bluuebunny/crossref_metadata_2025 huggingface dataset:
Eye Movements in Cerebellar and Combined Cerebellobrainstem Diseases
Authors: Wennmo Carsten , Hindfelt Bengt , Pyykkö Ilmari
Published: October 2014

We report a quantitative analysis of eye movement disturbances in patients with isolated cerebellar disorders and patients with cerebellar disorders and concomitant brainstem involvement. The most characteristic abnormalities in the exclusively cerebellar patients were increased velocities of the slow phases of vestibular nystagmus induced by rotation in the dark and increased peak velocities of the fast phases of optokinetic nystagmus induced by full-field optokinetic stimuli. Dysmetria of saccades was found in three of six cerebellar patients and gaze nystagmus in all six patients. The typical findings in the combined cerebellobrainstem group were reduced peak velocities of voluntary saccades, defective smooth pursuit and reduced peak velocities of the fast component of nystagmus during rotation in both the dark and light. All patients with combined cerebellobrainstem disorder had dysmetric voluntary saccades and gaze nystagmus. The numbers of superimposed saccades during smooth pursuit were uniformly increased. Release of inhibition in cerebellar disorders may explain the hyperresponsiveness and inaccuracy of eye movements found in this study. In addition, when lesions also involve the brainstem, however, integrative centers coding eye velocity are affected, leading to slow and inaccurate eye movements. These features elicited clinically may be useful in the diagnosis of cerebellar and brainstem disorders.
Parotid Gland and its Lymph Nodes as Metastatic Sites
Authors: Batsakis John G.
Published: October 2014

The parotid gland and its lymph nodes can serve as metastatic sites from regional and distant primary neoplasms. In the head and neck, the regions and neoplasms at risk for such metastases are melanomas and squamous cell carcinomas of the skin of the eyelids, frontal, temporal, posterior cheek and anterior ear regions. The mucous membranes of the upper aerodigestive tract may also be a site for a primary demonstrating parotid area metastases.
Functional Neck Dissection
Authors: Calearo Carlo V. , Teatini Gianpietro
Published: October 2014

The anatomical grounds of and surgical technique for functional neck dissection are described in detail in order to demonstrate that the radicalism of this procedure, from the viewpoint of surgical anatomy, is by no means less than that of the classical (so-called radical) neck dissection. From 1972 to 1978, 476 operations were performed (211 patients treated bilaterally and 54 unilaterally). The percentage of false negatives (ie, histologically proven metastases in clinically unsuspected nodes) was 14%, while the percentage of false positives (histological negativity in clinically suspected nodes) reached 53%. The total number of local recurrences in a three-year follow-up was nine (3.5%).
Basophilic Deposits in the Stria Vascularis
Authors: Zaytoun George M. , Schuknecht Harold F.
Published: October 2014

Basophilic deposits in the stria vascularis have been found in association with a multitude of disease entities. Their true significance and nature remain obscure. In the temporal bone collection at the Massachusetts Eye and Ear Infirmary are 22 cases with basophilic deposits in the stria vascularis. The ages of the subjects studied ranged from two days to 83 years. Atrophy of the stria vascularis was the main pathology seen in their temporal bones. The deposits were found in both ears in 82% of cases. They tend to show a striking polymorphism. Special histochemical stains suggest they contain glycogen. Hypertension and uremia were two health problems most of the subjects were suffering from during life. A theory is advanced as to the immune complex nature of these deposits. A review of the literature concerning this subject is also offered.
Auditory Brainstem Responses in Children with Early Recurrent Middle Ear Disease
Authors: Folsom Richard C. , Weber Bruce A. , Thompson Gary
Published: October 2014

Auditory brainstem responses were recorded from an experimental group of 15 children with early histories of recurrent middle ear disease for the purpose of examining the effects of reduced auditory input on auditory brainstem function. The responses from these children were analyzed in terms of absolute latencies, interwave latencies and latency shifts across sensation level. Comparisons were made to a control group of children with no history of middle ear disease. Results indicated significant differences between the groups. The experimental group demonstrated greater absolute latencies for waves III and V as well as greater interwave latencies. These findings support the interpretation of an association between early recurrent middle ear disease and brainstem function.
Frozen-Section Autoradiography of the Cochlea: Evidence for Differential Distribution of Amino Acids
Authors: Martin Glen K. , Wise Renee P. , Lonsbury-Martin Brenda L.
Published: October 2014

A histological method is described for embedding the whole cochlea in an egg yolk medium that permits frozen sectioning in the mid-modiolar plane. Resulting tissues can be processed using standard autoradiographic techniques and stained with Nissl or silver impregnation methods. Following identical intracochlear injections of tritiated proline or leucine and frozen sectioning of embedded cochleae, differential uptake patterns within the cochlea were revealed for these amino acids. Frozen sectioning of the cochlea promises to provide an efficient means to examine specific labeling patterns within the cochlear duct for compounds suspected of contributing to cochlear function by permitting the application of multiple histological techniques including routine stains and anterograde and retrograde tracers.
Laryngeal Amyloidosis and Laryngocele
Authors: Grybauskas Vytenis T. , Schild Joyce A. , Mafee Mahmood F.
Published: October 2014

