patients with LPR differed with a p value of < .0001. There was also a significant difference in the mean percentage of acid exposure times between normal subjects and patients with LPR (p = .003). We conclude that the upper probe gives accurate and consistent information in normal subjects and patients with LPR. The numbers of reflux events and acid exposure times are most important in distinguishing normal subjects from patients with LPR. The technology and methodology of probe testing is quite reliable and is consistent on a worldwide basis. C1 Med Coll Wisconsin, Dept Otolaryngol & Commun Sci, Milwaukee, WI 53226 USA. 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Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 177 EP 182 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800002 ER PT J AU Tateya, T Tateya, I Sohn, JH Bless, DM AF Tateya, T Tateya, I Sohn, JH Bless, DM TI Histologic characterization of rat vocal fold scarring SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagolog Assoc DE collagen type I; collagen type III; fibronectin; hyaluronic acid; rat model; vocal fold scarring ID HYALURONIC-ACID; INSUFFICIENCY; BIOMECHANICS; FIBRONECTIN; FIBROBLASTS; SUBSTANCE; MODEL; DIHA AB This study aimed to clarify the characteristics of rat vocal fold scarring by examining the alteration of key components in the extracellular matrix: hyaluronic acid, collagen, and fibronectin. Under monitoring with a 1.9-mm-diameter telescope, unilateral vocal fold stripping was performed, and larynges were harvested at 2, 4, 8, and 12 weeks after operation. The vocal folds were histologically analyzed with Alcian blue stain, trichrome stain, and immunofluorescence of collagen type I, collagen type III, and fibronectin. The scarred vocal folds showed less hyaluronic acid and more collagen types I and III than did the controls at all time points. Type III was stable for 12 weeks, while type I declined until 8 weeks and thereafter remained unchanged. Fibronectin increased for 4 weeks and then decreased; it was close to the control level at 8 and 12 weeks. These results suggest that the tissue remodeling process in scarred vocal folds slows down around 2 months after wounding. C1 Univ Wisconsin, Sch Med, Div Otolaryngol Head & Neck Surg, Dept Surg, Madison, WI USA. RP Tateya, I (reprint author), K4-789 CSC,600 Highland Ave, Madison, WI 53792 USA. 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Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 183 EP 191 PG 9 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800003 PM 15825566 ER PT J AU Sasaki, CT Marotta, J Hundal, J Chow, J Eisen, RN AF Sasaki, CT Marotta, J Hundal, J Chow, J Eisen, RN TI Bile-induced laryngitis: Is there a basis in evidence? SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE bile reflux; laryngitis ID GASTROESOPHAGEAL-REFLUX; DUODENOGASTRIC REFLUX; ACID; ESOPHAGITIS; PATHOGENESIS; TRYPSIN AB Most agree that bile reflux occurs with regularity in an otherwise healthy population and that biliary and acid reflux may play a synergistic role in damaging esophageal mucosa. But to what extent is laryngeal mucosa at risk? We constructed a saline-controlled rat model (n = 40) in which active component solutions of bile - taurocholic acid and chenodeoxycholic acid - were applied to intact laryngeal mucosa at various pH levels. Histologic sampling of the laryngeal mucosa allowed inflammation scores to be generated by a pathologist blinded to the solutions used. Both taurocholic acid at acid pH and chenodeoxycholic acid at basic pH preferentially induced statistically greater inflammation scores than did the saline control, approaching or exceeding inflammation scores attributed to hydrochloric acid at pH 1.2. These observations may clarify reasons for failure to uniformly control laryngeal injury by adequate suppression of gastric acid alone and may further justify alternative methods of laryngeal protection in patients refractory to adequate acid control. C1 Yale Univ, Sch Med, Otolaryngol Sect, New Haven, CT 06520 USA. Yale Univ, Sch Med, Dept Pathol, New Haven, CT 06520 USA. RP Sasaki, CT (reprint author), Yale Univ, Sch Med, Otolaryngol Sect, 333 Cedar St,POB 208041, New Haven, CT 06520 USA. CR HARMON JW, 1981, DIGEST DIS SCI, V26, P65, DOI 10.1007/BF01307977 HELSINGEN N Jr, 1960, Acta Chir Scand, V118, P190 HOGAN WJ, 1997, AM J MED, V103, P77 KAYE MD, 1974, J LAB CLIN MED, V83, P198 KOUFMAN JA, 1991, LARYNGOSCOPE S, V53, P101 LILLEMOE KD, 1982, SURGERY, V92, P276 SALO J, 1982, SURGERY, V92, P61 SALO JA, 1984, SCAND J GASTROENTERO, V19, P875 SEARS RJ, 1995, AM J GASTROENTEROL, V90, P211 Shaw G Y, 2000, Ann Otol Rhinol Laryngol Suppl, V184, P15 SHIMONO M, 1977, J ULTRA MOL STRUCT R, V59, P101, DOI 10.1016/S0022-5320(77)80032-4 VAEZI MF, 1995, GASTROENTEROLOGY, V108, P1897, DOI 10.1016/0016-5085(95)90156-6 Vaezi MF, 1996, GASTROENTEROLOGY, V111, P1192, DOI 10.1053/gast.1996.v111.pm8898632 NR 13 TC 22 Z9 23 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 192 EP 197 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800004 PM 15825567 ER PT J AU Clyne, SB Halum, SL Koufman, JA Postma, GN AF Clyne, SB Halum, SL Koufman, JA Postma, GN TI Pulsed dye laser treatment of laryngeal granulomas SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE laryngeal granuloma; pulsed dye laser ID LOW-DOSE RADIOTHERAPY; CONTACT ULCER; GLOTTAL DYSPLASIA; TUNABLE DYE; VOCAL FOLD; INTUBATION; PAPILLOMATOSIS; ANESTHESIA; ARGON AB Laryngeal granulomas are effectively treated with antireflux therapy and speech therapy. Failure to respond leads to treatment with Botox or surgical excision. We report on the use of the pulsed dye laser for treating chronic granulomas that do not respond to standard therapy. We performed a retrospective review from September 2002 to September 2003. Patients identified with chronic granulomas that were not responding to standard therapy were treated in our office with the pulsed dye laser. Ten patients were identified; the mean age was 58 years. Two patients underwent more than one pulsed dye laser treatment. Five of the 10 had resolution of their lesions, and 3 had a partial response. Two were unchanged. The average follow-up was 6 months, and there were no complications. We conclude that in-office use of the pulsed dye laser is a relatively safe and effective method for treating laryngeal granulomas that do not respond to antireflux therapy and speech therapy. C1 Wake Forest Univ, Sch Med, Dept Otolaryngol, Ctr Voice & Swallowing Disorders,Med Ctr, Winston Salem, NC 27157 USA. RP Postma, GN (reprint author), Wake Forest Univ, Sch Med, Dept Otolaryngol, Ctr Voice & Swallowing Disorders,Med Ctr, Med Ctr Blvd, Winston Salem, NC 27157 USA. 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Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 198 EP 201 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800005 PM 15825568 ER PT J AU Lee, M Ramaswamy, MR Lilien, DL Nathan, CAO AF Lee, M Ramaswamy, MR Lilien, DL Nathan, CAO TI Unilateral vocal cord paralysis causes contralateral false-positive positron emission tomography scans of the larynx SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE false-positive findings; larynx; positron emission tomography; unilateral vocal cord paralysis ID NECK-CANCER; EXTRACRANIAL HEAD; F-18-FDG PET; FOLD; MUSCLES; FLUORODEOXYGLUCOSE; FLUORINE-18-FDG; TUMORS; LUNG; FDG AB Positron emission tomography (PET) is used in the management of head and neck cancers. It identifies tissue with increased metabolic activity and is not specific for malignancy. A false-positive PET scan of the larynx is associated with vocal cord paralysis. We reviewed PET scan reports of patients with lung cancer from 1998 to 2001 to identify patients with increased 18-fluoro-2-deoxyglucose uptake in the larynx without a known history of head and neck cancer and then correlated this increased uptake with laryngoscopic findings. There were 17 patients who had a positive PET finding in the larynx. Fifteen of those had a false-positive PET scan in the larynx. All had contralateral vocal cord paralysis. Two patients were noted to have head and neck cancer. We conclude that vocal cord paralysis can cause a false-positive PET scan on the contralateral side of the larynx due to overactivity of laryngeal muscles that compensate for the paralyzed cord. C1 Louisiana State Univ, Hlth Sci Ctr, Dept Otolaryngol, Shreveport, LA 71130 USA. Louisiana State Univ, Hlth Sci Ctr, Dept Positron Emiss Tomog Imaging, Biomed Res Fdn, Shreveport, LA 71130 USA. Louisiana State Univ, Hlth Sci Ctr, Dept Radiol, Shreveport, LA 71130 USA. Louisiana State Univ, Hlth Sci Ctr, Dept Head & Neck Surg Oncol, Feist Weiller Canc Ctr, Shreveport, LA 71130 USA. RP Nathan, CAO (reprint author), Louisiana State Univ, Hlth Sci Ctr, Dept Otolaryngol, 1501 Kings Highway, Shreveport, LA 71130 USA. 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Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 202 EP 206 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800006 PM 15825569 ER PT J AU Nelson, M Dan, O Strome, M AF Nelson, M Dan, O Strome, M TI Direct revascularization is superior for rat parathyroid allotransplantation with FK506 SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagolog Assoc DE microvascular anastomosis; parathyroid transplantation; tacrolimus ID LARYNGEAL TRANSPLANTATION; MONOCLONAL-ANTIBODY; ALLOGRAFT; SURVIVAL; IMMUNOSUPPRESSION; CYCLOSPORINE; TACROLIMUS; GLANDS; AUTOTRANSPLANTATION; TOLERANCE AB Parathyroid gland allotransplantation has been a challenging goal for decades. Our objective was to optimize a parathyroid allotransplantation model for analysis of short-term or low-dose immunosuppressive regimens. Rats that had undergone parathyroidectomy received parathyroid allografts either by direct microvascular anastomoses as part of a composite laryngotracheal graft or by direct implantation into hind limb muscle. All rats were maintained on daily low-dose FK506 (tacrolimus). Intact serum parathyroid hormone (PTH) levels for both groups were recorded over a period of at least 45 days and compared with a repeated-measures mixed model. We found that microvascular anastomosis was superior to implantation for parathyroid gland survival, as all revascularized grafts immediately produced normal levels of PTH, whereas implanted grafts had a significantly slower recovery of function (p < .001). Four of the 11 implanted grafts (36%) never produced detectable PTH levels. Using this model, we are developing innovative strategies that will lead to successful parathyroid allotransplantation without the need for chronic immunosuppression. C1 Cleveland Clin Fdn, Head & Neck Inst, Cleveland, OH USA. RP Nelson, M (reprint author), Summit Ear Nose Throat Inc, 300 Locust St,Suite 150, Akron, OH 44302 USA. 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Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 207 EP 213 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800007 PM 15825570 ER PT J AU Eliashar, R Gross, M Goldfarb, A Sichel, JY AF Eliashar, R Gross, M Goldfarb, A Sichel, JY TI Purulent chondritis of the laryngeal framework cartilages SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE abscess; chondritis; cricoid cartilage; larynx; thyroid cartilage ID LARYNGOTRACHEAL STENOSIS; RECONSTRUCTION AB This manuscript reports on our experience with purulent chondritis of the laryngeal cartilages (PCLC), an entity that has not yet been described. Three patients had a diagnosis of PCLC. The probable causes were relapsing polychondritis, a previous prolonged intubation, and an idiopathic cause. The patients suffered from hoarseness and inspiratory stridor for 1 to 3 months before diagnosis. None complained of pain in the neck. Laryngoscopy showed supraglottic edema. A computed tomography scan revealed abscess formation between the intact inner and outer perichondria of the thyroid cartilage. The treatment included rigid endoscopy, external incision and drainage, and prolonged medical therapy. The culture results were Staphylococcus aureus in the first 2 cases and Aspergillus fumigatus in the third. The second patient (in whom the cricoid cartilage was also affected) required emergency tracheotomy. The other 2 patients did not require airway intervention. The rarity of PCLC and the relatively mild symptoms require a high index of suspicion for its diagnosis. C1 Hebrew Univ Jerusalem, Sch Med, Dept Otolaryngol Head & Neck Surg, Hadassah Med Ctr, Jerusalem, Israel. RP Eliashar, R (reprint author), Hebrew Univ Jerusalem, Sch Med, Dept Otolaryngol Head & Neck Surg, Hadassah Med Ctr, Jerusalem, Israel. 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Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 219 EP 222 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800009 PM 15825572 ER PT J AU Easterling, C Rittmann, T Hofmann, C Shaker, R AF Easterling, C Rittmann, T Hofmann, C Shaker, R TI Optimal stimulus intensity and reliability of air stimulation technique for elicitation of laryngo-upper esophageal sphincter contractile reflex SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE airway; gastroesophageal reflux; laryngo-upper esophageal sphincter contractile reflex; optimal stimulus intensity ID CLOSURE REFLEX AB To determine the optimal air stimulus intensity and duration for elicitation of the laryngo-upper esophageal sphincter (UES) contractile reflex, we studied 37 healthy volunteers 20 to 81 years of age. A sleeve device monitored the UES pressure. For laryngeal stimulation, we used an air stimulator unit (Pentax AP-4000) that incorporated a nasolaryngeal endoscope. The arytenoids and interarytenoid areas were stimulated at least three times by three different stimuli: 6-mm Hg air pulse with 50-ms duration, 10-mm Hg air pulse with 50-ms duration, and 6-mm Hg air pulse with 2-second duration. Of 1, 165 air stimulations, 1,041 resulted in mucosal deflections. Of these, 451 resulted in an abrupt increase in UES pressure. The response/deflection ratio for 6-mm Hg stimulation with 2-second duration was significantly higher than those for air pulses with 50-ms duration (p < .001). We conclude that although the laryngo-UES contractile reflex can be elicited by an air pulse with 50-ms duration, this ultrashort stimulation is not reliable. Using longer-duration pulses (at least 2 seconds) improves the reliability of elicitation of the laryngo-UES contractile reflex. C1 Med Coll Wisconsin, Dysphagia Inst, Div Gastroenterol & Hepatol, Milwaukee, WI 53226 USA. RP Shaker, R (reprint author), Froedtert Mem Lutheran Hosp, Div Gastroenterol & Hepatol, 9200 W Wisconsin Ave, Milwaukee, WI 53226 USA. 