bluuebunny/crossref_metadata_2025 huggingface dataset:
Brainstem Auditory Evoked Potentials in Patients with Cerebellopontine Angle Tumors
Authors: Møller Margareta B. , Møller Aage R.
Published: October 2014

Changes in the brainstem auditory evoked potentials of 27 patients with cerebellopontine angle tumors were analyzed. It was found that the most characteristic change was an increase in the latency of wave III on the affected side. In patients with tumors large enough to cause displacement of the brainstem, there was in addition an increase in the latency of wave III on the unaffected side. These results are consistent with recent observations regarding the neural generators of the brainstem auditory evoked potentials in humans.
Evaluation of the Auditory System: An Update
Authors: Brackmann Derald E. , Forquer Brian D.
Published: October 2014

The purpose of this paper is to describe the audiologic techniques currently used at the Otologic Medical Group, Inc. Auditory threshold in children is determined by a combination of behavioral and objective audiometric techniques. When behavioral techniques fail, auditory brainstem response audiometry combined with impedance audiometry gives a good estimate of hearing thresholds. Impedance audiometry is a valuable addition to the diagnosis of cochlear otosclerosis. This technique is also of benefit in the neurotologic evaluation. Auditory brainstem response audiometry is the most accurate method of detecting an acoustic tumor. We no longer use SISI, tone decay, or Bekesy tests. The newer audiometric studies have greatly improved our evaluation of the auditory system.
Sensorineural Hearing Loss in Stapedial Otosclerosis
Authors: Browning G. G. , Gatehouse S.
Published: October 2014

Controversy exists as to whether individuals with stapedial otosclerosis have elevated bone conduction thresholds due to cochlear involvement by the focus. A comparison was made between the Carhart-corrected bone conduction thresholds in 45 unoperated, non-noise-exposed individuals with stapedial otosclerosis and the thresholds in a matched random sample of the population with no conductive hearing loss. No consistent, significant difference was discerned. It is considered that individuals with stapedial otosclerosis do not in general have elevated bone conduction thresholds compared with control subjects. However, there was a suggestion that there may be a small, progressive elevation of bone conduction thresholds in older patients.
Etiopathogenesis of Otosclerosis: A Hypothesis
Authors: Yoo T. J.
Published: October 2014

It is hypothesized that otosclerosis is an autoimmune disease in response to native type II collagens of cartilage rests associated with globular ossei in the endochondral layer of the otic capsule. To support this hypothesis animal experimental data and human antibody data are shown.
Relevance of Conventional Radiography in Indicating Maxillary Antral Lavage
Authors: Kay Nicholas J. , Setia Ravi N. , Stone Joan
Published: October 2014

The conventional radiographs of 84 antra were used to study the relationship of radiographic interpretation with the lavage result. In addition, the interpretations by a clinician and a radiologist were compared, showing that there was no significant difference between the predictive accuracy of either. The only reliable radiographic predictor of lavage result was the presence of normality or a fluid level; opacity and so-called mucosal thickening were deemed unreliable and their validity was questioned.
Pathophysiology of Tinnitus
Authors: Møsller Aage R.
Published: October 2014

The hypothesis is presented that certain forms of tinnitus are related to abnormal phase-locking of discharges in groups of auditory nerve fibers. Recent developments in auditory neurophysiology have shown that neural coding of the temporal pattern of sounds plays an important role in the analysis of complex sounds. In addition, it has been demonstrated that when some other cranial nerves are damaged, artificial synapses can occur between individual nerve fibers such that ephaptic transmission between nerve fibers is facilitated. Such “crosstalk” between auditory nerve fibers is assumed to result in phase-locking of the spontaneous activity of groups of neurons which in the absence of external sounds creates a neural pattern that resembles that evoked by sounds.
Granular Cell Tumor of the Larynx in a 5-Year-Old Child
Authors: Gȧrrud Ø. , Elverland H. H. , Bostad L. , Mair I. W. S.
Published: October 2014

The youngest reported case of laryngeal granular cell tumor is presented together with transmission electron micrographs of the tumor cells. Whereas subglottic involvement is unusual in adults, a review of the literature reveals that three of the seven youngest patients (including the present patient) with laryngeal granular cell lesions had a subglottic tumor immediately below the anterior commissure.
Experimental Otitis Media with Effusion following Middle Ear Inoculation of Nonviable H Influenzae
Authors: DeMaria Thomas F. , Lim David J. , Briggs Bruce R. , Okazaki Nobuhiro
Published: October 2014

In order to test the hypothesis that nonviable bacteria can induce middle ear inflammation leading to persistent middle ear effusion (MEE), we conducted an animal experiment using formalin-killed Hemophilus influenzae, the bacterium reported to be the most common pathogen isolated from chronic MEEs. Over 70% of the chinchillas injected with formalin-killed H influenzae type b or a nontypeable isolate developed sterile, straw-colored serous MEEs, and exhibited histological evidence of extensive inflammatory changes of the middle ear mucosal connective tissue and epithelium. Control animals injected with pyrogen-free sterile saline did not exhibit any inflammatory changes or effusions in the middle ears. Our data suggest that endotoxin on the surface of H influenzae, a gram-negative bacterium, may be responsible for the induction of the otitis media with effusion. It is suggested that endotoxin (even when the organisms are no longer viable) may be responsible for the production of serous MEE and inflammatory changes in the middle ear.
Epstein-Barr Virus Nuclear Antigen-Positive Nasopharyngeal Hybrid Cells
Authors: Takimoto Toru , Hatano Motoichi , Furukawa Mitsuru , Umeda Ryozo
Published: October 2014

