bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphologic Changes in Contralateral Superior Vestibulo-Ocular Neurons following Labyrinthectomy in the Cat
Authors: Gacek Richard R. , Schoonmaker Joanne , Lyon Michael
Published: October 2014

Ultrastructural changes were measured in 22 contralateral superior vestibulo-ocular neurons (SVONs) from four cats painlessly sacrificed at 8 weeks and 25 contralateral SVONs from four cats sacrificed at 1 year following unilateral labyrinthectomy. The SVONs at 8 weeks showed a 43% decrease in somal size, a 34% loss in rough endoplasmic reticulum (RER), a 48% loss of ribosomes, and a 47% decrease in the number of synaptic profiles (SPs) contacting the soma. At 1 year the SVONs had a 31 % decrease in size, a 43% decrease in RER, a 50% loss of ribosomes, and a 71 % decrease in SPs. Synaptic vesicles (SVs) in both groups of SVONs showed no change in size or shape compared to control SVs. These findings resemble the contralateral SVON changes that occur following excision of the vestibular ganglion.
Acoustic Rhinometry in the Study of the Acute Nasal Allergic Response
Authors: Zweiman Burton , Doty Richard , Lane Andrew P. , Lanza Donald C. , Dhong Hun-Jun , Swift David , Kennedy David W.
Published: October 2014

Acoustic rhinometry is a recently developed method for the objective assessment of nasal patency. In this study, acoustic rhinometry was used to measure changes in nasal cavity dimensions in the immediate response to nasal allergen challenge in eight pollen-sensitive subjects. Acoustic rhinometric changes were compared with subjective symptoms, as well as histamine in nasal secretions, cytology of nasal mucosal scrapings, and changes in olfactory function. A significantly greater decrease in nasal airway caliber occurred following allergen challenge as compared to buffer diluent challenge in the same individuals (70% ± 1% versus 22% ± 5%). During an allergic response, a strong correlation was found between the minimum cross-sectional area and the volume of the nasal cavity measured by acoustic rhinometry (r = .9). However, no correlation was observed between nasal airway caliber and concomitant subjective congestion reported by the subjects. Amodest decrease in olfactory function was seenfollowing allergen challenge (3.1 ± 1.4 fewer odors identified correctly out of 20; p = .08). However, the alterations of olfactory function did not correlate with changes in nasal patency. The results presented in this study demonstrate that acoustic rhinometry has great potential as a reproducible method for the objective assessment of nasal obstruction occurring in nasal allergen challenge studies.
Pharyngeal Dermoids (“Hairy Polyps”) as Accessory Auricles
Authors: Heffner Dennis K. , Schall David G. , Thompson Lester D. R. , Anderson Virginia
Published: October 2014

The purpose of this study is to clarify the origin and nature of so-called hairy polyps or dermoids of the pharynx, which are often thought to be a variant of pharyngeal teratoma. For this purpose, a case is reported of a dermoid polyp involving the middle ear of an infant, the features of multiple examples of pharyngeal dermoid polyps and teratomas received for consultation by the Armed Forces Institute of Pathology are examined, and selected pertinent reports from the literature are reviewed. All three means are used to support the conclusion that these lesions are choristomatous developmental anomalies arising from the first branchial cleft area and that they essentially represent heterotopic accessory “ears” (auricles) without the growth potential of a teratoma.
Endoscopic Laser Medial Arytenoidectomy versus Total Arytenoidectomy in the Management of Bilateral Vocal Fold Paralysis
Authors: Wani Manish K. , Yarber Robert , Rosen Clark , Hengesteg Arne , Woodson Gayle E.
Published: October 2014

Bilateral laryngeal paralysis can result in severe airway compromise. A widely accepted treatment is endoscopic laser total arytenoidectomy (TA); however, vocal results are usually poor. An alternative approach, resection of only the medial portion of the arytenoid (medial arytenoidectomy [MA]), has the potential for less vocal impairment, but may not provide a sufficient airway. Laryngeal resistance (LR) was measured in vivo and ex vivo in 12 adult mongrel dogs with bilateral laryngeal paralysis after TA, MA, or no surgery (controls). The LR was significantly lower than in controls in both TA and MA, but there was no significant difference between TA and MA. Glottic area was also significantly higher in both MA and TA compared to controls, but again, there was no significant difference between TA and MA. Phonation could be elicited in all controls and 2 of 4 dogs with MA, but no dogs with TA. Our results show that MA offers airway improvement similar to that with TA and also has the potential for better vocal function.
Brain Stem Auditory-Evoked Potentials of Mice with Experimental Allergic Encephalomyelitis
Authors: Watanabe Tetsuo , Krug Marc S. , Cheng Kuang-Chuan , Yoo Tai-June
Published: October 2014

Experimental allergic encephalomyelitis (EAE) is an experimental model for multiple sclerosis. In order to study autoimmune retrocochlear hearing loss, we performed brain stem auditory-evoked potential (BAEP) studies on EAE mice. The EAE was induced in B 10.PL and (PL/J x SJL)F1 mice. In the BAEP study, all of the peak and interpeak latencies were prolonged significantly in the diseased mice. Hearing thresholds were slightly elevated in the immunized mice during the acute phase. Inflammatory and phagocytic cell infiltration, demyelination, and Vβ8.1, 8.2 T-cell receptor-positive cells were observed in the cochlear nerves or their proximity by histologic study. It is suggested that immunologic reactions identified with EAE also occurred in the cochlear nerve, and that these reactions were responsible for the hearing problems. It appears that EAE is a useful model system for studying autoimmune insults on the neural portion of the auditory system.
Effect of Lipoxygenase Inhibition on Mucous Glycoprotein Secretion from Chinchilla Middle Ear Fpithelial Cells in Vitro
Authors: Lin Jizhen , Kim Youngki , Ondrey Frank , Lees Chris , Juhn Steven K.
Published: October 2014

