Preservation of olfaction in anterior skull base surgery.

OBJECTIVES/HYPOTHESIS: In selected unilateral tumors and defects of the anterior skull base, the preservation of contralateral olfaction is achievable through a localized subcranial approach without compromising surgical objectives of resection or repair. STUDY DESIGN: Description of a functional adaptation of anterior skull base surgical techniques through a retrospective patient series. METHODS: Nine patients underwent anterior skull base surgery for unilateral cribriform plate disease including four malignant and two benign tumors, two encephaloceles, and one iatrogenic cribriform injury with cerebrospinal rhinorrhea. All nine patients consented to a localized subcranial approach to the anterior skull base to preserve the contralateral olfactory nerves. In four patients with benign disease a portion of the ipsilateral nerves was additionally conserved. Postoperative olfaction was assessed objectively with a commercially available smell test. Indications, technique, results, and complications are reported and discussed. RESULTS: All patients had eradication of disease with preservation of functional olfaction CONCLUSIONS: Conservation of olfaction is possible in selected cases of anterior skull base surgery when the lesion is unilaterally confined.

Immunohistochemical localization of nitric oxide synthase activity in upper respiratory epithelium.

Nitric oxide (NO) production in the respiratory epithelium of the upper airways has recently been described. To better delineate the role of epithelial NO, the authors of this study attempted to identify the cell type responsible for the production of NO in rat tracheal epithelium and human nasal epithelium. They localized the activity of NO through immunohistochemical analysis with an antibody to L-citrulline, a marker for activity of the L-arginine-dependent nitric oxide synthase (NOS) pathway. Using anti-inducible NOS (iNOS) and anti-constitutive NOS (cNOS) antibodies, they also attempted to identify the specific NO isotypes that were present. The tracheal and nasal epithelium demonstrated strong immunoreactivity to citrulline in ciliated cells. The ciliated cells of the nasal turbinates demonstrated strong iNOS positivity, but no significant cNOS immunoreactivity. The study findings that iNOS activity is present in ciliated epithelial cells of rat and human upper respiratory epithelium suggest that NO may play a role in epithelial homeostasis and could potentially play a role in the pathogenesis of mucociliary dysfunction.

A comparison of fast-rate, slow-rate, and silent previewing interventions on reading performance.

Researchers investigated the effects of three different previewing interventions on the oral reading rates of 12 junior and senior high school students with learning disabilities. Under fast-rate listening previewing (FRLP), students were instructed to follow silently as experimenters read from a text at an average rate that was 77.7% faster than the students' current oral reading rate. During slow-rate listening previewing (SRLP), students followed along as experimenters read at an average rate that was 22.5% faster than the students' reading rate. Students were instructed to read passages silently under silent previewing (SP). Immediately following each previewing intervention, students read the same passage aloud. The number of words read correctly per minute and the number of errors per minute served as dependent variables. The results showed statistically significant decreases in error rates under SRLP and SP. The results also showed that SRLP resulted in statistically significantly fewer errors per minute than FRLP. These results suggest that orally reading while students follow along at a rate much higher than their current reading rates may not be as beneficial as reading aloud at slower rates.