bluuebunny/crossref_metadata_2025 huggingface dataset:
Fabrication and Sensing Behavior of Cr2O3 Nanofibers via In situ Gelation and Electrospinning
Authors: Hao Rui , Yuan Jinying , Peng Qing
Published: October 2006

In this paper, we developed an in situ gelation method to simplify the electrospinning technique. Chromium hydroxide/polyvinyl alcohol (PVA) hybrid nanofibers were prepared by electrospinning technique and in situ gelation. Ultrathin fibers of chromium oxide with 150–200-nm diameters were obtained by high-temperature calcination of the hybrid fibers. Structural, morphological, and crystalline phase features of electrospun Cr2O3 nanofibers were studied by SEM, XRD, and DTA-TGA. Ethanol-sensing behavior of the nanofibers was also investigated.
Assembly of Gold Nanoparticles by Quadruple Hydrogen-bonded Ureidopyrimidinone-thiol Dimer as a New Type of Crosslinker
Authors: Kido Yasushi , Fujihara Hisashi
Published: October 2006

Quadruple hydrogen-bonded networks between gold nanoparticles and a new ureidopyrimidinone-thiol 1 were constructed and the remarkably stable layered films of redox-active gold nanoparticles crosslinked by 1 were formed on a gold electrode.
Radioactive suture in the treatment of head and neck cancer
Authors: Goode Richard L. , Fee Willard , Goffinet Donald , Martinez Alvaro
Published: October 2006

I‐125 seeds in Vicryl suture have been used as a radioactive suture in 24 cases of advanced malignancy of the head and neck. Twelve cases had metastatic carcinoma attached to the internal or common carotid artery. The goal was to excise surgically as much tumor as possible, then implant any residual tumor with this radioactive suture which remains as a permanent implant (half‐life of 60 days)
The opercular syndrome–diagnostic trap in facial paralysis
Authors: Crumley Roger L.
Published: October 2006

We describe a patient with a left facial paralysis and hemotympanum following left parieto‐occipital skull trauma. The initial admission diagnosis of intratemporal facial nerve injury secondary to temporal bone fracture was incorrect. Normal facial movements during involuntary activity (yawning, laughing at a joke) and focal seizure activity on the paralyzed side of the face, seen subsequently, indicated the site of lesion as supranuclear. The diagnosis of opercular syndrome was made.

This syndrome can result when the contralateral frontal lobe is injured. Supranuclear weakness of muscles supplied by the hypoglossal or spinal accessory nerves is also present. Unlike other central paralyses, the facial paralysis in operculum syndrome may not demonstrate “forehead sparing,” and consequently it may be mistaken for a peripheral paralysis. The neuroanatomic basis for the syndrome is discussed. Signs and symptoms are outlined to help the otolaryngologist avoid this diagnostic pitfall.
Survival after unplanned carotid rupture
Authors: Baxter William F.
Published: October 2006

A series of 13 cases with unplanned carotid rupture is summarized. Time from surgery and radiation to rupture, survival time after rupture, and whether tumor is present or not at death is given. The longest survivor lived one year and eight months after rupture and was one of three patients without known tumor at death.

Long‐term planning for care in the head and neck tumor patient should include the patient and family. Decisions should be made objectively by all rather than during acute care crises. Occasionally a decision not to treat a pending or actual carotid rupture may be the patient's choice.
Eye protection in the paralyzed face
Authors: Smith Mansfield F. W. , Goode Richard L.
Published: October 2006

All patients with a VIIth nerve paralysis with any limitation of closure of the eye should have in the office or out‐patient clinic setting: 1. paper tarsorrhaphy of the upper or possibly lower lid; 2. artificial tears and/or ointment; and 3. glasses to protect the cornea from air currents

Kinetic and static surgical procedures are discussed. The kinetic procedures include facial nerve repair and grafting, VIIth‐XIIth nerve anastamosis, muscle nerve block transplantation, transposition of nonparalyzed muscle and cross over. The principals of VIIth nerve repair and grafting are presented in the intracranial, internal auditory canal, labyrinthine, tympanomastoid and extratemporal sites. The static procedures include resection of redundant skin, fascia lata strip suspension, weakening of contralateral non‐paralyzed musculature, and adjunctive procedures such as resection of ptotic melolabial fold, plication of parotid‐masseteric fascia, dermal graft suspension, blepharoplasty, brow lift, canthoplasty, horizontal shortening of lower lid, fascial suspension of lower lip, McLaughlin tarsorrhaphy, and palpebral spring. Patient counseling is emphasized.
Medical genetics for the otorhinolaryngologist
Authors: Donnell George N. , Alfi Omar S.
Published: October 2006

Genetic disorders involving the ear, nose and throat can be looked at in essentially the same way that one would view other genetic problems. It is important to differentiate genetic disorders from those due to environmental influences. This may be difficult on clinical grounds, since similar clinical features may be produced by different environmental factors or by different genes or groups of genes. When the cause of the disorder can be established, the risks involved in a family having further offspring usually can be determined reasonably readily. In the uncharacterized situations, empiric risk figures are employed. Abnormalities of genetic origin fall into one of three main groupings: Chromosomal abnormalities, single gene mutations or polygenic inheritance. These situations are discussed and examples are given.
Skull base approach to glomus jugulare
Authors: Mischke Robert E. , Balkany Thomas J.
Published: October 2006

The skull base approach to the jugular bulb provides a better opportunity to preserve facial nerve function. Specifically, this applies to glomus jugulare tumors. Adequate exposure to remove even an extensive glomus jugulare tumor may be obtained by the skull base approach, working between the VIIth nerve left in its bony sheath and the lateral process of the first cervical vertebra.
The early diagnosis of acoustic tumors using posterior fossa cisternography with iophendylate
Authors: Gardner Gale
Published: October 2006

Posterior fossa cisternography is a basic method for confirming the presence of acoustic and other tumors of the cerebellopontine angle. A modified outpatient procedure with use of new instrumentation is described here, and comparisons are made to the conventional hospital procedure.

