bluuebunny/crossref_metadata_2025 huggingface dataset:
Nystagmus after experimental cervical lesions
Authors: Igarashi Makoto , Miyata Hideo , Alford Bobby R. , Wright William K.
Published: September 2006

Equilibrium disturbances may occur after neck lesions such as whiplash injuries. Abnormal proprioceptive inputs and vascular changes which involve not only the peripheral labyrinth, but also the brain stem are major factors producing these disturbances.

Neck proprioceptor ablation was performed in healthy young adult squirrel monkeys by unilateral section of C1, C2 dorsal roots, or by injection of 1 cc of 1 percent Xylocaine® without epinephrine into the unilateral deep neck region.

The dorsal root section was histologically confirmed by investigating spinal ganglion and adjacent nerve tissues. The Nauta stained spinal cord cross sections showed neuronal degeneration coming from the dorsal root.

No spontaneous nystagmus was observed in the present series after section of the C1, C2 dorsal roots or Xylocaine® injection.

After the Xylocaine® deep neck injection, the slow phase eye speed of optokinetic nystagmus declined in either direction in all animals. Slight decline of the quick component was also noticed. The wave form was also changed. The decline of slow phase eye speed partly represents the ablative effect of neck proprioceptors (joints, ligaments, and muscles), although the effect produced through other channels or by systemic toxicity cannot be eliminated. After the left C1, C2 dorsal root section, the slow phase eye speed declined only when there was clockwise stimulation. Statistical studies suggested significant differences between pre‐ and postoperative status. This finding suggested that the cervical input is connected to the oculo‐oculomotor pathway.

Immediately after left C1, C2 dorsal root section, a reduction of the slow phase eye speed of postrotatory nystagmus occurred after counter‐clockwise rotation. The randomization test was used, and it was found that the postoperative scores are significantly lower than the pre‐operative scores.

After the ablation of C1, C2 dorsal root, subjects failed to demonstrate any significant change in the pattern or numbers of pendular rotation nystagmic responses. On the other hand, three monkeys after Xylocaine® deep neck injection showed some change.

The present experimental results indicate that the slow phase eye speed is a proper nystagmic parameter to study the neck proprioceptor contribution to oculomotor function.

All animals after unilateral C1, C2 dorsal root section in the present series demonstrated moderate dysequilibrium (measured by the squirrel monkey rail test) confirming that neck injury can produce ataxia. There was no clear postoperative directional dominance of falls. For the diagnosis or investigation of the prognosis of many cervical disorders, bodily equilibrium examination is also important in addition to studying oculomotor function.
Symposium on prophylaxis and treatment of middle ear effusions.: Iii. The pathophysiology of effusion in otitis media
Authors: Lupovich Penn , Harkins Mina
Published: September 2006

An effort to characterize middle ear effusions by biochemical, histologic and physical means was undertaken in order to propose a hypothesis of the pathophysiology of serous otitis media.

A group of patients numbering 145 yielded 289 specimens for study. All patients had clinical chronic otitis media. The patient population ranged in age from two months to 14 years.

The following measurements were made. Microviscosity, smear with Wright's stain, total protein, glucose, alkaline phosphatase, acid phosphatase, GOT, CPK, alkaline phosphatase isoenzymes.

The data indicate that middle ear effusions are locally produced and represent a nonspecific inflammatory response of the middle ear mucosa.
Method for establishing electronystagmograms for normal humans subjected to caloric stimulation
Authors: Nagle Duane W. , Anderson Ernest G.
Published: September 2006

The purpose of this paper is to develop a method to determine how the eyes actually move in normal subjects, separately and in concert, in response to a given vestibular stimulus, that is, to develop a method of establishing electro‐nystagmogram norms for normal subjects.

A data acquisition system utilizing DC recordings was designed and built. The horizontal and vertical movement of each eye was measured independently utilizing a four‐channel DC system. Two two‐channel DC strip chart recorders were used for immediate visualization and also a seven‐channel data acquisition system which is capable of changing analog information into digital form. This information is recorded on magnetic tape which can be fed as data into a digital computer.

A computer program was developed which identified all nystagmus cycles and statistically established different values for the characteristics deemed necessary to the establishment of normal electro‐nystagmograms. The program also determines the correlation coefficient of the eye movement of the two eyes during caloric stimulation of a single labyrinth.

Since no prior knowledge was assumed as to how the eyes would respond to a given stimulus to the vestibular organ, the position of the electrical axis of the eye must be known at all times. This was documented by recording the circumferential movement of the eye on a duel channel, duel trace storage oscilloscope and photographing the resulting trace.

