bluuebunny/crossref_metadata_2025 huggingface dataset:
L-Azaserine Induced Preneoplasia in the Rat Pancreas. A Morphometric Study of Dietary Manipulation (Lipotrope Deficiency) and Ultrastructural Differentiation
Authors: Andry Christopher D. , Kupchik Herbert Z. , Rogers Adrianne E.
Published: November 2015

Putatively preneoplastic, pancreatic atypical acinar cell foci (AACF) and nodules (AACN), collectively termed atypical acinar cell lesions (AACL), were induced in male Lewis rats by L-azaserine (300 mg/kg body weight [bw] in divided doses). Rats given carcinogen and then fed a lipotrope deficient (LD) diet developed a significantly greater number of larger lesions than animals fed complete diet throughout the experiment. It is suggested that lipotrope deficiency plays a promoting role in this model of pancreatocarcinogenesis. Ultrastructural morphometric studies of AACF, when compared to control tissues, revealed the following significant results: 1) a decrease in surface area of cell cytoplasm with no change in nuclear area, and hence increased nucleus/cytoplasm (N/C) ratio; 2) a reduction in size and uniformity of zymogen granules; and 3) an increase in number of granules per μm2 of cell. The results suggest that arrested development of the AACF cells is associated with reduced cytoplasm and zymogen production per cell. AACL may be eosinophilic due to an overall increased concentration of zymogen in these hyperplastic lesions and not because individual acinar cells in the AACL contain an increased amount of zymogen or are “zymogen-rich,” as has been reported.
Hepatocellular Vacuolization in Rabbits: Effects of Feed Restriction, Orchiectomy and Ovariectomy
Authors: Weisbrode Steven E. , Maurer James K. , Bennett Frederic B. , Capen Charles C. , Bruce Robert D.
Published: November 2015

Previous studies have reported that striking variations in hepatocellular vacuolization occurs in rabbits and the magnitude of vacuolization correlated independently with weight and sex. The current study evaluated the effects of feed restriction and gonadectomy on this hepatocellular vacuolization. For 28 days, rabbits were fed either ad libitum (ad lib group), 100% of the National Research Council's recommended feed intake required for growth (100% group), or 50% of the NRC recommended feed intake required for growth (50% group). Feed consumption, weight gain, final body weight, absolute liver weight, and relative liver weight were not significantly different between the ad lib and 100% groups. Values for these parameters for both groups were significantly greater than for the 50% group. Rabbits in the 50% group had significantly less hepatocellular vacuolization than rabbits in the 100% group. Hepatocellular vacuolization in the 100% group did not differ from rabbits fed ad libitum. Hepatocellular vacuolization in the ad lib group was greater than in the 50% group but this difference was not significant. Ovariectomy and orchiectomy did not significantly alter hepatocellular vacuolization in either female or male rabbits, respectively, that were fed ad libitum for 28 days. However, intact females had significantly greater hepatocellular vacuolization than either intact or orchiectomized males. Conversely, hepatocellular vacuolization in ovariectomized females was not significantly different from that in intact and orchiectomized males. There were no significant differences in feed consumption, weight gain, final body weight, and absolute and relative liver weights among these intact and gonadectomized groups. Results of these studies indicate feed consumption can affect the degree of hepatocellular vacuolization in rabbits. In addition, intact female rabbits have greater hepatocellular vacuolization than males. This difference is reduced by ovariectomy.
Lysosomal Changes in Renal Proximal Tubular Epithelial Cells of Male Sprague Dawley Rats following Decalin Exposure
Authors: Eurell Thomas E. , Eurell Jo Ann C. , Schaeffer David J. , Mattie David R. , Alden Carl L.
Published: November 2015

A histochemical stain for acid phosphatase served as a marker for lysosomal alterations in renal tubular cells associated with male rat hyaline droplet nephropathy. Morphometric analysis and quantitative histochemistry were used to compare the size and acid phosphatase stain reaction of lysosomes in tubular epithelial cells of treated and control animals. Decalin exposure increased the size and significantly ( p < 0.01) reduced the acid phosphatase stain intensity of individual lysosomes. However, there was no significant different ( p > 0.05) between the acid phosphatase stain intensity of treated and control animals when analyzed on a whole cell basis. The increase in size of the lysosomes without a proportional increase in whole cell acid phosphatase stain intensity indicates a dilution or a failure to accommodate in the acid phosphatase concentration (stain intensity/μm2) per lysosome. All acid phosphatase stain reaction product was contained within intact lysosomes, mitigating against the hypothesis of lysosomal enzyme leakage as the cause of cell death in decalin-induced alpha 2U globulin nephropathy.
Short-Term Studies of MDL 19,660-induced Canine Thrombocytopenia
Authors: Yarrington John T. , Loudy David E. , Sprinkle-Cavallo Jean , Broersma Robert , Gibson John P.
Published: November 2015