Laryngeal amyloidosis and laryngoceles are uncommon. A unique case of both conditions occurring simultaneously is discussed. Preoperative computerized tomographic sections clearly demonstrated both disease processes, their extensiveness, and their intimate relation. These findings are correlated with the endoscopic and surgical findings. Gross and histopathologic specimens give full confirmation of the diagnosis. To our knowledge, this is the first case of laryngocele secondary to amyloidosis.
Rehabilitation of Swallowing after Stroke
Authors: Heimlich Henry J.
Published: October 2014

Seven consecutive patients who had lost the ability to swallow saliva or ingest food following cerebrovascular accidents were subsequently taught to eat again. Five patients were restored to eating a regular diet and two showed improvement limited by their underlying conditions. Prior to swallowing rehabilitation, their nutrition had been maintained by tube feedings for periods of 5 months to 3.9 years. Patients were instructed in sucking, elevation of the larynx, and coordination of those functions. This method has not been reported previously for use in stroke patients. Oral feeding was initiated with ice chips and progressed to a normal diet. Speech also improved after regaining deglutition. The clinical evidence suggests that paralysis initiated the swallowing disability which persisted due to disuse of retrainable pharyngeal muscles. The reflex sequence of deglutition can be retaught if lost due to stroke.
Aortic Wheeze: Intermittent Tracheal Obstruction Caused by a Rare Aortic Arch Anomaly
Authors: Buckwalter J. , Hellenbrand W. , Sasaki C. , Kleinman C. , Kopf G. , Markowitz R.
Published: October 2014

Cardiac and aortic arch anomalies are a well-known cause of tracheal and esophageal compression producing stridor and dysphagia. We present a rarely encountered aortic arch anomaly in a 12-month-old infant who suffered from intermittent pulmonary wheezing. A discussion of the subsequent evaluation including an esophageal contrast study, computed tomography, angiocardiography, and bronchoscopy, will emphasize the diagnostic importance of these examinations. Preoperatively, a variant of Celoria type B aortic arch interruption was established by cardiac catheterization. The ascending aorta solely supplied both carotid arteries. Both subclavian arteries arose from the descending aorta, and all flow to the descending aorta was supplied via bilateral markedly enlarged vertebral arteries as a bilateral subclavian steal. Three areas of tracheal compression were noted at bronchoscopy. The patient's anomalous circulation was improved by the placement of a Gore-Tex graft connecting the ascending and descending aorta. A right-sided arterial ligament was divided in order to further relieve tracheal compression.
Difficult Laryngoscopy/Intubation: The Child with Mandibular Hypoplasia
Authors: Handler Steven D. , Keon Thomas P.
Published: October 2014

The child with mandibular hypoplasia (Treacher Collins syndrome, Pierre Robin sequence, hemifacial microsomia, etc) presents the otolaryngologist and anesthesiologist with considerable problems when direct laryngoscopy and/or endotracheal intubation is attempted. In addition to the small mandible, several other features of these patients contribute to the difficult laryngoscopy: macroglossia, glossoptosis, trismus related to temporomandibular joint abnormalities, and prominent maxilla or maxillary incisors. Most of the techniques that have been described for laryngoscopy/intubation in problem cases are difficult or impossible to use in infants and young children with mandibular hypoplasia. We present a modification of the standard direct laryngoscopic procedure, utilizing the 9-cm anterior commissure laryngoscope and an optical stylet in the task of exposing and intubating the larynx of a child with mandibular hypoplasia.
Venturi Jet Ventilation through the Metal Endotracheal Tube: A Nonflammable System
Authors: Woo Peak , Strong M. Stuart
Published: October 2014

In an effort to design a fireproof and reliable method of ventilation during CO2 laser laryngoscopies, a new Venturi jet endotracheal tube coupler has been designed. This allows microdirect laryngoscopy. Its design features are described. Sixteen clinical cases of various laryngeal pathologies treated with direct laryngoscopy and laser excision are ventilated using this system. The clinical data and experiences are discussed. The arterial blood gases done at 20 minutes after muscular paralysis showed a median value of pH 7.45/PO2 252/PCO2 36. No complications or adverse effects were noted. The Venturi jet endotracheal tube coupler allows for jet ventilation through a metal endotracheal tube with reliable ventilation. This is an alternate, reliable, and fire-safe method during laser use.
Videolaryngoscopy
Authors: Yanagisawa Eiji , Strothers Gordon , Owens Terryl W. , Honda Kiyoshi
Published: October 2014

Videolaryngoscopy is a most useful and effective method of evaluation and documentation of physiological and pathological conditions of the larynx. It is of great value for making accurate diagnosis and planning proper treatment. It permits instant and simultaneous voice and video recording and later analysis. Videolaryngoscopy can be accomplished with either a flexible fiberscope or a rigid right-angled telescope. Fiberscopic videolaryngoscopy is more useful for voice analysis of speech disorders and evaluation of such functions of the larynx as phonation, singing, and swallowing. Telescopic videolaryngoscopy is superior for critical evaluation of anatomical and pathological changes of the laryngeal structures as well as close-up examination of vocal cord function. While fiberscopic laryngoscopy is technically easy, fiberscopic video documentation is much more difficult than telescopic video documentation. Telescopic videolaryngoscopy provides clearer and sharper images of the larynx. Advantages and disadvantages of each method are discussed.
Laryngeal Nerve Crush for Spastic Dysphonia
Authors: Som Max L. , Biller Hugh F. , Lawson William
Published: October 2014