Lipoxygenase is an enzyme that metabolizes arachidonic acid down to leukotrienes. Recent studies have shown that the enzyme is implicated in mucous glycoprotein (MGP) secretion stimulated by inflammatory mediators in the airways, suggesting its possible role in secretion of MGP from middle ear epithelial cells. To investigate a correlation between MGP secretion and the arachidonic acid metabolites, we examined the effects of nordihydroguaretic acid (NDGA, both a cyclooxygenase and lipoxygenase inhibitor), low-dose indomethacin (an inhibitor of cyclooxygenase), and A63162 (an inhibitor of lipoxygenase) on MGP secretion in cultured chinchilla middle ear epithelial cells. It was found that lipoxygenase inhibition led to reduction of MGP secretion from cultured chinchilla middle ear epithelial cells, while cyclooxygenase inhibition did not. Both cyclooxygenase and lipoxygenase inhibition resulted in profound blockage of MGP secretion in baseline and platelet activating factor-stimulated MGP secretion. It was concluded, therefore, that MGP secretion was linked to arachidonic acid metabolites, especially lipoxygenase products.
Tracheal Resection with End-to-End Anastomosis for Isolated Postintubation Cervical Trachea Stenosis: Long-Term Results
Authors: Laccourreye Ollivier , Naudo Philippe , Brasnu Daniel , Jouffre Véronique , Cauchois Regis , Laccourreye Henri
Published: October 2014

A 20-year experience with end-to-end tracheal resection and anastomosis for isolated postintubation stenosis of the cervical trachea, in a consecutive series of 32 adult patients, has been reviewed. Surgical death was never encountered. The overall incidences for superficial wound infection, pneumonia, and inferior left laryngeal nerve paralysis were 6.2%, 3.1%, and 3.1%, respectively. One-, 3-and 5-year actuarial anastomosis success rates were 96.7%, 93.3%, and 93.3%, respectively. Successful revision tracheal end-to-end anastomosis was performed once, resulting in an overall 96.9% success rate in our series. None of the following variables — sex, age, cause for intubation, intubation type (laryngotracheal and/or tracheotomy) and duration, delay from initial injury, presence of an open stoma, number of tracheal rings resected, and type of sutures used — were statistically related to the anastomosis success rate or the incidence of complications.
Distortion Product Otoacoustic Emission Test of Sensorineural Hearing Loss in Humans: Comparison of Unequal- and Equal-Level Stimuli
Authors: Sun Xiao-Ming , Jung Marjorie D. , Kim Duck O. , Randolph Kenneth J.
Published: October 2014

Distortion product otoacoustic emissions (DPOEs) at the frequency of 2f1 — f2 (f1 < f2) were measured in 77 human adult ears with normal hearing or sensorineural hearing loss. The purpose of this study was to compare the performances of DPOE tests conducted with two sets of stimuli: 1) L1 = 65, L2 = 50 dB sound pressure level (SPL) re 20 μPa (“65/50”), and 2) L1 = L2 = 65 dB SPL (“65/65”). Half-octave DPOE root-mean-square levels at 1,000, 2,000,4,000, and 6,000 Hz were computed from the initial DPOEs measured at 0.25-octave intervals. Correlation coefficient and decision-theory analyses were applied to evaluate the DPOE test performance. For both stimuli, DPOE level exhibited significant correlation with pure tone hearing threshold. When the criterion DPOE level distinguishing normal from impaired hearing was adjusted, the curves of sensitivity and specificity crossed, and the values at the crossing were higher than 80% at frequencies of 2,000 to 6,000 Hz for both stimuli. The area under the receiver operating characteristic (ROC) curve, which provides an overall evaluation of the test performance independent of the criterion DPOE level, was .90 or higher at 2,000 to 6,000 Hz for both stimuli. At 2,000 and 4,000 Hz, all measures of test performance were higher for the 65/50 stimulus than the 65/65 stimulus: area under the ROC curve (.96 to .97 versus .90 to .91, statistically significant, p < .001, Wilcoxon test), sensitivity/specificity (90% to 93% versus 80% to 85%), and correlation coefficient (.78 to .87 versus .66 to .79). At 1,000 and 6,000 Hz, the performances of the DPOE tests were similar for the two stimuli. These results support the conclusion that a DPOE test with L1 = 65 and L2 = 50 dB SPL provides a better performance than that with L1 = L2 = 65 dB SPL and recommend the use of stimuli with L1 being higher than L2 by about 15 dB. These results also support a growing view that 2f1 — f2 DPOEs can be utilized clinically as a reliable method of testing human sensorineural hearing loss.
Laryngeal Adjustment in Whispering
Authors: Tsunoda Koichi , Ohta Yasushi , Niimi Seiji , Soda Yasushi , Hirose Hajime
Published: October 2014