Preliminary data from a limited number of normal patients are shown to indicate order of magnitudes of the characteristics previously mentioned. This data also indicated that the characteristics of a normal electro‐nystagmogram were not affected by the temperature of the water used in the caloric stimulation.
Pathological changes in congenital deafness.
Authors: Bergstrom Lavonne , Hemenway William G. , Sando Isamu
Published: September 2006

The temporal bones of four infants with varying systemic and ear pathologies are described and discussed with reference to the probable effect on hearing and embryogenesis.
Surgical treatment of squamous cell carcinoma of the base of the tongue.
Authors: Whicker James H. , Desanto Lawrence W. , Devine Kenneth D.
Published: September 2006

One hundred two patients with squamous cell carcinoma of the base of the tongue were treated by surgery. The grade of the tumor did not influence survival; however, survival was influenced by the stage of the disease and the operation selected. Operations that provided wider access decreased the incidence of local recurrence. Of the 102 patients, 23 percent required either total or partial laryngectomy. The survival curves of the 23 patients suggest that management of the larynx is a key factor in treating larger cancers. Overall, the five‐year survival rate for the 102 patients was 42 percent. Surgery is the treatment of choice in squamous cell carcinoma of the base of the tongue.
Combined radiation therapy and surgery for carcinoma of the supraglottis and pyriform sinus.
Authors: Wang C. C. , Schulz M. D. , Miller D.
Published: September 2006

Following a review of the most recently accepted TNM system for glottic carcinoma and for supraglottic carcinoma as recently reported out by the American Joint Committee for Cancer Staging, a review of our work with glottic carcinoma and with supraglottic carcinoma is now presented. It was felt that T‐3 and T‐4 glottic carcinoma simulated T‐3 and T‐4 supraglottic carcinoma, although the latter is more likely to have cervical metastasis.

Conclusions of our work using 5,500 rads pre‐operatively for supraglottic carcinoma resulted in a 90 percent three‐year cure rate for T‐1 lesions, 79 percent cure rate for T‐2 lesions, 63 percent cure rate for T‐3 lesions and a 33 percent cure rate for T‐4 lesions. On the basis of our pathological studies and a follow‐up on the patients the conclusion was reached that T‐1, N‐0 or T‐2, N‐0 supraglottic carcinoma should be treated with radical radiation therapy with curative objective. For the T‐3 lesions with border line radiocurability a trial course of radiotherapy should be attempted. If the tumor shows satisfactory regression to a dose level of 4,500 rads of radiation therapy it should be continued to a curative dose level, and surgery should be reserved for radiation failures. On the other hand, if the tumor response to radiation is poor and if the tumor is large and extensive or deeply ulcerated as in T‐3 and T‐4 lesions which are often associated with lymph node metastasis, a planned combined approach of radiation and surgery is advised.
Symposium on trauma in otolaryngology. IV. Management of injuries to the larynx and trachea.
Authors: Harris Herbert H.
Published: September 2006

The past decade has witnessed an accelerated number of laryngeal and tracheal injuries. The present decade may see a rapid decline due to more safety devices on automobiles and a cessation of the military conflict.

A format has been recognized and accepted for the management of these injuries by many who have been interested and contributed to this subject. Open repair, internal splinting with a soft stent fixed to the thyroid cartilage, and often a split‐thickness skin graft to cover the raw areas is the choice of most.

In automobile accidents the type of injury usually falls into one of five categories: a. supraglottic tears and fractures; b. transglottic injuries; c. cricoid fractures; d. evulsion of the trachea from the cricoid; and e. lacerations or tears of the trachea.

Laceration by knives and small caliber gun shot wounds usually requires a laryngofissure for exposure and repair of the defect. Schrapnel wounds and blunt missile injuries with loss of skin and cartilage should be repaired immediately with a transfer of bone or cartilage in a pedicle skin flap.
Acoustic trauma of sportsman hunter due to gun firing
Authors: Odess John S.
Published: September 2006

A historical review of acoustic trauma is presented with documented proof of resulting hearing loss and established damage risk criteria for both steady state and impulse noise.

A detailed evaluation of impulse noise produced by the weapons and ammunition most frequently used by the sportsman hunter revealed that only a few of the rim firing tests fell short of the damage risk criteria for impulse noise. The muzzle energy exerts the greatest effect on the peak sound pressure level.

It is demonstrated that modification of the barrel of the firearm lowered the acoustical energy as much as 97.5 percent. Since most sportsmen hunters decline the use of ear defenders to protect their ears, this method is proposed as an alternative for the conservation of their hearing.
Rhinocerebral phycomycosis (mucorymycosis)
Authors: Stephan T. , Busis S. N. , Arena S. , Khurana R. C. , Danowski T. S.
Published: September 2006

An 18‐year‐old female, admitted with diabetic Ketoacidosis, was found to have rhinocerebral phycomycosis involving the hard palate with perforation into the maxillary antrum and extension to and loss of the left eye. She survived following extensive debridement and administration of Amphotericin‐B, but the relative contribution of each to her recovery was not established.
Cryosurgery for the treatment of chronic rhinitis
Authors: Ozenberger James M.
Published: September 2006