After 2 days of dosing, platelet counts progressively declined in dogs treated orally with 30 mg/kg/day of the antidepressant compound MDL 19,660 for 8 days. Accompanying the decrease in platelet counts was an increase in both large and vacuolated degenerating platelets. Upon cessation of dosing, the platelet counts returned to levels equal to or exceeding predosing levels within 4–7 days. Co-administration with aspirin, a known antiaggregating agent, had no protective effect on the drug-induced thrombocytopenia. In vitro testing of normal canine platelets in the presence of MDL 19,660 further revealed that spontaneous aggregation did not occur and that ADP-induced aggregation was inhibited. Drug-related platelet loss was also not prevented by the co-administration of prednisone, a steroid with immunosuppressive effects and inhibitory properties against reticuloendothelial cell phagocytosis of platelets. The results of the present investigation indicate that MDL 19,660 may produce in the dog a reversible thrombocytopenia in the form of vacuolar degeneration and subsequent destruction of the platelet by means other than aggregation or steroid-responsive mechanisms.
Bromotrichloromethane Hepatotoxicity. The Role of Stimulated Hepatocellular Regeneration in Recovery: Biochemical and Histopathological Studies in Control and Chlordecone Pretreated Male Rats
Authors: Faroon Obaid M. , Mehendale Harihara M.
Published: November 2015

It has been shown that BrCCl3 is a more potent hepatotoxin than CCl4. Pretreatment with nontoxic dietary levels of chlordecone (CD) results in amplification of BrCCl3 hepatotoxicity. The objective of this research was to investigate and compare the histopathological alterations during a time course after a low dose of BrCCl3 alone and in combination with dietary CD. Male Sprague-Dawley rats were maintained on 10 ppm dietary CD or normal diet for 15 days. On day 16, they received a single ip dose (30 μ1/kg) of BrCCl3 in corn oil (CO) vehicle or corn oil alone. Blood and liver samples were collected at 0, 3, 6, 12, 24, 36, 48, 72, 96, and 120 hr for serum enzymes and histopathological examination, respectively. Serum enzymes (SDH, ALT, AST) were significantly ( p < 0.05) elevated in rats receiving the CD + BrCCl3 combination in comparison to BrCCl3 alone. For 48 hr, a continuous increase in serum enzyme activities was detected in rats treated with CD + BrCCl3 combination, but not in the rats receiving other treatments (ND + BrCCl3, ND + CO, or CD + CO). The most extensive hepatolobular necrosis was observed in rats treated with the CD + BrCCl3 combination. Thirty-six hr after the administration of BrCCl3 to rats maintained on normal diet, high mitotic activity was observed, which continued through 72 hr resulting in complete restoration of hepatolobular structure. In contrast, rats receiving the combination of CD + BrCCl3 exhibited minimal and belated hepatomitotic activity for a short period of time, resulting in progressive hepatic failure, culminating in animal death. In conclusion, hepatotoxicity of a low dose of BrCCl3 alone appeared to be overcome via stimulated hepatocellular regeneration and hepatolobular restoration. CD appears to amplify BrCCl3 hepatotoxicity via interference with this hormetic mechanism, permitting a progressive and continued hepatic injury leading to complete hepatic failure, culminating in animal death.
The Health Diary as an Instrument for Nursing Research: Problems and Promise
Authors: Woods Nancy Fugate
Published: November 2015

In order to assess the utility of a health diary as a means for obtaining valid data about symptoms, the data obtained from 96 women's responses in family health diaries were compared with CMI-MR scores and self health ratings obtained from women during an interview. The symptoms reported in the diary were only weakly correlated with CMI-MR scores and poorly correlated with self-perceived health. Despite only meager support for the validity of specific kinds of symptoms reported in the diary, the advantages of this method warrant its further exploration use in nursing research.
The Airway Mechanics of Jet Ventilation
Authors: Lyons David , Stenzler Alex , Steinberg Harry , Abramson Allan , Ruder Chunilal
Published: November 2015

Jet venturi ventilation is frequently used in the airway management during microlaryngeal surgery. We have studied the relationships between the ventilating injector system and the lungs and outflow tract in a mechanical model. We found that tidal volume is directly proportional to system driving pressure, injector diameter, and lung compliance, and inversely proportional to airway resistance and outflow tract area.
Local Immune System in Human Adult and Fetal Larynx
Authors: Nakashima Tadashi , Makishima Kazumi
Published: November 2015

Using immunofluorescent and histopathologic techniques, we studied the distribution and secretory activity of the glands of the larynx from 51 adults and 15 human fetuses. Glandular buds were first observed at the 12th fetal week and glandular distribution became evident from the 16th fetal week. In the adult larynx, intraepithelial and submucosal glandular distribution was observed in each specimen. Immunofluorescent studies revealed the diffuse fluorescence for IgA not only in the submucosal or periglandular connective tissue area but also in the intraepithelial and submucosal glands. Secretory component (SC) synthesis was found mainly in each serous‐type glandular epithelium or acinus. In the submucosal or periglandular area, IgA‐producing plasma cells were numerous. In contrast, there was little fluorescence for IgA in the fetal laryngeal tissues. Secretory component, however, was found in each serous‐type glandular epithelium or acinus from the 16th week. Our observations suggest that local immune system by secretory IgA is active in the adult larynx, and the production of SC is inherently acquired in the fetal larynx.
Traumatic Porencephalic Cysts of the Ear Canal: Diagnosis and Therapy
Authors: Konrad Horst R. , Pearson Donald H. , VanWinkle Gregory , Hopla Dan
Published: November 2015

Porencephalic cysts of the ear canal are a late but unusual complication of temporal bone fractures in which the dura is torn. Since these cysts can develop as late as two and one‐half years after the initial fracture and lead to rupture and meningitis, this complication has potentially serious consequences for the patient.

