bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal Bone Anomalies Associated with Congenital Heart Disease
Authors: Egami Tetsuya , Sando Isamu , Myers Eugene N.
Published: October 2014

A temporal bone histopathological study was conducted to detect temporal bone anomalies in 20 ears (10 cases) of individuals with congenital heart anomalies. We restricted our study to patients more than one year of age, and to heart anomalies of unknown etiology. The temporal bones were obtained from refrigerated cadavers, fixed in formalin, embedded in celloidin, cut in a horizontal plane, stained with H & E, and mounted on glass slides for light microscopic study. Anomalies observed in the middle ear were: remnants of mesenchymal tissue (8 ears), wide angle of the facial genu (6 ears), persistence of the stapedial artery (5 ears), large defect of the facial canal (4 ears), high jugular bulb (4 ears), and bulky incus (2 ears). Inner ear anomalies consisted of a shortened cochlea (5 ears), anomaly of the horizontal canal (3 ears), anomaly of the posterior canal (2 ears), obliteration of the cochlear aqueduct (2 ears), and patent utriculoendolymphatic valve (1 ear). Most of the anomalies observed appeared to be due to arrested development, and resembled features which may be found at various stages of fetal life. Structural anomalies were more commonly found in the mesoderm than in the ectoderm, and middle ear anomalies were more frequently encountered than anomalies of the inner ear. No definite relationship between these anomalies observed in the temporal bone and hearing problems which had been recorded clinically for these patients could be detected. However, the large defect (more than one third of the circumference) of the facial canal, the high jugular bulb, and the stapedial artery persistence should be recognized as problems since they may be encountered during middle ear surgery.
Temporary Increase in Sensorineural Hearing Loss with Hearing Aid Use
Authors: Heffernan H. Patricia , Simons Marsha R.
Published: October 2014

Two cases are presented exhibiting temporary increases in sensorineural hearing loss following hearing aid use. Data suggesting this correlation are shown. There were no contributing middle ear problems during the period surveyed. The most significant changes in hearing thresholds were at frequencies 1000 and 2000 Hz. The use of different hearing aids, with decreased maximum power outputs, was not found to have similar effects on hearing threshold levels. A scheduling regime is recommended for introducing any new hearing aid to a child.
Sensorineural Hearing Loss and Pili Torti
Authors: Cremers C. W. R. J. , Geerts S. J.
Published: October 2014

Twelve patients with pili torti and sensorineural hearing loss have been described since 1965. We present two new families with this combination of symptoms, and a restudy of a third family. The genetic aspects are discussed. Tentatively it is concluded that pili torti is an autosomal dominant with a low penetrance of a pleiotropic manifestation of sensorineural hearing loss.
Aneurysmal Bone Cyst of Maxilla
Authors: Kane Kevin J.
Published: October 2014

A case of aneurysmal bone cyst of the maxilla is reported. The clinical and radiological features, histopathology and treatment, are described in detail. Although the pathogenesis is still obscure, surgical excision is considered to be the treatment of choice.
Response of Nasal Airway Resistance to Hypercapnia and Hypoxia in Man
Authors: McCaffrey Thomas V. , Kern Eugene B.
Published: October 2014

The response of nasal airway resistance (Rn) to various degrees of hypoxia and hypercapnia was measured in six subjects using active posterior mask rhinomanometry. All resistances were computed during expiration at the flow rate of 0.5 liter/sec. Hypercapnia, induced by breathing gas mixtures of various contents of carbon dioxide, significantly decreased Rn ( P < 0.05, Wilcoxon signed rank test). The reduction in Rn was proportional to the inspired partial pressure of carbon dioxide over a range of 0 to 50 torr. Breathing gas mixtures of high and low contents of oxygen produced no significant change in Rn ( P > 0.05, Wilcoxon signed rank test). These results indicate that the nasal airway is actively involved in the respiratory response to hypercapnia but not to moderate hypoxia.
Nasal Hemangioma of Pregnancy
Authors: Kent Donald L. , Fitzwater James E.
Published: October 2014