Twenty-two patients with a diagnosis of spastic dysphonia were treated by laryngeal nerve crush. All patients had initial improvement. Success at 3-year follow-up was 13%. Laryngeal nerve crush is no longer advocated as treatment for spastic dysphonia.
The Memorable Life of Hosmer A. Johnson, Early Midwestern Laryngologist
Authors: Friedberg Stanton A.
Published: October 2014

Hosmer A. Johnson, one of the early laryngologists in the Midwest, graduated in 1852 from Rush Medical College, and was the first intern in Chicago. With four other faculty members he left Rush in 1859 to establish what subsequently became the Northwestern University Medical School. He taught many subjects and was extremely active in local and national societies. An interest in diseases of the chest led him into laryngology and he became a charter member of the American Laryngological Association, where he reported on congenital tumors of the larynx, laryngeal paralysis, and cancer of the larynx. Dr Johnson was a master of six or seven foreign languages, a versatile civic leader, a talented orator, and was greatly admired for his medical skills. The breadth of his accomplishments and character made for a truly memorable life.
Early Experiences with Vocal Ligament Tightening
Authors: Guice Charles E. , LeJeune Francis E. , Samuels Paula M.
Published: October 2014

Loss of tension of the thyroarytenoid ligament is seen in elderly patients, in patients with chronic voice strain, and in patients who have had intubation trauma or laryngeal crush trauma. A tightening of the ligament by mobilizing a midline strip of the thyroid cartilage and advancing the upper end of this strip is described. The early results are encouraging; long-term results in older patients are not really known at this time.
Muscle Transposition in the Rehabilitation of the Paralyzed Larynx
Authors: Stearns Michael , Sutton Dwight , Neal G. David , Trachy Ron , Cummings Charles W.
Published: October 2014

Muscle transposition of the innervated omohyoid muscle into the tendon of the paralyzed posterior cricoarytenoid muscle was studied in a small series of subhuman primates. A similar procedure was described previously by King for treatment of bilateral recurrent nerve injuries. Our studies confirm that this procedure adequately enlarges the airway to allow normal activity without a tracheostomy. Histologic studies appear to show nerve ingrowth occurring at 6 months as in other neuromuscular pedicle procedures. The procedure is easily performed and causes no other muscle denervation.
Intralaryngeal Release for Tracheal Anastomosis
Authors: Conley John , Sachs Michael E. , Rabuzzi Daniel D.
Published: October 2014

An operation for obtaining additional length in order to achieve end-to-end anastomosis of the trachea without significant suture-line tension is described. The intralaryngeal procedure lengthens the larynx approximately 1 to 2 cm without restricting its function. It is an expedient, effective technique when used primarily, or adjunctively, with a suprahyoid or mediastinal release.
Selective Induction of Macrophages in the Middle Ear
Authors: McGhee Robert B. , Okazaki Nobuhiro , Demaria Thomas F. , Lim David J.
Published: October 2014

A method is described for inducing an influx primarily of macrophages into the middle ears of chinchillas using keyhole limpet hemocyanin (KLH, a strong immunogen) and mineral oil (a nonimmunogen) to provide adequate numbers of these cells for study. Although KLH and mineral oil both induced sterile otitis media in which macrophages were the predominant cell type present in the middle ear, the cytological and histological responses of the middle ears to these substances differed. KLH proved to be a much stronger inducer of actively phagocytic macrophages and also produced serous effusions in about 11% of the experimental animals. This experimental model provides an opportunity for the in vitro and in vivo study of the role of macrophages, the predominant cell type associated with human chronic otitis media with effusion, in the defense system of the middle ear.
Irrigation of the Maxillary Sinus by Canine Fossa Puncture: Experience with 202 Patients
Authors: Gay I. , Elidan J. , Chisin R.
Published: October 2014

Maxillary sinus lavage through the canine fossa was peformed on 202 patients. This procedure is relatively safe, easily learned and quickly performed, has minimal side effects and a very low percentage of failures, and is more acceptable to most patients. It should be used by otolaryngologists, at least as a useful alternative to the classical method.
Ameloblastoma of the Maxilla and Peripheral Ameloblastomas
Authors: Batsakis John G. , McClatchey Kenneth D.
Published: October 2014

Ameloblastomas arising in the supraperiosteal soft tissues (peripheral ameloblastoma) and those taking origin in the maxilla have distinctively different biologic behaviors. The peripheral ameloblastoma can be successfully treated by conservative excision while en bloc resection is warranted for the maxillary ameloblastoma. The effectiveness of primary surgical treatment of an ameloblastoma of the maxilla is the key to reduce morbidity and mortality from the lesion. Anatomic differences between the maxilla and mandible and an apparent more aggressive behavior of maxillary tumors also play a role in establishing the ameloblastoma of the maxilla as the most dangerous of the ameloblastomas.
Vascular Loop as a Cause of Vertigo
Authors: McCabe Brian F. , Harker Lee A.
Published: October 2014

A vascular loop in the internal auditory canal pressing upon the vestibular nerve was found in a series of eight patients with episodic vertigo and severe motion intolerance. All patients had failed medical and surgical therapy for vestibular Meniere's disease, which this syndrome closely mimics. A vestibular nerve resection or section medial to the vascular loop produced relief of symptoms in all patients, but one patient required a second operation. We have no test or study to reliably diagnose this syndrome preoperatively. The history appears to be the best indicator to date.
Incus Interposition
Authors: Pennington Claude L.
Published: October 2014