We describe three patients with porencephalic cysts of the ear canal, illustrate the pathogenesis of this lesion, and review the literature. Awareness of these lesions by the head and neck surgeon can lead to prompt diagnosis and treatment in this potentially fatal disorder.
Sphenoethmoidectomy: ITS Role in the Asthmatic Patient
Authors: Friedman William H. , Katsantonis George P. , Slavin Raymond G. , Kannel Philip , Linford Patricia
Published: November 2015

Fifty patients who underwent intranasal sphenoethmoidectomy at the St Louis University Medical Center between July 1977 and April 1980 have been evaluated with respect to preoperative extent of disease and medication requirement as well as postoperative course and reduction in medication requirements, if any. These patients were followed jointly by the Departments of Allergy and Otolaryngology. Most of these patients were not allergic, and over half had intrinsic asthma. Fifteen of the 50 patients, all asthmatic, gave a history of aspirin sensitivity. Many had had previous nasal surgical treatment for polyps.

Patients on large corticosteroid dosages had long‐lasting reductions or elimination of their corticosteroid requirements in most cases. Similarly, most patients had long‐lasting nasal airway improvement and reduction or elimination of recurring sinusitis. Antibiotics and antihistamine‐decongestant preparations were sharply diminished in these patients. Although aspirin sensitivity was associated with some of the more severe asthmatic patients, it appeared not to be a factor in the responses to surgical treatment.
Laryngology: From Galen to Garcia
Authors: Von Leden Hans
Published: November 2015

A brief cultural survey of the major highlights in the evolution of laryngology and voice science from Claudius Galen (c 130–200 AD) to Manuel Garcia (1805–1906) is presented.
Phenol Toxicity During Face Peels
Authors: Koopmann Charles F.
Published: November 2015

CHAIRMAN'S COMMENTS: This review by Koopmann summarizes the physiology and metabolism of phenol and useful guidelines to avoid phenol toxicity. The cosmetic surgeon should be aware of the serious, but fortunately rare, fatal cardiopulmonary sequelae that can result from the injudicious use of phenol during face peel surgery.
Tympanic Membrane Photography
Authors: Yanagisawa Eiji
Published: November 2015

Three currently available methods of tympanic membrane photography—Kowa camera photography, microscopic photography, and telescopic photography—are reviewed and their advantages, disadvantages, and results discussed.

Telescopic photography produces high‐quality pictures of the “entire” tympanic membrane. It is the most effective and reliable method of tympanic membrane photography available in 1981.
Hyperparathyroidism: A Study of 100 Cases
Authors: Petti George H.
Published: November 2015

A ten‐year study of all patients undergoing surgical treatment for hyperparathyroidism at Loma Linda University is presented. Clinical characteristics, laboratory analysis, differential diagnosis, associated diseases, operative techniques, and postoperative management of potential complications are evaluated. Some patients with secondary hyperparathyroidism underwent autotransplantation with good results; this technique is discussed. An approach is detailed that is successful in maintaining euparathyroidism.
Squamous Carcinoma of the Larynx in Patients Under the Age of 35 Years
Authors: Newman Richard K. , Byers Robert M.
Published: November 2015

Laryngeal carcinoma usually occurs in men between the ages of 50 and 70. In general, epithelial malignancies other than those involving the skin are rare in the young adult. Those squamous carcinomas arising in the lip, tongue, and tonsil appear to have a poorer prognosis than in the older adult. This study is a review of the medical records of 33 patients under the age of 35 years with squamous cell carcinoma of the larynx. The follow‐up of the entire series was at least 24 months with an overall survival rate of 81%. These results contrast to five‐year survival rates of 79%, 45%, and 14% of the lip, tongue, and tonsil, respectively, in patients from a similar age group.
Prosthetic Closure of Nasal Septal Perforations
Authors: Pallanch John F. , Facer George W. , Kern Eugene B. , Westwood William B.
Published: November 2015

One hundred seventy‐one patients had closure of symptomatic nasal septal perforations by insertion of a Silastic nasal septal prosthesis between June 1972 and August 1981. Follow‐up revealed that successful closure of the defect was accomplished in 73% of cases, with reduction in crusting and epistaxis and improvement in nasal respiration in many cases. Prefabricated prostheses have been effective in treating smaller perforations. The treatment of four patients with unusually large septal perforations by custom‐carved prostheses sized using computerized axial tomographic scanning is described.
Papillary Carcinoma of the Thyroid Occurring as Multiple Vascular Tumors
Authors: Bassett Mark , Cummings Charles W. , Kozie Daniel W.
Published: November 2015

A case of advanced papillary carcinoma in a 16‐year‐old boy is presented. While this case is typical of the indolent and locally invasive character of papillary carcinoma, it is remarkable for the extent of tumor involvement appearing as reactive lymphadenopathy. The pronounced tumor vascularity and the similarity of the needle biopsy specimen to chemodectoma both conflicted with the initial diagnostic impression. The correct diagnosis was confirmed only with definitive surgical therapy.
Nasal Polyps Causing Bone Destruction and Blindness
Authors: Rejowski James E. , Caldarelli David D. , Campanella Ruth S. , Penn Richard D.
Published: November 2015