Previous studies confirmed that during whispering the glottis is kept open to prevent vocal fold vibration and the supraglottal structures are constricted. However, there has been no study exploring the exact contour of the laryngeal lumen in the frontal dimension during the production of whispering. In order to further elucidate the nature of the laryngeal adjustments regarding the contour of the laryngeal lumen in whispering, and the role of supraglottal constriction in particular, we conducted a physiological study using magnetic resonance imaging. According to the results, the supraglottal structures were not only constricted but also shifted downward, attaching to the vocal fold to prevent vocal fold vibration completely during whispering. The results suggested the underlying mechanism of suppression of vocal fold vibration during the production of whispering.
Superior Laryngeal Nerve Brain Stem Evoked Response in the Cat
Authors: Kim Young-Ho , Kim Kwang-Moon , Hong Won Pyo , Kim Hong Yoon
Published: October 2014

The generator sources of each wave of the laryngeal brain stem evoked response (LBR) have yet to be precisely demonstrated, although this has been studied in several animal species. This study was carried out to record the near-field brain stem activity as well as the far-field brain stem activity in the cat under the same experimental setup, and to search for the generator sources of the waves. Under general anesthesia, the LBR tracings were recorded adjacent to and within the brain stem following direct electrical stimulation of the internal branch of the superior laryngeal nerve. Reproducible positive and negative waves were detected by the far- and near-field techniques. Mean latencies, configurations, and reproducibility of each wave were demonstrated. From these results, we speculate on the generator sources of each wave.
Migraine-Related Vestibulopathy
Authors: Cass Stephen P. , Ankerstjerne Jennifer K. P. , Yetiser Sertac , Furman Joseph M. , Balaban Carey , Aydogan Barlas
Published: October 2014

Migraine has been associated with specific vestibular disorders, including benign paroxysmal vertigo of childhood and benign recurrent vertigo in adults. Migraine may also play a role in chronic nonspecific vestibulopathy. Because scant data exist that describe the clinical findings and vestibular function abnormalities in suspected migraine-related vestibulopathy, we reviewed the history, physical examination, vestibular tests (electronystagmography, rotational chair, posturography), and response to treatment of 100 patients with diagnoses of migraine-related vestibulopathy. Dominant clinical features included chronic movement-associated dysequilibrium, unsteadiness, space and motion discomfort, and occasionally, episodic vertigo as an aura prior to headache, or true vertigo without headache. Common vestibular test abnormalities included a directional preponderance on rotational testing, unilateral reduced caloric responsiveness, and vestibular system dysfunction patterns on posturography. Treatment was usually directed at the underlying migraine condition by identifying and avoiding dietary triggers and prescribing prophylactic anti-migraine medications. Symptomatic relief was also provided using anti-motion sickness medications, vestibular rehabilitation, and pharmacotherapy directed at any associated anxiety or panic disorder.
Role of Ultrasound in the Assessment of Vocal Cord Function in Infants and Children
Authors: Friedman Ellen M.
Published: October 2014

The determination of the cause of stridor in the infant and child is an important directive for the otolaryngologist. The limitations of current clinical diagnostic techniques have provided the impetus for pursuing newer, more practical techniques to diagnose vocal cord paralysis in children. The purpose of this paper is to describe a new technique to image the larynx and determine its role in discerning vocal cord paralysis in children. This study began with an animal study (lamb model) demonstrating that computerized ultrasound can accurately delineate laryngeal anatomy and function. The human protocol included 27 patients (age 1 day to 14 years): 15 with normal larynges and 12 with vocal cord paralysis. Recorded ultrasound studies of these subjects were compiled in a randomly ordered videotape and presented twice and viewed in a blinded manner by four expert raters. Statistical analysis of their readings revealed that ultrasound is a highly accurate technique to document vocal cord paralysis, with a high degree of interrater and intrarater reliability. Beyond the accuracy and consistency of computerized ultrasound, there are many other aspects of this technique that make it clinically attractive. Laryngeal ultrasound is noninvasive, painless, and widely accepted. It is relatively safe, with no radiation exposure and no need for sedation or anesthesia. It is well tolerated by patients and their families. The results are easily displayed and recorded and available for hard copy storage. This investigation should not be interpreted as an endorsement for laryngeal ultrasound as a replacement for endoscopy in children. This work does indicate, however, that ultrasound is a technique that can accurately address the special issue of vocal cord mobility in infants and children. At present, this is the primary use for laryngeal ultrasound, although with additional investigation and sophistication it is likely that ultrasound of the larynx may become useful for other purposes.
Vocal Function following Vertical Hemilaryngectomy: Comparison of Four Reconstruction Techniques in the Canine
Authors: Andrews Robert J. , Calcaterra Thomas C. , Sercarz Joel A. , Kreiman Jody , Ye Ming , Berke Gerald S.
Published: October 2014

The goals of laryngeal reconstruction have been prevention of aspiration, production of a functional voice, and maintenance of an adequate airway for decannulation. A number of procedures for partial laryngeal reconstruction have accomplished these objectives. However, few studies have attempted to compare patients' vocal characteristics following different reconstruction procedures. In this study, an in vivo canine model was used to compare acoustic and aerodynamic measures of vocal function for the following vertical hemilaryngectomy reconstruction techniques: 1) a superiorly based sternohyoid muscle flap, 2) a modified epiglottic laryngoplasty, 3) a new procedure using a layered vascularized buccal mucosal flap and a transversely oriented sternohyoid muscle flap, and 4) hemilaryngeal transplantation combined with arytenoid adduction. Hemitransplantation provided the most efficient phonation of the four techniques. The vascularized buccal mucosa flap produced the best phonation of the autologous tissue techniques examined. Both vascularized buccal mucosa flap and hemilaryngeal transplantation subjects demonstrated a mucosal wave on stroboscopy. The results indicate that vocal function will improve as the layered structure of the vocal fold is more accurately replicated in a reconstructed hemilarynx. Endoscopic findings and whole organ sections are presented.
Acoustic Measurement of Change in Voice Quality with Treatment for Chronic Posterior Laryngitis
Authors: Hanson David G. , Chen Judy , Jiang Jack J. , Pauloski Barbara Roa
Published: October 2014