A series of patients selected for outpatient posterior fossa cisternography was studied using data processing techniques. Presenting symptoms and preliminary test results were compiled, and an impression established as to the likelihood of a tumor being present. Outpatient posterior fossa cisternography was performed, with examination under fluoroscopy in certain circumstances; surgery was performed in certain instances.

The results of diagnostic procedures, surgical procedures, and follow‐up studies were coded, analyzed by computer, and conclusions drawn.
Laser stapedotomy for otosclerosis
Authors: Perkins Rodney C.
Published: October 2006

The argon laser microscope recently developed by the author is used to vaporize the stapes tendon, the posterior crus and a rosette of holes in the stapes footplate in the surgical treatment of otosclerosis. An autogenous vein—stainless steel piston assembly is used to reconstruct the stapes portion of the ossicular chain.

The surgical technique and results in a preliminary series of 11 patients are reported. Rationale and advantages over conventional stapedectomy are discussed.
Pitfalls in the radiographic diagnosis of stenosis of the internal auditory canal
Authors: Pagani John J. , Thompson Jerome W. , Hanafee William N.
Published: October 2006

The syndrome of stenosis of the internal auditory canal is radiographically suggested by narrowing of the canal on temporal bone tomography or nonfilling on Pantopaquer̀ cysternography. The internal auditory canal ends medially at the porous acousticus. In the literature, the radiographs employed to demonstrate this stenosis show the narrowing to be medial to the porous acousticus and therefore extracanalicular. The presumed narrowing is actually in a neurovascular groove on the posterior aspect of the temporal bone. Temporal bone specimens were photographed and tomographed to demonstrate this point. These data suggest that present radiographic criteria for diagnosis of this syndrome are invalid.
Immediate reconstruction of contaminated central craniofacial injuries with free autogenous grafts
Authors: Stanley Robert B. , Schwartz Michael S.
Published: October 2006

Free autogenous osseous and soft tissue grafts were used for the immediate, one‐stage reconstruction of central craniofacial injuries involving the frontal sinus in 95 patients with wounds contaminated by either skin or nasal bacteria. Graft removal and delayed reconstruction were necessary in only one patient who suffered an infection in the first postoperative week. To date, no delayed complications are known to have occurred in any patient. As anticipated, long‐term follow‐up has been erratic (6 weeks to 5 years) and only suggestions rather than definite guidelines for the management of the sinus component of the injury can be made. However, this group of patients clearly demonstrates that multiple free autogenous grafts can be safely used for the acute reconstruction of contaminated central craniofacial fractures that are intimately related to the intracranial structures.
False positive stapedial reflexes and brain stem evoked response findings in patients with suspected retrocochlear lesions
Authors: Turner John S. , Saunders Anne Z.
Published: October 2006

Patients with suspected retrocochlcar disease are usually evaluated with stapedial reflex studies and BSER. Positive responses on these tests usually indicate the need for CT scans with air contrast myelogram. We have been impressed with the lack of sensitivity of these audiometric tests in separating tumor from non‐tumorous causes. Although we have never found an acoustic neuroma or cerebellopontine angle tumor without stapedial reflex and BSER abnormalities, we have encountered 20 patients who have strong evidence to support a retrocochlcar tumor on audiometric testing but with negative CT with air contrast scans. This report will deal with our experience with these cases and indicate the necessity for obtaining air contrast CT scans before alarming the patient about a retrocochlear disorder or possible surgery. There appear to be many non‐tumorous disorders associated with stapedial reflex decay and positive BSER.
Cervical ankylosing hyperostosis and airway obstruction
Authors: Hassard A. D.
Published: October 2006

Forestier's disease, or ankylosing hyperostosis of the cervical spine, has been described to cause dysphagia, foreign body sensation, and aspiration. We report two patients with ankylosing hyperostosis producing ulceration of the posterior plate of the cricoid cartilage, inflammatory edema, and secondary bilateral vocal cord paralysis with airway obstruction. This disease initially produces minimal dysphagia when the primary location of the osteophyte is just above and posterior to the cricoid, then, progressive airway obstruction.

The pathogenesis is infection superimposed on ulceration of the cricoid produced by laryngeal movement over a large, sharp osteophyte. Management included tracheostomy for airway management, endoscopy to rule out malignancy, intravenous antibiotic therapy, and surgical excision of the osteophyte.
Intratracheal thyroid ‐ familial occurrence
Authors: Donegan J. Oliver , Wood Michael D.
Published: October 2006

The presence of thryoid tissue within the tracheal lumen is an unusual cause of upper respiratory obstruction. Thyroid tissue in this location may represent true ectopic thyroid or may be caused by invnsion of the trachea by a malignant process.