Although nasal polyposis is a common entity, it is seldom considered a cause of bony destruction with consequent ophthalmologic and neurologic sequelae. Acute bilateral visual loss developed suddenly in a young, healthy woman with nasal polyps. Evaluation revealed erosion of the floor of the anterior cranial fossa, with compression of the optic nerves secondary to extensive paranasal and nasal polyposis. The clinical course, treatment, and histopathologic findings are discussed.
Medical Treatment of Chronic Sinusitis in the Immunocompetent and Immunosuppressed Patient: A Review
Authors: Rybak Leonard P.
Published: November 2015

Chronic sinusitis may arise from a variety of causes. Failure of mucociliary transport, nasal obstruction, and breakdown of the mucosal barrier are important mechanisms that may contribute to irreversible tissue pathologic changes in the paranasal sinuses. Diagnosis is usually made radiographically using plain films, polytomography, or computerized tomography. Medical treatment attacks underlying causes such as allergy or viscous mucus secretions. In addition to antibiotic therapy, management of the underlying medical problems, general prophylactic measures, immunologic reconstitution of specific immune deficiencies, and vaccine therapy when combined with surgical therapy are likely to help improve survival of the immunosuppressed patient with chronic sinusitis.
External Fixation
Authors: Adams George L.
Published: November 2015

External fixation of the mandible is required in complex fractures or to stabilize the mandibular segments during reconstruction. The method supplements interosseous wiring and intermaxillary fixation techniques.
Spatial Analysis of Midfacial Fractures with Multidirectional and Computed Tomography: Clinicopathologic Correlates in 44 Cases
Authors: Rowe Lee D. , Brandt‐Zawadzki Michael
Published: November 2015

The use of conventional tomography and recent application of computed tomography to the assessment of facial injuries permit a more precise preoperative spatial analysis of complex midfacial fractures. Forty‐four patients sustaining Le Fort I, II, or III maxillary fractures underwent multidirectional or computed tomography (CT) or both. The patterns of fractures of the maxilla and associated fractures of the mandible, zygomas, nasoethmoidal complex, frontal sinus, skull base, and cranial vault were correlated with surgical or clinical findings or both. In 91% of cases, CT or multidirectional tomography or both correctly identified the spatial pattern of fracture of the maxilla and its supporting pillars. Pure Le Fort II fractures were seen in only nine patients, while an isolated pure Le Fort I or III fracture was not encountered. Le Fort II and III fractures were commonly associated with additional tripod, frontal sinus, or nasoethmoidal complex dislocations.
Hyperosmolar Nonketotic Coma: Prevention, Diagnosis, and Treatment
Authors: Cooper Stephen G. , Tom Lawrence W.C. , Lowry Louis Dale
Published: November 2015

With the multi‐faceted approach to head and neck cancer today, maintaining caloric intake by long‐term enteral hyperalimentation is commonplace. Along with the tremendous advantages of this form of nutrition, the disadvantage of hyperosmolar nonketotic diabetic acidotic coma is present. Mortality rates are quoted from 40% to 70% according to the literature reviewed.1 Therefore, prevention is the best form of treatment. The cause, diagnosis, and treatment will be discussed.
Response of Laryngeal Airway Resistance to Chemoreceptor Stimulation: Effect of Pulmonary Afferent Denervation
Authors: McCaffrey Thomas V.
Published: November 2015

The response of laryngeal airway resistance to chemoreceptor stimulation was measured before and after vagotomy in ten anesthetized dogs. With the vagus nerves intact, stimulation of chemoreceptors produced a decrease in both inspiratory and expiratory laryngeal resistance. After bilateral vagotomy below the origin of the recurrent laryngeal nerves, stimulation of chemoreceptors produced a smaller decrease in inspiratory laryngeal resistance and an increase in expiratory laryngeal resistance. We concluded that pulmonary afferent input to the respiratory neurons maintains a low airway resistance during chemoreceptor stimulation.
Fibrinolytic Activity in the Inner Ear of Human Beings and Guinea Pigs
Authors: Inoue Sadami , Tanaka Kenzo
Published: November 2015

Fibrinolytic activity in the inner ear of human beings and guinea pigs was assayed qualitatively and quantitatively. It was found that fibrinolytic activity of the stria vascularis was caused by a conversion of plasminogen to plasmin by tissue plasminogen activator and was moderate in degree compared with that of other organs in both species. In human beings, endolymph showed higher plasminogen activator activity than that of CSF. Plasminogen activator activity was not detected in either endolymph or perilymph of guinea pigs. Thrombin infusion diminished plasminogen activator activity in the stria vascularis of guinea pigs.
Experimental Hypercholesterolemia and Auditory Function in the Chinchilla
Authors: Morizono Tetsuo , Sikora Michael A.
Published: November 2015

Possible harmful effects of a high‐cholesterol diet on auditory function were suggested by our previous work in rabbits, in which evoked potentials were measured from a chronic electrode inserted into the inferior colliculus. However, serum cholesterol levels in those rabbits tended to be extraordinarily high, ie, more than 1,500 mg/dL. Chinchillas were used in the present work as an animal model to study the relationship between hypercholesterolemia and auditory dysfunction. One percent cholesterol in standard Chinchow was fed to chinchillas for three months. The experimental groups showed a high mean cholesterol level of 437 ± 394 mg/dL (N = 9). Isopotential curve of the cochlear microphonics, threshold of action potentials (AP), and endocochlear DC potential did not differ from those in the control group. When moderately intense sound (12 kHz, 95 dB SPL) was given for ten minutes, however, the reduction in AP threshold was significantly greater (P=.036) in the cholesterol group. It is postulated that hypercholesterolemia may be one of the factors involved in differential susceptibility to noise.
Application of Epstein‐Barr Virus Serology to the Diagnosis and Staging of North American Patients with Nasopharyngeal Carcinoma
Authors: Neel H. Bryan , Pearson Gary R. , Weiland Louis H. , Taylor William F. , Goepfert Helmut H. , Pilch Ben Z. , Goodman Max , Lanier Anne P. , Huang Andrew T. , Hyams Vincent J. , Levine Paul H. , Henle Gertrude , Henle Werner
Published: November 2015