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PD MAR PY 2005 VL 114 IS 3 BP 223 EP 228 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800010 ER PT J AU Knecht, M Kittner, T Beleites, T Huttenbrink, KB Hummel, T Witt, M AF Knecht, M Kittner, T Beleites, T Huttenbrink, KB Hummel, T Witt, M TI Morphological and radiologic evaluation of the human nasopalatine duct SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE epithelium; nasal cyst; nose; olfaction; smell; vorneronasal organ AB In several mammals, a direct connection between the nasal cavity and the oral cavity is a common finding. The structure is named the nasopalatine duct (NPD). It has been hypothesized to be functional in terms of transportation of odorants from the oral cavity to the nasal cavity. In humans, the NPD exists during embryological development. The connection between the nasopalatine infundibulum and the incisive fossa is typically closed at the time of birth. We present the case of a 24-year-old man who presented with a persistent NPD. By means of a thin, soft tube, it was possible to probe the NPD. Magnetic resonance imaging revealed a bony gap between the hard palate and the alveolar process of the maxillary bone with a length of 16 mm and a width of 6 mm. In light of the literature of the past 500 years, this represents a rare finding of a persistent NPD. C1 Univ Dresden, Sch Med, Smell & Taste Clin, Dept Otorhinolaryngol, D-01307 Dresden, Germany. Univ Dresden, Sch Med, Dept Diagnost Radiol, D-01307 Dresden, Germany. Univ Dresden, Sch Med, Dept Anat, D-01307 Dresden, Germany. RP Hummel, T (reprint author), Univ Dresden, Sch Med, Smell & Taste Clin, Dept Otorhinolaryngol, Fetscherstr 74, D-01307 Dresden, Germany. EM thummel@rcs.urz.tu-dresden.de CR CLARA M, 1966, ENTWICKLUNGSGESCHICH, P263 CUVIER G, 1811, ANN MUSEUM, V18, P412 DUVERNEY M, 1771, OEUVRES ANATOMIQUES, V1, P221 FARMER ED, 1966, STONES ORAL PATHOLOG HALPERN M, 1987, ANNU REV NEUROSCI, V10, P325 Jacob S, 2000, ARCH OTOLARYNGOL, V126, P741 Knecht M, 2003, BEHAV NEUROSCI, V117, P1135, DOI 10.1037/0735-7044.117.6.1135 KOLLIKER A, 1877, GRATULATIONSSCHRIFT, P7 Leboucq H, 1881, ARCH BIOL, V2, P386 MERKEL F, 1877, ANATOM HEFTE, V3, P215 Noyes HJ, 1935, J DENT RES, V15, P155 ORAHILLY R, 1987, DEV STAGES HUMAN EMB, V631, P1 Potiquet M, 1891, REV LARYNGOL, V2, P737 ROSENTHAL N, 1827, Z PHYSL, V2, P289 RUDIGER N, 1873, TOPOGRAPHISCHE CHIRU, P106 Sadler T., 2003, LANGMANS MED EMBRYOL SANTORINI GD, 1724, VENETIIS SCHIEBLER T, 1997, ANATOMIE ZYTOLOGIE H, V6 STENSON N, 1685, BIBL ANATOM GENEV, V2, P763 SWANSON KS, 1991, J ORAL MAXIL SURG, V49, P268, DOI 10.1016/0278-2391(91)90217-A VESALE A, 1725, CORPORE HUMANI FABRI, V1 Williams PL, 1989, GRAYS ANATOMY, P354 NR 22 TC 8 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 229 EP 232 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800011 PM 15825574 ER PT J AU Vaiman, M Eviatar, E Shlamkovich, N Segal, S AF Vaiman, M Eviatar, E Shlamkovich, N Segal, S TI Use of fibrin glue as a hemostatic in endoscopic sinus surgery SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE endoscopic sinus surgery; fibrin glue; hemostatic ID TOXIC SHOCK SYNDROME; ENDONASAL OPERATIONS; NASAL PACKING; SEALANT AB Endoscopic sinus surgery (ESS), especially when combined with turbinectomy and/or with submucous resection of the septum, may involve postoperative bleeding that might end with nasal packing. Nasal packing causes pain, rhinorrhea, and inconvenience and may not stop the postoperative bleeding. The aim of our study was to compare the hemostatic properties of the second-generation surgical sealant Quixil (Crosseal) with those of nasal packing in ESS. We performed a prospective randomized trial in 64 consecutive patients who underwent ESS and presented excessive intraoperative and/or postoperative bleeding. They were allocated by the sealed-envelope method into two groups. A routine ESS procedure was ended with Merocel nasal packing in group 1, and with aerosol application of Quixil sealant at the operative site in group 2. The hemostatic effects were evaluated objectively in the clinic by anterior rhinoscopy and endoscopy and assessed subjectively by the patients at follow-up visits. In group 1, various types of postoperative bleeding occurred in 25% of patients. In group 2 there was no postoperative bleeding, except for 1 case of late hemorrhage (3.12%). Drainage and ventilation of the paranasal sinuses were not impaired. There were no allergic reactions to the glue. We conclude that aerosol application of fibrin glue can be readily performed in ESS, requires no special treatment (antibiotics), and appears to have an adequate hemostatic effect. The use of this second-generation glue in ESS appears to stop nasal bleeding well and to be relatively safe and convenient. C1 Tel Aviv Univ, Dept Otolaryngol, Assaf Harofeh Med Ctr, Sackler Fac Med, IL-69978 Tel Aviv, Israel. RP Vaiman, M (reprint author), 33 Shapira Str, IL-59561 Bat Yam, Israel. CR ABRAM AC, 1994, LARYNGOSCOPE, V104, P927 Annys E, 2000, Acta Otorhinolaryngol Belg, V54, P23 Damm M, 2002, LARYNGOSCOPE, V112, P310, DOI 10.1097/00005537-200202000-00020 GLEICH LL, 1995, OTOLARYNG HEAD NECK, V112, P238, DOI 10.1016/S0194-5998(95)70243-1 JOHANNESSEN N, 1992, ACTA OTO-LARYNGOL, P6 KALOGJERA L, 1995, ACTA OTO-LARYNGOL, V115, P304, DOI 10.3109/00016489509139315 MAY M, 1993, ENDOSCOPIC SINUS SUR MORGAN NJ, 1995, CLIN OTOLARYNGOL, V20, P411, DOI 10.1111/j.1365-2273.1995.tb00072.x *OMR CO, 2000, QUIX SUMM PROD CHAR Radosevich M, 1997, VOX SANG, V72, P133, DOI 10.1046/j.1423-0410.1997.7230133.x Scheule AM, 1998, GASTROINTEST ENDOSC, V48, P83, DOI 10.1016/S0016-5107(98)70138-5 Schliwa M., 1986, Cell Biology Monographs, V13, P1 SMITH LF, 1993, OTOLARYNG HEAD NECK, V108, P688 STAMMBERGER H, 1991, FUNCTIONAL SINUS SUR, P273 TEATINI GP, 1986, OTORHINOLARYNGOLOGY, V4, P123 Tierney PA, 1996, BRIT J CLIN PRACT, V50, P357 Vaiman M, 2002, RHINOLOGY, V40, P88 Vaiman M, 2002, OTOLARYNG HEAD NECK, V126, P388, DOI 10.1067/mhn.2002.123345 Vaiman M, 2002, RHINOLOGY, V40, P185 WAX MK, 1997, OTOLARYNGOL HEAD NEC, V117, P197 Wax MK, 1997, OTOLARYNG HEAD NECK, V116, P442, DOI 10.1016/S0194-5998(97)70292-4 Weber R, 2000, RHINOLOGY, V38, P49 Weber R, 2001, AM J OTOLARYNG, V22, P306, DOI 10.1053/ajot.2001.26499 Younis RT, 1996, ARCH OTOLARYNGOL, V122, P83 NR 24 TC 30 Z9 33 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 237 EP 241 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800013 PM 15825576 ER PT J AU Doherty, JK Maceri, DR AF Doherty, JK Maceri, DR TI Ossicular discontinuity and exostoses in proteus syndrome: A case report SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE conductive hearing loss; exostosis; ossicular discontinuity; proteus syndrome ID HEARING-LOSS; PTEN AB Proteus syndrome (PS) is a rare hamartomatous disorder characterized by mosaic overgrowth of multiple tissues that manifests early in life and is progressive. The presence of unilateral external auditory canal exostoses in a patient who is not a swimmer or surfer is suggestive of PS. However, hearing loss is not a typical feature. Here, we describe exostoses and ossicular discontinuity with conductive hearing loss in a patient with PS. The treatment consisted of canalplasty and ossicular chain reconstruction. A postoperative reduction was demonstrated in the patient's air-bone gap, from 21 dB to 13 dB for the pure tone average (four frequencies) and from 41 dB to 15 dB in the high-frequency range (6,000 to 8,000 Hz). Causes of ossicular discontinuity are discussed. Routine annual audiometric and otolaryngological evaluation should be considered in all patients with temporal bone involvement of PS. C1 Univ So Calif, Med Ctr, Dept Otolaryngol Head & Neck Surg, Los Angeles, CA 90033 USA. Childrens Hosp Los Angeles, Dept Otolaryngol Head & Neck Surg, Los Angeles, CA 90027 USA. RP Maceri, DR (reprint author), Univ So Calif, Med Ctr, Dept Otolaryngol Head & Neck Surg, 1200 N State St,Room 4136, Los Angeles, CA 90033 USA. CR ANDERSON H, 1971, ARCHIV OTOLARYNGOL, V93, P599 BALE PM, 1993, PEDIATR PATHOL, V13, P797 Becktor KB, 2002, CLEFT PALATE-CRAN J, V39, P233, DOI 10.1597/1545-1569(2002)039<0233:CADMOP>2.0.CO;2 BERGSTROM L, 1981, CLIN ORTHOP RELAT R, P58 Biesecker LG, 2001, JAMA-J AM MED ASSOC, V285, P2240, DOI 10.1001/jama.285.17.2240 Cohen M M Jr, 1979, Birth Defects Orig Artic Ser, V15, P291 Cohen MM, 2001, AM J MED GENET, V101, P1, DOI 10.1002/ajmg.1311 HAPPLE R, 1987, J AM ACAD DERMATOL, V16, P899, DOI 10.1016/S0190-9622(87)80249-9 Lublin M, 2002, J PEDIATR SURG, V37, P1013, DOI 10.1053/jpsu.2002.33832 MUSTAIN WD, 1981, LARYNGOSCOPE, V91, P599, DOI 10.1288/00005537-198104000-00013 RAMAN R, 1989, J CRANIO MAXILL SURG, V17, P143, DOI 10.1016/S1010-5182(89)80088-5 Smith JM, 2002, J MED GENET, V39, P937, DOI 10.1136/jmg.39.12.937 Waite KA, 2002, AM J HUM GENET, V70, P829, DOI 10.1086/340026 Zhou XP, 2002, J MOL DIAGN, V4, P114, DOI 10.1016/S1525-1578(10)60690-3 NR 14 TC 0 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 242 EP 246 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800014 PM 15825577 ER PT J AU Graham, SA Carter, KD AF Graham, SA Carter, KD TI Response of visual loss in allergic fungal sinusitis to oral corticosteroids SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE allergic fungal sinusitis; corticosteroids; visual loss ID DIAGNOSIS; RHINOSINUSITIS; STEROIDS AB Visual loss associated with allergic fungal sinusitis is most often treated with surgery followed by oral corticosteroids. A case is presented in which, because of substantial medical comorbidities, surgery could not be initially performed and the visual loss was corrected with prednisone alone. This case serves to reinforce the central role of corticosteroids in treatment of this enigmatic condition. C1 Univ Iowa, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA. Univ Iowa, Div Oculoplast & Orbital Surg, Dept Ophthalmol & Visual Sci, Iowa City, IA 52242 USA. RP Graham, SA (reprint author), Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, 200 Hawkins Dr,21201 PFP, Iowa City, IA 52242 USA. CR BENT JP, 1994, OTOLARYNG HEAD NECK, V111, P580, DOI 10.1016/S0194-5998(94)70525-9 Carter KD, 1999, AM J OPHTHALMOL, V127, P189, DOI 10.1016/S0002-9394(98)00371-7 Dhong HJ, 2001, DIS SINUSES DIAGNOSI, P179 DUNLOP IS, 1988, BRIT J OPHTHALMOL, V72, P127, DOI 10.1136/bjo.72.2.127 Ferguson BJ, 2000, LARYNGOSCOPE, V110, P799, DOI 10.1097/00005537-200005000-00010 Graham SM, 1999, CLIN OTOLARYNGOL, V24, P109 Graham SM, 1998, J ALLERGY CLIN IMMUN, V101, P139, DOI 10.1016/S0091-6749(98)70211-8 Klapper SR, 1997, OPHTHALMOLOGY, V104, P2094 Kuhn FA, 2000, OTOLARYNG CLIN N AM, V33, P419 Levin LA, 1999, OPHTHALMOLOGY, V106, P1268 Mabry RL, 1998, OTOLARYNG HEAD NECK, V119, P648, DOI 10.1016/S0194-5998(98)70027-0 Marple BF, 1999, AM J RHINOL, V13, P191, DOI 10.2500/105065899781389740 Ponikau JU, 1999, MAYO CLIN PROC, V74, P877 Roth M, 1994, Ear Nose Throat J, V73, P928 NR 14 TC 3 Z9 4 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 247 EP 249 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800015 PM 15825578 ER PT J AU Ximenes, JA Bohadana, SC Perazzio, AF Tsuji, DH Sennes, LU AF Ximenes, JA Bohadana, SC Perazzio, AF Tsuji, DH Sennes, LU TI Anatomy of the cricothyroid articulation: Differences between men and women SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 3rd Sao-Paulo-University Otolaryngology Meeting CY AUG 07-09, 2003 CL Sao Paulo, BRAZIL SP Sao Paulo Univ HO Sao Paulo Univ DE anatomy; arytenoid cartilage; cricothyroid articulation; gender difference; laryngeal framework surgery AB A greater difficulty in exposing the arytenoid cartilage during rotation surgeries has been observed for men. The objective of the present study was to describe the position of the cricothyroid articulation and the distance between the right and left articulations, and to compare these findings between genders. The following measurements were obtained for 16 cadavers (9 men and 7 women): angulation of the cricothyroid articulation in the cricoid ring, dimensions of the thyroid articular surface of the cricoid cartilage, and distance between the cricothyroid and cricoarytenoid articulations. The cricothyroid articulation angle was narrower in men than in women (p = .04). The major diameter of the articular facet of the thyroid cartilage was wider in men (p = .001). The longer lamina of the thyroid cartilage, as well as the more posterior position of the cricothyroid articulation, in men might explain the greater difficulty in exposing the arytenoid cartilage during laryngeal framework surgeries observed for this group of patients. C1 Univ Sao Paulo, Sch Med, Dept Otorhinolaryngol, Sao Paulo, Brazil. RP Ximenes, JA (reprint author), Rua Paula Ney,700-1202, BR-60140200 Fortaleza, Ceara, Brazil. RI Sennes, Luiz/E-6815-2012 CR Hong KH, 1998, OTOLARYNG HEAD NECK, V118, P714, DOI 10.1177/019459989811800530 ISSHIKI N, 1978, ARCH OTOLARYNGOL, V104, P555 KIRCHNER JA, 1993, LARYNGOSCOPE, V103, P1197, DOI 10.1288/00005537-199310000-00025 Maragos NE, 1999, LARYNGOSCOPE, V109, P1228, DOI 10.1097/00005537-199908000-00008 Reidenbach M M, 1995, Clin Anat, V8, P327, DOI 