This paper presents two patients from the same family who were found to have thyroid tissue in the trachea. The first illustrates the clinical course of a thyroid malignancy within the trachea, and the second had a true ectopic intratracheal thyroid mass.

The embryology, diagnosis, and management of ectopic intratracheal tyyriod are outlined.
Osteoradionecrosis of the maxilla and skull base
Authors: Silver Carl , Komisar Arnold , Kalnicki Shalom
Published: October 2006

Osteoradionecroses of the maxilla and base of skull are rare phenomena, usually seen after combined therapy for malignancies of the maxillary sinus. While the mandible is most commonly affected by osteoradionecrosis, the maxilla and skull base may also be affected when preoperative or postoperative radiotherapy is combined with surgery.

Contributing factors may be: high radiation dosage delivered to the treatment volume (> 6000 rads), loss of tissue protective effects due to surgery, decreased vascularity caused by surgery and radiation, and proximity of a contaminated field.

Onset of symptoms mny vary. One patient presented 25 years after postoperative radiotherapy. Major symptoms were pain, trismus, and purulent discharge. The best diagnostic modality remains the history and physical exam, as the area is readily accessible. CT scans may be helpful in diagnosis and treatment planning.

Therapy should follow time honored principles of local wound care. Home irrigations and hyperbaric therapy have been helpful in encouraging early sequestration and rapid healing.
Autoimmune vestibular dysfunction: Preliminary report
Authors: Hughes Gordon B. , Kinney Sam E. , Hamid Mohamed A. , Barna Barbara P. , Calabrese Leonard H.
Published: October 2006

Since 1981, 28 patients have been diagnosed with autoimmune inner ear disease. This preliminary, retrospective study reviews clinical and laboratory manifestations of autoimmune vestibular dysfunction.

Sixteen of 28 patients presented with dizziness (7 vertigo, 8 lightheadedness, 1 ataxia). Twelve of these patients presented with Meniere's syndrome. Seven of 16 dizzy patients underwent formal vestibular testing. Five had reduced vestibular response in the involved ear(s); one patient had positional nystagmus only; and one had normal results.

Of 17 patients with adequate follow‐up, 11 presented with dizziness. Hearing improved and dizziness resolved in two patients following treatment. Hearing stabilized and dizziness resolved in two. Hearing stabilized but lightheadedness (without vertigo) persisted in five. Hearing was lost and oscillopsia resulted in two patients.

Preliminary conclusions are 1. vestibular dysfunction in autoimmune inner ear disease is nonspecific; 2. bilateral vestibular dysfunction is more common; 3. Meniere's syndrome is relatively common; 4. medical management usually is helpful; surgery at this time does not seem appropriate; 5. vestibular treatment results tend to parallel auditory treatment results.
The application of magnetic resonance imaging in otolaryngology
Authors: Baker Hillier L.
Published: October 2006

Magnetic resonance imaging is a new diagnostic technique that is being applied to study disease processes that involve the upper aerodigestive tract and cranial nerves of interest to otolaryngologists. As with all imaging techniques, an in‐depth knowledge of the normal anatomy of a region is a prerequisite for the appreciation of disease states. In addition, magnetic resonance imaging requires a familiarity with the signal intensity produced by the different structures and the relationship of that signal to various radiofrequency pulse sequences that may be used. This report briefly reviews the techniques of magnetic resonance imaging and the normal anatomy of the cervical region and presents examples of pathologic processes that have been studied with this powerful diagnostic technique.
Tracheostomy in intensive care setting
Authors: Dayal Vijay S. , Masri William El
Published: October 2006

A detailed analysis of early complications resulting from tracheostomy in 50 consecutive patients, admitted to the Intensive Care Unit, who had required ototracheal intubation, is presented. The very low incidence of complications seen in this study supports the contention that a carefully performed tracheostomy is a safe procedure in the management of these critically ill patients. In view of this and the greater incidence of laryngeal and tracheal stenosis associated with longer periods of orotracheal intubation followed by tracheostomy, early tracheostomy should be considered in patients intubated for five days in whom further prolonged respiratory assistance is anticipated.
Effects of photosensitizer (hematoporphyrin derivative ‐ HPD) and light dose on vascular targets in the albino mouse ear
Authors: Davis R. Kim , Davis Kent , Straight Richard C. , Waner Milton
Published: October 2006