From 1978 to 1981, 151 patients with nasopharyngeal carcinoma (NPC) were enrolled in a prospective, collaborative study of North American patients, most of them white. Thirty‐seven had World Health Organization (WHO) type 1 tumors, and 114 had WHO types 2 and 3 tumors. The anti‐Epstein‐Barr virus (EBV) profile of elevated antibody titers directed against viral capsid antigen and early antigen was seen in 85% of the patients with WHO types 2 and 3 tumors but in only 16% of the patients with WHO type 1 tumors. Geometric mean titers tended to be higher in higher stages of the disease in several staging systems. Low antibody‐dependent cellular cytotoxicity at diagnosis appears to reflect a poorer prognosis, and the determination of antibody titers by this assay may prove to be useful for identifying persons in whom recurrent disease is likely to develop after conventional therapy. Anti‐EBV titers can aid in diagnosis and treatment planning in patients with NPC, particularly those with occult primary NPC.
Prognostic Factors Affecting the Success of Duckbill Vocal Restoration
Authors: Schuller David E. , Jarrow Jane E. , Kelly David R. , Miglets Andrew W.
Published: November 2015

This study analyzed a group of 20 patients undergoing duckbill vocal restoration at Ohio State University to determine if certain variables could predict success. Of the 20 patients, 19 developed successful speech. The 10 variables studied were age, alcohol use, living environment, stoma size, hearing acuity, educational level, work status, eye‐hand coordination, concomitant medical problems, and current mode of communication. A multiple correlation analysis of this data was undertaken and alcohol abuse and stoma size were found to have the highest correlation with developing successful duckbill speech. A formula based on these two variables has been derived that will predict the patient's success. It is the conclusion of this study that since patients are not uniformly successful in developing duckbill speech such a formula is of value in predicting success and should help the clinician identify patients who may have difficulties.
Mechanism of the Production of the Negative Endocochlear DC Potential in the Guinea Pig
Authors: Komune Shizuo , Huangfu Musan , Snow James B.
Published: November 2015

Changes in endocochlear DC potential (EP) and potassium ion concentrations in endolymph were measured simultaneously during anoxia or during perfusion of the perilymphatic space with furosemide, 10−2 M, in normal and kanamycin‐deafened guinea pigs. The potassium ion conductance (Gk) through the cochlear partitions was calculated. Thirty minutes after the onset of anoxia, the Gk is 22.1 μM/min/mV in normal guinea pigs and 4.8 μM/min/mV in kanamycin‐deafened guinea pigs. At that time the EP is‐29.5 mV in normal guinea pigs and 1.4 mV in kanamycin‐deafened guinea pigs. In the early stage of anoxia the rate of potassium ion concentration decrease in the endolymph per unit time is greater in normal guinea pigs than in kanamycin‐deafened guinea pigs. These results suggest a rapid increase in the permeability of potassium ions in the organ of Corti in the early stage of anoxia might produce a large negative potassium ion diffusion potential or negative EP in normal guinea pigs and the failure to develop the negative EP in kanamycin‐deafened guinea pigs might be due to the lack of such a rapid increase in the permeability because of the loss of the hair cells.
Auditory Brain Stem Response and Audiologic Tests in Idiopathic Facial Nerve Paralysis
Authors: Hendrix R.A. , Melnick William
Published: November 2015

Idiopathic facial nerve paralysis is believed by some to represent one aspect of a polyneuropathy. Conventional audiologic tests have not demonstrated involvement of the auditory portion of the eighth cranial nerve in this disorder. A case history is given of a patient with this disorder and an associated abnormal auditory brain stem response (ABR). Our study involved onetime evaluations of 17 patients with idiopathic facial nerve paralysis of varying durations. Each examination included clinical presentation and history, an audiogram, acoustic reflex, and ABR. Another patient had abnormal acoustic reflex test results (“unibox” pattern) suggestive of a brain stem lesion. On reexamination concurrent recovery of the paralysis and acoustic reflex was demonstrated. No auditory system disturbances secondary to the paralysis were detectable by ABR in this survey. The concurrent recovery of the “unibox” acoustic reflex and the facial paralysis suggests the association of a brain stem lesion with idiopathic facial nerve paralysis in this case.
Reconstruction of the Posterior Canal Wall with Proplast
Authors: Shea John J. , Malenbaum Bruce T. , Moretz William H.
Published: November 2015