10.1002/ca.980080504 Sataloff RT, 1998, J VOICE, V12, P112, DOI 10.1016/S0892-1997(98)80083-0 VILKMAN EA, 1987, ACTA OTO-LARYNGOL, V103, P117, DOI 10.3109/00016488709134706 Ximenes Filho João Aragão, 2003, Rev. Bras. Otorrinolaringol., V69, P371, DOI 10.1590/S0034-72992003000300012 Zeitels SM, 1999, ANN OTO RHINOL LARYN, V108, P1126 NR 9 TC 2 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD MAR PY 2005 VL 114 IS 3 BP 250 EP 252 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 906DN UT WOS:000227620800016 PM 15825579 ER PT J AU Battiata, AP Casler, J AF Battiata, AP Casler, J TI Sclerosing epithelioid fibrosarcoma: A case report SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE head and neck sarcoma; sclerosing epithelioid fibrosarcoma AB Sclerosing epithelioid fibrosarcoma (SEF) is a rare variant of fibrosarcoma. It is a mesenchymal neoplasm composed of round to oval cells dispersed in a nestlike or cordlike distribution on a highly collagenous tissue background and is now recognized as a distinct clinical entity. In this report we discuss the presentation, diagnosis, and treatment of SEE We focus on the unique histologic and immunohistochemical properties of this lesion. It is essential for both the surgeon and the pathologist to be aware of SEF and include it in the differential diagnosis for atypical head and neck neoplasms. Sclerosing epithelioid fibrosarcoma is a rare neoplasm that is now listed among the low-grade neoplasms that may occur in the head and neck. However, its behavior tends to be typical of more aggressive lesions. An awareness of this characteristic of SEF is essential for clinicians and pathologists alike. C1 Walter Reed Army Med Ctr, Dept Surg, Otolaryngol Head & Neck Surg Serv, Washington, DC 20307 USA. RP Battiata, AP (reprint author), Walter Reed Army Med Ctr, Dept Surg, Otolaryngol Head & Neck Surg Serv, Washington, DC 20307 USA. CR Antonescu CR, 2001, AM J SURG PATHOL, V25, P699, DOI 10.1097/00000478-200106000-00001 Bilsky MH, 2000, NEUROSURGERY, V47, P956, DOI 10.1097/00006123-200010000-00031 Hanson IM, 2001, J CLIN PATHOL, V54, P721 MEISKINDBLOM JM, 1995, AM J SURG PATHOL, V19, P979, DOI 10.1097/00000478-199509000-00001 NR 4 TC 5 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 87 EP 89 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500001 PM 15757185 ER PT J AU Semple, CW Berkowitz, RG Mitchell, PJ AF Semple, CW Berkowitz, RG Mitchell, PJ TI Embolization of an extracranial internal carotid artery pseudoaneurysm SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE aneurysm; carotid artery; deep neck space infection; endovascular embolization; pharyngeal abscess pseudoaneurysm ID HEMORRHAGE; ANEURYSM; CHILD AB Deep neck space infections are rarely complicated by pseudoaneurysms of the extracranial internal carotid artery. This condition has a high mortality rate with conservative management and significant morbidity with open surgical techniques. Recent advances in endovascular therapy have allowed embolization of the diseased vessel to be performed with a more acceptable safety profile. We report a case of an extracranial internal carotid artery pseudoaneurysm complicating a deep neck space infection in an adolescent that was treated with selective endovascular embolization. We present the findings of computed tomography, magnetic resonance angiography, and conventional angiography. C1 Royal Childrens Hosp, Dept Otolaryngol, Parkville, Vic 3052, Australia. Royal Melbourne Hosp, Dept Radiol, Melbourne, Vic, Australia. RP Berkowitz, RG (reprint author), Royal Childrens Hosp, Dept Otolaryngol, Flemington Rd, Parkville, Vic 3052, Australia. CR GARINO JP, 1987, AM J EMERG MED, V5, P220, DOI 10.1016/0735-6757(87)90325-1 Glaiberman CB, 2003, PEDIATR RADIOL, V33, P211, DOI 10.1007/s00247-002-0844-y HOGARTH T B, 1959, J Laryngol Otol, V73, P764, DOI 10.1017/S0022215100055985 LEE KJ, 2003, ESSENTIAL OTOLARYNGO, P428 Lotina S, 1997, Srp Arh Celok Lek, V125, P141 Moreau P, 1994, Ann Vasc Surg, V8, P409, DOI 10.1007/BF02133059 Naik DK, 1995, AUST NZ J SURG, V65, P620, DOI 10.1111/j.1445-2197.1995.tb01714.x Reisner A, 1999, J NEUROSURG, V91, P510, DOI 10.3171/jns.1999.91.3.0510 Salinger S, 1933, ARCHIV OTOLARYNGOL, V18, P464 NR 9 TC 7 Z9 8 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 90 EP 94 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500002 PM 15757186 ER PT J AU Kania, R Hans, S Garcia, D Brasnu, D De Mones, E Laccourreye, O AF Kania, R Hans, S Garcia, D Brasnu, D De Mones, E Laccourreye, O TI Supracricoid hemilaryngopharyngectomy in patients with invasive squamous cell carcinoma of the pyriform sinus - Part II Incidence and consequences of local recurrence SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE pyriform sinus; squamous cell carcinoma; supracricoid hemilaryngopharyngectomy ID RADIATION-THERAPY; PIRIFORM SINUS; HYPOPHARYNGEAL CARCINOMA; ORGAN PRESERVATION; SURGERY; CANCER; RADIOTHERAPY; PATTERNS AB Supracricoid hemilaryngopharyngectomy (SCHLP) was performed in 147 patients over a 19-year period for previously untreated invasive squamous cell carcinoma of the pyriform sinus. With a minimum of 3 years' follow-up, the current retrospective series was designed to document the incidence, risk factors, and consequences of local recurrence following SCHLP. Before operation, 97.4% of patients had an induction chemotherapy regimen. A complete clinical response and a complete histologic regression were noted in 21.7% and 16.8% of patients, respectively. A significant statistical relationship (p = .0001) was noted between complete, clinical response and complete histologic regression. Postoperative radiotherapy was used in 49.8% of patients. The overall local recurrence rate was 8.2%. The 5-year actuarial (Kaplan-Meier life-table method) local control estimate was 90.4%. As a function of T stage, the 5-year actuarial local control estimates were 96.2%, 91.1%, 92.9%, and 62.6% in patients with tumors classified as T I, T2, T3, and T4a, respectively. On univariate analysis, the overall local recurrence rate varied significantly, from 5.3% to 55.6% if the apex of the pyriform sinus was invaded (p = .02), 6.9% to 18.7% if the posterior pharyngeal wall was invaded (p=.03), and 6.3% to 60% if the margins of resection were positive (p=.02). In a stepwise regression model, positive margins of resection (odds ratio, 8.4; 95% confidence interval, 2.2 to 32.2; p = .002) and invasion of the apex of the pyriform sinus (odds ratio, 6.1; 95% confidence interval, 1.1 to 33.3; p = .04) were the variables statistically associated with an increased risk of local recurrence. Local recurrence resulted in a statistically significant increased risk of nodal recurrence (p = .005) and death (p < .004). The overall laryngeal preservation rate was 91.2%. From an oncological perspective, theme results suggest that SCHLP should become a major tool in the armamentarium of the head and neck surgeon and should be integrated into future trials aimed at organ preservation in patients with invasive squamous cell carcinoma of the pyriform sinus. C1 Univ Paris 05, Dept Otorhinolaryngol Head & Neck Surg, Hop Europeen Georges Pompidou, Assistance Publ Hop Paris, F-75015 Paris, France. RP Laccourreye, O (reprint author), Univ Paris 05, Dept Otorhinolaryngol Head & Neck Surg, Hop Europeen Georges Pompidou, Assistance Publ Hop Paris, 20-40 Rue LeBlanc, F-75015 Paris, France. CR AHMAD K, 1984, ACTA RADIOL ONCOL, V23, P21 Amdur RJ, 2001, HEAD NECK-J SCI SPEC, V23, P353, DOI 10.1002/hed.1044 BATAINI P, 1982, INT J RADIAT ONCOL, V8, P1277 CHARLSON ME, 1987, J CHRON DIS, V40, P373, DOI 10.1016/0021-9681(87)90171-8 Chevalier D, 1997, HEAD NECK-J SCI SPEC, V19, P1, DOI 10.1002/(SICI)1097-0347(199701)19:1<1::AID-HED1>3.0.CO;2-A Czaja JM, 1997, ANN OTO RHINOL LARYN, V106, P909 DUBOIS JB, 1986, RADIOLOGY, V160, P831 Garden AS, 1996, HEAD NECK-J SCI SPEC, V18, P317, DOI 10.1002/(SICI)1097-0347(199607/08)18:4<317::AID-HED2>3.0.CO;2-0 Greene FL, 2002, AJCC CANC STAGING MA, V6th Ho CM, 1997, ARCH OTOLARYNGOL, V123, P959 Hoffman HT, 1997, LARYNGOSCOPE, V107, P1005, DOI 10.1097/00005537-199708000-00001 KAPLAN EL, 1958, J AM STAT ASSOC, V53, P457, DOI 10.2307/2281868 Kraus DH, 1997, OTOLARYNG HEAD NECK, V116, P637, DOI 10.1016/S0194-5998(97)70240-7 LACCOURREYE H, 1987, ANN OTO RHINOL LARYN, V96, P217 LACCOURREYE O, 1993, LARYNGOSCOPE, V103, P1373 LACOURREYE O, 2005, ANN OTO RHINOL LARYN, V114, P25 Lefebvre JL, 1996, J NATL CANCER I, V88, P890, DOI 10.1093/jnci/88.13.890 LOOSER KG, 1978, HEAD NECK SURG, V1, P107, DOI 10.1002/hed.2890010203 MARKS JE, 1978, CANCER, V41, P1008, DOI 10.1002/1097-0142(197803)41:3<1008::AID-CNCR2820410332>3.0.CO;2-F MENDENHALL WM, 1987, HEAD NECK-J SCI SPEC, V10, P88, DOI 10.1002/hed.2890100205 MOHR RM, 1983, ARCH OTOLARYNGOL, V109, P384 Niibe Y, 2003, JPN J CLIN ONCOL, V33, P450, DOI 10.1093/jjco/hyg084 OGURA J H, 1960, Laryngoscope, V70, P1399 Pameijer FA, 1998, HEAD NECK-J SCI SPEC, V20, P159, DOI 10.1002/(SICI)1097-0347(199803)20:2<159::AID-HED10>3.0.CO;2-H Prades JM, 2002, ARCH OTOLARYNGOL, V128, P384 ROBBINS KT, 1991, ARCH OTOLARYNGOL, V117, P601 SHAH JP, 1976, AM J SURG, V132, P439, DOI 10.1016/0002-9610(76)90315-9 Steiner W, 2001, OTOLARYNG HEAD NECK, V124, P58, DOI 10.1067/mhn.2001.111597 VANDENBROUCK C, 1987, HEAD NECK-J SCI SPEC, V10, P4, DOI 10.1002/hed.2890100103 Zbaren P, 1997, LARYNGOSCOPE, V107, P511 NR 30 TC 10 Z9 10 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 95 EP 104 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500003 PM 15757187 ER PT J AU Bertholon, P Chelikh, L Tringali, S Timoshenko, AP Martin, C AF Bertholon, P Chelikh, L Tringali, S Timoshenko, AP Martin, C TI Combined horizontal and posterior canal benign paroxysmal positional vertigo in three patients with head trauma SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE benign paroxysmal positional vertigo; head trauma; positional nystagmus ID INJURY; CANALOLITHIASIS; NYSTAGMUS; DIZZINESS; FEATURES; VARIANT; BPPV AB We report 3 patients who complained of positional vertigo shortly after head trauma. Positional maneuvers performed in the plane of the posterior canal (PC; Dix-Hallpike maneuver) and the horizontal canal (HC; patients were rolled to either side in a supine position with the head raised 30degrees) revealed a complex positional nystagmus that could only be interpreted as the result of combined PC and HC benign paroxysmal positional vertigo (BPPV). Two patients had a right PC BPPV and an ageotropic HC BPPV, and I patient had a bilateral PC BPPV and a left geotropic HC BPPV. All 3 patients were rapidly free of vertigo after the PC BPPV was cured by the Epley maneuver and the geotropic HC BPPV was cured by the Vannucchi method. The ageotropic HC BPPV resolved spontaneously. Neuroimaging (brain computed tomography and/or magnetic resonance: imaging scans) findings were normal in all 3 patients. From a physiopathological viewpoint,. it is easy to conceive that head trauma could throw otoconial debris into different canals of each labyrinth and be responsible for these combined forms of BPPV. Consequently, in trauma patients with vertigo, it is mandatory to perform the Dix-Hallpike maneuver, as well as supine lateral head turns, in order to diagnose PC BPPV, HC BPPV, or the association of both. Early diagnosis and treatment of BPPV may help to reduce the postconcussion syndrome. C1 Hop Bellevue, Serv ORL, Dept Otorhinolaryngol Head & Neck Surg, F-42055 St Etienne 2, France. RP Bertholon, P (reprint author), Hop Bellevue, Serv ORL, Dept Otorhinolaryngol Head & Neck Surg, F-42055 St Etienne 2, France. CR BALOH RW, 1993, NEUROLOGY, V43, P2542 BALOH RW, 1995, NEUROLOGY, V45, P1297 BALOH RW, 1987, NEUROLOGY, V37, P371 BARBER H O, 1964, Laryngoscope, V74, P891 BERMAN JM, 1978, J OTOLARYNGOL, V7, P237 Bisdorff AR, 2001, NEUROLOGY, V57, P1085 BLAKLEY BW, 1994, OTOLARYNG HEAD NECK, V110, P391 Bronstein AM, 2003, J NEUROL NEUROSUR PS, V74, P289, DOI 10.1136/jnnp.74.3.289 Casani A, 1997, LARYNGOSCOPE, V107, P807, DOI 10.1097/00005537-199706000-00016 Casani AP, 2002, LARYNGOSCOPE, V112, P172, DOI 10.1097/00005537-200201000-00030 DAVIES RA, 1995, J NEUROL, V242, P222, DOI 10.1007/BF00919595 DelaMeilleure G, 1996, J NEUROL NEUROSUR PS, V60, P68, DOI 10.1136/jnnp.60.1.68 DIX MR, 1952, ANN OTO RHINOL LARYN, V61, P987 EPLEY JM, 1992, OTOLARYNG HEAD NECK, V107, P399 Fife TD, 1998, AM J OTOL, V19, P345 Fitzgerald DC, 1996, J TRAUMA, V40, P488, DOI 10.1097/00005373-199603000-00034 Katsarkas A, 1999, ACTA OTO-LARYNGOL, V119, P745, DOI 10.1080/00016489950180360 LEMPERT T, 1994, NEUROLOGY, V44, P2213 MCCLURE JA, 1985, J OTOLARYNGOL, V14, P30 Nuti D, 1996, J VESTIBUL RES-EQUIL, V6, P173 PAGNINI P, 1989, ORL J OTO-RHINO-LARY, V51, P161 Sakaida M, 2003, NEUROLOGY, V60, P1532 SCHUKNEC.HF, 1969, ANN OTO RHINOL LARYN, V78, P253 Steddin S, 1996, ANN NEUROL, V40, P918 Vannucchi P, 1997, J VESTIBUL RES-EQUIL, V7, P1 NR 25 TC 13 Z9 14 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 105 EP 110 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500004 PM 15757188 ER PT J AU Smith, JL Sweeney, DM Smallman, B Mortelliti, AJ AF Smith, JL Sweeney, DM Smallman, B Mortelliti, AJ TI State-dependent laryngomalacia in sleeping children SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article ID CONGENITAL LARYNGEAL STRIDOR; ACQUIRED LARYNGOMALACIA; BRONCHOSCOPY AB Laryngomalacia is a common congenital laryngeal abnormality. Despite its being widely discussed in the literature, the pathophysiology is not clearly understood. Both anatomic and neuromuscular theories have been suggested to explain laryngomalacia. We report 4 cases of laryngomalacia in which the presenting signs occurred during sleeps Awake flexible nasopharyngolaryngoscopy failed to demonstrate supraglottic structure collapse. Only while the patients were breathing spontaneously under general anesthesia was laryngomalacia noted. A proposed algorithm for diagnosis and treatment is included. These 4 cases of state-dependent laryngomalacia support a neuromuscular cause for laryngomalacia. C1 Upstate Med Univ, Dept Otolaryngol & Commun Sci, Syracuse, NY 13210 USA. Upstate Med Univ, Dept Anesthesia, Pediat Sect, Syracuse, NY 13210 USA. RP Mortelliti, AJ (reprint author), Upstate Med Univ, Dept Otolaryngol & Commun Sci, 750 E Adams St, Syracuse, NY 13210 USA. 