In 1970, cryosurgery was reported as effective treatment for chronic rhinitis.1 Since that time, several hundred patients have been treated with better results, almost no complications, and simplification of the techniques. Improved equipment, selection of patients, probe application, replacement of Freon with Nitrous Oxide as the cooling agent, and prevention of complications have been reported.5 Similar success has been reported by colleagues here and in England.4 Subjective and objective evaluation after three to four years suggests the superiority of this technique. While relief of obstruction is almost certain, even in the few patients for whom more than one treatment has been necessary, rhinorrhea and sneezing are not always relieved by simply destroying diseased mucosa. More recently, as a result of reports of relief of the latter symptoms by vidian nerve section,2,3 patients have been treated with a “hooked” nasal probe positioned on branches of the nerves at the spheno‐palatine foramen, either at the time of turbinectomy or later. The latter procedure is not considered to destroy the nerves permanently and is considered a “treatment” because nerves regenerate. At present cryosurgery is frequently used when mucosal disease results in “failure” of nasal septal surgery and as a complement of conventional reconstructive surgery. Relatively inexpensive Nitrous Oxide cryoprobes should make the technique available for most otolaryngologists.
Mass spectrometric observations of skin flap physiology
Authors: Toomey James M. , Wilson William R.
Published: September 2006

Mass spectrometric determination of tissue Po2 and Pco2 levels was carried out in a series of experimental single pedicle skin flaps. The skin incisions caused only a small and transient rise in Po2 and a lesser fall in Pco2 values. In the first two and one half hours after elevation flap Po2 levels were decreased and Pco2 levels increased to a progressively greater degree from the base to the distal end of the flap studied. During the subsequent hour the Po2Pco2 reading from the distal end of the flap stabilized, the proximal flap Pco2 return to baseline values and the proximal Po2 continued to decline gradually.

These findings are felt to reflect ischemia and/or altered metabolism of flap tissues. Further studies are planned to clarify this and other aspects of flap physiology.
Hyperlipoproteinemias in the etiology of inner ear disease
Authors: Spencer James T.
Published: September 2006

This paper is the report of a study of 300 patients with symptoms or findings indicative of the presence of inner ear disease who were studied and tested by lipoprotein phenotyping, and an incidence of 42.33 percent was found to have clearly defined hyperlipoproteinemia (HLP) on the basis of the laboratory tests with an additional 8.66 percent whose tests were presumptive enough to permit their classification as being hyperlipoproteinemic. Hyperlipoproteinemia has its greatest clinical significance in that its correlation with coronary artery disease (CAD) makes its early detection and subsequent treatment, at least by dietary control, most important in preventing the excessive mortality from atherosclerosis and its complications. The statistically high incidence of HLP in the 300 patients reported in this paper, who had either or both cochlear and vestibular symptoms, adds further credence to the work, observations, and reports of Rosen, whose epidemiological studies show a high correlation of hearing loss with elevated cholesterol, atherosclerosis, and coronary artery disease in those population groups whose dietary intake of saturated fats is high.

Otologists now need to join hands with the internists and pediatricians in seeking an early diagnosis of hyperlipoproteinemia. In so doing, a metabolic abnormality which apparently leads to labyrinthine dysfunction, coronary artery disease, and other related illnesses may be better controlled. May nutritionists also take note, as it is very apparent that what people are eating may not be good for them for, as Lucretius wrote in 55 B.C. in his treatise, “De Rerum Natura,” “One man's meat is another man's poison.”
Acute laryngeal injury with short‐term endotracheal anesthesia
Authors: Komorn Robert M. , Smith Courtland P. , Erwin Jack R.
Published: September 2006

Endotracheal intubation provides an excellent way of controlling a patient's airway. Except in long term intubation, where pressure necrosis, secondary infection and cicatrix formation are known causes of complications, an endotracheal tube is usually not considered a significant laryngeal hazard.

The following case reports of arytenoid dislocation, laryngeal laceration, pseudomembrane formation and vocal cord paralysis, illustrate the etiology and clinical problems that result from unsuspected laryngeal injury following elective short‐term endotracheal intubation for anesthetic purposes. Because most post‐extubation symptoms are thought to be caused by edema, the larynx is rarely examined, and the patient's symptoms are either ignored or treated with some combination of cold steam, steroids and antibiotics. Diagnosis and management of these injuries, is frequently compromised or delayed until either the symptoms persist for five to seven days or until airway obstruction, severe pain or aphonia develop.
The cartilage‐perichondrium graft in the treatment of posterior tympanic membrane retraction pockets
Authors: Linde Richard E.
Published: September 2006

As the progress in modern ear surgery continues it is becoming apparent that the integrity of the scutum, the posterior‐superior canal wall annular rim and the bony chordal eminence play vital roles in the prevention of posterior tympanic membrane retraction pockets.1,2,3,4,5 A dehiscence of any or all of these structures, coincident with eustachian tube dysfunction and posterior tympanic membrane retraction, can lead to destruction of the incudo‐stapedial joint complex with or without cholesteatoma formation. Hearing loss is the most common sequala.

The purpose of this paper is to describe the cartilage‐perichondrium graft repair of the posterior‐superior canal wall bony structures, as developed by the late Dr. Frederick Guilford, and to discuss the associated treatment of posterior tympanic membrane retraction pockets.