Sixteen patients who had symptoms and signs of chronic posterior laryngitis were evaluated before, during, and after treatment with omeprazole and nocturnal antireflux precautions. Data were analyzed for patients who complained of some hoarseness, who had no smoking history, and who completed all of the voice recording protocol. The patients' voices were recorded before, during, and following treatment with omeprazole and nocturnal antireflux precautions. Voice quality was analyzed by perceptual analysis, and acoustic signal data were measured for jitter, shimmer, and signal-to-noise ratio. Measures of jitter, shimmer, and signal-to-noise ratio changed significantly with treatment of posterior laryngitis (p < .01 for change in each of the measures). Acoustic measures showed some trend of deterioration with cessation of treatment, although the overall improvement in acoustic measures of voice quality was still statistically significant after treatment with omeprazole was discontinued. Although perceived abnormality of voice increased and decreased with the magnitude of measured perturbation of the acoustic signal for some patients, the perceptual assessments were not highly correlated with acoustic measures for individual patients, and the perceptual analysis group data did not show a significant change with time during treatment, in contrast to the significance of change in acoustic measures. The data demonstrate that acoustic measures of jitter, shimmer, and signal-to-noise ratio improve significantly with antisecretory and antireflux treatment of chronic posterior laryngitis, and that for individual patients, these are changes that are detected by trained listeners, but not at statistically high levels of confidence.
Safety of Esophagoscopy in the Irradiated Esophagus
Authors: Wax Mark K. , Ulewicz Dennis E. , Amirali Asef , Lough Richard
Published: October 2014

Carcinoma of the esophagus is a disease with a poor prognosis. Surgery is considered the treatment of choice. Patients who are surgically unresectable may receive radiotherapy, plus or minus chemotherapy. While this offers reasonable palliation, a significant number of patients develop benign or malignant strictures. Frequent esophagoscopy with dilation is required if they are to swallow. Patients with strictures or malignancy of the esophagus are more prone to complications if they undergo an esophagoscopy. We examined the morbidity of esophagoscopy in a group of patients who had received radiotherapy for carcinoma of the esophagus. Over a 10-year period, 21 patients receiving irradiation for carcinoma of the esophagus were examined. All patients underwent esophagoscopy for staging and diagnosis. The tumor locations were upper (6), middle (6), and lower (9) esophagus. The T-stages were 1 (7), 2 (6), 3 (6), and 4 (2). Five patients had dilation of a malignant stricture at the time of diagnosis. Fever developed and resolved within 24 hours in 2 patients. Following completion of irradiation, a total of 83 esophagoscopies were performed (range 1 to 11 per patient). Six patients with no tumor or stricture underwent 8 esophagoscopies (3 rigid, 5 flexible). There was 1 episode of minimal bleeding and 1 fever that resolved within 24 hours. Ten patients with malignant strictures underwent 62 esophagoscopies (5 rigid, 57 flexible). There were 17 (27%) episodes of fever (all resolved within 24 hours) and 14 (22%) episodes of bleeding. Five patients with benign strictures underwent 13 esophagoscopies (2 rigid, 11 flexible). One patient had a perforation that resolved with conservative treatment, and 1 patient developed an epidural abscess 2 months following dilation. This patient is the only one that required surgical intervention and had prolonged hospitalization. Esophagoscopy of the irradiated esophagus can be performed relatively safely and excellent palliation obtained. Morbidity consisting of minimal bleeding, and fever lasting less than 24 hours, is frequent but self-limited.
Molecular Analysis of the Pou3F4 Gene in Patients with Clinical and Radiographic Evidence of X-Linked Mixed Deafness with Perilymphatic Gusher
Authors: Bykhovskaya Yelena , Wilson David F. , Friedman Rick A. , Tu George , Farnes Lorne S. , Talbot J. Michael , Fischel-Ghodsian Nathan
Published: October 2014

The molecular defect in some patients with X-linked mixed deafness with perilymphatic gusher at stapes surgery (DEN3) was recently attributed to mutations in the POU3F4 gene. In this manuscript we describe the molecular analysis of the POU3F4 gene in 5 patients with clinical and radiographic evidence of DFN3. Novel mutations were found in 2 of the 5 patients analyzed, while 3 had an entirely normal protein coding sequence. The fact that 3 of the 5 patients with clinical histories and radiographic abnormalities characteristic of X-linked mixed deafness with perilymphatic gusher displayed normal POU3F4 gene sequences supports the possibility that not all patients with the characteristic phenotype have involvement of the POU3F4 gene.
Audiologic Findings in Patients with a Point Mutation at Nucleotide 3,243 of Mitochondrial Dna
Authors: Kitamura Ken , Nishizawa Masatoyo , Tamagawa Yuya , Hagiwara Hideo , Sajto Toshikazu , Ishida Takashi , Iwamoto Yasuhiko
Published: October 2014