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PD FEB PY 2005 VL 114 IS 2 BP 111 EP 114 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500005 PM 15757189 ER PT J AU Plouin-Gaudon, I Lawson, G Jamart, J Remacle, M AF Plouin-Gaudon, I Lawson, G Jamart, J Remacle, M TI Subtotal carbon dioxide laser arytenoidectomy for the treatment of bilateral vocal fold immobility: Long-term results SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE bilateral vocal fold immobility; carbon dioxide laser; subtotal arytenoidectomy ID CORD PARALYSIS; MEDIAL ARYTENOIDECTOMY; POSTERIOR CORDECTOMY; LARYNGEAL PARALYSIS; MANAGEMENT; SURGERY; REINNERVATION; ADDUCTION; FIXATION; STENOSIS AB Sixty-nine patients underwent subtotal carbon dioxide laser arytenoidectomy for treatment of bilateral vocal fold immobility between 1985 and 2000. The population included 69 patients whose mean age was 56 years (SD, 16 years; range, I I to 82 years). The mean follow-up was 50 months (SD, 44 months; range, I to 181 months). The overall postoperative peak expiratory/peak inspiratory flow ratio (normal value, 1) significantly improved (closer to 1; p = .0036). Voice analyses were also undertaken for 27 patients, almost exclusively after operation, given the context of initial emergency. The maximum phonation time averaged 6.57 seconds (median, 6 seconds). The phonation quotient remained high, with a mean of 503 (median, 440), and the mean conversational voice intensity remained around 59 dB. The median frequency analysis type was 3. The advantage of subtotal arytenoidectomy ties in the fact that it maintains a certain degree of rigidity along the posterior limit of the arytenoid frame, preventing inward collapse of the mucosa and thus lowering the risk of aspiration. C1 Louvain Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, B-5530 Yvoir, Belgium. Louvain Univ Hosp, Ctr Biostat & Med Documentat, B-5530 Yvoir, Belgium. RP Remacle, M (reprint author), Louvain Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, B-5530 Yvoir, Belgium. 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Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 115 EP 121 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500006 PM 15757190 ER PT J AU Karlidag, T Ilhan, N Kaygusuz, I Keles, E Yalcin, S Yildiz, M AF Karlidag, T Ilhan, N Kaygusuz, I Keles, E Yalcin, S Yildiz, M TI Roles of free radicals, nitric oxide, and scavenging enzymes in nasal polyp development SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE antioxidant; free oxygen radical; nasal polyp; nitric oxide ID EXPERIMENTAL OTITIS-MEDIA; LIPID-PEROXIDATION; OXYGEN RADICALS; SYNTHASE; EXPRESSION; MUCOSA; INJURY; SERUM; ASSAY; INFLAMMATION AB The aim of this study was to investigate the role of nitric oxide (NO), free oxygen radicals, and scavenging enzymes in the development of nasal polyp (NP) disease. This study included 41 patients who underwent endoscopic surgery because of NPs. Control specimens were taken from the inferior turbinate of 32 patients who underwent septoplasty. The levels of malondialdehyde (MDA), NO, and superoxide dismutase (SOD) were measured in intraoperative specimens of polyp tissue and turbinate mucosa. The levels of tissue NO were 191.06 +/- 26.62 mumol/mg of protein in patients with NPs and 145.30 +/- 19.19 mumol/mg of protein (p < .001) in the control group. The levels of MDA in the study and control groups were 12.47 +/- 2.12 nmol/mg and 8.83 +/- 1.08 nmol/mg (p < .01), respectively. The levels of SOD in the study and control groups were 50.77 +/- 14.74 U/mg and 77.93 +/- 15.31 U/mg (p < .001), respectively. It was determined that the levels of MDA in plasma and erythrocytes were higher in the patients with NPs than in the control group (p < .05). The levels of NO in plasma and erythrocytes in both groups were similar. The levels of SOD in plasma and erythrocytes were lower in patients with NPs than in the control group (p > .05). Increases in the levels of tissue MDA and NO and decreases in scavenging enzymes in patients with NPs as compared to control groups may indicate the presence of free radical damage in patients with nasal NPs. New studies are needed to clarify the efficacy of using antioxidants in the treatment of NPs. C1 Firat Univ, Fac Med, Dept Otorhinolaryngol, TR-23119 Elazig, Turkey. Firat Univ, Fac Med, Dept Biochem, TR-23119 Elazig, Turkey. RP Karlidag, T (reprint author), Firat Univ, Fac Med, Dept Otorhinolaryngol, TR-23119 Elazig, Turkey. 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Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 122 EP 126 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500007 PM 15757191 ER PT J AU Yuge, T Nibu, K Kondo, K Shibahara, J Tayama, N Sugasawa, M AF Yuge, T Nibu, K Kondo, K Shibahara, J Tayama, N Sugasawa, M TI Loss of FHIT expression in squamous cell carcinoma and premalignant lesions of the larynx SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE dysplasia; FHIT; head and neck squamous cell carcinoma; larynx ID LUNG-CANCER; GENE; PROTEIN; ABNORMALITIES; DYSPLASIA; 3P14.2; TUMORS; LINES; HEAD AB The tumor suppressor gene FHIT (fragile histidine triad) at chromosomal position 3p14.2 is altered by deletions in human tumors. The frequency and specificity of its inactivation vary among carcinomas, but few articles have referred to premalignant lesions such as dysplasia. We studied the expression of FHIT in a series of squamous cell carcinomas and premalignant lesions of the larynx. We observed 36 laryngeal carcinoma biopsy specimens and 70 dysplasia biopsy specimens. We studied FHIT expression in carcinoma and dysplasia with the immunohistochemical ABC (avidin-biotinylated peroxidase complex) method. Loss of FHIT protein was observed in 42% of the squamous cell carcinomas and 23% of the premalignant lesions. There was no significant difference among the three grades of dysplasia in FHIT expression. These findings of loss of FHIT protein expression, not only in squamous cell carcinoma, but also in premalignant lesions, indicate that FHIT alterations play an important role in the early events of carcinogenesis. C1 Univ Tokyo, Shinjuku Ku, Int Med Ctr Japan,Grad Sch Med, Dept Otolaryngol, Tokyo 1628655, Japan. Univ Tokyo, Dept Otolaryngol Head & Neck Surg, Grad Sch Med, Tokyo 113, Japan. Univ Tokyo, Dept Pathol, Grad Sch Med, Tokyo, Japan. Kobe Univ, Dept Otolaryngol Head & Neck Surg, Grad Sch Med, Kobe, Hyogo 657, Japan. RP Yuge, T (reprint author), Univ Tokyo, Shinjuku Ku, Int Med Ctr Japan,Grad Sch Med, Dept Otolaryngol, Toyama 1-21-1, Tokyo 1628655, Japan. CR BLACKWELL KE, 1995, CANCER, V75, P457, DOI 10.1002/1097-0142(19950115)75:2<457::AID-CNCR2820750208>3.0.CO;2-9 Gotte K, 2000, ANTICANCER RES, V20, P1057 Greenspan DL, 1997, CANCER RES, V57, P4692 Hayashi S, 1997, CANCER RES, V57, P1981 HELLQUIST H, 1982, CLIN OTOLARYNGOL, V7, P11, DOI 10.1111/j.1365-2273.1982.tb01557.x Ji L, 1999, CANCER RES, V59, P3333 JONES MH, 1992, ONCOGENE, V7, P1631 Lee JI, 2001, CANCER RES, V61, P837 Lima CD, 1997, SCIENCE, V278, P286, DOI 10.1126/science.278.5336.286 Ohta M, 1996, CELL, V84, P587, DOI 10.1016/S0092-8674(00)81034-X Pace HC, 1998, P NATL ACAD SCI USA, V95, P5484, DOI 10.1073/pnas.95.10.5484 Silvestri F, 1997, Acta Otolaryngol Suppl, V527, P49 Sozzi G, 1998, ADV CANCER RES, V74, P141, DOI 10.1016/S0065-230X(08)60766-6 Sozzi G, 1997, CANCER RES, V57, P5207 Sozzi G, 1996, CELL, V85, P17, DOI 10.1016/S0092-8674(00)81078-8 Sozzi G, 1998, CANCER RES, V58, P5032 Tanimoto K, 2000, BRIT J CANCER, V82, P838, DOI 10.1054/bjoc.1999.1009 van Heerden WFP, 1999, J ORAL PATHOL MED, V28, P433 Virgilio L, 1996, P NATL ACAD SCI USA, V93, P9770, DOI 10.1073/pnas.93.18.9770 Yoshino K, 2000, INT J CANCER, V85, P6, DOI 10.1002/(SICI)1097-0215(20000101)85:1<6::AID-IJC2>3.3.CO;2-Y NR 20 TC 6 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 127 EP 131 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500008 PM 15757192 ER PT J AU Sonoda, S Kataoka, H Inoue, T AF Sonoda, S Kataoka, H Inoue, T TI Traction of lateral cricoarytenoid muscle for unilateral vocal fold paralysis: Comparison with Isshiki's original technique of arytenoid adduction SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE arytenoid adduction; Isshiki method; lateral cricoarytenoid muscle; traction of lateral cricoarytenoid muscle ID CORD PARALYSIS; CANINE MODEL; MEDIALIZATION; SURGERY AB Between 1995 and 1997, we performed Isshiki's original method of arytenoid adduction alone or as an adjunct to type I thyroplasty for the treatment of unilateral vocal fold paralysis. From 1997 onward, we performed arytenoid adduction by traction of the lateral cricoarytenoid muscle (Iwamura's method), because it reduces discomfort to the patient and avoids rotation of the thyroid cartilage. Preliminary experiments and surgical procedures involving traction of the lateral cricoarytenoid muscle are described. Of 21 patients with a maximum phonation time of less than 9 seconds, 14 underwent type I thyroplasty as an adjunct to our method of arytenoid adduction and 7 underwent arytenoid adduction alone. Sixteen patients (76%) were able after surgery to extend their maximum phonation time beyond 10 seconds; this result compares favorably with the results of Isshiki's original adduction technique. We describe useful anatomic landmarks for approaching the lateral cricoarytenoid muscle in the hope that more voice surgeons will adopt this approach in the treatment of unilateral vocal fold paralysis. C1 Shiga Univ Med Sci, Dept Otolaryngol, Otsu, Shiga 5202192, Japan. RP Sonoda, S (reprint author), Shiga Univ Med Sci, Dept Otolaryngol, Otsu, Shiga 5202192, Japan. CR BAKEN RJ, 1977, FOLIA PHONIATR, V29, P206 Friedrich G, 1997, J VOICE, V11, P345, DOI 10.1016/S0892-1997(97)80014-8 Gacek M, 1996, LARYNGOSCOPE, V106, P1528, DOI 10.1097/00005537-199612000-00016 GREEN DC, 1991, ANN OTO RHINOL LARYN, V100, P280 HAJI T, 1994, P 3 INT S PHON KYOT, P67 Hoffman Henry T., 1996, Head and Neck, V18, P174, DOI 10.1002/(SICI)1097-0347(199603/04)18:2<174::AID-HED10>3.0.CO;2-F ISSHIKI N, 1978, ARCH OTOLARYNGOL, V104, P555 Iwamura S, 1996, HEAD NECK SURG JPN, V6, P1 Kraus DH, 1999, HEAD NECK-J SCI SPEC, V21, P52 MARAGOS N, 1994, P 3 INT S PHON KYOT, P62 Noordzij JP, 1998, ANN OTO RHINOL LARYN, V107, P454 PEARSON BW, 1975, LARYNGOSCOPE, V85, P700, DOI 10.1288/00005537-197504000-00014 SAWASHIM.M, 1968, ARCH OTOLARYNGOL, V87, P289 SLAVIT DH, 1992, ANN OTO RHINOL LARYN, V101, P321 YAMAGUCHI H, 1994, P 3 INT S PHON KYOT, P224, DOI 10.1109/ISSCC.1994.344660 Zeitels SM, 1998, ANN OTO RHINOL LARYN, V107, P2 NR 16 TC 6 Z9 6 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 132 EP 138 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500009 PM 15757193 ER PT J AU Ishida, H Yoshida, T Iwae, S Amatsu, M AF Ishida, H Yoshida, T Iwae, S Amatsu, M TI Immunohistochemical study on distribution of mast cell phenotypes in human laryngeal mucosa: Evidence for laryngeal type I allergy SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article ID NASAL-MUCOSA; HETEROGENEITY; LARYNGITIS AB It is controversial whether or not type I allergic reactions can occur in the human laryngeal mucosa. To clarify this issue, we studied the distribution of mast cell phenotypes in the human laryngeal mucosa using the immunohistochemical staining method with antihuman tryptase and chymase antibodies. A large number of mast cells are present in the superficial layer of subepithelial connective tissue (SECT) of the epiglottis, arytenoid, and subglottis. Although mast cells containing both tryptase and chymase are predominant in the deep layer of the SECT, the majority of mast cells containing tryptase alone are located in both the epithelial layer and the superficial layer of the SECT. We conclude that the human laryngeal mucosa has the potential to induce type I allergic reaction. C1 Kobe Univ, Dept Otorhinolaryngol Head & Neck Surg, Grad Sch Med, Chuo Ku, Kobe, Hyogo 657, Japan. Shinsuma Gen Hosp, Dept Otolaryngol, Kobe, Hyogo, Japan. RP Ishida, H (reprint author), Kobe Univ, Dept Otorhinolaryngol Head & Neck Surg, Grad Sch Med, Chuo Ku, 7-5-1 Kusunoki Cho, Kobe, Hyogo 657, Japan. CR BOERHAAVE H, 1986, TXB HISTOLOGY, P497 Brodnitz F S, 1971, Otolaryngol Clin North Am, V4, P579 CHADWICK SJ, 2002, ALLERGY IMMUNOLOGY O, P249 CHURCH MK, 2001, ALLERGY, P303 Corey JP, 1998, OTOLARYNG CLIN N AM, V31, P189, DOI 10.1016/S0030-6665(05)70038-4 Domeij S, 1996, ANN OTO RHINOL LARYN, V105, P825 FOKKENS WJ, 1992, CLIN EXP ALLERGY, V22, P701, DOI 10.1111/j.1365-2222.1992.tb00194.x IRANI AMA, 1989, CLIN EXP ALLERGY, V19, P143, DOI 10.1111/j.1365-2222.1989.tb02357.x IWAE S, 1995, LARYNX JPN, V7, P1 KAWABORI S, 1995, CLIN EXP ALLERGY, V25, P173, DOI 10.1111/j.1365-2222.1995.tb01023.x Lidegran M, 1996, ACTA ANAT, V157, P135 Naito K, 1999, EUR ARCH OTO-RHINO-L, V256, P455, DOI 10.1007/s004050050188 Naito K, 1999, EUR ARCH OTO-RHINO-L, V256, P209, DOI 10.1007/s004050050142 OKUDA M, 1983, EUR J RESPIR DIS, V64, P7 Okuda M, 1999, ALLERGY, V54, P50, DOI 10.1111/j.1398-9995.1999.tb04406.x PANG LQ, 1974, OTOLARYNG CLIN N AM, V7, P719 RHODIN JAG, 1974, HISTOLOGY TEXT ATLAS, P607 Sala E, 1996, CLIN OTOLARYNGOL, V21, P42, DOI 10.1111/j.1365-2273.1996.tb01023.x SHANAHAN F, 1987, INT ARCH ALLER A IMM, V83, P329 WILLIAMS RI, 1972, ANN OTO RHINOL LARYN, V81, P558 NR 20 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 139 EP 143 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500010 PM 15757194 ER PT J AU Marchioni, D Ghidini, A Dallari, S Menabue, S Trani, M Presutti, L AF Marchioni, D