The cartilage‐perichondrium graft is obtained at surgery from the posterior conchal region. The cartilage is fashioned to fit the dehiscent bone in the posterior‐superior canal wall segment. The perichondrium supports the cartilage and is used to repair any tympanic membrane perforation.

Ten cases are presented in which the cartilage‐perichondrium graft was used. No posterior tympanic membrane retraction pockets were noted in follow‐up of these cases.
Rhabdomyosarcoma of the ear region: A long‐term survival
Authors: Webb Blair M. , Mcfarland James J.
Published: September 2006

Rhabdomyosarcoma of the ear region has been considered uniformly lethal. In view of this, two cases of rhabdomyosarcoma of the ear region are presented. Each occurred within the first four years of life. The first case was one of a two‐year‐old male with rhabdomyosarcoma of the mastoid area invading the lateral portion of the dura. He was treated with radical neck dissection and wide local excision of the tumor, including resection of dura and grafting of the defect; he also received Velban, Vincristine, and Cytoxan. He is alive and free of disease 96 months after the initial diagnosis.

The second case was one of a three and one half year old male who had alveolar rhabdomyosarcoma of the post‐auricular region of the right ear. This was treated with radical neck dissection, radical local excision and an 18‐month course of Vincristine and Actinomycin D. This patient is alive and free of disease 25 months after the original diagnosis.

It is encouraging that we have one long‐term survivor and one survivor of over two years, from a disease previously considered as uniformly lethal. Awareness by the otologist of the presence of this tumor and attention to the child in the first decade of life presenting with an apparent suppurative ear disease with unusual lack of systemic systems, particularly when associated with a facial nerve paralysis, will lead to earlier diagnosis and more vigorous treatment. Perhaps more of these children can be salvaged with the combination of early diagnosis, radical surgical removal and chemotherapy.
Ultrastructure of the polysaccharide nose: Its relationship to allergy and carbohydrate dysfunction
Authors: Smith Maynard P. , Frable William J.
Published: September 2006

Recently, the senior author (M. P. S.)1 presented a study which offered clinical evidence for a correlation between nasal polyps and an abnormal carbohydrate metabolism. Patients presenting the typical “allergic” nose with pale, edematous mucous membranes demonstrated few positive allergic reactions but frequently showed some carbohydrate dysfunction. Over half of these patients had a family history of diabetes mellitus. A common finding in the patients studied was a pale nasal mucosa, the paleness seemingly attributable to a polysaccharide abnormality rather than to an atopy.

The present research was initiated in an effort to elucidate the etiology of the pale nasal mucosa. Biopsies of nine patients with pale mucous membranes were taken and analyzed by means of electron microscopy in order to relate clinical and ultrastructural findings. The most striking result was lamination in basement membrane structure. Specifically, membrane thickness and lamination were more prominent in those patients with a positive family history of diabetes; furthermore, multiple membrane duplication was particularly outstanding in those individuals demonstrating an abnormal glucose tolerance. Although clinical evidence has strongly indicated that paleness results from vascular changes as well as from an accumulation of polysaccharides in the nasal ground substance, no positive correlation could be made between the degree of paleness and the multiplicity of lamination. Several factors were suggested which may have limited the probability of showing a significant correlation: the small sample of patients studied, the relatively small amount of biopsy material obtained, and perhaps most important, the unpredictable variability in paleness.

The authors suggest that a carbohydrate dysfunction could explain the physical changes observed in the basement membranes. A high glucose level would increase the availability of substrate to the cells involved in basement membrane synthesis, resulting in increased concentrations of free glucose and of glucose‐galactose disaccharides in the glycoproteins of the membrane material. The abnormally high percentage of glucose in the molecules could lead to structural defects in the basement membrane which would no doubt substantially interfere with its function as a filtration barrier. Vascular changes are not always related to the duration or the severity of the disease; thus, statistically, hypertrophy or lamination of the basement membrane would not necessarily correlate with the extent of carbohydrate dysfunction.
An electromyographic study of recurrent laryngeal nerve conduction and its clinical applications
Authors: Atkins Joseph P.
Published: September 2006

Electromyographic techniques were used to study laryngeal nerve conduction in dogs and in man. The data obtained confirmed that there is a 2–5 msec difference in latency between the left and right recurrent laryngeal nerve. Conduction velocities were determined by actual measurement in dogs and calculated from known anatomic data in humans.

Conduction velocity in both species was the same bilaterally. The actual value varied, depending upon the site of stimulation. It is slower the more distal the stimulating cathode is placed. Proximal conduction velocity is approximately 65 M/sec. Distal conduction velocity approximately 30 M/sec. Study of bilateral activity indicated that the onset of electrical activity is simultaneous ± 5 msec.