An epithelial-like hybrid cell line was established by cell fusion of 8-azahypoxanthine-resistant epithelial cells (Ad-AH) with lymphoblastoid cells (A2L), derived from the human nasopharynx. The nasopharyngeal hybrid cells, designated as A2L/AH, were Epstein-Barr virus (EBV)-associated nuclear antigen (EBNA)-positive by the anticomplement immunofluorescence method. Furthermore, the treatment of the hybrid cells with 5-Iodo-2′-deoxyuridine (IUDR) induced early antigen (EA) and viral capsid antigens (VCA), while the treatment of nonproducer lymphoblastoid cells, A2L, induced EA but not VCA. The appearance of IUDR-induced VCA in the hybrid cells suggests that some factor produced by the Ad-AH cells might neutralize a repressed state of VCA and thus activate these antigens with the treatment of IUDR. These established nasopharyngeal hybrid cells might be useful for studies of in vitro nasopharyngeal carcinoma (NPC) since no EBV-carrying NPC cell lines have been established.
Effect of Denervation on Parotid Gland Function
Authors: Levin S. L.
Published: October 2014

In 110 subjects with traumatic severance of secretory nerves, salivation was studied to determine the effect of denervation on gland function. A sequence of responses was found in which an initial hyperpositive response to cholinergic agents was blocked by atropine (stage I): this effect was reversed and increased salivation occurred in both latent (stage II) and overt (stage III) forms of the atropine paradox. The hypothesis suggested is that chemoreceptive cells of parotid membranes include a minimum of five populations of cholinergic receptors which respond differentially to parasympathetic agonists and antagonists.
Osseous and Fibro-Osseous Conditions Affecting the Craniofacial Bones
Authors: Harrison D. F. N.
Published: October 2014

Fifty-eight patients with osseous or fibro-osseous conditions affecting the craniofacial bones are reviewed in order to determine difficulty of diagnosis, natural history, and management. In many patients separation into individual categories is possible on clinical grounds alone. However, by correlating clinical examination with radiological and histological findings, it is clear that each of the pathological conditions discussed is a separate entity and not merely part of a broad spectrum of bony disorders.
Neurophysiologic Assessment of Endolymphatic Hydrops
Authors: Morizono Tetsuo , Sikora Michael A.
Published: October 2014

An electrophysiological method for assessing endolymphatic hydrops of the cochlea in an animal model of Meniere's disease is described. Eighth nerve gross action potentials (AP) were evoked by tone bursts presented at discrete phases of a simultaneously delivered 50-Hz pure tone. Hydropic cochleas showed significantly less modulation of AP amplitude and latency than normal cochleas. This method may be useful in objectively evaluating Meniere's disease with electrocochleography.
Reversible Hearing Loss after Meningitis
Authors: Guiscafré Héctor , Martínez M. C. , Benitez-Díaz Luis , Muñoz Onofre
Published: October 2014

Hearing loss (HL) was prospectively studied in 236 children with meningitis using brainstem auditory evoked responses. Hearing loss was detected in 38 (16.1%) in the acute phase of the disease and in 10 (5.2%) of 193 patients who were tested 6 months later. Hearing loss was more frequent and more severe in patients with bacterial meningitis (25.4% in the acute phase, and 8% 6 months later) than in patients with viral and tuberculous meningitis. In half of the affected cases the auditory lesion was bilateral. Follow-up was possible in 32 patients with early postmeningitic HL. Ten (31.2%) had permanent HL while the remaining 22 (68.7%) recovered normal hearing. Severe initial losses tended to be permanent, whereas minimal and intermediate losses were generally reversible and patients recovered completely in 1 to 6 months. The high incidence of HL in bacterial meningitis suggests that any one of the existing methods of auditory screening should be performed in all patients during the convalescent period.
Flexible Transbronchial Needle Aspiration
Authors: Wang Ko Pen , Gupta Prabodh K. , Haponik Edward F. , Erozan Yener S.
Published: October 2014

Flexible transbronchial needle aspiration provides a bronchoscopic method for the diagnosis and staging of mediastinal neoplasms. Increasing experience has confirmed the usefulness of this procedure and has identified several technical factors that influence its yield and safety.
Short Latency Vestibular Evoked Response to Acceleration Stimuli Recorded by Skin Electrodes
Authors: Elidan J. , Lev S. , Sohmer H. , Gay I.
Published: October 2014