A mitochondrial tRNALeu(UUR) mutation at nucleotide 3,243 is known to be found in most patients with MELAS (mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes) and has also been identified in several families with maternally inherited diabetes mellitus and hearing loss. We report here audiologic features in patients with hearing loss associated with the mutation. Four patients without and five with MELAS were studied. Most of the patients had bilateral progressive sensorineural hearing loss. The most common shape of the audiogram was sloping, while cases in the advanced stages had flat audiograms. Speech discrimination scores were generally poor and did not parallel the degree of hearing loss. The present study suggests that the lesion for hearing loss could include both cochlear and retrocochlear involvement, but does not demonstrate a significant difference in the audiologic findings between patients with and without MELAS.
Single Dose of Betamethasone in Combined Medical Treatment of Secretory Otitis Media
Authors: Hemlin Claes , Carenfelt Christer , Papatziamos Georgios
Published: October 2014

With the objective of evaluating the efficacy of cefixime and the combination of cefixime and betamethasone in the treatment of secretory otitis media (SOM), we enrolled 142 children 2 to 12 years old in a randomized, double-blind, placebo-controlled study. All children suffered from SOM, verified by otomicroscopy and tympanometry, of at least 3 months' duration. Active treatment was a 10-day course of cefixime with and without a single dose of 6 mg betamethasone. One hundred forty children were available for efficacy evaluation 14 to 23 days after the start of treatment. A statistically significant treatment effect was found in the group treated with cefixime plus betamethasone (n = 59), with a 44.1% cure rate as compared to 19.7% in the cefixime-treated group (n = 61; p < .005) and 5% in the placebo group (n = 20; p < .005). Relapse rates were high and no statistically significant differences between groups remained at last valid visit. Adverse events possibly or probably associated with active treatment were reported in 11 cases (9.2%). One patient reported a severe adverse event. No serious events occurred. The study did not show any significant long-term effect of cefixime treatment or any long-term treatment benefit with the addition of betamethasone to the antibiotic.
Investigation of the 4,000-Hertz Dip by Detailed Audiometry
Authors: Murai Kazuo
Published: October 2014

It is well known that a 4,000-Hz dip is often observed in the initial stage of noise-induced hearing loss and acoustic trauma, but it does not always occur as a result of these causes, and quite often the cause is unknown. Pure tone audiograms of 159 patients (76 cases of noise-induced hearing loss, 62 cases of hearing loss of unknown cause, 21 cases of familial hearing loss) with a 4,000-Hz dip were studied by detailed audiometry to clarify this configuration. The types of dip were classified into 11 groups; however, the basic types are the cone type, bowl type, and dish type, which show the smooth line of the hearing threshold. There were no clear differences in dip configuration among the 3 causes of hearing loss. It was thought that the dips displayed similar configurations regardless of the cause.
Changes in Length and Spatial Orientation of the Vocal Fold with Arytenoid Adduction in Cadaver Larynges
Authors: Woodson Gayle E. , Hengesteg Arne , Yeung Daniel , Rosen Clark A. , Chen Naidy
Published: October 2014

Videoendoscopy suggests that arytenoid adduction (AA) surgery not only medializes the paralyzed vocal fold, but increases the length of its membranous portion so that it more closely resembles the normal side. This could represent either real length change or out-of-plane rotation. Computed tomography scanning was performed on adult male cadaver larynges before and after the AA procedure to measure changes in length and spatial orientation of the vocal fold. Three-dimensional coordinates of radiopaque markers on the anterior commissure, posterior glottic midline, and vocal processes were determined. The distance between the vocal processes was 3.9 mm before, and 0.8 mm after AA. The mean vocal fold length was 12.4 mm before, and 13.4 mm after AA (p = .14). The vocal process moved consistently caudally, an average of 3.5 mm (p = .02). The data suggest that clinically apparent vocal fold length changes with AA could be an illusion due to vertical displacement of the vocal process, and not actual lengthening.
Kaposi's Sarcoma of the Larynx
Authors: Schiff Neil F. , Woo Peak , Annino Donald J. , Shapshay Stanley M.
Published: October 2014

Kaposi's sarcoma (KS) is a neoplastic vascular disorder, classically arising in the skin of the lower extremities. As a consequence of the acquired immunodeficiency syndrome (AIDS) epidemic, an increasing number of patients have been found to have KS. In AIDS patients, KS appears to exhibit a more diffuse nature and frequently affects the head and neck. Mucosal lesions are most often seen, commonly involving the oral cavity. Only rare cases of laryngeal involvement have been recorded in the literature. We report 2 cases of KS of the supraglottic larynx. Our first patient, an elderly man of Mediterranean descent, complained of voice change and throat discomfort. Endoscopy with biopsy for diagnosis allowed conservative treatment with chemotherapy. Our second patient was a younger man with AIDS who presented with symptoms of airway obstruction. Management with carbon dioxide laser epiglottectomy was successful in relieving that patient's symptoms. Although rare, KS may present in both healthy and immunocompromised patients, and must be considered in the differential diagnosis of all violaceous lesions of the larynx.
Hearing Loss (In Nonoperated Ears) in Relation to Age in Osteogenesis Imperfecta Type I
Authors: Garretsen Anton J. T. M. , Cremers W. R. J. , Huygen Patrick L. M.
Published: October 2014

Hearing loss was studied in relation to age in nonoperated ears in a group of 142 subjects with autosomal dominant osteogenesis imperfecta type I, which was compared to that in a random subsample of 70 subjects. In the n = 142 group, particularly below the age of 30 years, considerable selection (ie, for ear surgery) had occurred on hearing loss. The hearing threshold increased gradually with age. A hearing loss of greater than 30 dB (Fletcher index) was observed for 51 % of the subjects older than 20 years and younger than 60 years. The median hearing loss progressed from the 10th to the 45th years of life with an average annual threshold increase (ATI) of 1 dB/y (0.5 to 4 kHz) up to 1.7 dB/y (8 kHz). Sensorineural loss accounted for 0.6 dB/y ATI at 0.5 to 4 kHz and 1.3 dB/y ATI at 8 kHz; conductive loss accounted for 0.4 dB/y ATI at all frequencies.
Ototoxic Effect of Erythromycin on Cochlear Potentials in the Guinea Pig
Authors: Kobayashi Toshimitsu , Marcus Daniel C. , Rong You , Ohyama Kenji , Chiba Toshihiko , Takasaka Tomonori
Published: October 2014