Following simultaneous bilateral vagus nerve stimulation there is a time lag of 3 msec, in the onset of electrical activity in the right and left recurrent laryngeal muscles. Since vocalization does not occur until 350–400 msec after onset of electrical activity in the laryngeal muscle, it is felt that, in comparison, 3 msec is an insignificant difference in symmetry. In addition phonation is a function of subglottic pressure and tension in the vocal cord and not muscular vibration; therefore, there is no physiologic reason for nerve impulses to arrive simultaneously in the adductor muscles.

Electromyography and nerve conduction studies can lead to greater precision in diagnosis and treatment of laryngeal disorders. The study can be done with little or no morbidity and the equipment is easily available. It is recommended for studying patients with disorders of voice that could have a neurologic basis.
Post‐radiation perichondritis and cartilage necrosis of the larynx
Authors: Mcgovern Francis H. , Fitz‐Hugh J. Slaughter , Constable William
Published: September 2006

Under certain circumstances laryngeal cartilage damage following radiation therapy can take place. Two cases of post‐radiation perichondritis with cartilage necrosis are reported, and the factors predisposing to its development, the methods of treatment, and the techniques of radiation therapy are discussed. The danger of repeated intralaryngeal manipulation in the radiation patient is stressed. The authors advise that T1N0 and T2N0 laryngeal lesion be treated with 6,000 rads over a three to five‐week period. Homogeneity is achieved in the treated volume by employing wedged filters. Surgery is advised in T3 or larger lesions usually after preoperative cobalt radiation.
Diagnostic significance of air in the head and neck
Authors: Nahum Alan M. , Bone Robert C.
Published: September 2006

Air in the head and neck is normally found in the sinuses and air and food passages. The presence of air in an abnormal location indicates a pathologic change which may require observation, further diagnostic tests, or immediate therapeutic action. The various causes are listed and possible treatment modalities are considered.
Superior vestibular and “singular nerve” section — Animal and clinical studies
Authors: Silverstein Herbert , Makimoto Kazuo
Published: September 2006

Three patients are presented who experienced improved hearing for one month following a middle cranial fossa superior vestibular and “singular nerves” section.

Depriving the vestibular labyrinth of its blood supply results in severe degeneration of the ampulla of the three semicircular canals and macula of the utricle, complete reversal of the sodium‐potassium ratio of the vestibular endolymph and elevation of vestibular endolymph and perilymph protein concentrations.

If the blood supply is preserved denervation of either the cochlea or vestibular labyrinth does not result in degeneration of the sense organs or alterations in the biochemistry of the inner ear fluids.

The cochlea appears normal histologically and cochlear endolymph has normal sodium‐potassium ion concentration after cutting the superior and “singular nerves” with accompanying vessels.

This may be the first evidence that vestibular endolymph is secreted in the vestibular system and is independent of cochlear endolymph.

The marked biochemical and histological changes observed in the vestibular labyrinth after cutting the superior vestibular and “singular nerves” with their blood supply in the internal auditory canal may have an effect on the clinical course of Ménière's disease.
Development and cell kinetics of the kreisler (kr/kr) mouse
Authors: Ruben Robert J.
Published: September 2006

The abnormal development of the inner ear of the homozygotic kreisler mouse was studied. The abnormality noted was a lack of flattening of the caudolateral wall of the 11‐day otocyst. As the cell kinetics of the 11‐day homozygotic otocyst was determined, the 11‐day kreisler otocyst was found to have a shortened cell cycle.
Otological manifestations of leukemia
Authors: Paparella Michael M. , Berlinger Norman T. , Oda Makoto , El Fiky Fakhry
Published: September 2006

The authors have been fortunate to study the currently largest single series of temporal bones from patients with various forms of leukemia, including the first reported cases of erythroleukemia. Histologically, the middle ear showed leukemic infiltration and/or hemorrhage much more frequently than did the inner ear or external auditory canal. No sound relationship exists between the anatomical location of hemorrhage in the temporal bone and clinical otological symptomatology. A better relationship exists between the anatomical site of leukemic infiltration of the temporal bone and clinical otological symptomatology. Twenty percent of these patients experienced otological complications directly attributable to their leukemia. An additional 28 percent of these patients experienced clinical otological problems for which a leukemic etiology could not be definitely established by histopathological study of their temporal bones. Otological complications occurred most frequently in patients with the acute forms of leukemia, and specifically, in acute lymphocytic leukemia.
Saddle nose deformity: Etiology, prevention, and treatment; augmentation rhinoplasty with polyamide
Authors: Beekhuis G. Jan
Published: September 2006