A 10- to 15-year follow-up study of patients with modeled incus interposition procedure for restoration of hearing reveals that hearing gains as reported in 1972 were sustained by long-term postoperative care despite resurgence of problems from negative middle ear air pressures.
Tympanomastoidectomy
Authors: Cole James M. , Reams Carl L.
Published: October 2014

Since 1956, 1,540 tympanomastoidectomy procedures for cholesteatoma or chronic suppurative otitis media with mastoiditis have been performed; 180, done from 1972 through 1980, were reviewed in detail for effectiveness of surgery, control of disease, and hearing results. The majority of the procedures were done for cholesteatoma. Almost all of these had preoperative sclerotic or poorly developed mastoids as judged by x-ray examination. A limited open-cavity technique with one-stage tympanic repair has resulted in long-term control of cholesteatoma in the mastoid segment in almost every case and reasonable success in control of middle ear disease and preservation or improvement in hearing. Properly performed modified radical mastoid cavities seldom cause problems in postoperative care, do not preclude swimming, and do not impair concomitant tympanoplastic repair. Failure to control disease in the middle ear or to improve hearing is the major problem. Revision tympanoplasty can correct some of these remaining problems, but is usually an elective procedure.
Experiences with the Cochlear Implant in Preschool Children
Authors: House William F. , Berliner Karen I. , Eisenberg Laurie S.
Published: October 2014

Years of experience with the cochlear implant in profoundly deaf adults led to a decision to attempt to extend the benefits of this device to children. As of March 15, 1983, 43 deaf children ranging in age from 2.7 to 17.5 years have been implanted. Seventeen of these are children under 6 years of age. All had worn hearing aids but demonstrated little or no benefit from them. Auditory thresholds with the implant are significantly better than those obtained unaided and with hearing aids. Although a longer period of experience is required, the preschool-aged children can eventually make the same auditory discriminations as older children and adults. Long-term impact on speech and language development remains to be determined, but there is already evidence for significant improvement in these areas.
Cochlear Prostheses: Stimulation-Induced Damage
Authors: Miller Josef M. , Duckert Larry G. , Pfingst Bryan E. , Malone Mark A.
Published: October 2014

The effects of 4 weekly, three-hour exposures to continuous sinusoidal (1 kHz) electrical stimulation of the inner ear at various current levels were assessed in the chronically implanted guinea pig. With scala tympani stimulation, histopathological damage, including new bone growth, was observed for currents at and above 100 μA rms. No changes were observed in similarly implanted, but not stimulated cochleas. At equal current levels, less damage was found in subjects stimulated via electrodes placed on the round window and promontory, as compared to the scala tympani. Consistent reversible changes in threshold and suprathreshold features of the electrically evoked auditory brainstem response (EABR) were found. The magnitude of EABR change was directly related to exposure stimulus current level and to cochlear stimulation site. Suprathreshold features of the EABR were more sensitive to continuous stimulation exposures than threshold measures. Reversible EABR changes were found in the presence and absence of stimulation-induced histopathology.
Tympanosclerosis: Clinical Implications of the Theory of Pathogenesis
Authors: Schiff Maurice
Published: October 2014

Tympanosclerosis is a preventable disease. Its elimination is more the responsibility of the pediatrician and general practitioner than the otolaryngologist's. The education of our colleagues is the most effective way of possibly eliminating this disease process. Cholesteatoma and tympanosclerosis may have similar causative factors, but certainly have different pathogenic developmental patterns; their occurrence together in otologic disease is coincidental. The mechanism of this disease process shows that the subepidermal and submucosal connective tissue layers of the eardrum are the ones involved. The cure for tympanosclerosis may be achieved more easily than its amelioration. This may seem like a strange paradox, but cure is intimately bound up with prevention which is the key for the clinical significance of this theory of pathogenesis. The pediatrician and the general practitioner, or family physician — the first to see the children with their ear problems — are urged to refer patients to an otologist when fluid is turbid. Development of tympanosclerosis must be prevented in the early but treatable stages. Prevention is less costly than repair.
Microendoscopic Surgery of the Hypopharyngeal Diverticulum Using Electrocoagulation or Carbon Dioxide Laser
Authors: van Overbeek Jos J. M. , Hoeksema Paul E. , Edens Enje Th.
Published: October 2014

In 1964 we started to treat hypopharyngeal (Zenker's) diverticula endoscopically, using the procedure described by Dohlman. With the increase in the number of patients (274 patients up until 1982), the technique and the instruments used have improved. This paper describes the technique we have used since 1981, which involves exposure of the tissue bridge between esophagus and diverticulum with the aid of a specially designed scope and subsequent severance of this bridge under microscopic control. In 12 cases the bridge was severed by electrocoagulation, while the CO2 laser was used for this purpose in another 12 cases. Both techniques have given good results. Essential advantages or disadvantages of either of these methods could not be elicited. We regard the use of an operating microscope as a great improvement.
Secretory Immunoglobulin a Antibodies to Respiratory Viruses in Middle Ear Effusionl of Chronic Otitis Media with Effusion
Authors: Yamaguchi Tatsuji , Urasawa Tomoko , Kataura Akikatsu
Published: October 2014