The mechanism of hearing loss due to the administration of intravenous erythromycin was investigated in the albino guinea pig, and it was found for the first time that this drug causes cochlear dysfunction. The endocochlear potential (EP) and the cochlear microphonics (CM) recorded at the first cochlear turn transiently decreased when erythromycin was administered intravenously at dosages of 100 and 150 mg/kg. The averaged maximum decrease in EP was 16 mV (n = 5) and 33 mV (n = 5) for 100 and 150 mg/kg, respectively. The maximum decrease in the CM was about 25% when the EP reached its lowest value with the injection of 150 mg/kg. A complete recovery of the EP and CM ensued within 20 minutes after each erythromycin dose. The perilymphatic perfusion of 3 mmol/L of erythromycin decreased the EP and CM; however, in contrast to the intravenous administration, the decrease of the CM was nearly complete and both the EP and CM were irreversible. Hearing loss due to intravenously administered erythromycin could likely be attributable to the transient dysfunction of the stria vascularis, although concomitant dysfunction of the central auditory pathway cannot be excluded.
Distribution and Heritability of Recurrent Ear Infections
Authors: Kvaerner Kari J. , Harris Jennifer R. , Tambs Kristian , Magnus Per
Published: October 2014

The distribution of recurrent ear infections was obtained from a population-based sample of 2,750 pairs of Norwegian twins born between 1967 and 1974. The lifetime prevalence of self-reported recurrent ear infections was 8.9%, with a significant predominance of female cases. The mean age of onset was 4.2 years, with a gradual decrease in occurrence from 2 to 7 years of age. Among monozygotic pairs, the rate of tetrachoric correlation between co-twins was almost identical in males (0.73, SE 0.08) and females (0.74, SE 0.06), but among the dizygotic pairs the correlation was clearly higher in males (0.53, SE 0.12) than in females (0.20, SE 0.12). The value in the unlike-sexed dizygotic twins (0.25, SE 0.05) was intermediate to that of the like-sexed male and female dizygotic pairs. The relative contribution of genes and environment to variability in the predisposition to develop otitis media was estimated by means of structural equation modeling. Variation in liability to ear infections was mainly explained by additive genetic and dominance factors in females, for whom heritability was estimated at 74%. The remaining 26% of the variation in liability was explained by individual environmental factors. In males, 45% of the variation could be accounted for by genetic factors, 29% by common familial environment, and the remaining 26% by individual environmental effects.
Reversible Sensorineural Hearing Loss after Renal Transplant Immunosuppression with OKT3 (MUROMONAB-CD3)
Authors: Hartnick Christopher J. , Cohen Alan F. , Smith Richard V.
Published: October 2014

Reversible and irreversible ototoxicity has been documented following the administration of various therapeutic agents. Reversible hearing loss is a known complication following the administration of quinine, salicylates and other nonsteroidal anti-inflammatory drugs, and erythromycin. We report a case of reversible hearing loss following OKT3 (murine monoclonal antibody CD3) administration. OKT3, a monoclonal antibody used as an immunosuppressant following cadaveric renal transplants, was associated with a transient sensorineural hearing loss that reversed following discontinuation of OKT3.
Immunohistochemistry of Lymphocytes and Macrophages in Human Celloidin-Embedded Temporal Bone Sections with Acute Otitis Media
Authors: Ganbo Tetsuya , Sando Isamu , Suzuki Chiaki , Balaban Carey D. , Sudo Masaharu
Published: October 2014

Immunohistochemical analyses were used to investigate the distribution of lymphocytes and macrophages in routine human temporal bone sections obtained from a subject with acute suppurative otitis media. Primary antibodies specific for human CD3 and CD43 (T-lymphocytes), CD20 (B-lymphocytes), CD45 (leukocyte common antigen), and CD68 (macrophages) were used. As a pretreatment, the sections were soaked in antigen retrieval solution (saturated sodium hydroxide-methanol solution in methanol at a ratio of 1:3). A second antigen retrieval procedure (microwave treatment in 1 % zinc sulfate) was also employed for identifying CD3-positive cells. Then the avidin-biotin-peroxidase complex technique was performed. Positive reactions to all antibodies but anti-CD68 were observed in the mucosa of the eustachian tube, tympanic cavity, and mastoid air cells. Particularly, cells positive to anti-CD3 or anti-CD43 were making a diffuse invasion upon the lamina propria. CD68-positive cells were scattered only in the effusion of mastoid air cells. These results suggest that the retrospective immunohistochemical study of archival temporal bone sections is a promising approach to investigate the pathogenesis of otitis media.
Effect of Photodynamic Therapy on Selected Laboratory Values of Patients with Nasopharyngeal Carcinoma
Authors: Tao Zheng D. , Zhao Su P. , Lai Jin P. , Xiao Jian Y. , Tian Yong Q.
Published: October 2014