Ghidini, A Dallari, S Menabue, S Trani, M Presutti, L TI The normal-weight snorer: Polysomnographic study and correlation with upper airway morphological alterations SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE anatomic abnormalities; Muller's maneuver; normal-weight snorer; obstructive sleep apnea syndrome; polysomnography ID OBSTRUCTIVE SLEEP-APNEA; MULLER MANEUVER; OBESE-PATIENTS; NONOBESE; SCALE; SITES; NECK AB Obesity is recognized as playing an important role in causing snoring and in turning simple snoring into obstructive sleep apnea syndrome (OSAS). From our series of patients with sleep disturbances, we studied a group of 43 normal-weight snorers in whom we detected a significant number of OSAS episodes. An articulated diagnostic protocol was adopted, and Muller's maneuver was extensively applied. The resulting data were compared to data from a group of 43 obese patients from the same series. The major risk factor for developing OSAS in normal-weight snorers appears to be anatomic abnormalities, in particular, septal deviation and base of tongue hypertrophy. Soft palate hypertrophy alone is not enough, although in obese snorers it can produce a sleep disorder. The normal-weight snorer needs to be thoroughly investigated because of the significant risk of developing OSAS and for the detection of multiple concomitant sites of obstruction. C1 Univ Modena, Dept Otorhinolaryngol, Polyclin Hosp Modena, I-41100 Modena, Italy. RP Marchioni, D (reprint author), Viale Monchio 30-4, I-41100 Modena, Italy. CR Fogel RB, 2003, SLEEP, V26, P150 Hori T, 2001, PSYCHIAT CLIN NEUROS, V55, P305 HORNER RL, 1989, EUR RESPIR J, V2, P613 JOHNS MW, 1993, CHEST, V103, P30, DOI 10.1378/chest.103.1.30 Manni R, 1999, J SLEEP RES, V8, P319, DOI 10.1046/j.1365-2869.1999.00166.x Mortimore IL, 1998, AM J RESP CRIT CARE, V157, P280 Nelson S, 1997, CHEST, V111, P154, DOI 10.1378/chest.111.1.154 NISHIMURA Y, 2003, ACTA OTO-LARYNGOL, V550, P22 Rama AN, 2002, CHEST, V122, P1139, DOI 10.1378/chest.122.4.1139 SHER AE, 1985, LARYNGOSCOPE, V95, P1483 STAUFFER JL, 1989, AM REV RESPIR DIS, V140, P724 Terris DJ, 2000, LARYNGOSCOPE, V110, P1819, DOI 10.1097/00005537-200011000-00010 Whittle AT, 1999, THORAX, V54, P323 Young T, 1997, J ALLERGY CLIN IMMUN, V99, P757 NR 14 TC 1 Z9 1 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 144 EP 146 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500011 PM 15757195 ER PT J AU Oestreicher-Kedem, Y Raveh, E Kornreich, L Popovtzer, A Buller, N Nageris, B AF Oestreicher-Kedem, Y Raveh, E Kornreich, L Popovtzer, A Buller, N Nageris, B TI Complications of mastoiditis in children at the onset of a new millennium SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE acute mastoiditis; acute otitis media; child; complications ID INTRACRANIAL COMPLICATIONS; OTITIS-MEDIA; MANAGEMENT AB The aim of the present study was to review our recent experience in the diagnosis and treatment of acute mastoiditis and its complications in a single tertiary-care, university-affiliated pediatric center. Ninety-eight children with 101 episodes of acute mastoiditis were included in the study. The mean interval from onset of illness to mastoiditis was 4.5 days. Ear cultures most often grew Streptococcus pneumoniae and Pseudomonas aeruginosa (23.7% each). Complications occurred in 15.8% of episodes. The only factor differentiating children with and without complications was white blood cell count. These findings indicate that acute mastoiditis not only is a complication of prolonged infection of the middle ear, but may also present as an acute infection of the mastoid bone that can progress within 48 hours. The complication rate remains high, and antibiotic treatment at the onset of symptoms does not prevent complications. A high white blood cell count on admission may serve as a predictive factor of complicated cases. C1 Schneider Childrens Med Ctr, Dept Otolaryngol, Petah Tiqwa, Israel. Schneider Childrens Med Ctr, Dept Imaging, Petah Tiqwa, Israel. Rabin Med Ctr, Petah Tiqwa, Israel. Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel. RP Oestreicher-Kedem, Y (reprint author), 17 Feivel St, IL-62995 Tel Aviv, Israel. CR AbuAmer Y, 1997, J CLIN INVEST, V100, P1557, DOI 10.1172/JCI119679 Bahadori RS, 2000, PEDIATR INFECT DIS J, V19, P212, DOI 10.1097/00006454-200003000-00007 Bizakis JG, 1998, INT J PEDIATR OTORHI, V45, P163, DOI 10.1016/S0165-5876(98)00024-X Cohen-Kerem R, 1999, J LARYNGOL OTOL, V113, P1081 Dhooge IJM, 1999, INT J PEDIATR OTORHI, V49, pS109, DOI 10.1016/S0165-5876(99)00144-5 Gliklich RE, 1996, ARCH OTOLARYNGOL, V122, P135 Go C, 2000, INT J PEDIATR OTORHI, V52, P143, DOI 10.1016/S0165-5876(00)00283-4 HOPPE JE, 1994, INFECTION, V22, P178, DOI 10.1007/BF01716698 Kvestad E, 2000, INT J PEDIATR OTORHI, V52, P149, DOI 10.1016/S0165-5876(00)00287-1 Linder TE, 2000, INT J PEDIATR OTORHI, V56, P129, DOI 10.1016/S0165-5876(00)00410-9 Luntz M, 2001, INT J PEDIATR OTORHI, V57, P1, DOI 10.1016/S0165-5876(00)00425-0 Luntz M, 1994, Ear Nose Throat J, V73, P648 Niv A, 1998, INT J PEDIATR OTORHI, V46, P9, DOI 10.1016/S0165-5876(98)00110-4 PALVA T, 1959, J Laryngol Otol, V73, P573, DOI 10.1017/S0022215100055742 PALVA T, 1985, J LARYNGOL OTOL, V99, P127, DOI 10.1017/S0022215100096407 Petersen CG, 1998, INT J PEDIATR OTORHI, V45, P21 Spiegel JH, 1998, LARYNGOSCOPE, V108, P822, DOI 10.1097/00005537-199806000-00009 Spratley J, 2000, INT J PEDIATR OTORHI, V56, P33, DOI 10.1016/S0165-5876(00)00406-7 NR 18 TC 19 Z9 19 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 147 EP 152 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500012 PM 15757196 ER PT J AU Matsunaga, T Kumanomido, H Shiroma, M Goto, Y Usami, S AF Matsunaga, T Kumanomido, H Shiroma, M Goto, Y Usami, S TI Audiological features and mitochondrial DNA sequence in a large family carrying mitochondrial A1555G mutation without use of aminoglycoside SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE cochlea; hereditary hearing loss; mitochondria; nonsyndromic hearing loss ID NON-SYNDROMIC DEAFNESS; RIBOSOMAL-RNA MUTATION; HEARING-LOSS; SENSORINEURAL DEAFNESS; POINT MUTATIONS; GENE; POLYMORPHISM; PEDIGREE AB To elucidate the pathophysiological and genetic mechanisms of hearing loss associated with the homoplasmic mitochondrial A1555G mutation in the absence of aminoglycoside expo sure, we conducted audiological and genetic analyses on 67 maternally related members of a large Japanese family carrying this mutation. A consistent pattern was evident in the audiograms, with features of sensory presbycusis, cochlear origin at all levels of hearing loss, and a high degree of vulnerability of outer hair cells. That the degree of hearing loss was similar in affected subjects within the same sibling group but differed between sibling groups suggests the involvement of nuclear modifier genes. Total mitochondrial DNA sequences were completely identical among subjects with various levels of hearing loss, and lacked additional pathogenic mutations. For the diagnosis of sensorineural hearing loss, the mitochondrial A1555G mutation should be considered when these features are present even in the absence of aminoglycoside exposure. C1 Natl Tokyo Med Ctr, Dept Otolaryngol, Meguro Ku, Tokyo 1528902, Japan. Natl Ctr Neurol & Psychiat, Dept Mental Retardat & Birth Defect Res, Tokyo, Japan. Shinshu Univ, Sch Med, Dept Otorhinolaryngol, Matsumoto, Nagano 390, Japan. RP Matsunaga, T (reprint author), Natl Tokyo Med Ctr, Dept Otolaryngol, Meguro Ku, Higashigaoka 2-5-1, Tokyo 1528902, Japan. CR Akanuma J, 2000, J HUM GENET, V45, P337, DOI 10.1007/s100380070004 [Anonymous], 2000, 7029 ISO, P1 Braverman I, 1996, ARCH OTOLARYNGOL, V122, P1001 Brierley EJ, 1998, ANN NEUROL, V43, P217, DOI 10.1002/ana.410430212 Bykhovskaya Y, 1998, AM J MED GENET, V77, P421, DOI 10.1002/(SICI)1096-8628(19980605)77:5<421::AID-AJMG13>3.0.CO;2-K Casano RAMS, 1998, AM J MED GENET, V79, P388, DOI 10.1002/(SICI)1096-8628(19981012)79:5<388::AID-AJMG11>3.0.CO;2-N COATS AC, 1977, ARCH OTOLARYNGOL, V103, P605 ElSchahawi M, 1997, NEUROLOGY, V48, P453 Estivill X, 1998, AM J HUM GENET, V62, P27, DOI 10.1086/301676 Fischel-Ghodsian N, 1999, HUM MUTAT, V13, P261, DOI 10.1002/(SICI)1098-1004(1999)13:4<261::AID-HUMU1>3.0.CO;2-W GELFAND SA, 2001, ESSENTIALS AUDIOLOGY, P139 Guan MX, 1996, HUM MOL GENET, V5, P963, DOI 10.1093/hmg/5.7.963 Hamasaki K, 1997, BIOCHEMISTRY-US, V36, P12323, DOI 10.1021/bi970962r Jerger J., 1973, MODERN DEV AUDIOLOGY, P75 MATSUNAGA T, 2003, 26 MIDW RES M ASS RE, P487 Matthijs G, 1996, EUR J HUM GENET, V4, P46 MITOMAP, HUM MIT GEN DAT NORTON S J, 1992, Seminars in Hearing, V13, P1, DOI 10.1055/s-0028-1085137 NUSSBAUM RL, 2001, THOMPSON THOMPSON GE, P244 Pandya A, 1999, AM J HUM GENET, V65, P1803, DOI 10.1086/302658 PREZANT TR, 1993, NAT GENET, V4, P289, DOI 10.1038/ng0793-289 Sajjadi H, 2000, EAR: COMPREHENSIVE OTOLOGY, P545 SELTERS WA, 1977, ARCH OTOLARYNGOL, V103, P181 Sininger YS, 1998, PEDIAT OTOLOGY NEURO, P127 Tono T, 1998, AM J OTOL, V19, P754 Usami S, 1997, LARYNGOSCOPE, V107, P483, DOI 10.1097/00005537-199704000-00011 NR 26 TC 7 Z9 9 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 153 EP 160 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500013 PM 15757197 ER PT J AU Tinling, SP Nabili, V Brodie, HA AF Tinling, SP Nabili, V Brodie, HA TI Fine structure histopathology of labyrinthitis ossificans in the gerbil model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE electron microscopy; histopathology; labyrinthitis ossificans; meningitis ID HEARING-LOSS; PNEUMOCOCCAL MENINGITIS; BACTERIAL-MENINGITIS; ANIMAL-MODEL; CHILDREN; EAR; SEQUELA AB Labyrinthitis ossificans (LO) is the pathological deposition of new bone within the lumen of the cochlea and labyrinth. This process occurs most commonly as a result of infection or inflammation affecting the otic capsule. Trauma and vascular compromise can also lead to neo-ossification within the otic, capsule. The mechanism that regulates,this process remains unestablished. This study details the end-stage histopathology in high-re solution plastic thin sections. Twenty Mongolian gerbils were infected by intrathecal injection of Streptococcus pneumoniae type 3 followed by subcutaneous penicillin G procaine (8 days) and were. painlessly sacrificed 3 months later. The cochleas were serially divided and sectioned for light and electron microscopy. Sixteen of 20 animals (27 of 40 cochleas) demonstrated LO. Cochlear damage was most extensive in the vestibule and basal turn and decreased toward the apex, which often appeared normal. The histopathologic findings consisted of 1) new bone, calcospherites, osteoid, and fibrosis without dense connective tissue or osteoblasts extending from the endosteal wall into the lumen of the vestibule and scala tympani; 2) areas of dense connective tissue and osteoid enclosed by epithelial cells conjoined with the organ of Corti, stria vascularis, spiral ligament, and vestibular (Reissner's) membrane; and 3) partial to complete loss of the organ of Corti, spiral ligament cell bodies, stria vascularis, and spiral ganglion cells. Osteoblastic activity was not demonstrated in end-stage ossification in LO in the gerbil model. Neo-ossification appears to occur by calcospherite deposition along collagen-like fibrils within osteoid. The destruction of the organ of Corti, spiral ganglion cells, stria vascularis, and cells of Reissner's membrane and the spiral ligament occurs even in the absence of ossification of the cochlear duct. C1 Univ Calif Davis, Sch Med, Dept Otolaryngol, Davis, CA 95616 USA. RP Brodie, HA (reprint author), Otolaryngol Res Lab, 1515 Newton Ct,Room 209, Davis, CA 95616 USA. CR BERLOW SJ, 1980, LARYNGOSCOPE, V90, P1445, DOI 10.1288/00005537-198009000-00004 BHATT SM, 1993, J INFECT DIS, V167, P675 BLOOM W, 1972, TXB HISTOLOGY, P158 Brodie HA, 1998, OTOLARYNG HEAD NECK, V118, P15, DOI 10.1016/S0194-5998(98)70369-9 CHOLE RA, 1987, AM J OTOLARYNG, V8, P325, DOI 10.1016/S0196-0709(87)80051-0 CROWE SJ, 1928, T AM OTOL SOC, V18, P210 DODGE PR, 1984, NEW ENGL J MED, V311, P869, DOI 10.1056/NEJM198410043111401 EISENBERG LS, 1984, OTOLARYNG HEAD NECK, V92, P700 FINITZOHIEBER Y, 1981, INT J PEDIATR OTORHI, V3, P275 FRIEDMANN I, 1993, PATHOLOGY EAR, P70 HAGENS EW, 1940, ANN OTO RHINOL LARYN, V49, P168 HARRIS JP, 1990, ACTA OTO-LARYNGOL, V110, P357, DOI 10.3109/00016489009107455 KEANE WM, 1979, ARCH OTOLARYNGOL, V105, P39 Kesser BW, 1999, OTOLARYNG HEAD NECK, V120, P628, DOI 10.1053/hn.1999.v120.a92772 KOTZIAS SA, 1965, AM J OTOL, V6, P490 LINDSAY JR, 1973, ANN OTOL RHINOL L S5, V82, P88 Merchant SN, 1996, AM J OTOL, V17, P375 Nabili V, 1999, LARYNGOSCOPE, V109, P931, DOI 10.1097/00005537-199906000-00017 NADOL JB, 1978, LARYNGOSCOPE, V88, P739 NOVAK MA, 1990, OTOLARYNG HEAD NECK, V103, P351 PAPARELLA MICHAEL M., 1967, ANN OTOL RHINOL LARYNGOL, V76, P554 Perlman HB, 1939, ARCHIV OTOLARYNGOL, V29, P12 ROSENHALL U, 1978, ACTA OTO-LARYNGOL, V85, P243 STUTMAN HR, 1987, CLIN PEDIATR, V26, P431, DOI 10.1177/000992288702600901 Taylor J.F., 1992, BONE GROWTH, P21 VERNON M, 1967, LARYNGOSCOPE, V77, P1856, DOI 10.1288/00005537-196710000-00008 NR 26 TC 1 Z9 2 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 161 EP 166 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500014 PM 15757198 ER PT J AU Dufour, X Kauffmann-Lacroix, C Goujon, JM Grollier, G Rodier, MH Klossek, JM AF Dufour, X Kauffmann-Lacroix, C Goujon, JM Grollier, G Rodier, MH Klossek, JM TI Experimental model of fungal sinusitis: A pilot study in rabbits SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE aspergillosis; Aspergillus fumigatus; experimental sinusitis; fungal sinusitis; rabbit ID PARA-NASAL SINUSES; PARANASAL SINUSES; ASPERGILLOSIS; HISTOPATHOLOGY; SURGERY; BALLS AB We have established an experimental model of fungal sinusitis in rabbits to analyze the chronology and the pathogenesis of the development of noninvasive fungal sinusitis due to Aspergillus