The nasal hemangioma of pregnancy is an uncommon but impressive cause of epistaxis. One patient with this condition recently treated at the Keller Army Hospital, West Point, exemplifies the problems encountered in the diagnosis and treatment of this puzzling disorder.
Mucosubstances in Otitis Media with Effusion
Authors: Bernstein Joel M. , Boerst M. , Hayes E. Russell
Published: October 2014

Histochemical localization of sialomucins and sulfated polysaccharides have been demonstrated in the mucous membrane of the middle ear in different middle ear effusions. Inasmuch as a more neutral stain with alcian blue-PAS is still present after treatment with neuraminidase, it is strongly suggested that neutral polysaccharides coexist with neuraminic acid in the middle ear glycoproteins. Sulfated polysaccharides are present only in the mucoid effusions. The use of precise nomenclature for mucosubstances is strongly recommended and is outlined. The nature of the specificity of the histochemical stains is discussed.
Eustachian Tube Function and Tympanoplasty
Authors: Cohn Arnold M. , Schwaber Mitchell K. , Anthony Lois S. , Jerger James F.
Published: October 2014

Despite the reduction in incidence of acute suppurative otitis media since the introduction of antibiotics, the incidence of chronic middle ear effusion and chronic otitis media have not experienced a similar reduction. Eustachian tube dysfunction is believed to be a principal etiological factor in these cases. The inflation-deflation technique to measure tubal function has shown promise in a number of laboratories, and is the basis for our present studies. Traditional application of this technique has been to document the capability of patients with chronic otitis media to equilibrate an induced positive or negative pressure. These patients are compared to a control group of patients with recent traumatic perforation, negative otologic histories, and normal tympanograms in the uninvolved ear. We have applied this test to observe its relationship to successful take of a tympanic membrane graft. The overall pattern of our results suggests that the capability to reduce an induced negative pressure is most frequently associated with successful tympanic membrane closure. However, compromise or even total failure to reduce an induced negative pressure does not preclude successful grafting of the tympanic membrane; nor should such failure to reduce negative pressure by this technique serve as a contraindication to surgery. Our results do suggest that during induced positive pressure application, spontaneous opening of the eustachian tube at opening pressures below +150 mm H2O may be discriminatory between success and failure.
Necrotizing Sialometaplasia of the Nasopharynx
Authors: Merwin Gerald E. , Duckert Larry G. , Pollak Kurt
Published: October 2014

Necrotizing sialometaplasia is an uncommon salivary gland disease originally described by Abrams et al in 1973. The disease may occur wherever salivary gland tissue is found. Theories on the etiology of this disorder have been advanced, but never definitely determined. Treatment consists of adequate biopsy and observation until healing occurs at six to eight weeks. While the disease is considered benign, its similarity to more aggressive neoplasms can be both disturbing and misleading to the patient and the clinician. Such a case of necrotizing sialometaplasia of the nasopharynx is presented to demonstrate the clinical and histological similarity of this disease to carcinoma. In this case, the patient first presented with a neck mass which could easily have been mistaken for a regional metastasis. The current literature is reviewed.
Cytomegalovirus Isolation from a Human Inner Ear
Authors: Davis Larry E. , James Charles G. , Fiber Frederick , McLaren Leroy C.
Published: October 2014

Cytomegalovirus (CMV) infection of the fetus has been associated with congenital deafness or hearing loss. This association has previously been based on clinical or pathological studies. We report an infant who died with the congenital CMV syndrome in which CMV was isolated from the perilymph of the inner ear providing additional evidence that this virus can infect the labyrinth.
Structure and Development of Vestibular Hair Cells in the Larval Bullfrog
Authors: Li Cheuk W. , Lewis Edwin R.
Published: October 2014