Short latency vestibular evoked response to repetitive acceleration stimuli were recorded by skin electrodes in cats, using electronic filtering and averaging techniques. The evoked response is composed of six to eight waves during the first 10 ms after the stimulus. These are followed by longer latency responses which are myogenic in nature. All of these waves disappear with the animal's death and after excision of both eighth nerves. In recordings from the animal after excision of the eighth nerve on one side, the response patterns of excitation versus inhibition are demonstrated using excitatory and inhibitory acceleration stimuli. The possible generators of the evoked response are discussed in the light of the physiology of the vestibular pathways.
Effects of Analog and Digital Filtering on Auditory Middle Latency Responses in Adults and Young Children
Authors: Suzuki Tokuro , Hirabayashi Minato , Kobayashi Kiyoko
Published: October 2014

Effects of analog high pass (HP) filtering were compared with those of zero phase-shift digital filtering on the auditory middle latency responses (MLR) from nine adults and 16 young children with normal hearing. Analog HP filtering exerted several prominent effects on the MLR waveforms in both adults and young children, such as suppression of Po (ABR), enhancement of Nb, enhancement or emergence of Pb, and latency decrements for Pa and the later components. Analog HP filtering at 20 Hz produced more pronounced waveform distortions in the responses from young children than from adults. Much greater latency decrements for Pa and Nb were observed for young children than for adults in the analog HP-filtered responses at 20 Hz. A large positive peak (Pb) emerged at about 65 ms after the stimulus onset. From these results, the use of digital HP filtering at 20 Hz is strongly recommended for obtaining unbiased and stable MLR in young children.
Mycotic Aneurysm of the Internal Carotid Artery
Authors: Bolender Nicole-Fr. , Loeser John D. , Bassett Marc R. , Patterson H. Clifton
Published: October 2014

A 17-year-old man presented with signs of rupture of a high cervical internal carotid aneurysm. Following angiographic demonstration of the aneurysm, he was immediately treated by balloon catheter occlusion. Eight days later the ligation of the supraclinoid portion of the internal carotid on the left was prompted by the formation of blood clots and emboli from this segment. The patient tolerated both procedures well.
The Physician's Contribution to National Security
Authors: Hiatt Howard H.
Published: October 2014

Nuclear weapons make possible the ultimate epidemic. Since their use would lead to human and material damage orders of magnitude more extensive than anything ever known, and since the medical community would be impotent to respond in any meaningful way, all efforts must be directed to the prevention of nuclear war. By ensuring that the medical realities are known to decision-makers and the people of the world, the medical community can help focus attention on the critical need for an effective prescription for prevention and thereby can contribute in an important fashion to national security.
Significance and Means by Which Laryngeal Cancer Invades Thyroid Cartilage
Authors: Harrison D. F. N.
Published: October 2014

Involvement of the thyroid cartilage attracts a high T rating in all systems of classification for carcinoma of the larynx. Evaluation of 145 patients with laryngeal cancer treated by total laryngectomy emphasizes the difficulties of preoperatively determining cartilage invasion. The operative specimen was serially sectioned and studied to determine the means by which ossified and nonossified thyroid cartilage is invaded by carcinoma. A minimum 5-year follow-up of these cases indicates the prognostic significance of such invasion.
Partial Laryngectomy for Transglottic Cancers
Authors: Biller Hugh F. , Lawson William
Published: October 2014

A reconstructive procedure was utilized after three-quarter laryngectomy in five patients with transglottic cancers. The physiologic reconstruction was successful in four of the five, and tumor control was 100% in all of the patients. It is concluded that with proper selection patients with transglottic cancers may survive after partial laryngeal surgery.
Selecting Variants in Pharyngeal Reconstruction
Authors: Shah Jatin P. , Spiro Ronald H. , Shemen Larry , Strong Elliot W.
Published: October 2014

A dramatic change in the techniques of immediate pharyngeal reconstruction in the last 10 years is largely due to the availability of myocutaneous flaps, microvascular techniques, and the increasing popularity of the “gastric pull-up” operation. The experience of the Head and Neck Service of Memorial Sloan-Kettering Cancer Center in repair of the pharynx following pharyngeal resection between 1974 and 1983 is reviewed and the changing trends in the philosophy of pharyngeal reconstruction are highlighted. The methods of reconstruction used were deltopectoral flap, gastric pull-up, free microvascular bowel transfer, and pectoralis myocutaneous flap. The indications, morbidity, effectiveness, and complications for each of these procedures are discussed. The optimal reconstructive methods for partial and total pharyngeal reconstruction are as follows: 1) primary closure for defects not exceeding one third of the circumference of the pharynx; 2) pectoralis myocutaneous flap repair for pharyngeal defects with loss of up to 70 % of the circumference of the pharynx; 3) gastric pull-up with pharyngogastrostomy for defects exceeding 70 % of the circumference of the pharynx; 4) gastric pull-up for all pharyngoesophageal defects where the lower margin of resection is below the tracheostome; and 5) reversed pectoralis myocutaneous flap with split thickness skin graft on the muscle for secondary closure of the pharyngostome.
Evaluation and Treatment of Recurrent Spasticity after Recurrent Laryngeal Nerve Section
Authors: Dedo Herbert H. , Izdebski Krzysztof
Published: October 2014