We determined pre- and post-photodynamic therapy (PDT) serum levels of soluble interleukin-2 receptor (SIL-2R) and interleukin-2 (IL-2), as well as activity of natural killer (NK) cells, among 24 patients with either persistent or recurrent nasopharyngeal carcinoma (NPC), using a double-antibody sandwich technique, tritiated thymidine-deoxyribonucleoside incorporation, and iodine 125-uridine-deoxyribonucleoside release techniques, respectively. The results showed that the post-PDT serum level of SIL-2R had significantly declined (p < .0005), while that of IL-2 and the NK cell activity had significantly increased (p < .0005), compared with pre-PDT values, suggesting an immunoenhancing effect of PDT on NPC patients.
Effects of Indomethacin, Dexamethasone, and Erythromycin on Endotoxin-Induced Intraepithelial Mucus Production of Rat Nasal Epithelium
Authors: Takahashi Yukimitsu , Shimizu Takeshi , Sakakura Yasuo
Published: October 2014

We produced hypertrophic and metaplastic changes of goblet cells in rat nasal respiratory epithelium by the intranasal instillation of endotoxin (ETN). In the present study, we examined in vivo effects of indomethacin (IND), dexamethasone (DEX), and erythromycin (EM) on intraepithelial mucus production using this animal model. Intraperitoneal injection of IND (2 to 4 mg/kg body weight x 4 days) or DEX (4 to 8 mg/kg body weight x 4 days) significantly inhibited intraepithelial mucus production induced after 3 days of ETN instillations. Intraperitoneal injection of EM (100 mg/kg body weight x 8 days), aminobenzylpenicillin (ABPC, 200 mg/kg body weight x 8 days), and cephalothin (CET, 200 mg/kg body weight x 8 days) also inhibited intraepithelial mucus production induced after 7 days of ETN instillations. When compared with ABPC and CET, EM had a greater inhibitory effect. These results indicate that ETN-induced intraepithelial mucus production can be inhibited by treatment with the anti-inflammatory drugs IND and DEX. Antibiotics such as EM, ABPC, and CET will also be effective, probably by preventing secondary bacterial infection, and EM has an additional inhibitory effect on intraepithelial mucus production.
Parosteal Osteogenic Sarcoma of the Mastoid Bone
Authors: Seely Daniel R. , Gates George A.
Published: October 2014

Parosteal osteogenic sarcoma (POS) is an uncommon surface bone tumor, most often arising from the metaphyseal end of long bones. Involvement of the cranial bones is rare, with only 1 case of mastoid bone POS previously reported in the literature. Two patients with POS of the mastoid are presented, 1 followed up for 25 years after surgical treatment. The presenting signs and symptoms, as well as distinctive radiographic findings, are discussed. Histologic features are also described. Typically, cranial POS appears as a sessile, densely ossified surface growth with radiating bone spicules that blend with surrounding soft tissue. Treatment is en bloc resection, which is curative in most cases.
Bacterial Flora of Stethoscopes' Earpieces and Otitis Externa
Authors: Brook Itzhak
Published: October 2014

External otitis caused by Staphylococcus aureus was observed in a nurse after extensive use of a stethoscope. The infection recurred and a similar organism was isolated from the stethoscope's earpiece. The infection did not recur after the earpiece was cleansed after each use. In a prospective study, the bacterial flora of 35 earpieces was evaluated. Fifty-three isolates, 36 aerobic or facultative and 17 anaerobic, were recovered. The number of organisms per earpiece ranged from 14 to 204 (average 92 ± 17). The predominant isolates were Staphylococcus epidermidis (16 isolates), Propionibacterium acnes (12), and S aureus (7). The study demonstrates the colonization of the stethoscope's earpiece with microorganisms that possess the potential for causing nosocomial infection.
Aging Rat Vestibular Ganglion: II. Quantitative Electron Microscopic Evaluation
Authors: Lyon Michael J. , King Jeffrey M.
Published: October 2014

This laboratory has shown that age-related vestibular ganglion cell loss does not occur in the Wistar rat as it does in humans. However, in that study, intracellular changes were evident. The purpose of the present study was to quantitate some of these changes. The volume densities of mitochondria, rough endoplasmic reticulum (RER), Golgi apparatus, and aging pigment, as well as the diameter of the vestibular ganglion cells, of young (3 to 5 months) and old (24 to 31 months) female Wistar rats were determined by electron microscopy and stereological techniques. The data show a significant decrease in the volume densities of mitochondria (11.4%), Golgi apparatus (8.1%), and RER (8.9%), a significant increase in aging pigment (327%), and no change in mean profile diameter. These results suggest a decreased capacity for oxidative metabolism and protein synthesis that may reflect a decrease in the number of hair cells innervated by each ganglion cell and/or in the number of central connections. In either case, these findings suggest impaired metabolic and functional capabilities.
Transoral Teflon Injection under Flexible Laryngovideostroboscopy for Unilateral Vocal Fold Paralysis
Authors: Chu Pen-Yuan , Chang Shyue-Yih
Published: October 2014

Intracordal Teflon injection is a widely accepted method for the treatment of glottic incompetence due to unilateral vocal fold paralysis. It can be performed transorally via direct or indirect laryngoscopy, as well as transcutaneously under laryngovideoscopy. However, these procedures still have their disadvantages. The technique we introduce is to perform the procedure transorally while using a curved injection needle under flexible laryngovideostroboscopic monitoring. With topical anesthesia, the patient can phonate naturally during the procedure. The surgeon can visualize the needle and injection site clearly under high-resolution flexible laryngovideostroboscopy. Stroboscopic examination during surgery enables the surgeon to monitor the improvement of vocal fold vibration. Twenty consecutive patients treated with this technique were studied. The preliminary results are satisfactory. The technique we introduce is an outpatient procedure with high applicability and low morbidity. This technique is a good, cost-effective alternative to standard operative direct laryngoscopy with injection.
Meniere's Syndrome and Migraine: Incidence in one Family
Authors: Oliveira Carlos A. , Bezerra Roberta L. , Araújo Mercedes F. , Almeida Vanessa F. , Messias Christiane I.
Published: October 2014