Many ears with prior radical or modified radical mastoidectomy operations can be rehabilitated by reconstruction of the posterior canal wall with the porous biocompatible implant material Proplast. Many techniques have been advanced for reconstruction of the posterior canal wall and/or obliteration of the mastoid bowl. We prefer reconstruction of the posterior canal wall to obliteration of the mastoid bowl on the theoretical grounds that with obliteration you lose the pneumatic buffer of the mastoid air cell system and you might be burying infection and/or cholesteatoma in the depths of the mastoid. In this article we shall present our results with elimination of the open mastoid bowl by reconstruction of the posterior canal wall with Proplast. A retrospective study of 83 consecutive patients who underwent reconstruction of the posterior canal wall with Proplast during the 5‐year period 1974 to 1978 was undertaken. The surgical technique consisted of rebuilding the tympanic membrane, when necessary, repairing the ossicular chain, when necessary, and reconstructing the posterior canal wall. The overall success rate for the posterior canal wall reconstructions was 46% (38 of 83). However, after modifications were made in the technique, especially in the use of thicker fascia and/or perichondria and periosteum over the Proplast, the success rate increased dramatically to 68% (19 of 28).
Monitoring Auditory Nerve Potentials during Operations in the Cerebellopontine Angle
Authors: Øller Aage R. , Jannetta Peter J.
Published: November 2015

Direct monitoring of auditory nerve potentials was performed in 19 patients undergoing retromastoid craniectomy and microvascular decompression of cranial nerves. In addition, brain stem auditory evoked potentials (BSEPs) were monitored in these patients. No patient suffered significant hearing loss. Direct monitoring of auditory nerve potentials complements the recording of BSEPs because the auditory nerve potentials can be visualized without averaging many responses. Therefore the effect of any intraoperative manipulation that is harmful to the auditory nerve can be detected instantaneously.
Experimental Studies for Correction of Superior Laryngeal Paralysis by Fusion of the Thyroid to Cricoid Cartilages
Authors: Thompson Jerome W. , Ward Paul H. , Schwartz Ilsa R.
Published: November 2015

Contraction of the cricothyroideus muscles (CTMs), innervated by the superior laryngeal nerves (SLNs), modulates the voice by tilting the thyroid cartilage anteriorly onto the top of the cricoid and tensing the vocal cords. Either unilateral or bilateral paralysis of the SLNs is disabling for individuals with above‐average voice demands. Some patients never compensate for this paralysis; there is no surgical procedure recognized to correct it. This study tested the hypothesis that surgical fusion of the thyroid and cricoid cartilages anteriorly can correct the problems of SLN injury by duplicating the mechanical tilt of the thyroid onto the cricoid cartilage normally produced by the CTMs. The SLNs were cut in 12 dogs. In six the cricoid and thyroid cartilages were fused anteriorly. Vocal cord and airway function was assessed preoperatively, immediately postoperatively, and 6 to 10 weeks after surgery. Following surgery there was no airway compromise and there appeared to be a more satisfactory compensation for the SLN paralysis in the fused larynges as compared with the unfused controls as determined by cinelaryngoscopic analysis.
The Survival of Costal Cartilage Graft in Laryngotracheal Reconstruction
Authors: Zalzal George H. , Cotton Robin T. , McAdams A. James
Published: November 2015

Acquired subglottic stenosis in children is a difficult problem. One of the successful procedures used to correct this condition is an autogenous costal cartilage graft to the subglottis and upper trachea. The fate of the cartilage graft is not known, despite the good results of the procedure. Prompted by recovery of viable cartilage graft from two patients previously operated upon by this procedure, we performed autogenous costal cartilage grafting to the subglottic area of fifty young New Zealand rabbits, with inspection of these grafts at 2‐ and 4‐month postoperative intervals. The purpose of this study is to prove the survival of autogenous costal cartilage grafts in the subglottic area. Gross and histologic examination 2 and 4 months postoperatively showed viable cartilage as well as lining of the graft with respiratory epithelium in the majority of cases.
Frontal Sinus Obliteration using Liposuction
Authors: Denneny James C.
Published: November 2015

Frontal sinus obliteration is performed for a variety of reasons, including chronic sinus disease, traumatic injuries, mucoceles, and osteomas of the sinus. Once the decision is made to obliterate the sinus, it is paramount that all mucosal remnants be removed and that the material used to fill the irregular expanses of the frontal sinus help prevent recurrence of the disease process. The materials most commonly used for this purpose are fat, muscle, and pericranium. Fat obtained from the abdomen, gluteal area, or lateral thigh is probably the most frequently used substance. The procurement of fat in the traditional way adds significant time to the operation and is associated with significant morbidity at the donor site. Fat obtained in this manner is often bulky and does not truly conform to the sinus contour. In an attempt to minimize operating time and donor‐site morbidity—as well as obtain a more malleable graft—we used liposuction to obtain our fat grafts for sinus obliteration. Using this method, we were able to obtain an adequate amount of tissue from either the abdomen or lateral thigh in all patients. We have used this technique in eleven patients, with follow‐ups ranging from 3 to 18 months. We have had no donor‐site morbidity and (to date) there has been no recurrence of sinus disease in these patients. While the follow‐up period is not adequate for final evaluation in these patients, we believe this is a valuable adjunct to frontal sinus surgery.
Functional Electrical Stimulation for the Treatment of Bilaterial Recurrent Laryngeal Nerve Paralysis
Authors: Otto Randal A. , Davis William
Published: November 2015