Of 365 spastic dysphonia patients treated by recurrent laryngeal nerve (RLN) section to date, 44 (12%) have experienced recurrence of the spastic dysphonia. Most of these 44 patients had moderately severe to very severe spastic dysphonia before the RLN section was performed. We believe, therefore, that preoperative severity is an important predictor of the likelihood of recurrence. Twenty-eight patients with recurrent spastic dysphonia following RLN section were further treated by one or more carbon dioxide laser thinnings of the paralyzed vocal fold. Following this procedure, 23 patients (50 %) achieved eradication of spasticity, while a mild degree of spasticity remained in 17 (39%). These findings lead us to conclude that even though spastic dysphonia may recur following RLN section, a viable secondary surgical procedure is available.
The Clinical Voice Laboratory
Authors: Gould Wilbur J.
Published: October 2014

In the past decade the number of voice laboratories has increased dramatically. Their primary mission is to enhance patient care by the application of knowledge gained from basic research. They also are dedicated to further improvement of diagnostic and therapeutic resources. The strength of the voice laboratory lies in collaboration between the clinician and the scientist.
Selective Reinnervation of Vocal Cord Adductors in Unilateral Vocal Cord Paralysis
Authors: Crumley Roger L.
Published: October 2014

Laryngeal reinnervation procedures were performed in a series of dogs. An attempt was made to reinnervate the vocal cord adductors with one nerve graft, while a different nerve was grafted to the abductors. The recurrent laryngeal nerve was dissected distally to its terminal branches, where the abductor-adductor sorting out occurs. The abductor branch was reinnervated with a phrenic nerve graft as previously described. The adductor division was grafted with one of the following nerves: proximal recurrent laryngeal, external branch of superior laryngeal, or ansa hypoglossi. Results revealed that in most cases it was indeed possible to reinnervate the adductive and abductive vocal cord muscles separately. Recurrent laryngeal nerve anastomosis to the distal adductor division produced strong reinnervation, but appeared to inhibit in some way the phrenic reinnervation of the abductor branch. Ansa hypoglossi anastomosis to the adductor division seemed to induce satisfactory reinnervation of the adductor musculature with the least noticeable donor deficit.
Esophageal Burns Secondary to Disc Battery Ingestion
Authors: Maves Michael D. , Carithers Jeffrey S. , Birck Herbert G.
Published: October 2014

Accidental ingestion and impaction of disc batteries in the esophagus has been a constant predictor of severe morbidity presumably due to leakage of highly caustic potassium or sodium hydroxide contained in these electric cells. Fewer than ten reports of esophageal burns from disc battery ingestion have appeared in the medical literature; an additional case involving ingestion of a mercury disc battery was recently encountered at the James Whitcomb Riley Hospital for Children, Indiana University School of Medicine. Two children died as a direct result of the impaction and resultant esophageal burn; six children experienced perforation of the esophagus, with four children developing tracheoesophageal fistulae. We report the ingestion of a 1.35-V mercury camera disc battery by a 10-month-old girl in whom a severe burn of the anterior midesophagus was noted 18 to 22 hours after impaction. The child subsequently developed a tracheoesophageal fistula and esophageal stricture at the site of the burn and required tracheotomy, closure of the fistula, partial esophagectomy and gastrostomy for eventual successful management. Stimulated by this experience, we have conducted an in vivo study of the time course and severity of esophageal burns resulting from alkaline and mercury battery ingestion in 15 cats. Mucosal damage can be seen as early as one hour after ingestion, rapidly progressing to involvement of all muscular layers by four hours. Removal of this foreign body should be assigned highest priority to prevent rapid development of these burns and the long-term sequelae mentioned above. Additionally, manufacturers of these batteries (commonly used in cameras, calculators and other electronic devices) and the general public should be made aware of the severe nature of these burns and the need for proper disposal of these batteries.
Carbon Dioxide Laser in Subglottic Hemangioma
Authors: Healy Gerald , McGill Trevor , Friedman Ellen M.
Published: October 2014

Congenital subglottic hemangioma is a potentially life-threatening lesion which frequently presents before the age of 6 months. Many forms of therapy have been advocated for the treatment of this difficult lesion. The use of the carbon dioxide laser has been advocated in the past and this report represents an update in treating 31 patients from 1975 to 1983. The success rate was 94 % and the complication rate was 6.5%. This form of therapy is an effective and valuable addition to those already available for this troublesome lesion.
Localized Amyloidosis of the Head and Neck and Upper Aerodigestive and Lower Respiratory Tracts
Authors: Simpson George T. , Skinner Martha , Strong M. Stuart , Cohen Alan S.
Published: October 2014

Seven cases of localized amyloidosis limited to structures of the head and neck and upper aerodigestive and lower respiratory tracts evaluated and treated at Boston University Hospitals in a recent 7-year period were reviewed. Negative Congo red staining of abdominal adipose aspiration biopsy or rectal biopsy specimens established that the amyloidosis was not systemic. Localized amyloidosis occurred in discrete masses in a variety of sites in the aerodigestive tract including the orbit, nasopharynx, lips, floor of mouth, tongue, larynx, and tracheobronchial tree. Five patients required surgical excision because of significant airway obstruction or organic dysfunction. Amyloid deposits completely excised with the carbon dioxide laser have not recurred, though other amyloid masses may appear elsewhere within the same organ or region. Amyloidosis may occur primarily or secondarily to other disease states. Localized amyloidosis has not been chemically identified but is usually defined by the absence of systemic features. While rare, amyloidosis must be recognized and understood by the otolaryngologist head and neck surgeon to allow appropriate diagnostic and therapeutic planning.
Modern Endoscopic and Microscopic Photography in Otolaryngology
Authors: Müller-Hermann Eberhard , Pedersen Peter
Published: October 2014