Saddle nose deformity is characterized by an abnormally concave dorsum with an apparent upward tilting of the nasal tip; the osseous or the cartilaginous vault or both regions may be affected. Over the years, the etiology has changed: formerly syphilis was a major cause of destruction of the nasal supporting structures; today, mechanical and surgical trauma to the nose, fractures, septal hematoma, and racial features are the primary causes of saddle nose deformity; the incidence is increasing as fractures from high‐speed automobile accidents increase, and as Orientals and Negroes seek elective nasal plastic procedures. Prevention involves early treatment of nasal injuries in childhood, which affects the growth centers in the nose; treatment of hematoma that may follow injury at any age; avoidance of excessive hump removal during rhinoplastic operations. Treatment of saddle nose deformity, either for physiologic and/or for cosmetic reasons, is augmentation rhinoplasty. Filler materials range from human living or cadaveric tissue — autografts or homografts of bone or cartilage —, heterografts — animal cartilage or processed bone; and inorganic implant materials — metals, synthetic alloplastics. A brief review of the materials and their use during the years gives evidence that the “ideal” material is still to be found. The author's experience with the alloplastic, polyamide mesh, in 30 patients within the last two years has led to initial satisfactory results in 27 patients and subsequently satisfactory results in two patients; one patient awaits a reimplantation. In the three patients who had initial failures there was underlying infection. In all 30 patients the polyamide mesh was well tolerated by the human host; there were no foreign body reactions, no rejections. It was found that the host tissues actually invaded the implant, giving it stability and incorporating it into the host tissues. No implant became displaced. The polyamide mesh has approximately the same flexibility as the host tissues, and the naturally semimobile part of the nose can be readily moved around, providing a repair that approaches the normal nose. The cosmetic effects are entirely satisfactory, and the author believes that polyamide mesh is a valuable adjunct to augmentation rhinoplasty and expects to continue to use it for correction of saddle nose deformity and also to document the results over a long postoperative period. All augmentation materials have advantages and disadvantages; these are summarized in Table I.
Impairment of function of the intrinsic laryngeal muscles after regeneration of the recurrent laryngeal nerve
Authors: Satoh Isei , Harvey Joseph E. , Ogura Joseph H.
Published: September 2006

Complete return of laryngeal function, as evidenced by normal excursion of the vocal folds during respiration and phonation, seldom follows division and repair of the laryngeal nerves. In order to investigate this phenomenon further the recurrent laryngeal nerve was sectioned and repaired in five dogs. Some functions of the intrinsic laryngeal muscles in these dogs were observed at intervals following repair of the nerve and compared to other dogs in which the nerve had been crushed or subjected to sustained pressure.

Results obtained utilizing a high speed movie camera, electromyographic, and evoked electromyographic techniques, suggest that the reinnervated intrinsic laryngeal muscles showed impaired function when compared with normal muscles. The mechanisms possibly active in causing this reduction of function are discussed.
Surgical treatment of squamous cell carcinoma of the tonsil
Authors: Whicker James H. , Desanto Lawrence W. , Devine Kenneth D.
Published: September 2006

From 1960 through 1968, we examined 117 patients with carcinoma of the tonsil. Of these 117 patients a choice of the primary treatment modality existed for 96 patients, and 68 percent had surgery as their initial treatment. The absolute five‐year survival for all patients undergoing surgical procedures designed to cure was 48 percent. Tonsillar cancers are neither anaplastic nor markedly radiosensitive. The incidence of local recurrence in seven published series in which the primary tonsillar cancer was treated with radiation averaged 49 percent. We believe that the local recurrence rate of 19 percent in our surgical series reflects our dependence on frozen tissue examination and suggests that surgery offers a good chance of eradicating operable tonsillar carcinoma.
Nasal mastocytosis
Authors: Mckenna E. L.
Published: September 2006

The treatment of obstructed nose due to removable lesions such as adenoidal hypertrophy, nasal polyps, tumors or deviation of the septum is surgical. In the non‐surgical obstructed nose the establishment of the proper diagnosis in order to institute proper therapy is obvious. The allergic nose is treatable in most instances with antihistamines, decongestants, and, appropriately, by desensitization. There is a considerable body of patients with non‐allergic perennial rhinitis who have no surgical obstruction, and who have been treated, usually for years, with the usual modes appropriate for the allergic nose. The results universally are poor.

Nasal biopsies have been used to show a marked difference of infiltration of the mast cell in the submucosa of patients with perennial rhinitis who have neither obstruction due to surgically treatable conditions or due to allergic rhinitis. It is postulated that the mast cells infiltrate the nasal mucosa in response to factors yet to be determined. The mast cell contains chemical mediators which when released into the nasal tissue cause the symptoms of perennial rhinitis. The diagnosis cannot be made by direct visualization or even by nasal mucus smears but only made by biopsy. Surgery and allergy management usually fail in these patients, and usually they respond only to an honest explanation of the condition and short term steroid therapy.
Neurofibromatosis with laryngeal involvement
Authors: Maisel Robert H. , Ogura Joseph H.
Published: September 2006

VRD rarely involves the larynx. This benign disease presents as localized tumor tending to conservation surgery or as massive involvement. In the latter situation, as in the case discussed, removal of important organs is contraindicated even if partial tumor extirpation is required.
Carcinoma of maxillary antrum: The role of pre‐operative irradiation
Authors: Pearlman Alexander W. , Abadir Rushdy
Published: September 2006

Nineteen patients with carcinoma of the maxillary antrum were treated sequentially with pre‐operative irradiation and radical surgery.