Photodynamic damage to normal tissues, including skin, appears to occur by photooxidative damage to the normal microvasculature as the primary target sensitized by HPD bound to the vascular wall or endothelial cell. Initial damage to the microvasculature was measured by the increase in vascular permeability (VP) as measured by Evans Blue dye (EB) extravasation as a function of HPD and laser light (632 nm) dose. Albino, Swiss‐Webster mice (♀ 122–25 g, 5 mice per group) were injected intraperitoneally (IP) with incremental doses of HPD (Photofrin II, Photofrin Medical, Inc.) (1, 10, 20, 30, 40 and 50 mg/kg). After 48 hours the left ear of each mouse was masked as a control and the right ear was irradiated at 632 nm using the Aurora‐Lexel Argon‐dye laser (Cooper Laser Sonics, Inc.) with an intensity of 50 mW/cm2 and light doses of 0, 25, 50, 75, and 100 J/cm2 directed to a 3‐mm spot on the mouse ear. No EB leakage occurred in the absence of HPD at any light dose or in the absence of light at any HPC dose. Vascular permeability increased as a function of HPD dose up to 30 mg/kg. AT 50 mg/kg HPD, there was a decrease in VP. At each HPD dose above 10 mg/kg, the VP increased as a function of light dose up to 75 J/cm3. Further increase in light dose was without effect. The amount of HPD porphyrin recovered from irradiated ears decreased as a function of light dose. There appeared to be an irreversible photo destruction of the porphyrin exposed to light.
Biostimulation of human caecinoma cells with the argon laser: A previously unreported potential iatrogenic effect of lasers
Authors: Castro Dan J. , Fetterman Harold R. , Ward Paul H. , Saxton Romaine E. , Castro Donna J.
Published: October 2006

The human squamous carcinoma cell line Ps was subjected to treatment with a single mode argon laser at 514.5 nm. The temperature and energy levels delivered to the target cells were determined by a reproducible method of dosimetry. At energy levels between 860 to 990 J/cm2 and a corresponding temperature of 39±1 °C, a significant delayed stimulation in DNA synthesis was noted after 24 hours, but the cells remained viable. However, at energy levels and temperatures higher or equal to 1100 J/cm2 (41 °C), an immediate suppression of DNA synthesis was accompanied by nonviability of the Ps carcinoma cells. These results indicate that the argon laser has potential for selective biostimulation on carcinoma cell duplication at the specific “non‐thermal” range of 39±1 °C. Similar effects were not observed when the Ps carcinoma cells were heated to this same temperature using a standard heat bath. This phenomenon appears to represent a previously undescribed potential iatrogenic effect of the monochromatic laser beam in the treatment of cancer.
Surgical management of severe laryngomalacia
Authors: Holinger Lauren D. , Konior Raymond J.
Published: October 2006

Infants and children with laryngomalacia exhibit varying degrees of upper airway obstruction and dysphagia. Although the disorder is usually self‐limited, the potential exists for symptoms so severe that operative intervention cannot be avoided. Relief of progressive airway compromise traditionally has involved bypassing the obstruction with tracheotomy. Recently, endoscopic surgical management of the most severe cases has been reexamined by the authors and others.

Thirteen infants and children underwent supraglottoplasty (also referred to as epiglottoplasty or partial arytenoidectomy) for severe, complicated laryngomalacia. Endoscopic laser removal of flaccid supraglottic tissue resulted in improvement of the airway in all patients. In most patients, associated symptoms improved or completely resolved. Supraglottoplasty is an effective alternative to tracheotomy in carefully selected patients with severe laryngomalacia.
Alterations in glycoconjugate expression following malignant transformation of human oropharyngeal squamous mucosa
Authors: Freije Steven A. , Mostofi Reza S. , Bostwick David G.
Published: October 2006

Malignant transformation of the squamous mucosa in the human oropharynx may be accompanied by alterations in carbohydrate production. Glycoconjugate expression was assessed by examining lectin‐binding patterns and ABH isoantigen expression in human biopsy specimens from nine cases of carcinoma in situ and ten cases of invasive squamous cell carcinoma as well as adjacent normal squamous mucosa. Ten different fluoresceinconjugated lectins were used. Each lectin binds to specific nonreducing end‐terminal carbohydrate residues. Wheat germ agglutinin and peanut agglutinin displayed intense cytoplasmic and/or membrane binding in more than 90% of the carcinoma in situ and squamous cell carcinoma specimens. However, only 40% of normal squamous epithelium specimens displayed intense cytoplasmic and/or membrane binding with wheat germ agglutinin and peanut agglutinin. Bandieraea simplicifolia I and Helix pomatia exhibited weak binding in less than 35% of normal and neoplastic tissues. Weak cnnnvalia ensiformis binding was identified infrequently in the superficial layers of normal squamous mucosa, but was not found in neoplastic epithelium. None of the cases displayed binding for Dolichos biflorus, Ulex europaeus I, Sophora japonica, Glycine maximus, or Ricinus communis. Monoclonal antibodies directed against ABH blood group isoantigens showed increased cytoplasmic immunoreactivity for anti‐H in dysplastic and neoplastic tissues, when compared with normal squamous mucosa. These findings indicate that wheat germ agglutinin and peanut agglutinin and H isoantigen are useful markers of malignancy in squamoproliferative lesions of the oropharynx, apparently reflecting alterations in expression of N‐acetyl‐D‐glucosamine and galactose‐related sugars, which appear following malignant transformation.
Gadolinium‐enhanced magnetic resonance imaging in temporal bone lesions
Authors: Millen Steven J. , Daniels David L. , Meyer Glenn A.
Published: October 2006

A 2‐year experience with an enhancement agent in magnetic resonance imaging (MRI) is examined through case presentations. Characteristics of the agent Gadolinium DTPA/Dimeglumin are reviewed. Radiographic capabilities in enhanced versus unenhanced MRI are compared. Temporal bone lesions, including acoustic neuromas and facial nerve neuromas, are presented. Recent experience with facial nerve enhancement in Bell's palsy is also presented. Greater accuracy in defining small temporal bone lesions and increased delineation of facial nerve involvement appear to be significant benefits with enhanced MRI.
Septal chondromucosal flap with preservation of septal integrity
Authors: Weisman Robert A.
Published: October 2006