fumigatus. Thirty-four Pasteurella-free New Zealand white rabbits divided into three groups were included in this study. In the first group (10 rabbits), A fumigatus was inoculated into the maxillary sinus. In the second group (10 rabbits), A fumigatus was inoculated into the maxillary sinus in the presence of a wound in the mucosa. In the third group (14 rabbits), A fumigatus was inoculated into the maxillary sinus in the presence of a blocked ostium. On days 15 and 30, endoscopic, histopathologic, bacterial, and mycological examinations of both maxillary cavities and mucous membrane were performed. The rabbits were painlessly sacrificed 30 days after inoculation; mucosal and bone biopsies of the maxillary sinus cavities were performed for histopathologic studies. We found that noninvasive fungal sinusitis had been induced in 2 rabbits of the second group and 8 rabbits of the third group : We conclude that introduction of fungi into a sinus with a blocked ostium induces fungal sinusitis. The present model of experimental fungal sinusitis seems to be reproducible and suitable for further studies of the development of fungal sinusitis. C1 Ctr Med Univ Poitiers, Dept Otorhinolaryngol Head & Neck Surg, Poitiers, France. Ctr Med Univ Poitiers, Lab Parasitol & Med Mycol, Poitiers, France. Ctr Med Univ Poitiers, Dept Histopathol, Poitiers, France. Ctr Med Univ Poitiers, Microbiol Lab, Poitiers, France. RP Klossek, JM (reprint author), Ctr Hosp Univ, Dept Otorhinolaryngol Head & Neck Surg, BP 577, F-86021 Poitiers, France. CR BRANDWEIN M, 1993, OTOLARYNG CLIN N AM, V26, P949 Chakrabarti A, 1997, J MED VET MYCOL, V35, P295 DeShazo RD, 1997, NEW ENGL J MED, V337, P254, DOI 10.1056/NEJM199707243370407 DRETTNER B, 1987, ACTA OTO-LARYNGOL, V103, P432 Ferguson BJ, 2000, OTOLARYNG CLIN N AM, V33, P389 Ferreiro JA, 1997, HEAD NECK-J SCI SPEC, V19, P481 Kara CO, 2003, J OTOLARYNGOL, V32, P140, DOI 10.2310/7070.2003.37281 KELEMEN G, 1955, ARCHIV OTOLARYNGOL, V61, P497 KENNEDY DW, 1989, ANN OTO RHINOL LARYN, V98, P901 Klossek JM, 1997, LARYNGOSCOPE, V107, P112, DOI 10.1097/00005537-199701000-00021 KURUP VP, 1981, COMP IMMUNOL MICROB, V4, P161, DOI 10.1016/0147-9571(81)90002-3 LEGENT F, 1989, ARCH OTO-RHINO-LARYN, V246, P318, DOI 10.1007/BF00463584 Min Yang-Gi, 1993, Rhinology (Utrecht), V31, P101 PERKO D, 1991, Rhinology (Utrecht), V29, P185 ROMETT JL, 1982, LARYNGOSCOPE, V92, P764, DOI 10.1288/00005537-198207000-00010 STAMMBERGER H, 1984, ANN OTO RHINOL LARYN, V93, P251 WESTRIN KM, 1991, ORL J OTO-RHINO-LARY, V53, P299 NR 17 TC 11 Z9 18 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD FEB PY 2005 VL 114 IS 2 BP 167 EP 172 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 897HB UT WOS:000226993500015 PM 15757199 ER PT J AU Alvarez-Neri, H Penchyna-Grub, J Porras-Hernandez, JD Blanco-Rodriguez, G Gonzalez, R Rutter, MJ AF Alvarez-Neri, H Penchyna-Grub, J Porras-Hernandez, JD Blanco-Rodriguez, G Gonzalez, R Rutter, MJ TI Primary cricotracheal resection with thyrotracheal anastomosis for the treatment of severe subglottic stenosis in children and adolescents SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 84th Annual Meeting of the American-Broncho-Esophagological-Association CY APR 30-MAY 01, 2004 CL Phoenix, AZ SP Amer Broncho Esophagol Assoc DE child; cricotracheal resection; laryngotracheal reconstruction; subglottic stenosis; thyrotracheal anastomosis ID PEDIATRIC LARYNGOTRACHEAL RECONSTRUCTION; PRIMARY TRACHEAL ANASTOMOSIS; PARTIAL CRICOID RESECTION; CARTILAGE GRAFTS; MITOMYCIN-C; EXPERIENCE; EXCISION; UPDATE AB Severe subglottic stenosis in children is best managed by laryngotracheal reconstruction or cricotracheal resection (CTR). We describe clinical outcomes with CTR and end-to-end anastomosis in pediatric patients with severe subglottic stenosis in a tertiary-care pediatric teaching hospital in Mexico City. We prospectively followed up all consecutive patients younger than 18 years of age with a Myer-Cotton grade 3 or 4 subglottic stenosis who underwent CTR between May 1, 2000, and March 31, 2003. The frequency of each clinical outcome was calculated. Twenty-two patients (16 boys [72.7%] and 6 girls [27.3%]) were included. The mean age at operation was 4.6 years (range, 11 months to 16 years). Eighteen patients (81.8%) required primary CTR, and 4 (18.2%) required extended CTR. Seventeen (77.3%) had grade 3 stenosis, and 5 (22.7%) had grade 4 stenosis. Six (27.3%) had associated clinical conditions, and 3 (13.6%) had associated vocal cord mobility defects. All were tracheostomy-dependent at presentation, and none had undergone previous airway surgery. Ten (45.5%) underwent one-stage surgery, and 12 (54.5%) had a concomitant temporary tracheotomy. No intraoperative complications occurred. Seventeen patients (77.3%) developed postoperative granulation tissue requiring endoscopic resection. The mean follow-up was 1.2 years (range, 2 months to 2.8 years). No deaths occurred. Fifteen children (88.2%) with grade 3 stenosis and 5 (100%) with grade 4 stenosis were decannulated, for an overall decannulation rate of 90.9%. Partial cricoid resection with end-to-end anastomosis has been a feasible procedure with reproducible successful results among our patients. We conclude that CTR performed as a primary procedure is an effective treatment for the management of severe subglottic stenosis in children. C1 Hosp Infantil Mexico Dr Federico Gomez, Dept Otorhinolaryngol, Mexico City, DF, Mexico. Hosp Infantil Mexico Dr Federico Gomez, Dept Thorac Surg & Endoscopy, Mexico City, DF, Mexico. Cincinnati Childrens Hosp, Med Ctr, Div Otolaryngol, Cincinnati, OH USA. RP Penchyna-Grub, J (reprint author), 162 Col Doctores, Mexico City 06720, DF, Mexico. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 BP 2 EP 6 PN 1 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000002 PM 15697155 ER PT J AU Shaffer, MJ Jackson, CE Szabo, CA Simpson, CB AF Shaffer, MJ Jackson, CE Szabo, CA Simpson, CB TI Vagal nerve stimulation: Clinical and electrophysiological effects on vocal fold function SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 83rd Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 02-03, 2003 CL NASHVILLE, TN SP Amer Broncho Esophagol Assoc DE epilepsy; hoarseness; laryngeal electromyography; vagal nerve stimulator; vocal cord paralysis; vocal cord paresis; Voice Handicap Index ID VAGUS NERVE; PARTIAL SEIZURES; SAFETY AB More than 16,000 vagal nerve stimulators (VNSs) have been implanted for refractory epileptic seizures. The most commonly reported side effect is hoarseness. This study examines the effects of VNS placement on vocal fold function. Eleven patients who had undergone VNS placement at our institution were recruited. Subjective evaluation by a panel of speech and language pathologists of both connected speech and videolaryngoscopy recordings were used both at rest and during VNS activation. Additional subjective evaluation included use of the Voice Handicap Index for the study group. These results were compared to data from age- and sex-matched controls. Objective data included maximum phonation time in the study and control groups, as well as laryngeal electromyography performed on the VNS-implanted patients only. Motor unit potential morphology and recruitment, as well as spontaneous activity, were analyzed bilaterally for the cricothyroid and thyroarytenoid muscles. Significant differences were found between the study and control groups subjectively for vocal quality and videolaryngoscopy parameters. Vocal fold tension, supraglottic muscular hyperfunction, and reduced vocal fold mobility were the most common findings during VNS activation. Two of 10 patients had immobile left vocal folds in the absence of active stimulation. The maximum phonation time was generally reduced in the subject group, but this reduction did not reach statistical significance. Finally, 6 of 10 patients had abnormal electromyographic results, including large-amplitude polyphasic motor unit potentials and decreased recruitment. We conclude that implantation of a VNS can affect vocal fold function. The effects are magnified during periods of active stimulation. There is the potential for nerve degeneration after prolonged repetitive stimulation, and there may be a trend toward greater vocal fold dysfunction with higher stimulation parameters. C1 Univ Texas, Hlth Sci Ctr, Dept Otolaryngol Head & Neck Surg, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Div Neurol, Dept Med, San Antonio, TX 78229 USA. RP Simpson, CB (reprint author), Univ Texas, Hlth Sci Ctr, Dept Otolaryngol Head & Neck Surg, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 BP 7 EP 14 PN 1 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000003 PM 15697156 ER PT J AU Daly, KA Hoffman, HJ Casselbrant, ML Kvaerner, KJ Rovers, MM Uhari, M Zielhuis, G AF Daly, KA Hoffman, HJ Casselbrant, ML Kvaerner, KJ Rovers, MM Uhari, M Zielhuis, G TI Epidemiology, natural history, and risk factors SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 8th Post Symposium Research Conference CY JUN 07-08, 2003 CL Ft Lauderdale, FL ID ACUTE OTITIS-MEDIA; RESPIRATORY-TRACT INFECTIONS; TYMPANOSTOMY TUBE INSERTION; SYNCYTIAL VIRUS-INFECTION; ATTENDING DAY-CARE; A GENE LOCUS; PRESCHOOL-CHILDREN; EAR INFECTIONS; EFFUSION; CHILDHOOD C1 Univ Oulu, Dept Pediat & Adolescence, Oulu, Finland. Univ Minnesota, Dept Otolaryngol, Minneapolis, MN USA. NIDCD, NIH, Bethesda, MD USA. Univ Pittsburgh, Sch Med, Childrens Hosp Pittsburgh, Dept Otolaryngol, Pittsburgh, PA USA. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 SU 194 BP 8 EP 15 PN 2 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 888UJ UT WOS:000226399400003 ER PT J AU Strocker, A Ford, R Patel, S Ayad, I Shapiro, N AF Strocker, A Ford, R Patel, S Ayad, I Shapiro, N TI Airway evaluation of conjoined twins SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 83rd Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 02-03, 2003 CL NASHVILLE, TN SP Amer Broncho Esophagol Assoc DE airway; conjoined twins; endoscopy ID MANAGEMENT AB Case reports in the literature on conjoined twins discuss the difficulties with anesthesia and surgical separation; however, the role of airway endoscopy as a means of evaluating the respiratory tract has not been described. This case of thoraco-omphalo-ischiopagus laterally conjoined twins demonstrates the importance of videoendoscopic airway evaluation in the management of conjoined twins. Direct laryngoscopy and bronchoscopy was used to evaluate ventilator dependence and demonstrated tracheal anomalies that were partially responsible for difficulties with weaning and endotracheal tube placement. Knowledge of the airway anomalies assisted in ventilator management of the twins, and the neonatalogists were able to proceed with greater confidence because no surgically correctable airway obstruction was found. Direct laryngoscopy and bronchoscopy offer valuable information about thoracopagus conjoined twins and should be included in the preoperative evaluation of planned separation of conjoined twins, as well as being used for conjoined twins who are ventilator-dependent. C1 Univ Calif Los Angeles, Sch Med, Div Head & Neck Surg, Dept Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Sch Med, Dept Anesthesiol, Los Angeles, CA 90095 USA. RP Shapiro, N (reprint author), Univ Calif Los Angeles, Sch Med, Div Head & Neck Surg, Dept Surg, CHS Room 62-158,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM nshapiro@ucla.edu CR Anderson T, 2002, AM J MED GENET, V109, P155, DOI 10.1002/ajmg.10070 CHITKARA U, 2002, OBSTETRICS NORMAL PR, P827 DIAZ JH, 1987, ANESTHESIOLOGY, V67, P965, DOI 10.1097/00000542-198712000-00015 Greenwood JE, 2001, PROG OCEANOGR, V48, P1, DOI 10.1016/S0079-6611(00)00046-X HOSHINA H, 1987, ANESTHESIOLOGY, V66, P424, DOI 10.1097/00000542-198703000-00032 Malone FD, 2000, CLIN PERINATOL, V27, P1033, DOI 10.1016/S0095-5108(05)70062-2 Norsidah A M, 1996, Med J Malaysia, V51, P420 STOLL BJ, 2000, NELSON TXB PEDIAT, P474 TOWEY RM, 1979, ANAESTHESIA, V34, P187, DOI 10.1111/j.1365-2044.1979.tb06277.x NR 9 TC 3 Z9 3 PU ANNALS PUBL CO PI ST LOUIS PA 4507 LACLEDE AVE, ST LOUIS, MO 63108 USA SN 0003-4894 J9 ANN OTO RHINOL LARYN JI Ann. Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 BP 15 EP 18 PN 1 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000004 PM 15697157 ER PT J AU Bluestone, CD Alper, CM Buchman, CA Felding, JU Ghadiali, SN Hebda, PA Sando, I Stangerup, SE Swarts, JD Takahashi, H AF Bluestone, CD Alper, CM Buchman, CA Felding, JU Ghadiali, SN Hebda, PA Sando, I Stangerup, SE Swarts, JD Takahashi, H TI Eustachian tube, middle ear, and mastoid anatomy; Physiology, pathophysiology, and pathogenesis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 8th Post Symposium Research Conference CY JUN 07-08, 2003 CL Ft Lauderdale, FL ID ACUTE OTITIS-MEDIA; OSTMANNS FATTY TISSUE; VELI PALATINI MUSCLE; STREPTOCOCCUS-PNEUMONIAE INFECTION; AIDED 3-DIMENSIONAL RECONSTRUCTION; SYNCYTIAL VIRUS-INFECTION; NECROSIS-FACTOR-ALPHA; LATE-PHASE ALLERGY; EPITHELIAL-CELLS; POSTNATAL-DEVELOPMENT C1 Univ Pittsburgh, Sch Med, Dept Otolaryngol, Pittsburgh, PA USA. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 SU 194 BP 16 EP 30 PN 2 PG 15 WC Otorhinolaryngology SC Otorhinolaryngology GA 888UJ UT WOS:000226399400004 ER PT J AU Branski, RC Rosen, CA Verdolini, K Hebda, PA AF Branski, RC Rosen, CA Verdolini, K Hebda, PA TI Acute vocal fold wound healing in a rabbit model SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 83rd Annual Meeting of the American-Broncho-Esophagological-Association CY MAY 02-03, 2003 CL NASHVILLE, TN SP Amer Broncho Esophagol Assoc DE mucosal wound healing; scar; vocal fold ID GROWTH-FACTOR; MANAGEMENT; SKIN; SCAR AB Several authors have eloquently described the characteristics of vocal fold scar, a long-term consequence of vocal fold injury. However, events in the acute stage of mucosal injury, which lead up to fibrosis, have been largely overlooked. The current study describes acute events with regard to mucosal re-formation in a rabbit model. Vocal fold injury was induced surgically. A fibrinous clot was present 1 day after injury. Massive cellular infiltration was noted on day 3, and complete epithelial coverage was achieved by day 5. Also, neo-matrix deposition was noted as early as 5 days after injury, and more mature collagen was seen by day 7. The general timetable described in the current study can contribute to the experimental foundation for the development of regenerative models of healing in the vocal folds. Most notably, the proliferation phase of wound healing appears to occur approximately 3 days after injury, indicating a critical time for intervention. Manipulation and/or alteration of naturally occurring neo-matrix deposition and organization may yield improved biophysical function of the injured vocal fold. C1 Univ Pittsburgh, Sch Med, Dept Otolaryngol, Voice Ctr, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Commun Sci & Disorders, Voice Ctr, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Pediat Otolaryngol, Otolaryngol Wound Healing Lab, Pittsburgh, PA USA. Univ Pittsburgh, McGowen Inst Regenerat Med, Pittsburgh, PA USA. Univ Pittsburgh, Dept Cell Biol & Physiol, Pittsburgh, PA USA. RP Rosen, CA (reprint author), Univ Pittsburgh, Sch Med, Dept Otolaryngol, Voice Ctr, 200 Lothrop St,Suite 500, Pittsburgh, PA 15213 USA. 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PD JAN PY 2005 VL 114 IS 1 BP 19 EP 24 PN 1 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000005 PM 15697158 ER PT J AU Laccourreye, O Ishoo, E De Mones, E Garcia, D Kania, R Hans, S AF Laccourreye, O Ishoo, E De Mones, E Garcia, D Kania, R Hans, S TI Supracricoid hemilaryngopharyngectomy in patients with invasive squamous cell carcinoma of the pyriform sinus - Part I: Technique, complications, and long-term functional outcome SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE conservation surgery; pyriform sinus; squamous cell carcinoma ID ORGAN PRESERVATION; HEMIPHARYNGO-HEMILARYNGECTOMY; VOICE PRESERVATION; SURGERY; RADIOTHERAPY; TRACHEOSTOMY; RADIATION AB On the basis of a retrospective review of an inception cohort of 135 patients, with an isolated, previously untreated, moderately differentiated to well-differentiated invasive squamous cell carcinoma of the pyriform sinus and a minimum of 3 years of follow-up, consecutively managed with a supracricoid hemilaryngopharyngectomy (SCHLP) at a single tertiary referral care center and locally controlled, the authors review in detail the surgical technique, highlight the potential technical pitfalls, and document the complications and long-term functional outcome. The overall postoperative mortality rate was 3.7%. The overall mortality rate directly related to the SCHLP was 1.5%. A significant surgical complication directly related to SCHLP completion was noted in 9.6% of cases. The mean lengths of time to removal of the tracheotomy and feeding tubes were 9 and 19 days, respectively. The mean duration Of hospitalization was 25 days. Normal swallowing without aspiration by the first postoperative month was noted in 64.6% of patients. Temporary grade 1-2 aspiration and grade 3 aspiration were noted in 26.9% and 8.5% of patients, respectively. Overall, in our series,, successful oral alimentation without gastrostomy or completion total laryngectomy was achieved in 91.9% of patients by the first postoperative year, and the incidences of permanent gastrostomy, completion total laryngectomy, and aspiration-related death were 0.7%, 1.5%, and 0.7%, respectively. 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PD JAN PY 2005 VL 114 IS 1 BP 25 EP 34 PN 1 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000006 PM 15697159 ER PT J AU Lim, DJ Hellstrom, SO Alper, CM Andalibi, A Bakaletz, LO Buchman, CA Caye-Thomasen, P Chole, RA Herman, P Lee, HY Kang, SH Hermansson, A Hussl, B Iino, Y Jung, TTK Kawauchi, H Kerschner, J Lin, JZ Merchant, SN Paparella, MM AF Lim, DJ Hellstrom, SO Alper, CM Andalibi, A Bakaletz, LO Buchman, CA Caye-Thomasen, P Chole, RA Herman, P Lee, HY Kang, SH Hermansson, A Hussl, B Iino, Y Jung, TTK Kawauchi, H Kerschner, J Lin, JZ Merchant, SN Paparella, MM TI Animal models; Anatomy and pathology; Pathogenesis; Cell biology and genetics SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 8th Post Symposium Research Conference CY JUN 07-08, 2003 CL Ft Lauderdale, FL ID NONTYPABLE HAEMOPHILUS-INFLUENZAE; ACUTE OTITIS-MEDIA; MIDDLE-EAR MUCOSA; NECROSIS-FACTOR-ALPHA; EUSTACHIAN-TUBE DYSFUNCTION; OUTER-MEMBRANE PROTEIN; STREPTOCOCCUS-PNEUMONIAE INFECTION; IN-SITU HYBRIDIZATION; ROUND WINDOW MEMBRANE; VIRUS-40 HYBRID VIRUS C1 Hop Lariboisiere, Dept Otorhinolaryngol, F-75475 Paris, France. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 SU 194 BP 42 EP 49 PN 2 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 888UJ UT WOS:000226399400006 ER PT J AU Zenk, J Bozzato, A Steinhart, H Greess, H Iro, H AF Zenk, J Bozzato, A Steinhart, H Greess, H Iro, H TI Metastatic and inflammatory cervical lymph nodes as analyzed by contrast-enhanced color-coded Doppler ultrasonography: Quantitative dynamic perfusion patterns and histopathologic correlation SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE diagnosis; head and neck; tumor; ultrasonography ID POWER DOPPLER; DIFFERENTIAL-DIAGNOSIS; TUMOR ANGIOGENESIS; DUPLEX SONOGRAPHY; NECK TUMORS; GRAY-SCALE; ULTRASOUND; LYMPHADENOPATHY; HEAD; BREAST AB Use of contrast-enhanced color-coded Doppler (ultra)sonography (CCDS) in evaluating enlarged lymph nodes has been subject to numerous attempts to define criteria for differentiation between benign and malignant lesions. Evaluation of dynamic perfusion patterns with contrast-enhanced CCDS in cervical lymph nodes offers new possibilities of differential diagnosis. A total of 28 patients with clinically enlarged lymph nodes were included in this study. Contrast-enhanced CCDS was performed on each patient. The color signals from nodes <15 min in diameter were analyzed with a specialized computer program. Each node was later examined through immumohistochemical staining. Vascularization as shown by unenhanced CCDS was significantly greater in metastatic lymph nodes than in reactively enlarged lymph nodes (8.66% versus 2.81%; p = .01). The maximum vascularization area after contrast injection did not show any significant change (26.61% versus 28.63%; p = .75). Comparison of values obtained before and after contrast enhancement showed the largest relative increase in vascularization in inflammatory lymph nodes, from a factor of 19.55 to a factor of 10.03 (p = .025). Dynamic values such as contrast enhancement, behavior of dynamic values referred to time, and the evaluated vascularized area did not show any significant difference. The metastatic lymph nodes (5.46 versus 3.33; p = .007) predominantly consisted of large blood vessels. The increased vascularization in the unenhanced CCDS examination of metastatic lymph nodes seems to be associated with the increased number of large blood vessels. An increased vessel density, due to a greater number of total vessels, is related to an inflammatory process. Color Doppler mapping has been proven to depict useful aspects distinguishing benign from malignant lymph nodes of the neck; however, a definitive differentiation between lymph nodes involved with malignancy and inflammatory changes remains difficult. C1 Univ Erlangen Nurnberg, Dept Otorhinolaryngol Head & Neck Surg, D-91054 Erlangen, Germany. Univ Erlangen Nurnberg, Dept Radiol, D-91054 Erlangen, Germany. RP Zenk, J (reprint author), Univ Erlangen Nurnberg, Dept Otorhinolaryngol Head & Neck Surg, Waldstr 1, D-91054 Erlangen, Germany. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 BP 43 EP 47 PN 1 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000008 PM 15697161 ER PT J AU Badke, MB Miedaner, JA Shea, TA Grove, CR Pyle, GM AF Badke, MB Miedaner, JA Shea, TA Grove, CR Pyle, GM TI Effects of vestibular and balance rehabilitation on sensory organization and dizziness handicap SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE balance; dizziness; posturography; vestibular rehabilitation ID VESTIBULOSPINAL FUNCTION; DYNAMIC POSTUROGRAPHY; POSTURAL CONTROL; DISORDERS; STABILITY; OUTCOMES; VERTIGO; SUPPORT AB This retrospective Study was undertaken to assess balance recovery and dizziness handicap in 32 patients after a vestibular and balance rehabilitation program. Outcomes were compared between 12 patients with peripheral vestibular disorders and 20 patients with central or mixed balance disorders. The patients were tested with posturography (sensory organization test [SOT]) and the Dizziness Handicap Inventory (DHI) before and after their therapy program. The vestibular SOT, composite SOT, and functional DHI scores obtained before and after exercise were significantly improved in both the peripheral and central groups. The visual SOT mean scores obtained before and after therapy were significantly different only for the group with central or mixed vestibular disorders. Changes in SOT scores were not directly correlated with changes in DHI scores. Outcome measures of vestibular rehabilitation protocols confirmed objective and subjective improvement of balance and dizziness handicap in patients with peripheral and central vestibular disorders. C1 Univ Wisconsin Hosp & Clin, Dept Orthoped & Rehabil, Middleton, WI 53792 USA. Univ Wisconsin Hosp & Clin, Dept Otolaryngol, Middleton, WI 53792 USA. RP Badke, MB (reprint author), Univ Wisconsin Hosp & Clin, Dept Orthoped & Rehabil, 6630 Univ Ave, Middleton, WI 53792 USA. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 BP 48 EP 54 PN 1 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000009 PM 15697162 ER PT J AU Ryan, AF Juhn, SK Andalibi, A Bakaletz, LO Ehrlich, GD Jung, TTK Li, JD Lin, JZ Post, CJ AF Ryan, AF Juhn, SK Andalibi, A Bakaletz, LO Ehrlich, GD Jung, TTK Li, JD Lin, JZ Post, CJ TI Biochemistry SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 8th Post Symposium Research Conference CY JUN 07-08, 2003 CL Ft Lauderdale, FL ID NECROSIS-FACTOR-ALPHA; ACUTE OTITIS-MEDIA; MIDDLE-EAR FLUID; PLATELET-ACTIVATING-FACTOR; EUSTACHIAN-TUBE FUNCTION; CYTOKINE EXPRESSION; NITRIC-OXIDE; EFFUSION; INTERLEUKIN-1-BETA; CHOLESTEATOMA C1 Univ Calif San Diego, Div Otolaryngol, La Jolla, CA 92093 USA. Allegheny Gen Hosp, Ctr Genom Sci, Pittsburgh, PA 15212 USA. House Ear Res Inst, Gonda Dept Cell & Mol Biol, Los Angeles, CA USA. Univ Minnesota, Dept Otolaryngol, Minneapolis, MN USA. Loma Linda Univ, Div Otolaryngol, Ctr Med, Loma Linda, CA 92350 USA. Wexner Inst Pediat Res, Childrens Res Inst, Dept Pediat, Columbus, OH USA. Allegheny Singer Res Ctr, Ctr Genom Sci, Pittsburgh, PA USA. RP Ryan, AF (reprint author), Univ Calif San Diego, Div Otolaryngol, La Jolla, CA 92093 USA. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 SU 194 BP 50 EP 55 PN 2 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 888UJ UT WOS:000226399400007 ER PT J AU Cho, KJ Cho, SG Lee, DH AF Cho, KJ Cho, SG Lee, DH TI Natural killer T-cell lymphoma of the tongue SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE natural killer cell; T-cell lymphoma; tongue ID NON-HODGKINS-LYMPHOMA; NASAL; RADIATION; CLASSIFICATION; FEATURES AB Lymphoma, which represents about 5.4% of all neoplasms and, more significantly, 19% to 28% of malignant neoplasms, is the most common nonepithelial malignancy of the head and neck area in Koreans. Natural killer T-cell (NK/T-cell) lymphoma is a lymphoma of putative natural killer cell lineage. NK/T-cell neoplasms are generally rare, but they are more common in people of East Asian, Mexican, or South American descent. These neoplasms are highly aggressive and show a strong association with Epstein-Barr virus. The preferential site of extranodal NK/T-cell lymphoma is the nasal cavity, and there has been no report of NK/T-cell lymphoma developing from the tongue. We encountered a rare case of NK/T-cell lymphoma of the tongue, which we report with a review of the literature. C1 Catholic Univ Korea, Coll Med, Dept Otolaryngol Head & Neck Surg, Uijeongbu 480130, Gyeonggi, South Korea. Catholic Univ Korea, Coll Med, Dept Internal Med, Uijeongbu 480130, Gyeonggi, South Korea. RP Lee, DH (reprint author), Catholic Univ Korea, Uijeongbu St Marys Hosp, Dept Otolaryngol Head & Neck Surg, 65-1 Gumoh Dong, Uijeongbu 480130, Gyeonggi, South Korea. 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PD JAN PY 2005 VL 114 IS 1 BP 55 EP 57 PN 1 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000010 PM 15697163 ER PT J AU Ryan, AF Juhn, SK Andalibi, A Bakaletz, LO Ehrlich, GD Jung, TTK Li, JD Lin, JZ Post, CJ AF Ryan, AF Juhn, SK Andalibi, A Bakaletz, LO Ehrlich, GD Jung, TTK Li, JD Lin, JZ Post, CJ TI Interaction between middle ear and inner ear in otitis media SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 8th Post Symposium Research Conference CY JUN 07-08, 2003 CL Ft Lauderdale, FL ID HIGH-FREQUENCY HEARING; SPIRAL LIGAMENT FIBROCYTES; BACTERIAL-CELL WALL; STREPTOCOCCUS-PNEUMONIAE; NITRIC-OXIDE; RAT MODEL; PNEUMOCOCCAL MENINGITIS; INFLAMMATORY CYTOKINES; MESSENGER-RNA; GUINEA-PIGS C1 Univ Calif San Diego, Div Otolaryngol, La Jolla, CA 92093 USA. Allegheny Gen Hosp, Ctr Genom Sci, Pittsburgh, PA 15212 USA. House Ear Res Inst, Gonda Dept Cell & Mol Biol, Los Angeles, CA USA. Univ Minnesota, Dept Otolaryngol, Minneapolis, MN USA. Loma Linda Univ, Med Ctr, Div Otolaryngol, Loma Linda, CA USA. Wexner Inst Pediat Res, Childrens Res Inst, Dept Pediat, Columbus, OH USA. Allegheny Singer Res Ctrt, Ctr Genom Sci, Pittsburgh, PA USA. RP Ryan, AF (reprint author), Univ Calif San Diego, Div Otolaryngol, La Jolla, CA 92093 USA. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 SU 194 BP 56 EP 59 PN 2 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 888UJ UT WOS:000226399400008 ER PT J AU Carrillo, JF Celis, MA Ramirez-Ortega, M Rivas, B Ochoa, FJ AF Carrillo, JF Celis, MA Ramirez-Ortega, M Rivas, B Ochoa, FJ TI Osteoplastic maxillotomy for treatment of neoplasms of the nasopharynx and infratemporal fossa SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE infratemporal fossa surgery; nasopharyngeal angiofibroma surgery; nasopharyngeal tumor; skull base surgery; surgery of nasopharynx ID MAXILLARY SWING APPROACH; FORT-I OSTEOTOMY; QUALITY-OF-LIFE; SKULL BASE; CRANIAL BASE; NECK-CANCER; TUMORS; MANAGEMENT; RESECTION; HEAD AB Approaches to the infratemporal fossa and nasopharynx are difficult because of the anatomic complexity of these regions. We describe our experience with osteoplastic maxillotomy, with our own modifications, and evaluate oncological outcomes and postoperative quality of life. Ten patients underwent osteoplastic maxillotomy, 3 of whom had a diagnosis of malignancy, and 7 of whom had nasopharyngeal angiofibromas (NPAs). A Weber-Fergusson incision was made to develop facial flaps and preserve the vascularity of the maxilla. Osteotomies were performed through the facial aspects of the maxilla, on the orbital rims, and on the malar eminence for the medial variant of the procedure. The anterolateral variant involved descent of the temporalis muscle with preservation of the facial nerve, and a zygomatic osteotomy. Four craniotomies were done. Two patients had the medial variant of the procedure, and 8 had the anterolateral variant. The complications were transient and mild. The patients who had malignancies are alive with no disease, and there was I recurrence among the 7 patients with NPAs. We found excellent aesthetic results in 8 of the 10 patients, and no change in basic functions in 8 patients. Osteoplastic maxillotomy allows resection of massive NPAs with no significant bleeding. Resection of malignant lesions with good results is feasible. C1 Inst Nacl Cardiol Ignacio Chavez, Head & Neck Dept, Mexico City, DF, Mexico. Inst Nacl Cardiol Ignacio Chavez, Neurosurg Serv, Mexico City, DF, Mexico. Inst Nacl Cardiol Ignacio Chavez, Plast & Reconstruct Surg Serv, Mexico City, DF, Mexico. Inst Nacl Cardiol Ignacio Chavez, Inst Nacl Cancerol, Mexico City, DF, Mexico. Inst Nacl Cardiol Ignacio Chavez, Dept Pharmacol, Mexico City, DF, Mexico. RP Carrillo, JF (reprint author), Selva 45,Apt 401,Col Insurgentes Cuicuilco, Mexico City 04530, DF, Mexico. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 BP 58 EP 64 PN 1 PG 7 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000011 PM 15697164 ER PT J AU Barenkamp, SJ Ogra, PL Bakaletz, LO Chonmaitree, T Heikkinen, T Hurst, DS Kawauchi, H Kurono, Y Leiberman, A Murphy, TF Patel, JA Sih, TM St Geme, JW Stenfors, LE AF Barenkamp, SJ Ogra, PL Bakaletz, LO Chonmaitree, T Heikkinen, T Hurst, DS Kawauchi, H Kurono, Y Leiberman, A Murphy, TF Patel, JA Sih, TM St Geme, JW Stenfors, LE TI Microbiology and immunology SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 8th Post Symposium Research Conference CY JUN 07-08, 2003 CL Ft Lauderdale, FL ID ACUTE OTITIS-MEDIA; NONTYPABLE HAEMOPHILUS-INFLUENZAE; MIDDLE-EAR EFFUSIONS; RESPIRATORY SYNCYTIAL VIRUS; DAY-CARE-CENTERS; STREPTOCOCCUS-PNEUMONIAE COLONIZATION; ANTIBIOTIC-RESISTANT PNEUMOCOCCI; EOSINOPHIL CATIONIC PROTEIN; EUSTACHIAN-TUBE OBSTRUCTION; AUDITORY-CANAL EPITHELIUM C1 St Louis Univ, Sch Med, Dept Pediat, St Louis, MO 63104 USA. Univ Tromso, Dept Otolaryngol, Inst Clin Med, N-9001 Tromso, Norway. Univ Sao Paulo, Sch Med, Lab Med Invest, Sao Paulo, Brazil. SUNY Buffalo, Sch Med, Childrens Hosp, Dept Pediat, Buffalo, NY USA. Wexner Inst Pediat Res, Childrens Res Inst, Dept Pediat, Columbus, OH USA. Univ Texas, Med Branch, Dept Pediat, Childrens Hosp, Galveston, TX 77550 USA. Turku Univ Hosp, Dept Pediat, FIN-20520 Turku, Finland. Tufts Univ, Dept Otolaryngol, Boston, MA 02111 USA. Shimane Med Univ, Dept Otolaryngol, Izumo, Shimane 693, Japan. Kagoshima Univ, Dept Otolaryngol, Kagoshima 890, Japan. Soroka Univ, Ctr Med, Dept Otolaryngol Head & Neck Surg, Beer Sheva, Israel. Ben Gurion Univ Negev, Fac Hlth Sci, Beer Sheva, Israel. SUNY Buffalo, Div Infect Dis, Buffalo, NY USA. Washington Univ, Sch Med, Dept Pediat & Mol Microbiol, St Louis, MO USA. RP Barenkamp, SJ (reprint author), St Louis Univ, Sch Med, Dept Pediat, St Louis, MO 63104 USA. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 SU 194 BP 60 EP 85 PN 2 PG 26 WC Otorhinolaryngology SC Otorhinolaryngology GA 888UJ UT WOS:000226399400009 ER PT J AU Wedman, J van Weissenbruch, R AF Wedman, J van Weissenbruch, R TI Chronic recurrent multifocal osteomyelitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE chronic osteomyelitis; frontal bone; multifocal osteomyelitis; osteomyelitis; sphenoid bone ID FOLLOW-UP; CHILDREN; DISEASE AB We report what is, to our best knowledge, the first case of chronic recurrent multifocal osteomyelitis (CRMO) in which the frontal and sphenoid bones were involved. Characterized by a prolonged and fluctuating course of osteomyelitis at different sites, CRMO is self-limited, although sequelae can occur. The diagnosis is one of exclusion. It is important to publish cases like this, because the recognition of CRMO can prevent aggressive surgical and medical treatment. C1 Univ Groningen, Med Ctr, Dept Otorhinolaryngol, NL-9700 RB Groningen, Netherlands. RP Wedman, J (reprint author), Univ Groningen, Med Ctr, Dept Otorhinolaryngol, POB 30001, NL-9700 RB Groningen, Netherlands. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 BP 65 EP 68 PN 1 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000012 PM 15697165 ER PT J AU Wang, CP Hsu, WC Young, YH AF Wang, CP Hsu, WC Young, YH TI Vestibular evoked myogenic potentials in neurofibromatosis 2 SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE caloric test; inferior vestibular nerve; neurofibromatosis 2; vestibular evoked myogenic potential ID BILATERAL ACOUSTIC NEUROFIBROMATOSIS; RADIOSURGERY; TUMORS AB Neurofibromatosis 2 (NF2) is characterized by bilateral vestibular neurofibromas. Although the facial nerve, the cochlear nerve, and the superior division of the vestibular nerve can be evaluated before surgery, whether the inferior division of the vestibular nerve is affected remains undetermined without an operation. A total of 7 patients with NF2 (2 men and 5 women) underwent pure tone audiometry, caloric testing, vestibular evoked myogenic potential (VEMP) testing, and magnetic resonance imaging. Audiometry revealed mean hearing levels of less than 26 dB for 1 ear, 26 to 70 dB for 8 ears, 71 to 90 dB for 3 ears, and more than 90 dB for 2 ears. Caloric testing revealed an absent response in 71% of the 14 ears. Seven ears underwent VEMP testing, and only 1 ear (14%) displayed absent VEMPs. Magnetic resonance imaging depicted space-occupying lesions in all 14 auditory canals: small tumors in 3 ears, medium tumors in 7 ears, and large tumors in 4 ears. The tumor size of NF2 is related to the caloric response, but is unrelated to the mean hearing level or VEMPs. In conclusion, NF2 originates from the superior vestibular nerve more often than the inferior vestibular nerve. It more often infiltrates the cochlear nerve than the inferior vestibular nerve. C1 Natl Taiwan Univ Hosp, Dept Otolaryngol, Taipei, Taiwan. RP Young, YH (reprint author), Natl Taiwan Univ Hosp, Dept Otolaryngol, 1 Chang Te St, Taipei, Taiwan. 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PD JAN PY 2005 VL 114 IS 1 BP 69 EP 73 PN 1 PG 5 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000013 PM 15697166 ER PT J AU Bonfils, P Halimi, P Le Bihan, C Nores, JM Avan, P Landais, P AF Bonfils, P Halimi, P Le Bihan, C Nores, JM Avan, P Landais, P TI Correlation between nasosinusal symptoms and topographic diagnosis in chronic rhinosinusitis SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE chronic rhinitis; chronic sinusitis; symptoms ID CHRONIC HYPERPLASTIC RHINOSINUSITIS; COMPUTED-TOMOGRAPHY; PARANASAL SINUSES; CT EVALUATION; SINUSITIS AB Rhinitis and sinusitis concern roughly a quarter of the population in the Western world. They are associated with a wide range of symptoms: nasal obstruction, anterior and posterior nasal discharge, sneezing episodes, facial pain or congestion, and taste and smell disorders. The aim of this prospective study was to evaluate the clinical significance of these various symptoms as a function of the topographic diagnosis of chronic rhinosinusitis. The study involved 474 patients with signs of chronic perennial and persistent rhinosinusitis. The disorders of the nasal cavities and paranasal sinuses were classified into three main diagnostic categories: chronic rhinitis, localized sinusitis (mainly, anterior sinusitis), and diffuse rhinosinusitis (ie, nasal polyposis). A principal components analysis was performed. The symptom patterns of the three main clinical entities differed greatly. Most of the following clinical signs-nasal obstruction, anterior and posterior nasal discharge, sneezing, and facial congestion-are found in all diagnostic categories and hold no specific clinical significance. By contrast, four symptoms seem to have a substantial differentiating potential: anosmia and complete loss of flavor for diffuse rhinosinusitis, cacosmia for localized anterior sinusitis, and severe facial pain for localized sinusitis. This study proposes a new analysis of the relationship between symptoms of chronic rhinosinusitis and findings on a sinus computed tomography scan. C1 European Hosp Georges Pompidou, ENT Dept, Dept Otolaryngol, F-75015 Paris, France. European Hosp Georges Pompidou, Dept Radiol, F-75015 Paris, France. Univ Paris 05, Necker Enfants Malades Fac, Paris, France. Hop Necker Enfants Malad, Dept Biostat, Paris, France. Raymond Poincare Hosp, Dept Internal Med, Garches, France. Univ Auvergne, Fac Med, Dept Biophys & Biostat, Clermont Ferrand, France. RP Bonfils, P (reprint author), European Hosp Georges Pompidou, ENT Dept, Dept Otolaryngol, 20 Rue LeBlanc, F-75015 Paris, France. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 BP 74 EP 83 PN 1 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000014 PM 15697167 ER PT J AU Yildirim, A Tosun, F Alaomeroglu, M AF Yildirim, A Tosun, F Alaomeroglu, M TI Synovial sarcoma of the nasal septum SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article DE nasal septum; synovial sarcoma ID NECK; HEAD AB No case of synovial sarcoma of the nasal septum has so far been reported. We present a patient with synovial sarcoma of the nasal septum and review the related literature. The patient underwent local excision without adjuvant therapy. There was no local recurrence or distant metastasis in the 18-month follow-up period. C1 Cumhuriyet Univ, Fac Med, Dept Otolaryngol Head & Neck Surg, TR-58140 Sivas, Turkey. Gulhane Mil Med Acad, Fac Med, Dept Otolaryngol Head & Neck Surg, Ankara, Turkey. Gulhane Mil Med Acad, Fac Med, Dept Pathol, Ankara, Turkey. RP Yildirim, A (reprint author), Cumhuriyet Univ, Fac Med, Dept Otolaryngol Head & Neck Surg, TR-58140 Sivas, Turkey. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 BP 84 EP 86 PN 1 PG 3 WC Otorhinolaryngology SC Otorhinolaryngology GA 887QG UT WOS:000226320000015 PM 15697168 ER PT J AU Giebink, GS Bakaletz, LO Barenkamp, SJ Green, B Gu, XX Heikkinen, T Hotomi, M Karma, P Kurono, Y Kyd, JM Murphy, TF Ogra, PL Patel, JA Pelton, SI AF Giebink, GS Bakaletz, LO Barenkamp, SJ Green, B Gu, XX Heikkinen, T Hotomi, M Karma, P Kurono, Y Kyd, JM Murphy, TF Ogra, PL Patel, JA Pelton, SI TI Vaccine SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 8th Post Symposium Research Conference CY JUN 07-08, 2003 CL Ft Lauderdale, FL ID NONTYPABLE HAEMOPHILUS-INFLUENZAE; ACUTE OTITIS-MEDIA; OUTER-MEMBRANE PROTEIN; MORAXELLA BRANHAMELLA CATARRHALIS; PNEUMOCOCCAL VIRULENCE PROTEINS; STREPTOCOCCUS-PNEUMONIAE; INTRANASAL IMMUNIZATION; CONJUGATE VACCINE; MIDDLE-EAR; NASOPHARYNGEAL CARRIAGE C1 Univ Minnesota, Sch Med, Dept Pediat, Minneapolis, MN 55455 USA. Wexner Inst Pediat Res, Childrens Res Inst, Dept Pediat, Columbus, OH USA. St Louis Univ, Sch Med, Dept Pediat, St Louis, MO USA. Wyeth Lederle Vaccines, W Henrietta, NY USA. NIDCD, NIH, Rockville, MD USA. Turku Univ Hosp, Dept Pediat, FIN-20520 Turku, Finland. Wakayama Med Univ, Dept Otolaryngol Head & Neck Surg, Wakayama, Japan. Univ Helsinki, Cent Hosp, Dept Otolaryngol, Helsinki, Finland. Univ Canberra, Div Sci & Design, Canberra, ACT, Australia. Kagoshima Univ, Dept Otolaryngol, Kagoshima 890, Japan. SUNY Buffalo, Sch Med, Childrens Hosp, Dept Pediat, Buffalo, NY USA. SUNY Buffalo, Div Infect Dis, Buffalo, NY USA. Univ Texas, Med Branch, Childrens Hosp, Dept Pediat, Galveston, TX 77550 USA. Boston Univ, Sch Med, Dept Pediat, Boston, MA 02215 USA. RP Giebink, GS (reprint author), Univ Minnesota, Sch Med, Dept Pediat, Minneapolis, MN 55455 USA. 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Otol. Rhinol. Laryngol. PD JAN PY 2005 VL 114 IS 1 SU 194 BP 114 EP 139 PN 2 PG 26 WC Otorhinolaryngology SC Otorhinolaryngology GA 888UJ UT WOS:000226399400012 ER PT J AU Jung, TTK Alper, CM Roberts, JE Casselbrant, ML Eriksson, PO Gravel, JS Hellstrom, SO Hunter, LL Paradise, JL Park, SK Spratley, J Tos, M Wallace, I AF Jung, TTK Alper, CM Roberts, JE Casselbrant, ML Eriksson, PO Gravel, JS Hellstrom, SO Hunter, LL Paradise, JL Park, SK Spratley, J Tos, M Wallace, I TI Complications and sequelae SO ANNALS OF OTOLOGY RHINOLOGY AND LARYNGOLOGY LA English DT Article; Proceedings Paper CT 8th Post Symposium Research Conference CY JUN 07-08, 2003 CL Ft Lauderdale, FL ID ACUTE OTITIS-MEDIA; 1ST 3 YEARS; RAT TYMPANIC MEMBRANE; LATERAL SINUS THROMBOSIS; PARENT-REPORTED LANGUAGE; ACUTE MASTOIDITIS; VENTILATION TUBES; HEARING-LOSS; INTRACRANIAL COMPLICATIONS; EARLY-CHILDHOOD C1 Loma Linda Univ, Med Ctr, Div Otolaryngol, Loma Linda, CA 92350 USA. 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