Seven of 19 patients (37 percent) were free of disease for longer than three and one half years (one patient for two years).

Infrastructure tumors were more favorable than those involving the entire antrum. The control rate for infrastructure tumors was five of 11 patients (45 percent).

The most important cause of failure is the inability to destroy the tumor locally or early local recurrence.

Pre‐operative irradiation at a dose level of 6,000 rads in five weeks or its equivalent is an important addition to the treatment of advanced antral cancer.
Cryosurgery of respiratory structures. II. Cryonecrosis of the lung
Authors: Neel H. Bryan , Farrell Kenneth H. , Payne W. Spencer , Desanto Lawrence W.
Published: September 2006

This study was undertaken in dogs and monkeys to assess the sequelae of cryosurgery of the lung. In seven animals, a cryoprobe was repeatedly applied to the entire right middle lobe. In no instance was the probe inserted through the pleura into pulmonary parenchyma, but the pulmonary parenchyma was firmly compressed beneath the probe tip during freezing. This permitted through‐and‐through freezing of the entire right middle lobe and ensured complete cryonecrosis of the entire lobe. In three animals, a portion of the right lower lobe was also frozen by repeatedly applying the probe tip to the midportion of that lobe.

All animals survived the procedures, and all resumed normal activity within 24 hours of operation. There were no pleural space complications except for the production of pleural adhesions. All lesions had the features of an acute hemorrhagic infarct, characterized by intense local hemorrhage and complete coagulation necrosis, typical of cryolesions. Subsequently, there was total collapse and fibrosis of underlying pulmonary tissue with areas of hemorrhagic necrosis, hemosiderin in macrocytes, focal calcification, and hyalinization. Serum lactic dehydrogenase values and leukocyte counts promptly increased after cryosurgery; however, all values returned to normal within 14 days, and no significant changes were noted thereafter. Thoracic roentgenograms showed changes consistent with consolidation of the right middle lobe, and by seven weeks, the only roentgeno‐graphic evidence of the cryotreated middle lobe was a small density in the hilus. Histologically, this was a small mass of scarified tissue that sealed the bronchial stump and major vessels at the hilus and consisted of organized fibrosis.
Management of undescended lingual and subhyoid thyroid glands
Authors: Wertz Max L.
Published: September 2006

There are approximately 400 reported cases of undescended thyroid glands. Ninety percent of these are located in the base of the tongue, and 10 percent in the anterior neck superficial to the hyoid bone. The presumptive diagnosis is usually made by scintiphotography. These glands are probably quantitatively deficient and function at marginal levels. Apparently, TSH stimulation causes hypertrophy, usually at an early age, producing undesirable symptoms or local cosmetic change.

The treatment varies, depending upon the problems that arise: observation, suppressive doses of thyroid, isotope suppression, surgical excision, and autotransplantation are methods used in attempting to benefit these patients.

This communication deals with guidelines for therapy and attempts to evaluate allotransplantation based on the available data. To date, some degree of success has been obtained by autotransplantation; however, a more vigorous effort by the medical community is needed to obtain and report clinical and laboratory data to evaluate autotransplantation fully.
Prevention of post‐rhinoplasty edema
Authors: Stucker Fred J.
Published: September 2006

Postoperative edema was investigated in 50 consecutive rhinoplasty patients utilizing essentially the same technique. All patients were operated upon by the author. Thirty‐five patients were positioned so that the head was elevated 90† postoperatively, and 15 patients were placed in the more commonly utilized position of 30† elevation. Photographs were obtained at 24 hours following surgery. The periorbital edema was then graded on a scale 0 to 3 by four rhinoplastic surgeons who were unaware of any change in postoperative care. Using the chi‐square test there was a statistically significant difference between the two groups. This study allows one to expect less postoperative edema if the patient's head is maximally elevated.
Sinography and the radiolucent foreign body: A case report
Authors: Smith Curran J. , Black Franklin O. , Smith Raymond O.
Published: September 2006

A case of an evasive radiolucent foreign body of the infratemporal fossa is reported in which the simple technique of sinography permitted localization and successful excision. The technique is recommended for the evaluation of chronically draining wounds to determine the extent and course of the sinus tract and to aid in the detection of radiolucent foreign bodies.
Vidian neurectomy — Some technical remarks
Authors: Nomura Yasuya
Published: September 2006

This paper describes a new surgical technique of vidian neurectomy. Although the vidian canal is approached transantrally, it differs from the conventional technique in that this procedure does not require dissection of the pterygopalatine fossa.

The maxillary sinus is opened, using Caldwell‐Luc's procedure; a U‐shaped mucosal incision is made and lifted up, exposing the posterior bony wall as well as a posterior part of the medial bony wall of the antrum. After removing the bony wall, the periosteum covering the pterygopalatine fossa and the nasal mucosa (underside) are revealed. There is a crevice between these soft tissues. The maxillary surface of the sphenoid can be easily touched by a small periosteal elevator inserted into the crevis. The medial corner of the pterygopalatine fossa is pushed aside laterally with the covering periosteum. This exposes a part of the bony surface of the maxillary surface of the sphenoid. Go upward, touching on the maxillary surface until the elevator goes into the funnel‐like opening of the vidian canal. The content of the vidian canal is electrocauterized and sectioned. It is important to expose the whole circumference of the bony opening of the vidian canal. This guarantees the complete section of the vidian nerve. The canal is plugged with a piece of gelatine sponge and bone wax. The mucosal flap is returned back.