Nasal septal flaps are a convenient source of lining and support in nasal reconstructive surgery. Most technical descriptions of these flaps demonstrate designs that result in septal perforation. By properly planning the design of a contralateral mucosal flap, septal perforation can be avoided when septal chondromucosal flaps are used. Eight such flaps have been used by the author, four to provide lining and support in total nasal reconstruction after removal of very large basal cell cancers, and four to repair cerebrospinal fluid leaks. None of these eight patients developed septal perforations. Details of the operative technique and illustrative cases are presented.
Functional endonasal sinus surgery (FESS) in the pediatric age group
Authors: Gross Charles W. , Gurucharri Michael J. , Lazar Rande H. , Long Thomas E.
Published: October 2006

Functional endonnsal sinus surgery has become a popular mode of surgical treatment for sinus disease in the United States. The literature has primarily addressed its use in the adult population. We present our series of 57 children who underwent functional endonasal sinus surgery. The children ranged in age from 3 to 15 years. Follow‐up was from 3 to 13 months. Fifty‐four of the patients were treated for chronic or recurrent sinus infections. Three patients were treated for complications of acute sinusitis. All patients tolerated the procedure well, and there were no major complications. We conclude that functional endonasal sinus surgery is a safe procedure in the pediatric age group. Although postoperative follow‐up in the series was very short, early results appear encouraging. The technical approach is similar to that used in the adult procedure. The pediatric procedure, however, requires a follow‐up nasal endoscopy under general anesthesia to achieve optimal results.
Synchronous facial vascular vasodilation and salivatory response to atropine in the parasympathetically denervated human salivary parotid gland
Authors: Levin Samuil L.
Published: October 2006

Hypersalivation and facial skin hyperemia that simultaneously emerge in response to atropinization have been observed in patients who suffered trauma to the skull base combined with damage of the parasympathetic secretory and vasodilatory fibers in the greater and lesser petrosal nerves at the tip of the temporal bone pyramid. The study was facilitated by special vacuum capsules applied to both outlet ducts of the parotid glands. Hyperemia and hyperthermia of the face were evaluated visually, by thermometer readings, and color photography. The events described are distinct from those reported in the literature (i.e., paradoxical disturbances of facial and salivary gland innervation). This study analyzes the mechanism of initiation and the manifestations of this complex syndrome.
Normal brainstem auditory evoked potentials in adult hypothyroidism
Authors: Vanasse Michel , Fischer Catherine , Berthezène François , Roux Yves , Volman Gabriel , Mornex René
Published: October 2006

Nervous system dysfunction and hearing loss are part of the clinical picture of hypothyroidism. Several studies on visual evoked potential and two brainstem auditory evoked potential studies have shown abnormalities in this disease that are reversible with treatment. It has been suggested that visual evoked potential and brainstem auditory evoked potential could be useful to evaluate the effects of hypothyroidism on the central nervous system and to monitor the response to treatment. We recorded brainstem auditory evoked potentials in 15 adult hypothyroid patients immediately before treatment. All patients were women, ranging in age from 34 to 82 years. Fourteen also had an audiometric study. In five patients, both tests were repeated 20 to 22 months after treatment. Audiometry showed that hearing loss increased with age, suggesting that hearing loss in these patients could be secondary more to aging than to hypothyroidism. When compared to sex‐matched controls of similar ages, our patients showed no statistically significant differences in brainstem auditory evoked potentials before treatment. Brainstem auditory evoked potential values were not modified in the five patients whose tests were repeated after treatment. The normality of these results raises serious objections to the clinical use of brainstem auditory evoked potential for central nervous system evaluation and therapy monitoring in adult hypothyroidism.
An autosomal dominant inherited syndrome with congenital stapes ankylosis
Authors: Teunissen Bert , Cremers Cor W. R. J.
Published: October 2006

A newly recognized autosomal dominant inherited syndrome associated with congenital conductive deafness, hy‐peropia, broad thumbs, broad first toes, short distal phalanges, and syndactyly is reported. The conductive loss was the result of congenital stapes ankylosis and, in two cases, was associated with ankylosis of the short process of the incus in the fossa incudis. Stapedectomy improved hearing in these patients. Fused cervical vertebrae are also an associated feature.
KTP‐532 laser tonsillectomy: A comparison with standard technique
Authors: Oas Richard E. , Bartels James P.
Published: October 2006

It has been stated that laser excision of oral and oro‐pharyngeal lesions result in less intraoperative blood loss, reduced postoperative pain, and quicker wound healing, but few controlled studies have been done to substantiate these claims. A study was undertaken to examine the benefits of the KTP‐532 laser in a group of 31 patients who underwent tonsillectomy. One tonsil was removed with the KTP‐532 laser and the other was excised with conventional dissection and snare technique. Patients were not told which tonsil was removed with the laser. Pain, healing, and intraoperative blood loss comparing one side to the other was assessed.

