Twelve New Studies in March 2004 Journal Issue

Newswise — Below are news briefs on studies published in the March issue of Otolaryngology—Head Neck Surgery, the peer-reviewed, scientific journal of the American Academy of Otolaryngology—Head and Neck Surgery. Abstracts of these research studies can be viewed at http://www2.us.elsevierhealth.com/scripts/om.dll/serve?action=searchDB&searchDBfor=home&id=HN

Nasal obstruction can be uncomfortable and can lead to sinusitis or significant sleep disorders. "Radiofrequency Treatment of Turbinate Hypertrophy: A Randomized, Blinded, Placebo-Controlled Clinical Trial," a study by two otolaryngologist—head and neck surgeons at the University of Oklahoma Health Sciences Center, sought to determine the effectiveness and safety of using radiofrequency volumetric tissue reduction (RFVTR) to treat nasal obstruction caused by inferior turbinate hypertrophy, or an enlargement of the thin, spongy, bony plate with curved margins, located on the lateral wall of the nasal cavity. Their findings in this first randomized trial found that RFVTR is significantly better than placebo in treating patients with this disorder.

Many baby boomers remember their tonsils being removed with the use of a scalpel. Today, new procedures are in use by ear, nose, and throat specialists for tonsillectomies for enlarged or infected tonsils. Two popular procedures used in tonsillectomies today include radiofrequency ablation, radiant energy to reduce the volume of tonsillar tissue, and electrocautery, metal cauterizing instrument heated by an electric current. The findings of "Radiofrequency Ablation Versus Electrocautery in Tonsillectomy" revealed no differences in blood loss, difficulty of operation, or post-operative hemorrhage rates between the two procedures. Patients preferred radiofrequency ablation because the procedure produced less post-operative pain.

Revision surgery is often required for the treatment of chronic rhinosinusitis but the procedure is one of the most difficult for endoscopic surgeons. "Revision Endoscopic Frontal Sinus Surgery with Surgical Navigation" explores whether the use of surgical navigation systems allows more precise dissections and great rates of frontal recess patency, or openness. Stanford University otolaryngologist—head and neck surgeons found that navigation systems provide a valuable contribution to the outcome of this procedure.

Topical nasal steroids such as Beclomethasone Dipropionate and Fluticasone Propionate are used in the treatment of asthma, rhinitis, and nasal polyps. A 1996 study had reported post-operative increase of infection after the use of Fluticasone Propionate following endoscopic surgery for nasal polyp removal. A study from three otolaryngologist—head and neck surgeons in Mexico City attempted to determine the prevalence of nasal and paranasal infections with the use of nasal steroids after endoscopic removal of the polyps and polyposis recurrence rate. The findings of "Infections Following Endoscopic Polypectomy Using Nasal Steroids" revealed that nasal steroids do not increase the prevalence of infection after polyp removal.

The optical coherence topography (OCT) instrument uses a beam of light to measure the thickness of the retina and the light-sensitive inner lining of the back of the eye. Now, a team of researchers from the Harvard Medical School and the University of California-Irvine have utilized this revolutionary technology to obtain cross-sectional images of the rat cochlea. "Imaging the Internal Structure of the Rat Cochlea using Optical Coherence Tomography at 0.827 µm and 1.3 µm" is a new study that concludes the OCT is effective in identifying the scala vestibuli, scala media, scala tympani, modiolus, spiral ligament, and several turns of the cochlea.

A mandibulectomy, including the condyle, is also referred to as removal of the lower jaw along with the head of the mandible, the neck of the mandible and pterygoid fovea. This complex surgical procedure is often necessary with tumor removal associated with head and neck cancer, one of the more deadly forms of cancer. Head and neck surgeons at Wake Forest University School of Medicine evaluated the use of titanium condylar prosthesis after tumor resection in a study, "Minimizing Complications in the Use of Titanium Condylar Head Reconstruction Prosthesis." Pentoxifylline is used to improve blood flow in patients with circulation problems and is often administered to patients who have undergone radiation therapy.

"Prophylactic Effect of Pentoxifylline on Radiotherapy Complications: A Clinical Study" was conducted in Turkey and assessed the benefit of this medication. The researchers found that pentoxifylline was effective in preventing late skin changes, fibrosis, and soft tissue necrosis in patients receiving postoperative radiotherapy for squamous cell carcinoma.

A multi-center study with 14 sites and 16 investigators resulted in the "Outcomes in Nasal Septoplasty: Results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) Study." This prospective, observational outcomes study sought to assess disease-specific quality of life outcomes in adults with nasal obstruction. The researchers found that in patients with septal deformity, nasal septoplasty provided improvement in disease-specific quality of life, high patient satisfaction, and decreased medication use.

How do residents along America's Gulf Coast respond to mold and other antigens? An otolaryngologist—head and neck surgeon from the University of Texas conducted a retrospective evaluation of serial endpoint allergy skin test in 75 patients. The results of "Patterns in Mold Sensitivity in the Subtropical Gulf Coast" found that cockroaches, dust mites, and grass produced the most common positive skin tests among patients, with many having a similar response to molds.

New concerns about terrorist attacks using biological agents as weapons spurred two otolaryngologist-head and neck surgeons to present information to their colleagues in the study, "Smallpox: What Every Otolaryngologist Should Know." Their comprehensive literature review supported the conclusion that smallpox manifestations in the head and neck often present as acute airway obstruction and produce long-term conditions such as ectropion (roll out of eyelid margins), nasal vestibular stenosis, conductive hearing loss, and blindness.

Pediatric meningitis has been identified as a significant risk factor leading to sensorineural hearing loss in the afflicted child. A prospective pilot study in a children's hospital in India assessed whether an effective vaccine program would be of value. The results reported in "Vaccine-Preventable Pediatric Post-Meningitic Sensorineural Hearing Loss in Southern India" suggest that such a program would reduce prevalence of Streptococcus pneumonia and Haemophlus influenza type b would decrease the incidence of sensorineural hearing loss due to bacterial meningitis.

The platysma myocutaneous flap may not be well known. However, this skin flap has attached subjacent muscle and blood supply and offers a reconstruction option for relatively small soft tissue defects in the head and neck area. Past research has noted arterial and/or venous compromise; a study, "Venous Drainage of the Platysma Myocutaneous Flap," suggests a possible benefit of external jugular vein harvest in continuity with use of the platysma flap in reconstruction efforts.

These studies were published in Otolaryngology—Head and Neck Surgery, the peer-reviewed, scientific journal of the American Academy of Otolaryngology—Head Neck Surgery. The findings of these research studies do not necessarily reflect the policies or opinions of the Academy. The American Academy of Otolaryngology—Head and Neck Surgery represents more than 10,000 physician-specialists dedicated to the diagnosis and treatment of the wide range of disorders of the ear, nose, throat, and related structures of the head and neck.