In order to obtain evidence that viral infection may be involved in chronic otitis media with effusion, an attempt was made to detect secretory IgA antibodies to respiratory viruses in the effusions. The enzyme-linked immunosorbent assay used with purified viral antigens was employed for detecting antibodies in this study. Secretory IgA antibodies against adenoviruses, respiratory syncytial, and parainfluenza type 2 viruses were demonstrated in 31 of 128 effusions (27 of 114 ears with chronic otitis media with effusions and 4 of 14 ears with blue eardrum conditions). The specificity of antibody activity to each virus was confirmed by an absorption test.
Nomenclature of Developmental Tumors
Authors: Batsakis John G.
Published: October 2014

The terms hamartoma, choristoma, embryoma, teratoma and dermoid refer to separate and distinct tumors in the head and neck. Not only is the histogenesis unique to each entity, their clinicopathologic presentations are such that they may be easily separated. The diagnostic terminology is not interchangeable although contemporary use would make it seem so.
Wound Tension and Blood Flow in Skin Flaps
Authors: Larrabee Wayne F. , Holloway G. Allen , Sutton Dwight
Published: October 2014

The relationship between wound-closing tension, blood flow, and flap viability is examined using piglets as an experimental model. Twenty-seven rectangular skin flaps with random-pattern blood flow were created and closed under varying tensions. Closing tensions were accurately measured using a stabilized mechanical force gauge. In flaps with an impaired blood supply, there was a statistically significant increase in flap necrosis for those flaps closed with greater than 250 g of tension. The laser Doppler demonstrated a clear-cut inverse relationship between flap tension and blood flow in these flaps which correlated well with the experimental flap necrosis seen.
Squamous Metaplasia of the Subglottic Space and its Relation to Smoking
Authors: Stell P. M. , Watt J.
Published: October 2014

A macroscopic staining method was used to assess the incidence and extent of squamous metaplasia of the subglottic portion of the larynx. A total of 226 postmortem specimens were studied, 105 from nonsmokers and 121 from smokers. More than half of the specimens stained showed some metaplasia, but the incidence and extent of metaplasia was greater in smokers than in nonsmokers, and women were more affected than men. The incidence of metaplasia was greater in pipe and cigar smokers than in nonsmokers, but previous smokers did not differ from nonsmokers.
Silent Otitis Media: An Animal Study
Authors: Meyerhoff William L. , Giebink G. Scott , Shea Donald A.
Published: October 2014

Recent clinical and laboratory observations suggest that otitis media can occur in the absence of visible tympanic membrane changes (silent otitis media). Temporal bone histopathology was studied in 38 chinchillas that had been subjected to conditions known to predispose these animals to otitis media. Morphological changes were compared to a control group of 25 nonmanipulated animals. The tympanic membranes were examined at intervals and during the immediate premortem period with the operating microscope. Thirty-one tympanic membranes in the experimental group and all tympanic membranes in the control group were judged to be normal (gray and translucent) throughout the study period. The middle ears from the experimental group histologically manifested varying amounts of effusion, mucosal edema, granulation tissue, hyperemia of the subepithelial space, hemorrhage in the middle ear space, and abundant polymorphonuclear leukocytes in the middle ear cleft. These findings were not present in the control group.
Adrenoceptors in the Control of Human Nasal Mucosal Blood Flow
Authors: Andersson Karl-Erik , Bende Mats
Published: October 2014

The blood flow in the human nasal mucosa is controlled by the functional state of the resistance vessels. This blood flow was studied by means of the 133Xe washout method. Using topical application of drugs that stimulate or block adrenoceptors, including clinical doses of nasal decongestants, we classified the adrenoceptors of the resistance vessels in the mucosa. The results suggest that stimulation of α2-adrenoceptors causes a reduction of nasal mucosal blood flow; stimulation of α1- and β2-adrenoceptors seems to have no significant effects. Drugs that selectively stimulate α2-adrenoceptors, as well as those with preference for α1-adrenoceptors, cause nasal decongestion. To avoid the negative effects of a nasal mucosal blood flow reduction, it is suggested that a nasal decongestant with an α1-adrenoceptor stimulating effect should be preferable to a drug acting mainly on α2-adrenoceptors, provided that the decongestive effects are equal.
Natural Killer-Mediated Cytotoxicity in Patients with Laryngeal Carcinoma
Authors: Sartoris A. , Morra B. , Poggio E. , Cortesina G. , Di Fortunato V. , Bussi M. , Marcato P. , Cavallo G. P. , Beatrice F. , Rendine S.
Published: October 2014

Natural killer (NK)-mediated cytotoxicity against the K562 cell line was evaluated in normal subjects and in patients with laryngeal cancer. Results showed reduced lymphocyte cytotoxicity in patients with neoplastic disease and further reduction in NK activity following postoperative radiation therapy. The authors discuss the possibility of using this test in the immunological monitoring of patients with laryngeal carcinoma.
Cochlear Implant versus Vestibular Stimulation
Authors: Bleeker J. D. , Wit H. P.
Published: October 2014

Results obtained with cochlear electrode implants in totally deaf patients indicate that this means of transmitting auditory information can be of great help in lipreading and remote sound contact. However, using an alternate approach involving fenestration of the labyrinth and acoustical stimulation of the vestibular nerve, we generated a signal in an animal model superior in quality to that generated by electrical stimulation of the cochlea of the cat. This communication raises the question of whether a vestibular signal could be processed so that a deaf person could hear and identify sounds.
Benign Pleomorphic Adenomas in Children
Authors: Malone Barbara , Baker Shan R.
Published: October 2014