On the evening of surgery, 83% of patients selected the side that underwent standard dissection and snare tonsillectomy as the most painful. By midweek, however, approximately equal numbers of patients selected the laser side as the most painful. At the end of 1 week, 63% of patients felt more pain on the laser dissection side. Possible reasons for these results are discussed.

Intraoperative blood loss was significantly reduced with the use of the KTP‐532 laser, but healing was not accelerated.
Quantitative bacteriology of closed‐suction wound drainage in contaminated surgery
Authors: Becker Gary D. , Welch William D.
Published: October 2006

This study was designed to evaluate the predictive value of quantitative bacteriology of closed‐suction postoperative wound drainage in identifying the patient likely to develop wound infection as well as its subsequent flora. Forty‐one patients undergoing major cancer surgery of the head and neck were studied. Postoperatively, closed‐suction wound drainage was cultured, and anaerobic and aerobic bacterial isolates were quantitated. The wound infection rate was 20% (8/41). No trend toward increased rate of wound infection with increased numbers of bacteria colonizing the wound was observed. Additionally, there was no consistent correlation between species of bacteria isolated from closed‐suction wound drainage and recovery from subsequent wound infection.

Quantitative bacteriology of closed‐suction wound drainage after contaminated head and neck cancer surgery does not accurately predict which patients were likely to become infected, or the probable bacteriology of subsequent wound infection.
Fine‐needle aspiration biopsy: Application to pediatric head and neck masses
Authors: Mobley David L. , Frable Mary Ann Smith , Wakely Paul E.
Published: October 2006

Fine‐needle aspiration biopsy cytology is widely used to screen masses in adults. The authors present a series of 89 fine‐needle aspiration biopsies performed between January 1973 and December 1988 on 86 pediatric patients with clinically significant head and neck masses. All fine‐needle aspiration diagnoses were confirmed by subsequent surgical biopsy, autopsy, or clinical follow‐up for a minimum of 18 months. Of 21 tumors identified, 19 were malignant.

Of the 89 aspirations performed, 67 required no subsequent surgical biopsy. In 11 of these cases, meta‐static or recurrent tumor was diagnosed and appropriate therapy instituted. Fifteen of the 89 aspirates revealed previously undiagnosed tumors requiring surgical intervention.

One false‐negative and two false‐positive results were obtained. No radical treatment resulted from the false‐positive diagnoses, and no patient delay in treatment occurred because of the false‐negative result. The sensitivity was 94.4%, and the specificity was 97.1%. The usefulness and cost‐effectiveness of fine‐needle aspiration is stressed.
Retrolabyrinthine vestibular nerve section: Efficacy in disorders other than meniere's disease
Authors: Kemink John L. , Telian Steven A. , Langman Alan W. , El‐Kashlan Hussam
Published: October 2006

The retrolabyrinthine vestibular nerve section has evolved as an effective treatment for intractable vertigo of peripheral vestibular origin when hearing preservation is desired. This report studies the efficacy of retrolabyrinthine vestibular nerve section for control of vertigo due to causes other than Meniere's disease. This report details our experience with 42 patients with a wide variety of diagnoses. The reduced success rate of retrolabyrinthine vestibular nerve section in these patients is difficult to evaluate, as very few patients have been analyzed with respect to their specific diagnoses. Of patients who underwent retrolabyrinthine vestibular nerve section for control of vertigo, 23 patients had uncompensated vestibular neuritis and 19 others had a wide range of other diagnoses. For patients with uncompensated vestibular neuritis (n = 23), the physician record noted that 39% of patients were cured and 30% improved. This compares to our series of patients with Meniere's disease (n = 48), where 94% were cured and 2% improved. The true vestibular abnormality may be less reliably identified in patients with uncompensated vestibular neuritis, contributing to the less effective results. Since the development of a vestibular rehabilitation program, retrolabyrinthine vestibular nerve section for uncompensated vestibular neuritis has been all but abandoned. Retrolabyrinthine vestibular nerve section appears to achieve a high cure rate in patients with sensorineural hearing loss associated with their vestibular abnormalities. While retrolabyrinthine vestibular nerve section is helpful for control of vertigo in some diagnoses, a substantial incidence of persistent postoperative dysequilibrium was noted.
Facial nerve regeneration through autologous nerve grafts: A clinical and experimental study
Authors: Spector J. Gershon , Peterein Judy , Lee Patty , Roufa Dikla
Published: October 2006

Human facial nerve regeneration was compared in two systems: autologous neural cable grafts (N = 56) and direct end‐to‐end anastomosis (N = 34). The data were analyzed based on the following criteria: facial symmetry and muscle tone at rest, degree of total facial reinnervation, voluntary motion, syn‐kinesis, and electrophysiologic testing. Facial tone and symmetry at rest, and electrophysiologic tests were similar, while voluntary motion and facial rein‐nervation were decreased and synkinesis increased in the autologous cable graft repairs. Electrophysiologic tests failed to distinguish between the two repair methods in successful regenerates. Neural cable grafts were associated with more mass movement and less fine precise emotive facial movement. Excellent cable graft repair results diminish with time because of continual progressive synkinesis, which may take up to 4 years to develop.