We have previously presented the concept of electrophysiologic pacing of bilaterally paralyzed vocal cord abductors as a solution to the difficult problem incurred in this clinical situation. Initially, we demonstrated that it was indeed feasible to electrophysiologically pace abduction of the vocal cords synchronously with respiration, employing the EMG activity of the diaphragm as a trigger stimulus. Further research has led us to evaluate other possible physiologic trigger stimuli to ascertain which of these will prove most suitable in long‐term pacing studies. In this article, we will report our preliminary results, employing negative intrathoracic pressure occurring with respiration—as detected by an implanted pressure transducer as a trigger stimulus. This device was interfaced with a muscle stimulator attached to electrodes placed in the cricoarytenoid muscles in five canines whose recurrent laryngeal nerves had been sectioned bilaterally. In all animals, obvious physiologic synchrony of vocal cord abduction and a reduciton of negative inspiratory intratracheal pressure was achieved during electrical pacing. This reinforces our initial findings that it is indeed feasible to pace vocal cord abduction in bilaterial recurrent laryngeal nerve paralysis with resultant return of physiologic normality to the glottis. Thus, functional electrical stimulation offers an alternative approach to the difficult problems incurred in the patient with bilateral recurrent laryngeal nerve paralysis. It also demonstrates that physiologic negative intrathoracic pressure activity occurring with inspiration can be a trigger source.
Subrenal capsule assay for squamous cell carcinoma of the head and neck
Authors: Stiernberg Charles M. , Rotzler William H. , Valyi‐Nagy Klara , Hokanson James A. , Hale Price E.
Published: November 2015

The murine subrenal capsule assay is an in vivo method for determining the responsiveness of solid tumor xenografts to chemotherapeutic agents. It was used in this study for the purposes of (1) constructing growth curves of squamous cell carcinoma of the head and neck and (2) collecting pilot data on the effects that indomethacin and cisplatin have on this malignant condition. Nine of the ten assays performed were evaluable. Indomethacin, cisplatin, or both were used as treatment drugs in each assay. One‐millimeter fragments of viable tumor, from patients with head and neck squamous cell carcinoma, were implanted beneath the renal capsules of normal immunocompetent mice. Baseline and posttreatment measurements were made of the xenografts, and response to treatment was determined by comparing changes in tumor sizes of the test and control groups. Results indicated that reduction in tumor sizes occurred in indomethacin‐treated mice in four assays and in cisplatin‐treated mice in six assays. In addition, two separate growth curves were calculated by plotting the mean change in tumor size in five mice per day on days 3 through 7. In conclusion, the subrenal capsule assay is a relatively rapid and inexpensive assay in which squamous cell carcinoma remains viable and therapeutic agents can be tested. However, clinical trials that use this assay to choose treatment drugs are needed in order to correlate assay results with clinical responses.
Early and Late Dilatation for Acquired Subglottic Stenosis
Authors: Campbell Bruce H. , Dennison Bruce F. , Durkin Gretchen E. , Strigenz Michael A. , Toohill Robert J.
Published: November 2015

There has been widespread use of periodic dilatations in the management of subglottic stenosis. However, some authorities have questioned the value in the overall rehabilitation of patients affected by this disorder. The first phase of this study included fourteen large dogs in which acute subglottic lesions were created by use of a high‐speed electric drill and electrocautery. Twelve animals served as the experimental group and two animals were controls. Obstructing lesions developed in all the animals within 7 to 21 days. When at least a 50% obstruction developed in an animal, a treatment plan was instituted that included at least weekly dilatation, removal of granulations, and administration of intralesional steroids and/or systemic steroids and antibiotics. The two control animals became totally obstructed and were killed. Varying degrees of subglottic stenosis developed in all twelve experimental animals after 8 weeks of dilatation, but none required a tracheotomy. These twelve animals were then subjected to 8 additional weeks of dilatation and antibiotics, and supplemental steroids were used in some animals from this study. It can be concluded that (1) early periodic dilatation and granulation removal in the acutely injured subglottis is effective in prevention of severe stenosis, (2) late periodic dilatations in chronic subglottic stenosis are not helpful in further alleviation of obstruction, (3) the concomitant use of antibiotics and systemic steroids did not appreciably prevent or alter the development of subglottic stenosis, and (4) the concomitant use of intralesional steroids appeared to be of benefit in the management of chronic acquired subglottic stenosis.
Threshold Sensitivity and Frequency Selectivity Measured with Round Window Whole Nerve Action Potentials in the Awake, Restrained Chinchilla
Authors: Spagnoli Scott D. , Saunders James C.
Published: November 2015

Chronic electrodes, placed on the round windows of four adult chinchillas, were used to measure whole‐nerve action potential (AP) thresholds and tuning curves. The AP quiet thresholds were within 17 dB of thresholds measured by behavioral methods and within 3 dB of those measured by other evoked response procedures. The AP tuning curves, obtained by a simultaneous masking procedure, were also similar to previously measured tuning curves in the chinchilla. These results indicate that long‐term indwelling electrodes can be successfully placed on the chinchilla round window and used to measure threshold sensitivity and frequency selectivity. Recordings from these electrodes could be used in a variety of situations and may be particularly useful in studying the effects of noise on the cochlea.
Preoperative Computerized Tomographic Imaging in Hyperparathyroidism
Authors: Krebs Festus J. , Archer Carol R. , Awwad Eric E. , Friedman William H.
Published: November 2015