The autodynamic through-the-lens (TTL) computer flash with automatic exposure and the Freiburg endophotographic and microphotographic (EPS and MPS) system are described. This system provides accurately exposed endophotographs and microphotographs irrespective of the sort of endoscope, microscope, localization, and film material used.
Tracheomalacia in Infants and Children
Authors: Benjamin Bruce
Published: October 2014

The clinical features of tracheomalacia depend on the location, length, and severity of the weakness of the tracheal wall. There is firm evidence that tracheomalacia in association with tracheoesophageal fistula is due to malformation and deficiency in the tracheal wall, but in other types of tracheomalacia the evidence is less conclusive. A classification is proposed, based on the known histopathologic and endoscopic changes. Endoscopy is considered the most reliable diagnostic examination.
An Unusual Form of Laryngeal Paralysis Associated with Arnold-Chiari Malformation
Authors: Birns Jeffrey W.
Published: October 2014

This paper alerts the otolaryngologist to a previously unreported type of laryngeal paralysis (adductor type) in association with the Arnold-Chiari malformation. A survey of the literature fails to reveal any similar documented cases of absent laryngeal sensory function in association with this neurological defect. All prior reports have dealt with abductor laryngeal paralysis associated with the Arnold-Chiari malformation in which airway obstruction was the predominant laryngeal symptom. In the patient reported here, aspiration was the predominant symptom and was due to total loss of laryngeal sensation. This report describes this patient's clinical findings in detail, reviews the literature, and discusses management.
Neodymium: Yag Laser Fiber Steering Device for Carbon Dioxide Laser Rigid Bronchoscope Set
Authors: Ossoff Robert H.
Published: October 2014

A steering device for the Nd:YAG laser fiber to be used in conjunction with the rigid carbon dioxide laser bronchoscope set has been designed. This device inserts into the proximal end of the rigid bronchoscope and has the ability to accept a rigid optical telescope and the Nd:YAG laser fiber, and to evacuate smoke from the operative field.
Natural Cytotoxicity and Interferon Production in Patients with Recurrent Respiratory Papillomatosis
Authors: Naiman Hillel B. , Ruben Robert J. , Doyle Angela T. , Kadish Anna S.
Published: October 2014

The observation that interferon (IFN) therapy causes regression of lesions in some patients with recurrent respiratory papillomatosis (RRP) raises the possibilities that these patients may have abnormalities in endogenous IFN production or in antitumor immune responses stimulated by IFN. We have measured IFN production and natural cytotoxicity (NK activity) in nine patients with RRP, three of whom were receiving exogenous IFN at the time of testing. Production of IFN-γ induced by the T cell mitogen Staphylococcus enterotoxin A was normal in all patients. Production of IFN-α induced by two viruses (Sendai and Newcastle disease viruses) was normal in the six untreated patients, but significantly lower in the patients on IFN therapy. Natural cytotoxicity against K562 target cells, both spontaneous and IFN-stimulated, was normal in all RRP patients tested. Thus, we have shown that the NK-IFN system was intact in untreated patients with RRP. IFN-α production in the RRP patients on IFN therapy was low. The significance of these findings is discussed.
Pediatric Endoscopy: A Review of 616 Cases
Authors: Friedman Ellen M. , Healy Gerald B. , Williams Michael , McGill Trevob G. I.
Published: October 2014

Congenital and acquired lesions of the pediatric airway may lead to significant morbidity and mortality. A review of 616 endoscopic procedures, carried out over a 2-year period, was undertaken. Of these procedures, 270 were diagnostic and 346 were therapeutic. This paper outlines the clinical indications, the role of radiology, and the diagnoses revealed by this retrospective review. Of particular interest was the fact that 11.5% of the patients had lesions in more than one anatomic site in the upper aerodigestive tract. The complications were divided into intraoperative, immediate postoperative, and delayed. In total, there was a 1.6% complication rate.
Endolymphatic Fistulization
Authors: Austin David F.
Published: October 2014

Three previous papers have detailed my experience with various methods of surgical treatment of Meniere's disease: 1) surgery for all patients: 2) surgery for only those patients who demonstrated patency of the vestibular aqueduct as seen on tomographic examination; and 3) prognostic tests to determine which patients were most suitable for endolymphatic sac surgery. This paper details the results of endolymphatic shunt surgery performed on 43 patients over a 3-year period, restudying my prior conclusions. All patients were operated using a new method of capillary endolymph dispersement regardless of tomographic findings. The results are compared to the results of the prior studies to determine whether the findings of tomography are correlated with success or failure of shunt operations, a conclusion that others have questioned. This study clearly shows that the present technique affords better results than prior methods regardless of the x-ray findings. In addition, the tomographic findings correlate closely to the clinical pattern of the disease and to the success or failure of the operation.
Endolymphatic Duct and Sac in Patients with Meniere's Disease
Authors: Ikeda Minoru , Sando Isamu
Published: October 2014