Eight‐millimeter neural cable graft repairs of the buccal division of the facial nerve in rabbits (N = 8) demonstrate, at 5 weeks, equal myelinated and more unmyelinated axons than in the normal nerve controls. Neural cable graft repairs demonstrate two features not found in the normal nerve: 1. myelin debris and 2. two subpopulations of axons extrafascicular and intrafascicular. Myelin debris predisposes towards extrafascicular axon regeneration. Extrafascicular axons are the major neurite regenerates (63%). Intrafascicular axons are the major reinnervators of the distal transected nerve stump. Electrophysiologic studies demonstrate decreased conduction velocities which are related to the number and size of myelinated axonal regenerates. The implications for neurite reinnervation of the autologous cable graft and their role in synkinesis are discussed.
Rebound caloric nystagmus
Authors: Kumar Arvind , Pieri Albert , Krol Glenn
Published: October 2006

Rebound caloric nystagmus (RCN), a distinctly different phenomenon from secondary phase nystagmus (SPN), was serendipitously discovered during the course of routine neurotological evaluations. RCN occurred when the horizontal semicircular canal was brought into a truly horizontal plane after the primary phase nystagmus (PPN) had ended. The maximum slow‐phase velocities (SPVMax) of both PPN and RCN were almost identical. The pathological lesion was an Arnold‐Chiari malformation (ACM). Two other patients with posterior fossa lesions also showed RCN. To determine if RCN is an unrecognized normal phenomenon, 11 healthy subjects were tested. The average SPV of RCN in normals was 0.7 degrees per second. Such a small value of RCN is probably of no significance. It therefore appears that RCN is a sign of posterior fossa neuroaxial lesions.
Configuration of the glottis in laryngeal paralysis. I: Clinical study
Authors: Woodson Gayle E.
Published: October 2006

It is widely accepted in the American literature that the cricothyroid muscle is responsible for the paramedian position of the vocal fold in recurrent laryngeal nerve paralysis. However, support in the literature for this theory is not conclusive, and the cadaveric vocal fold position expected after lesions of the vagus nerve has also been reported in patients with an intact superior laryngeal nerve. This study compares the configuration of the glottis in patients with unilateral paralysis due to known lesions of either the recurrent laryngeal or vagus nerve. Normal subjects were studied as controls. Results indicate that the alteration of glottic configuration in laryngeal paralysis cannot be adequately characterized by standard terms of vocal fold position. The paralyzed vocal fold is shortened, with anterior rotation of the arytenoid. Patients with vagus nerve lesions had a statistically insignificant tendency for a more lateral vocal fold position, but a discrete difference in position between the two groups was not identified. This study also confirms prior observations that paralyzed vocal folds are frequently not denervated. These findings have significant implications for management of laryngeal paralysis.
The radiographic incidence of chronic sinus disease in the pediatric population
Authors: Lesserson Jonathan A. , Kieserman Stefan P. , Finn Douglas G.
Published: October 2006

The otolaryngologist is frequently consulted for paranasal sinus disease which has been identified as an incidental finding on computed tomography (CT) in children. The significance of such a finding is difficult to interpret without prior knowledge of the actual incidence of chronic sinus mucosal hypertrophy in the general pediatric population.

In this study of pediatric CT scans from busy otolaryngology and ophthalmology clinics, the radiographic incidence of sinus disease in the general pediatric population is estimated. One hundred forty‐two CT scans of the orbits and temporal bones obtained over an 18‐month period were reviewed. Fifty‐eight (41%) scans showed some mucosal thickening or opacification in at least one sinus. When patients were stratified by age, or by the presence or absence of chronic otitis media or respiratory tract disease, exclusive of clinical sinusitis, there was no statistical difference between groups.

The authors conclude that the asymptomatic child with an incidental paranasal sinus finding on CT scan need not be worked up further unless clinical symptoms and signs are elicited.
Auditory evoked potentials at 40 Hz (SSR40Hz) in post‐trauma coma patients
Authors: Serafini G. , Acra W. , Scuteri F. , Palmieri A. M. R. , Simoncelli C.
Published: October 2006

The authors evaluated auditory evoked steady state rest potentials at 40 Hz (SSR40Hz) in 21 posttrauma coma patients and compared their predictive value for prognosis of survival and quality of life with the results of the electroencephalogram (EEG), the computed tomography (CT) scan, and the Glasgow Coma Scale. SSR40Hz potentials recorded immediately after trauma had a maximum (100%) sensibility and specificity for a fatal prognosis and a high value for life prognosis. Consequently they appear to be a useful parameter for deciding on organ explant procedures. The EEG was more reliable in predicting a quality of life prognosis.
Reserpine inhibits the nak ATPase activity of the stria vascularis in the cochlea
Authors: Kanoh Naoyuki
Published: October 2006

The function of the stria vascularis in the cochlea is believed to be the production of endolymph. The mechanisms that maintain or control the function of the stria vascularis, however, remain unclear. In the present study, the effects of one‐shot reserpine administration on the NaK ATPase activity of the stria vascularis in guinea pigs were investigated. NaK ATPase activity was shown to be completely inhibited 3 to 20 days after reserpinization, and was detectable again 60 days after reserpinization. As reserpine is an adrenergic neuron blocker, these results suggest that catecholamines may play an essential role in the maintenance or control of NaK ATPase activity, and that the stria vascularis may be one of the target organs of catecholamines.
Acidic and basic FGF mRNA expression in the middle ear mucosa during experimental acute and chronic otitis media
Authors: Koutnouyan Hrair A. , Ryan Allen F. , Baird Andrew
Published: October 2006