Benign pleomorphic adenomas of the salivary gland in children are rare. Reported are 30 patients under the age of 21 years presenting with this neoplasm. Twelve patients were first seen with recurrent or persistent tumor following previous attempts at removal. Retreatment resulted in control of the neoplasm in eight patients with follow-up from 5 to 24 years. Two additional patients have developed malignant degeneration of their neoplasms. All 18 previously untreated patients have remained free of recurrence. As with adults, the treatment of choice for benign pleomorphic adenomas of the parotid gland developing in children is parotidectomy with preservation of the facial nerve. Tumors arising in the submandibular gland are best treated by complete excision of the gland as well as the tumor.
Incidence of Reciprocal Synapses on Outer Hair Cells of the Human Organ of Corti
Authors: Nadol Joseph B.
Published: October 2014

The incidence of reciprocal synapses at the base of outer hair cells of the human organ of Corti was studied by electron-microscopic serial section reconstruction. Reciprocal synapses were found in each of six ears from five individuals. A total of 1,386 serial sections and the neural poles of 25 outer hair cells in two individuals were examined. Fourteen of the 25 outer hair cells (56 %) possessed reciprocal synapses. The incidence of reciprocal synapses increased from the first to the third rows of outer hair cells, as determined by the percentage of outer hair cells and afferent nerve terminals of each row demonstrating reciprocal synapses and the average number of reciprocal synapses per hair cell in each row. Hair cells with reciprocal synapses had more afferent and fewer efferent terminals per hair cell than hair cells without reciprocal synapses.
Carbonic Anhydrase Activity in Stria Vascularis and Dark Cells in Vestibular Labyrinth
Authors: Watanabe Kensuke , Ogawa Akira
Published: October 2014

Carbonic anhydrase activity was demonstrated ultracytochemically in the dark cells of the vestibular labyrinth and in the stria vascularis of the guinea pig. Reaction products were found both in the dark cells and in the stria vascularis. Localization of carbonic anhydrase was very similar between the dark cells and the intermediate cells, but the marginal cells had a different localization pattern. In both the dark cells and the intermediate cells, the reaction products were deposited in the cytoplasm, especially in the infoldings. In the marginal cells, carbonic anhydrase activity was observed on the lateral plasma membrane of the apical area and in a few apical vesicles, but was not detected in the infoldings of the deep portion. Reaction products were also observed in the intercellular spaces between the marginal cells. No reaction products were observed in the basal cells and transition cells. Carbonic anhydrase activity was observed in the cytoplasm of capillary endothelial cells and the fibrocytes of the spiral ligament. It is considered that carbonic anhydrase may play a major role in water and electrolyte transport in both the dark cells and stria vascularis.
Pathways and Pitfalls in Partial Laryngectomy
Authors: Kirchner John A.
Published: October 2014

Some 350 surgical specimens obtained at partial or total laryngectomy were photographed immediately after operation and processed for study by serial section. Intralaryngeal barriers to the spread of cancer are demonstrated on one hand and pathways of infiltration and destruction on the other. The following conclusions are based on these studies: two major elastic tissue barriers that influence the spread of vocal cord cancer are the dense mass of connective tissue at the anterior commissure which prevents invasion of the thyroid cartilage until very late, and the conus elasticus, under which vocal cord cancer may advance subglottically under the intact overlying mucosa. This conceals the actual extent of cancer below the glottis and is the usual cause of local recurrence after hemilaryngectomy. A large subglottic component of a glottic or transglottic cancer is sometimes associated with extension of disease within the cancellous interior of the thyroid ala or cricoid ring under an intact mucosa. A large ventricle or saccule may harbor the bulk of a glottic cancer under an intact ventricular band. Hemilaryngectomy is usually contraindicated once the extent of such a tumor is recognized. Removal of the hyoid bone is rarely necessary at horizontal supraglottic partial laryngectomy. Its preservation facilitates postoperative deglutition. Partial laryngectomy should not be attempted for pyriform sinus cancer if inspection reveals involvement of the apex.
Voice Analysis of the Partially Ablated Larynx
Authors: Blaugrund Stanley M. , Meltzer James , Gould Wilbur J. , Bloch Carol , Haji Tomoyuki , Baer Thomas
Published: October 2014

This study attempts to obtain a data base of objective information on the phonatory characteristics of the partially ablated larynx. Twenty patients who had previously undergone partial laryngectomy with glottic reconstruction underwent videolaryngoscopy. The visualizations obtained revealed that the mechanism of voice production was due in part to sphincterization and compensatory hypertrophy of glottic and supraglottic remnants. Aerodynamic and phonatory function tests together with acoustical and perceived voice quality analyses of these partially ablated larynges tend to corroborate the videotape impressions in many instances. However, data accumulated thus far only reveal trends that cannot yet be subjected to definitive interpretations. With the incorporation of other methods of evaluation, augmented by the inclusion of more patient material, it is hoped that the information obtained can be used to improve reconstructive techniques, monitor surgical results, and enhance methods of voice rehabilitation in these patients.
The Caldwell-Luc Operation Revisited
Authors: Yarington C. Thomas
Published: October 2014