Structure and development of hair cells in vestibular sensory organs of the larval bullfrog were examined with scanning electron microscopy. The larval vestibular sensory epithelia resembled those of the adult frog. Based on morphology of the ciliary tufts, seven hair cell types were identified. One of them, the type A hair cell, appears to be the morphogenetic precursor of other hair cell types. The size of the stereocilia of type A hair cells is comparable to the surrounding microvilli. The distribution of immature type A hair cells suggests that the periphery of the sensory epithelia is the principal growth zone and the site of formation of new hair cells. However, a far greater number of type A hair cells were found in high frequency sensitive sensory organs (sacculus, amphibian and basilar papillae) than low frequency sensitive vestibular sensory structures (canal cristae, utriculus and lagena). This phenomenon may suggest that the time period required for the maturation of type A hair cells to their ultimate hair cell types in the low frequency sensitive vestibular organs is shorter than in the high frequency sensory structures. It is also possible that the low frequency sensitive vestibular organs may have completed their morphogenetic development in the early larval stages, while morphogenesis of hair cells in the high frequency sensory structures continues throughout the lifetime of a bullfrog.
Endoscopic Teflon® Keel for Anterior Glottic Web
Authors: Dedo Herbert H.
Published: October 2014

Anterior glottic webs are generally repaired with a McNaught keel placed and removed by laryngofissure. Attempts have been made since 1922 to repair these webs endoscopically. An endoscopic technique using a Teflon keel which has been successful in properly selected cases is presented.
Benign Tumors and Lesions of the Larynx in Children
Authors: Simpson George T. , McGill Trevor , Healy Gerald B. , Strong M. Stuart
Published: October 2014

Benign lesions of the airway in infants and children may endanger the airway and compromise laryngeal function. The CO2 laser provides an elegant method of transoral surgical excision without compromising laryngeal function or airway competence. It avoids the risks of such other treatment modalities as external surgical approaches, prolonged steroid therapy, and radiation. It is applicable to a wide variety of lesions without the necessity of tracheotomy. Hospitalization is minimized. Ten cases are presented to show the wide applicability of this technique. Gross pathology and pre- and postoperative findings are demonstrated and discussed, as is the safety and efficacy of the laser soft-tissue interaction.
Cricopharyngeal Myotomy in Pharyngeal Paralysis
Authors: Van Overbeek Jos J.M. , Betlem Hans C.
Published: October 2014

A brief outline of the causes and symptoms of hypopharyngeal paresis is followed by a discussion of the diagnostic possibilities of manometry and cineradiography. It was found that the pharyngoesophageal sphincter mechanism remains intact in the case of complete paralysis of the hypopharynx. When there are severe symptoms of dysphagia, myotomy of the pharyngoesophageal sphincter is to be considered on the basis of these diagnostic findings. This procedure can lead to substantial improvement of the symptoms. Sphincterotomy yielded very favorable results in five out of nine patients, two of whom are discussed in some detail by way of illustration.
Effect of Cholinergic Drugs on the Perilymphatic Oxygen Tension
Authors: Yagi N. , Fisch U.
Published: October 2014

The effect of the intravenous injection of cholinergic drugs on perilymphatic oxygen tension (Po2) was measured using the polarographic method in 20 cats. Acetylcholine, pilocarpine and neostigmine produced minimal but statistically significant changes in perilymphatic Po2. Atropine and scopolamine did not influence the Po2 of the perilymphatic space. The reported results show that under normal conditions the cholinergic receptors of the vestibular vessels have little effect on the permeability of arterial Po2.
Temporal Bone Histopathology in Deafness Due to Cryptococcal Meningitis
Authors: Harada Takehiko , Sando Isamu , Myers Eugene N.
Published: October 2014

This paper reports on a patient who survived an attack of cryptococcal meningitis eight years prior to his death. A bilateral sensorineural hearing loss had been noted a short time before the patient was admitted to the hospital, and was the only complication after he recovered from the disease. Histopathologic study of the temporal bones showed a similar pattern of pathology in both ears, the most striking finding being a severe loss of spiral ganglion cells in Rosenthal's canal, and of cochlear nerve fibers in the osseous spiral lamina and internal auditory meatus. The vestibular nerve was mostly free from pathology. The organ of Corti was atrophic but the hair cell population appeared to be almost normal. A slight number of cryp-tococci were observed in limited areas of the cochlear and the saccular nerves in the internal auditory meatus. The severe pathology of the cochlear nerve was compatible with audiologic evaluations, which pointed to a retrocochlear lesion. Thus, this case demonstrates some characteristic aspects of cryptococcal infection of the temporal bone: The primary site of invasion was the cochlear nerve in the internal auditory meatus and the modiolus, leading to the loss of ganglion cells and nerve fibers, while the vestibular nerve appears to have been resistant to infection.
Role of Periosteum on the Fate of Pedicle Osteocutaneous Grafts
Authors: Canalis Rinaldo F. , Hemenway William G. , Ward Paul H.
Published: October 2014