The endolymphatic ducts and sacs of 25 temporal bones with idiopathic endolymphatic hydrops from individuals with Meniere's disease were studied and compared with the same number of control bones without endolymphatic hydrops from individuals with no premortem history of otologic disease. The control bones were selected so that the sizes of their vestibular aqueducts matched those temporal bones from individuals with Meniere's disease. The endolymphatic ducts and sacs of all bones were studied by the medial view-graphic reconstruction method and or histological observation under a light microscope. In the endolymphatic duct and sac of many of the temporal bones from patients with Meniere's disease were noted a diminution of the width of the endolymphatic duct in its isthmus portion, an increase in the area of the collapsed lumen of the endolymphatic sac, fibrotic changes in the perisaccular loose connective tissue, and an increase in the quantity of intraluminal eosinophilic material. The frequencies with which these pathological findings were noted in bones from individuals with Meniere's disease and in control bones were statistically significantly different. No significant differences were observed under light microscopic study between these two groups with regard to the condition of the epithelial cells, the degree of rugosity of the endolymphatic sac, or the appearance of melanin-like pigmentation of hyalinization in the perisaccular connective tissue.
Recent Advances in Hearing Aid Selection and Adjustment
Authors: Skinner Margaret W.
Published: October 2014

Recent research has shown that speech is most intelligible for hearing-impaired individuals when it is amplified to a comfortable level in specific frequency regions between 250 and 6,000 Hz, and is limited below the discomfort level. If commercial hearing aids and earmold coupling are adjusted appropriately, they will provide amplified sound within these parameters for most hearing-impaired individuals. A clinical procedure is described 1) to preselect an aid and earmold with the approximate electroacoustic characteristics that are needed, 2) to determine the gain actually provided by this hearing aid/earmold combination, and 3) to adjust the hearing aid and/or earmold if the gain and maximum output do not meet the prescribed criteria, or if the wearer finds the sound quality unacceptable.
High Frequency Audiometry
Authors: Tonndorf Juergen , Kurman Barbara
Published: October 2014

After a brief discussion of the past use of and clinical need for high frequency hearing tests, a new technique is described that uses a special electric transduction mode: a 60-kHz carrier frequency is modulated by the desired audiofrequency. The combined signal is applied to the skin over the mastoids by Mylar-covered electrodes. On perception, the audiofrequency part of the input shows all the properties of a bone-conduction signal. The carrier frequency is dispersed in the tissues. Production and calibration of electrical high frequency signals, up to 20 kHz, is straightforward and easier than that of conventional air-conduction and (vibromechanical) bone-conduction signals. The efficacy of the method is illustrated by means of preliminary hearing tests conducted on several subjects.
Vestibular and Auditory Function in Usher's Syndrome
Authors: Kumar Arvind , Fishman Gerald , Torok Nicholas
Published: October 2014

Usher's syndrome is a recessive hereditary disorder in which a congenital hearing loss is combined with nyctalopia, retinal degeneration, and restriction of visual fields. The results of a comprehensive ophthalmic and neurotologic study on 70 patients are reported. Two distinct clinical and presumed genetic types were discernible on the basis of hearing impairment and vestibular sensitivity and, to a lesser extent, deterioration of retinal photoreceptor function. Such a classification has proved valuable in diagnosis, prognosis, and genetic counselling.
1984 Santa Barbara State-of-the-Art Symposium on Otosclerosis
Authors: Smith Mansfield F. W. , Hopp Martin L.
Published: October 2014

A state-of-the-art symposium on otosclerosis convened in Santa Barbara, California on Jan 6, 1984. The panel included some of the most distinguished and experienced otosclerosis surgeons in the world, with a collective experience of over 100,000 stapes operations. The purpose of the symposium was to develop guidelines for safe management of otosclerosis and to identify the at-risk patient for surgery. Topics included techniques developed by these surgeons through avoidance, recognition, and correction of technical problems; complications; and errors that lead to poor results. Discussed in order were patient evaluation, performance of surgery, and postoperative care.
Magnetic Resonance Imaging in Acoustic Neuroma Diagnosis
Authors: House John W. , Waluch Victor , Jackler Robert K.
Published: October 2014

Magnetic resonance imaging (MRI) is capable of providing excellent images of the contents of the internal auditory canal and cerebellopontine angle. In order to determine whether MRI is comparable to air contrast computed tomography in the diagnosis of small acoustic neuromas, 44 patients with suspected retrocochlear disease were studied with both CT and MRI. Twenty-one lesions were identified successfully with MRI and CT. The size of the tumors ranged from 4 mm to 5 cm. In twenty-three nontumor patients the normal audiovestibular nerve bundles were well visualized. Air contrast CT, on the other hand, was falsely positive in two cases. The results of this study indicate that MRI is suitable as the primary anatomic investigation in patients suspected of having retrocochlear lesions. It has the advantages of being highly reliable as well as free of ionizing radiation and the need for invasive procedures. The expense of MRI compares favorably with that of combined intravenous and gas contrast CT.
Complications in the Approach to Acoustic Tumor Surgery
Authors: Wiet Richard J. , Raslan Wasim , Kazan Robert P. , Herzon Garrett D.
Published: October 2014