Since 1992, we have applied a standard questionnaire to all our Meniere's syndrome patients. We ask about other family members affected by the symptoms and about the presence of the usual migraine symptoms. Through this questionnaire we have identified a family that has some members affected by Meniere's syndrome alone, some others with associated migraine, and still others with migraine alone. Two members of this family started out with migraine and later in life developed Meniere's syndrome. The genetic transmission follows an autosomal dominant pattern for both Meniere's syndrome and migraine. We have interviewed and studied 19 affected persons from several generations of this family, who form the basis of this report. The possibility of a common autosomal dominant genetic determinant for Meniere's syndrome and migraine and its implications for the causation of Meniere's disease are discussed.
Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated with Head and Neck Cancers: Review of the Literature
Authors: Ferlito Alfio , Rinaldo Alessandra , Devaney Kenneth O.
Published: October 2014

In a minority of patients with malignant tumors, signs and symptoms develop that cannot be explained on the basis of the mass effect produced by the primary tumor or its metastases, or production of a hormone normally associated with the tissue type that has given rise to the malignant tumor; these peculiar symptom complexes are known as paraneoplastic syndromes, and may be divided into endocrinologic, dermatologic, hematologic, neurologic, and osteoarticular manifestations. In the head and neck region in particular, the syndrome of inappropriate antidiuretic hormone production (SIADH, or Schwartz-Bartter syndrome) is a well-recognized form of paraneoplastic syndrome that may accompany head and neck malignancies. Most of such tumors are squamous carcinomas, with lesser numbers of olfactory neuroblastomas, small cell neuroendocrine carcinomas, adenoid cystic carcinomas, and undifferentiated carcinomas; sarcoma was reported in only a single instance. The lesions associated with the development of SIADH have most often been located in the oral cavity, and less often in the larynx, nasopharynx, hypopharynx, nasal cavity, maxillary sinus, parapharyngeal space, salivary glands, and oropharynx. Key features of SIADH include serum hypo-osmolality; an unexpectedly high urinary specific gravity; an absence of edema or dehydration; normal adrenal, thyroid, and renal function; hyponatremia; and an elevation of plasma vasopressin.
Respiratory Activity of the Rat Posterior Cricoarytenoid Muscle
Authors: Berkowitz Robert G. , Chalmers John , Sun Qi-Jian , Pilowsky Paul M.
Published: October 2014

An anatomic and electrophysiological study of the rat posterior cricoarytenoid (PCA) muscle is described. The intramuscular nerve distribution of the PCA branch of the recurrent laryngeal nerve was demonstrated by a modified Sihler's stain. The nerve to the PCA was found to terminate in superior and inferior branches with a distribution that appeared to be confined to the PCA muscle. Electromyography (EMG) recordings of PCA muscle activity in anesthetized rats were obtained under stereotaxic control together with measurement of phrenic nerve discharge. A total of 151 recordings were made in 7 PCA muscles from 4 rats. Phasic inspiratory activity with a waveform similar to that of phrenic nerve discharge was found in 134 recordings, while a biphasic pattern with both inspiratory and post-inspiratory peaks was recorded from random sites within the PCA muscle on 17 occasions. The PCA EMG activity commenced 24.6 ± 2.2 milliseconds (p < .0001) before phrenic nerve discharge. The results are in accord with findings of earlier studies that show that PCA muscle activity commences prior to inspiratory airflow and diaphragmatic muscle activity. The data suggest that PCA and diaphragm motoneurons share common or similar medullary pre-motoneurons. The earlier onset of PCA muscle activity may indicate a role for medullary pre-inspiratory neurons in initiating PCA activity.
Indications for, Contraindications to, and Interruption of Craniofacial Procedures
Authors: Cernea Claudio R. , Teixeira Gilberto V. , Vellutini Eduardo A. S. , dos Santos Luiz R. Medina , Siqueira Mário G.
Published: October 2014

In spite of increasing experience with skull base surgery, some of the guidelines for indications for operations may vary according to the institution. One-hundred two patients underwent craniofacial oncologic resections at our institution from 1982 to 1995. A retrospective analysis of the indications for and contraindications to these procedures was undertaken. The main indications for malignant tumors were skin lesions with direct invasion of the anterior or lateral skull base (69%) and nasal-paranasal sinus tumors (21%). The main indications for benign tumors were glomus lesions (26%), menigiomas (22%), and fibro-osseous lesions of the anterior skull base (19%). The main contraindications were extensive invasion of the central nervous system, invasion of the cavernous sinus and/or internal carotid artery by aggressive malignancies, and bilateral orbital invasion in a nonblind patient. Also, 6 patients had their procedures interrupted during craniotomy for several reasons — extensive central nervous system invasion (2 cases), bilateral orbital invasion (1), lack of brain retraction (1), lack of histologic diagnosis during the operation (1), and purulent discharge at the frontal sinus (1). Craniofacial oncologic operations are extensive surgical procedures that have to be properly indicated in order to obtain low levels of morbidity and mortality. The selection of cases is of paramount importance. In some instances, it seems advisable even to interrupt these operations in the first phase.