The controversy concerning the indications for intranasal antrostomy versus the Caldwell-Luc operation has been debated for many years. Arguments against the Caldwell-Luc procedure are primarily based upon morbidity of the procedure, while arguments against nasal antrostomy point to inadequate access, exposure, and failure to eradicate disease. This presentation reviews the literature and the author's experience with over 270 Caldwell-Luc procedures. Some technical considerations that have produced good results are suggested. The exact indications for nasal antrostomy remain unclear.
Deep-Lobe Parotid Gland Tumors
Authors: Batsakus John G.
Published: October 2014

Fewer than 10% of all parotid gland tumors arise from the deep portion of the gland. The great majority are benign and are mixed tumors. Their clinical presentation in the parapharyngeal space is uncommon, but in the event, the principal differential diagnosis is the elimination of an oropharyngeal primary salivary gland tumor.
Granular Cell Tumor of the Trachea
Authors: Mikaelian Diran O. , Israel Harold , Cohn Herbert , Jabourian Zaven
Published: October 2014

Granular cell tumors are rare neoplasms that arise in different regions of the body. Their cell of origin is still debated among many pathologists, but recent authors consider them to be neurogenic. These tumors are believed to be benign; however, local recurrences after excision and multifocality arouse suspicions for malignancy. In the head and neck, granular cell tumors occur most frequently in the tongue. In the laryngotracheobronchial tree, most tumors reported have been in the larynx and the next most in the bronchi. Only six cases of true tracheal occurrences have been reported previously; two additional cases are reported in this paper. The literature of the cell of origin of these tumors is reviewed, the different theories are presented, and diagnosis, treatment, and follow-up are discussed.
Spontaneous Perforation of the Esophagus as a Manifestation of Dermatomyositis
Authors: Thompson Jerome Walter
Published: October 2014

Spontaneous perforation of the esophagus evolving into a retropharyngeal abscess in a child with severe dermatomyositis is reported. Clinical presentation and successful management are discussed. Aggressive surgical debridement with extensive drainage, multiple antibiotic coverage, and careful steroid management are advocated. The histopathology and clinical presentation of dermatomyositis as a type of polymyositis are discussed as pertinent to the otolaryngologic clinician. The literature is reviewed and results of a retrospective analysis of head and neck manifestations are reported in 50 children with dermatomyositis treated at Children's Hospital, Los Angeles, over the past 20 years.
Pulmonary Arteriopexy to Relieve Tracheobronchial Compression by Dilated Pulmonary Arteries
Authors: Berlinger Norman T. , Lucas Russell V. , Foker John
Published: October 2014

Adequate treatment of pulmonary artery compression of the tracheobronchial tree requires a high index of suspicion for the diagnosis, precise localization of the sites of airway compromise by bronchoscopy, and accurate identification of the anatomy of the obstructing vascular structures. Surgical correction of this vascular anomaly to relieve airway compression is necessary in many infants and should be performed promptly. Pulmonary artery plication, arteriopexy, or aneurysmorrhaphy is well tolerated and can be dramatically successful in improving airway patency.
Antibodies to Epstein-Barr Virus in Patients with Nasopharyngeal Carcinoma and in Comparison Groups
Authors: Neel H. Bryan , Pearson Gary R. , Taylor William F.
Published: October 2014

One hundred fifty-one patients with nasopharyngeal carcinoma (NPC) were enrolled in a prospective collaborative study of North American patients (most were white). Serum samples were collected concurrently from 903 Mayo patients for comparisons of serologic analyses. Both IgA antiviral capsid antigen [VCA (IgA)] and the anti-early antigen [EA (D)] antibody responses were associated with diagnosis, but not always in the same way. Both responses were positive in 85% of patients with World Health Organization types 2 and 3 NPC. Only 16 % with WHO type 1 NPC had positive IgA responses and only 35% had positive EA (D) responses, prevalences close to those in the comparison groups. Increased titers were found in the squamous carcinoma comparison group with tumors of the tongue and in the group with benign nasal polyps (p<0.01). We believe that the tests are specific, sensitive, and useful in diagnosis and treatment planning in patients with NPC, particularly those with occult primary NPC.
Liver Transplants in Children: Importance for the Otolaryngologist
Authors: Reilly James S. , Casselbrant Margaretha L. , Stool Sylvan E. , Bluestone Charles D.
Published: October 2014

Orthotopic liver transplantation (OTLT) for children with end stage liver failure has doubled 1-year survival rates to over 70% with the employment of cyclosporine and prednisone in conjunction with skilled surgical and medical specialists providing supportive care. The otolaryngology service has assisted in the care of 18 of 61 children undergoing OTLT, particularly in managing respiratory problems that required improved pulmonary toilet and prolonged intubation. The prevention of atelectasis of the lung and subsequent sepsis appears to be improved by prompt bronchoscopy.
Coccidioidomycosis of the Larynx
Authors: Batsakis John G.
Published: October 2014

Coccidioidomycosis, while endemic to the American Southwest, may occur in travelers on return to their homes. Usually asymptomatic in human hosts, approximately 40% of infected subjects will have pulmonary signs and symptoms and 2% will have dissemination from the pulmonary foci. The larynx may be secondarily involved or may be the site of sputum inoculation.
Cordless Telephones: A Threat to Hearing
Authors: Singleton George T. , Keim Robert J. , Whitaker David L. , Kemker F. J.
Published: October 2014