The surgery of hyperparathyroidism can be technically very difficult, even for an experienced surgeon. Until the present decade, preoperative localization procedures were of little help because of poor resolution of imaging modalities, significant morbidity, and the cost of invasive procedures. The efficacy of preoperative high‐resolution CT scanning was evaluated in ten patients with primary hyperparathyroidism who had not previously been operated on. Contrast and noncontrast scans were performed on each patient, under the supervision of an experienced radiologist. Surgical findings were the standard against which all CT scans were judged. Each patient was diagnosed as having a single adenoma. Preoperative scans localized eight of ten adenomas for an overall sensitivity of 80 percent. In one patient, the adenoma was incorrectly localized for a specificity of 89 percent. The smallest adenoma correctly localized measured 4×4 mm in its axial dimensions. In addition to shortening operative time, accurate preoperative localization permitted use of unilateral dissection technique. Recent literature has repeatedly proved unilateral dissection superior to bilateral dissection by production of identical cure rates and a 2‐ to 12‐fold decrease in postoperative hypocalcemia. We suggest that CT scanning be considered in the routine preoperative workup of patients who have primary hyperparathyroid disease.
Subjective Concomitants of Motion Sickness: Quantifying Rotation‐induced Illness in Squirrel Monkeys
Authors: Wilpizeski Chester R. , Lowry Louis D. , Green Steven J. , Smith B. Davison , Melnick Howard
Published: November 2015

It has been suggested by numerous researchers that the development of conditioned food aversion (CFA) in experimental animals represents the presence of a subjective state of illness. Squirrel monkeys with proven susceptibility to rotation‐induced vomiting were given surgical bilateral labyrinthectomies, a procedure known to abolish signs and symptoms of motion sickness in human beings. Postoperatively, labyrinthectomized monkeys neither vomited nor revealed any reduction in food consumption when exposed to provocative rotation. Other samples of monkeys known to be refractory to horizontal rotation and to sinusoidal vertical motion also exhibited little tendency to acquire a conditioned aversion to banana. But monkeys who had sham operations and those who revealed weak‐to‐strong signs of motion sickness exhibited a marked CFA (significant reduction in food intake). The strength of CFA was much greater when elicited in the test vehicle when compared with response in the home cage. The findings are interpreted as support for a limited application of CFA procedures for inferring the presence of motion‐induced nausea and malaise.
The Second John J. Conley Lecture
Authors: Medoff Mark
Published: November 2015

Editor's Note: This lecture by Mark Medoff was delivered at the opening ceremony of the 1987 Annual Meeting of the AAO‐HNS in Chicago. The frank expression of deep and personal feelings that relate to the living experience of this sensitive author are not commonly disclosed in a scientific journal, but their penetration into the consciousness of his audience goes beyond the revelations that were so real for him. Our link with the playwright is intimated in his Academy Presidential Citation “for fostering understanding and insight into the problems of the deaf, by those possessing hearing, through his play, Children of a Lesser God.” We are exposed to a variety of degrees of wonderment, shadowed memories, escaped uneasiness, and a desire to break away. And then, at the end, Mr. Medoff defiantly proclaims, “This is the way to the stars.” There is no argument against psychological dynamism, idealism, and triumphant Survival.
Posterior semicircular canal occlusion in the normal hearing ear
Authors: Parnes Lorne S. , McClure Joseph A.
Published: November 2015

This report outlines our experience with posterior semicircular canal occlusion, a new operative procedure for intractable benign paroxysmal positional vertigo (BPPV). We postulate that the resulting solid canal “plug” prevents endolymph movement within the posterior canal, which effectively fixes the cupula. This selectively abolishes the receptivity of the posterior canal to both angular acceleration and gravity without influencing the other inner ear receptors. We previously reported the success of this procedure in two patients with BPPV and a co‐existing profound sensorineural hearing loss in the affected ear. Since that report, a slightly modified technique has been used to occlude six more posterior canals—five in normal hearing ears. While our follow‐up times range from only 3 to 18 months, all eight patients continue to be relieved of their BPPV. Temporary mixed hearing losses occurred in three of the five ears with normal preoperative hearing. Hearing in all five patients ultimately returned to the preoperative state. We believe this procedure is a simpler and safer alternative to singular neurectomy for the treatment of intractable benign paroxysmal positional vertigo.
Cricoid Quartersection vs. Anterior‐Posterior Cricoid Split: Effect on Subglottic Growth in Rabbits
Authors: Foggia David A. , Gray Steven D. , Kelly Kevin M.
Published: November 2015

Five‐week‐old New Zealand white rabbits were divided into three groups: control, anterior‐posterior cricoid split with stent, and cricoid quartersection (anterior‐posterior‐lateral cricoid split) with stent. The stents were removed 2 weeks after placement. The rabbits were allowed to grow for six months, at which time they were killed and the larynges were studied. Average, minimal, and maximal subglottal cross‐sectional areas were calculated for each animal and adjusted for weight. The cricoid quarter section group had significantly greater average, minimal, and maximal subglottal cross‐sectional areas compared to controls and significantly greater minimal and maximal cross‐sectional areas compared to the anterior‐posterior cricoid split group. The anterior‐posterior cricoid split group and the control group did not significantly differ with respect to any of the three parameters. The results indicate that anterior‐posterior cricoid split and cricoid quartersection do not adversely affect subglottic growth. Cricoid quartersectioning was superior to the anterior‐posterior cricoid split in its ability to expand subglottic airway dimension.