This surgical procedure may be properly termed as “Transantral Subperiosteal Vidian Neurectomy.”
The origin and functions of nasal mucus
Authors: Taylor Miles
Published: September 2006

Using histochemical techniques the source and nature of nasal mucus and secretions has been investigated.

The secretions from the serous and mucous glands in the stroma consist of acid mucopolysaccharides and mucoprotein. The mucins from the goblet glands are similar but sulfated. The large ducts have a secretory function also.

The capillary net lies in the epithelium, allowing rapid transudation to take place. The basement membrane is PAS negative during early life and is permeable. It becomes progressively more PAS positive with age because of this.

A comparative study of the uses of mucus has shown that its physio‐chemical characteristics are the most prominent. Mucus may act as a retainer for substances, exhibit surface electrical activity, have permeability and act as a mesh. It is an adhesive, protects the mucosa and transports particulate matter. It allows heat transfer and has water holding properties.

It is suggested that mucus has been utilized throughout evolution because of its protean physiochemical properties.
Tumor surgery of the temporal bone
Authors: Arena Sebastian
Published: September 2006

Adequate tumor surgery of the temporal bone continues to be difficult and hazardous. This is because of its relationship to vital vascular and neural structures.

A classification of tumors of the temporal bone and a system of surgery for these tumors is presented, based on 30 malignancies of the external canal and middle ear, and on four tumors involving the jugular foramen, infratemporal fossa, and posterior fossa.

Tumors involving only the external canal require that the excision involves the parotid as well as the external canal. It is not always possible to preserve the facial nerve.

Tumors which extend to the middle ear are more complex and require en bloc temporal bone resection. Tumors which involve the petromastoid and tympano‐tubal areas are also in this more complex group.

The complications of en bloc resection are severe but can be successfully resolved in most instances. All patients who had recurrence of disease demonstrated evidence of recurrence within six months. Ominous signs are positive neck nodes or infiltration of tumor into the surrounding soft tissues (parotid).

Large tumors of the jugular foramen, infratemporal fossa and posterior fossa have been considered inoperable in the past.

Techniques have been developed in temporal bone resection that have made many of these tumors surgically accessible. This involves the incorporation of microsurgical and neurosurgical techniques.

Large glomus tumors and meningiomas can be resected through the cooperative efforts of the otolaryngologist and neurosurgeon.
Synovial sarcoma of the cervical area
Authors: Liebman Emil P. , Harwick Robert D. , Ronis Max Lee , Gaynor Edward B.
Published: September 2006

Synovial sarcoma is a malignant tumor which usually arises from the extremities. Involvement of the cervical area has been quite rare and to date only 12 cases have been reported. Two additional cases are reported in this paper and their management discussed. Case 1 is a 32‐year‐old white female with a submucosal mass of the right retromolar area displacing the tonsillar fossa and soft palate anteriorly. Surgical exploration revealed a well encapsulated mass separate from the parotid gland. Surgical excision was carried out on August 30, 1972. Pathological report was a synovial sarcoma. There has been no recurrence to date. Case 2 is a 34‐year‐old male with a 4 to 5 centimeter submandibular mass. Sialography and carotid arteriography were non‐contributory. Biopsy showed synovial sarcoma. On May 12, 1973, surgical excision of the mass was carried out with the ipsilateral attached greater corneal of the hyoid bone and right hypoglossal nerve which ran into the tumor. Postoperative X‐ray therapy was given. There is no recurrence to date. Discussion: Synovial sarcoma represents a type of mesenchymal tumor whose differention can mimic non‐neoplastic synovial membrane. Histologically the tumor contains two neoplastic cell types. These are described as the fibrosarcomatous element and the synovial element. The tumor usually has no true capsule and grows by expansion with adherance to surrounding structures. The rate of growth is slow but the long term prognosis is poor. Metastasis usually occurs via blood stream most commonly to the lungs. Regional lymph node metastasis occurs in areas outside of the head and neck but has not been recorded in synovial sarcoma of the head and neck to date. Surgical excision is agreed to be the mode of treatment. The value of X‐ray therapy is uncertain but Pack and Ariel were able to show their best results with a combination of surgical resection followed by postoperative X‐ray therapy. It has been suggested that synovial sarcoma of the head and neck may behave in a more benign manner than synovial sarcoma elsewhere. Long term follow‐up is not available in enough of the cervical sarcoma cases to determine if this is true. Until a more benign behavior is proven the tumor should be treated as an aggressive malignancy. Wide surgical excision is the treatment of choice. Postoperative X‐ray therapy should be considered.