Earlier diagnosis and cooperation with allied specialists in neurosurgery have lessened complications of acoustic tumor surgery. To date, complications cannot always be prevented. The controversy over which approach is best for acoustic tumor extirpation still continues. While teams must answer this question themselves, our experience favors the transtemporal approach. Of the potential disabilities from this operation, facial paralysis or its sequelae remain the most frequent. The transtemporal approach gives a more accurate anatomical definition of the facial nerve. Efforts to preserve hearing (especially with tumors 2 cm or larger), when matched with the potential sequelae of facial paralysis, may prove futile.
Endolymphatic Sac-Mastoid Shunt Surgery a Nonspecific Treatment Modality?
Authors: Thomsen Jens , Tos Mirko , Bretlau Poul , Johnsen Niels Jon
Published: October 2014

The reason for the effectiveness of endolymphatic sac-mastoid shunt surgery in the treatment of patients with Meniere's disease is still open for debate. In a double-blind study, published in 1981, we could not demonstrate any difference between the effect of a simple mastoidectomy and a regular endolymphatic sac-mastoid Silastic sheet shunt. However, a significant reduction in symptoms could be demonstrated in both groups, and 70% of patients in both groups could be classified as successes. The patients were reexamined 3 years after surgery, and it was still not possible to demonstrate any differences between the sham and the active surgery. In this study, no significant differences between the two groups have been found at follow-up averaging 84 months, and success has been maintained in about 70% of patients. The only three failures, who have consistent vertiginous attacks, have been confined to the actual shunt group. Two patients in the active group have lost their hearing as compared with none in the sham group, and 35% of the patients have now developed bilateral disease. We believe that endolymphatic sac-mastoid shunt surgery is a nonspecific treatment modality, and we find no need for sac shunt surgery. The vast majority of the patients can be successfully treated by nonsurgical means, but we emphasize that above all the patient must be assured that in the event of persistent debilitating symptoms, a surgical solution to the problem is available.
Endolymphatic Hydrops: Can it Be Controlled?
Authors: Schuknecht Harold F.
Published: October 2014

While endolymphatic shunt procedures are conceptually logical, there are characteristics of underlying pathological conditions and host response that severely limit the probabilities of achieving functional shunts.
Comparison of Different Speech Processing Strategies on Patients Receiving the Same Implant
Authors: Simmons F. Blair , Dent Laurel J. , Van Compernolle Dirk
Published: October 2014

Two subjects with transcutaneously connected 8-electrode scala tympani implants were given subsets of the Minimal Auditory Capabilities test during stimulation with five speech processing strategies — two single channel and three multichannel. While there were significant (p = 0.05%) scores on some items with all types of stimulation, one subject did as well with single channel analog as with multichannel stimulation. She is an enthusiastic full-time user of single channel stimulation. The other, a nonuser of the same device, preferred (and performed better with) one of multichannel stimulation. This is an interim report because neither subject has yet had the opportunity of nonlaboratory use of the multichannel schemes.
Porous Polyethylene Prosthesis: Continuing Experience
Authors: Brackmann Derald E.
Published: October 2014

Members of the Otologic Medical Group have been using a porous polyethylene prosthesis since mid-1976. Several modifications of technique have evolved, which are described. Short-term hearing results are the same as with previous techniques, but they are more stable long term. Extrusion now occurs in approximately 5% of cases, usually due to a eustachian tube problem. In general we are pleased with our results and plan to continue to use these prostheses.
Influence of Growth Hormone on Nasal Septal Growth in Rats
Authors: Vetter U. , Voigt K. H. , Heinze E. , Pirsig W.
Published: October 2014

Growth activity of the rat septal cartilage was evaluated by incorporating radiolabeled sulfate into three areas of the septal cartilage (anterior, central, and posterior). Growth activity of the septal cartilage was determined in normal rats and in hypophysectomized rats treated either with saline or human growth hormone (hGh) injections. Human growth hormone treatment selectively stimulated sulfate incorporation in the posterior area, which is situated anterior to the septoethmoidal junction, whereas sulfate incorporation was not influenced in the anterior and central area by hGh treatment compared to saline treatment. However, both wet and dry weight was significantly increased by hGh treatment compared to saline treatment in hypophysectomized rats.
Experimental Investigations on the Suitability of the Carbon Dioxide Laser for Stapedotomy
Authors: Thoma Josef , Mrowinski Dieter , Kastenbauer Ernst R.
Published: October 2014