Several patients with documented permanent sensorineural hearing losses secondary to the use of cordless telephones have been evaluated. In the interests of saving space and weight, these units have the ear receiver double as the ringing or bell device. The output of the bell on all of the units we have tested to date has been in the 140-dB range on the A scale. In each instance, the patient held the telephone against the ear when ringing occurred, and in three instances a loud extraneous crack was transmitted. Unlike regular cord-type telephones, these devices have no automatic gain control in the receiver circuit.
Catecholamine-Secreting Infratemporal Fossa Paraganglioma
Authors: Cantrell Robert W. , Kaplan Michael J. , Winn H. Richard , Atuk Nuzhet O. , Jahrsdoerfer Robert A.
Published: October 2014

Extraadrenal paragangliomas are tumors of the paraganglion system, usually arising from the carotid bodies, the glomus jugulare, or the glomus tympanicum. These tumors are capable of secreting catecholamines which can cause severe hypertensive crises. This paper reports a case of a patient who suffered a cerebral vascular accident due to hypertension resulting from a catecholamine-secreting infratemporal fossa paraganglioma. Any patient with a history of paroxysmal hypertension, headaches, and palpitations should be evaluated for a catecholamine-secreting tumor. Diagnosis and management of these tumors is best accomplished by a team including a radiologist, an endocrinologist, an anesthesiologist, a pathologist, an otolaryngologist—head and neck surgeon, and when the tumor invades the cranial cavity, a neurosurgeon. In this case, precise radiographic mapping of the tumor extent and its blood supply, control of hypertension with adrenergic blocking agents, and depletion of catecholamine stores using α-methyl-p-tyrosine allowed total extirpation through a craniofacial approach and a successful outcome.
Aural Rehabilitation in a Teaching Hospital: Evaluation and Results
Authors: Alberti P. W. , Corbin H. , Pichora-Fuller M. K. , Riko K.
Published: October 2014

More than 1,000 hearing-impaired adults who underwent hearing aid evaluations in a teaching hospital were followed for a minimum of 1 year. Questionnaires, which included over 300 clinical items, were developed for computer entry by audiological staff. This data was analyzed to obtain demographic information about the population and the effectiveness of the intervention. The program was evaluated in terms of criteria ranging from simple compliance with the recommendation to purchase an aid, attendance at scheduled follow-up appointments, adequacy of the amplification system, patient competence in handling the aid, frequency and duration of aid use, and benefit in specific listening situations. It can be concluded that simple compliance figures overestimate program success. Even 1 year after purchase many patients still had practical difficulties with the aid, and use and benefit patterns were still developing. Directions for program change have been determined as measurement of success has been more critically defined and goals for rehabilitation have broadened.
Sensorineural Hearing Loss in Otitis Media
Authors: Paparella Michael M. , Morizono Tetsuo , Le Chap T. , Choo Young Bin , Mancini Fernando , Lidén Gunnar , Sipilä Pekka , Kim Chong Sun
Published: October 2014

Additional evidence is presented to support the hypothesis that both acute purulent otitis media (POM) and chronic suppurative otitis media (COM) can cause high frequency sensorineural hearing loss. In selected patients and in animals (chinchillas) in a pilot study using electrophysiological methods, both temporary threshold shifts and permanent threshold shifts of basal cochlear turn involvement were demonstrated in POM. Data of cochlear involvement in 475 ears with bilateral COM, 607 ears with unilateral COM, and 607 ears serving as controls were obtained from six centers in five countries. In group 1 (15 dB or greater), 43% of ears with unilateral COM and 42% of ears with bilateral COM showed losses, for a combined odds ratio eight times that in controls. In group 2 (30 dB or greater), 16% of ears with unilateral COM and 17% of ears with bilateral COM demonstrated, respectively, seven and ten times that in controls. These statistically significant findings influence clinical considerations.
Invasion of the Microcirculation in Head and Neck Cancer
Authors: Batsakis John G.
Published: October 2014

Microvascular invasion by carcinoma cells is one of the first steps for the potential development of metastases. Because of an extensive and destructive triage of the cells, the histologic finding of such invasion is not pathognomonic for the establishment of metastases. From a practical standpoint, microvascular invasion correlates with an increased incidence of lymph node metastases, but not with distant spread.
Acoustic Neuroma Surgery: An Eclectic Approach with Emphasis on Preservation of Hearing
Authors: Cohen Noel L. , Berg Howard , Hammerschlag Paul , Ransohoff Joseph
Published: October 2014

During the past 10 years, 157 patients have been operated on at the New York University-Bellevue Medical Center for acoustic neuromas and other cerebellopontine angle tumors. We describe our diagnostic protocol with joint neurosurgical evaluation leading to either translabyrinthine (otology only) or suboccipital-transmeatal (combined otology-neurosurgery) surgery. The decision is made on the basis of tumor size, level of hearing, age, and health of the patient. Using these criteria, 105 suboccipital and 59 translabyrinthine operations were performed with eight patients having had two-stage operations. In 12 of 29 patients, hearing was successfully preserved. Of 18 patients with good hearing and extracanalicular tumors less than 2 cm, hearing was preserved in 11. We describe the surgical technique used in this suboccipital-transmeatal operation and present illustrative cases in detail.