Fibroblast growth factors (FGFs) induce the proliferation and differentiation of cells of mesodermal and neuroectodermal origin. Using in situ hybridization, messenger ribonucleic acid encoding acidic FGF, basic FGF and FGF receptor 1 (FGFR1) were localized in the middle ear mucosa of experimental animals with acute and chronic immunemediated otitis media with effusion (OME). Basic FGF‐labeled cells were seen in the subepithelial connective tissue layer (SE) preferentially near the epithelial basement membrane. Acidic FGF‐labeled cells were seen in the SE, preferentially near blood vessels and occasionally in the cellular middle ear effusion (CE). FGFR1‐labeled cells were seen in the SE and in the CE. The distribution of labeled cells in the middle ear suggests that basic FGF is produced by fibroblasts, acidic FGF is produced by leukocytes, and FGFR1 is produced by both fibroblasts and leukocytes. A role is proposed for these peptides in the proliferation and maintenance of the middle ear submucosa during otitis media.
The head and neck manifestations of mycosis fungoides
Authors: Brennan Joseph A.
Published: October 2006

Mycosis fungoides (MF) is a cutaneous T‐cell lymphoma that may progress to involve lymph nodes, the spleen, and other visceral organs. We have retrospectively reviewed our 10‐year experience with MF at the Johns Hopkins Hospital. Forty‐five patients received treatment for MF between 1983 and 1992. Approximately 70% of the patients with MF presented with cutaneous or extracutaneous lesions of the head and neck. The head and neck manifestations, clinical assessment, and treatment of our patient population are presented. Mycosis fungoides is a potentially lethal disease that frequently involves the head and neck region and should be included in the differential diagnosis of cutaneous head and neck lesions.
Endolymphatic sac tumors: Histopathologic confirmation, clinical characterization, and implication in von hippel‐lindau disease
Authors: Megerian Cliff A. , Mckenna Michael J. , Nuss Roger C. , Maniglia Anthony J. , Ojemann Robert G. , Pilch Ben Z. , Nadol Joseph B.
Published: October 2006

The term “endolymphatic sac tumor” (ELST) was coined to identify the likely origin of aggressive papillary tumors of the temporal bone. To evaluate the validity of this designation, the temporal bone collection at the Massachusetts Eye and Ear Infirmary was accessed in an effort to determine the pathologic relationship between these tumors and the endolymphatic sac. The search resulted in the identification of a de‐novo papillary epithelial lesion arising within the confines of the endolymphatic sac in a patient with von Hippel‐Lindau (VHL) disease who harbored a large, destructive ELST in the opposite temporal bone. This finding provides the most substantial evidence to date regarding the origin of the ELST and the accuracy of its nomenclature.

Seven additional clinical cases of ELST were identified and analyzed in order to define the natural history of these tumors. All patients had a history of sensorineural hearing loss diagnosed an average of 10.6 years prior to tumor discovery. The presence of a polypoid external auditory canal mass, facial paralysis, and evidence of a destructive mass arising on the posterior fossa surface of the temporal bone were common physical and radiographic findings. The management of these patients, as well as those who are probably prone to such tumors (i.e., VHL patients), is discussed.
Function preservation in stage III squamous laryngeal carcinoma: Results with an induction chemotherapy protocol
Authors: De Andréas L. , Brunet J. , Léapez‐Pousa A. , Burguéas J. , Quer M. , Leóan X. , Guedea F. , Vega M. , Mesíaa R. , Líapez J.J.
Published: October 2006

Until recently, standard treatment for stage III laryngeal carcinoma (LC) was total laryngectomy and radiotherapy. Recent data suggest that induction chemotherapy (ICH) plays a role in preserving function in advanced head and neck cancer. No reports to date prospectively evaluate ICH exclusively in stage III LC. The authors designed a sequential phase II trial to assess if ICH allowed a conservative treatment in this disease. The objective of the first part of the study was to rule out a complete response rate with ICH below 30% with P≤.05. ICH protocol consisted of three courses of cisplatin 100 mg/M2 on day 1 and 5‐fluorouracil 5000 mg/M2 continuous infusion over 120 hours. Radiotherapy was administered to patients who attained a complete response (CR). Functional surgery (FS) was planned for patients with partial response. A total laryngectomy followed by radiotherapy was performed when FS was not feasible. Fifty‐two previously untreated patients (all males) with squamous stage III LC were diagnosed in our institution, and 46 were entered in the ICH trial. After 9 patients were included, data showed 7 (78%) CR, ruling out a CR rate of less than 30%. After ICH, a CR was achieved in 29 (63%) of 46 patients. At the end of treatment, 35 patients (76%) had a functioning larynx. With a median follow‐up of 3 years, larynx function was preserved in 26 (57%) of 46 patients and in 64% of survivors. Four‐year actuarial larynx function preservation, overall survival, and disease‐free survival were 55%, 77%, and 67%, respectively. Karnofsky performance score over 80% was the only significant prognostic factor in overall survival (94% at 4 years) and disease‐free survival (78% at 4 years). In conclusion, the authors believe that ICH followed by response‐related second treatment is safe and effective in preserving laryngeal function in stage in LC. There is no evidence of worsening survival.