Surgery of the footplate may cause a number of possible complications such as cochlear hearing defects or even complete loss of hearing. This has made it necessary to look for improved techniques. When a laser is used for stapedotomy, the energy transmitted to the cochlea must be reduced to the lowest possible level. We thus investigated the carbon dioxide laser to determine whether it would prove to be more advantageous than the argon laser. Animal experiments showed that CO2 laser irradiation is well tolerated. Tests performed on isolated petrous bone resulted in the development of a new surgical instrument suitable for stapedotomy using the CO2 laser. Temperature and pressure measurements were carried out on a simplified model of the human cochlea. Our findings indicated that, with both types of laser, the irradiation required to perforate the otosclerotically thickened footplate adversely affects temperature and pressure development in the cochlea.
Judgment of Voice Improvement after Recurrent Laryngeal Nerve Section for Spastic Dysphonia: Clinicians versus Patients
Authors: Sapir Shimon , Aronson Arnold E. , Thomas Jack E.
Published: October 2014

Four or more years after recurrent laryngeal nerve section for adductor spastic dysphonia, 25 patients assessed their voice quality and phonatory effort in relation to presurgical status, using categorical ratings (gradations of better or worse, and of easier and harder) and also numerical ratings. Quality was judged better by 88%, and effort easier by 84%; but many thought the improvement was only moderate or slight. Three speech pathologists, assessing presurgical and current recordings of the patients' voices numerically, rated the majority of the better and easier voices much closer to their presurgical status than to normal. Clinicians were highly consistent and reliable in their assessments. Patients were often in disagreement with clinician ratings and generally rated their dysphonia as less severe than the clinicans did. These discrepancies are discussed within the context of contradictory opinions regarding the efficacy of recurrent laryngeal nerve section for the treatment of adductor spastic dysphonia.
Inhibition of Hamster Tongue Carcinogenesis by Selenium and Retinoic Acid
Authors: Goodwin W. Jarrard , Huijing Frans , Bordash Gerard D. , Altman Norman
Published: October 2014

The inhibitory effect of selenium, 13-cis-retinoic acid, and their combination was studied in an animal model in which squamous cell carcinoma of the tongue was induced by 0.5% 9,10 dimethyl-1,2 benzanthracene (DMBA). A controlled, blinded experiment was carried out using 60 Syrian hamsters divided into four groups of 15 each. When compared to controls, the mean day of carcinoma onset was delayed 3 weeks for animals given selenium, 6 weeks for animals given retinoic acid, and 5.5 weeks for animals given selenium plus retinoic acid. The differences between each experimental group and the control group are statistically significant. We conclude that both selenium and retinoic acid inhibit the development of DMBA-induced squamous cell carcinoma of the tongue in hamsters. The dose of retinoic acid used produces a stronger inhibitory effect, but is associated with significant toxicity. At the doses used, combined inhibitory effect is no greater than that for retinoic acid alone.
Dynamics of Otosclerosis-Like Lesions in LP/J Mice
Authors: Cramer Henry B. , Chole Richard A.
Published: October 2014

The LP/J inbred mouse is the first known animal to spontaneously develop otosclerosis-like bone lesions in the middle and inner ear. These abnormal bone foci resemble human otosclerotic lesions, are inherited, and produce a progressive hearing loss. On the basis of histological evaluation alone, it was unclear whether these otosclerosis-like lesions in LP/J mice develop suddenly or gradually as in human otosclerosis. To study the dynamics of lesion formation, four different colored fluorochrome bone labels were given in sequence to postpubertal LP/J mice and CBA/J mice as normal controls. All of the otosclerosis-like lesions incorporated at least one fluorochrome, and half were labeled with two or more markers indicating continuous lesion growth over many weeks. It appears that otosclerosis-like lesions in LP/J mice develop during early adulthood and progress gradually as in human otosclerosis.
Atypical Cogan's Syndrome: An Autoimmune Disease?
Authors: Peeters G. J. H. C. M. , Cremers C. W. R. J. , Pinckers A. J. L. G. , Hoefnagels W. H. L.
Published: October 2014

A 22-year-old woman is described with gastrointestinal complaints, sclerokeratitis, and a bilateral progressive hearing loss. The clinical picture, the outcome of lymphocyte stimulation tests against S antigen (retina soluble antigen), outer rod segment, and scleroprotein, and the successful administration of corticosteroids after a partial spontaneous hearing improvement, are suggestive of an autoimmune disease.
A Reexamination of Experimental Type II Collagen Autoimmunity: Middle and Inner Ear Morphology and Function
Authors: Harris Jeffrey P. , Woolf Nigel K. , Ryan Allen F.
Published: October 2014

Type II collagen autoimmunity has been reported to result in a number of middle and inner ear morphological and functional abnormalities. We investigated the immunological, electrophysiological, and anatomical effects of this autoimmune state in well-established Wistar-Furth rat models of type II collagen autoimmune arthritis. Seventeen animals immunized with bovine type II collagen were divided into short term (1–3 months postimmunization) and long term (9–11 months) groups. Thirty-three experimental ears were tested electrophysiologically and were compared to nine ears of unimmunized Wistar-Furth rats. No hearing loss was found in the immunized animals, except for four animals that showed middle ear abscess formation consistent with spontaneous, purulent otitis media. All immunized animals showed very significant serum and perilymph antibody titers to type II collagen. No morphological abnormalities of the external, middle, or inner ears could be identified in the noninfected experimental animals. These findings do not support previously reported observations that type II collagen autoimmunity results in ear disease.