Recent studies on the fate of pedicle osteocutaneous grafts have shown that they remain viable and may be actively involved in the mechanics of bone repair. This communication reports on a series of experiments aimed to clarify the role of periosteum in the survival of pedicle-assisted bone grafts. Osteocutaneous grafts were developed in dogs in such a manner as to isolate the implant from normal recipient bone. Free bone grafts were used as controls and a group of pedicle periosteal grafts were studied as potential sources of bone formation. Specimens were evaluated at regular intervals over a 40-week period. The pedicle bone grafts maintained their viability and developed vigorous osteoneogenesis. The process was progressive and eventually resulted in partial substitution of the original graft by new bone of periosteal origin. The free bone grafts were resorbed and no bone formation was obtained in pedicle periosteum specimens. The study provides clear evidence that under experimental conditions no bone contact is needed to maintain the viability of pedicle osteocutaneous grafts. It also shows that the periosteum has the leading role in the restructuring process of these grafts.
Laryngeal Paralysis Teflon® Injection
Authors: Montgomery William W.
Published: October 2014

This report is a review of the literature combined with the author's experience concerning Teflon injection of the larynx. Included are the etiology and diagnosis of vocal cord paralysis, indications and contraindications for Teflon injection of the larynx, its histopathology, pre- and postoperative management, proper and improper techniques for injecting Teflon, complications, and reasons for failure.
Effects of Neonatal Conductive Hearing Loss on Brain Stem Auditory Nuclei
Authors: Webster Douglas B. , Webster Molly
Published: October 2014

Both postnatal auditory deprivation and experimentally produced conductive hearing losses in mice result in incomplete maturation of most brain stem auditory neurons. The affected groups are: octopus cell, globular cell, small spherical cell, and large spherical cell groups in ventral cochlear nuclei; and the lateral superior olive and medial nucleus of the trapezoid body of the superior olivary complex. When 45 days of auditory deprivation are followed by 45 days of normal acoustic stimulation, there is incomplete maturation of neurons in: multipolar cell, globular cell, small spherical cell, and large spherical cell groups in ventral cochlear nuclei; lateral superior olive and medial nucleus of trapezoid body in superior olivary complex; and central nucleus of inferior colliculus. A critical period exists when adequate sound stimulation is needed for full development of these neurons.
Vein of the Vestibular Aqueduct
Authors: Mazzoni Antonio
Published: October 2014

The vein of the vestibular aqueduct (VVA) was investigated in a series of 40 human temporal bones. The processing included vascular injection with a colored medium, decalcification and cutting in serial, thick sections, which were put in a clear fluid and studied with a stereo-microscope. The labyrinthine roots of the VVA are the single veins of the ampulla and simple limbs of the semicircular canals and of the posterior wall of the utricle. They drain the rich capillary bed of the simple endolymphatic walls of the canals and the utricle, as well as a small peripheral area of the cristae and the utricular macula. The VVA leaves the vestibule through an individual bone canal running parallel to the vestibular aqueduct up to the dura of the posterior side of the petrosa in the area of the endolymphatic sac. It then opens in the inferior petrosal sinus or the jugular bulb. The vein receives other branches from the bone, dura and sac. Correct information on the course of this vein appears to be lacking in contemporary textbooks and articles, although it has been correctly described since the last century.
Traveling Waves Demonstrated by a Revolving Helix
Authors: Benítez Luis D.
Published: October 2014

A simple procedure for the demonstration of traveling waves in actual morion in the classroom is described. Using a matched set of experimental data on a) peak amplitude of basilar membrane oscillations, and b) phase-lag along the membrane, both for a given frequency of stimulation, it is possible to construct a solid spiral, or helix, of constantly changing diameter and pitch. When projected on a screen, the helix will look like a longitudinal amplitude gradient along the basilar membrane; as the helix is rotated, the projection will appear as a traveling wave. It is suggested that the device, because of its inherent simplicity, is a useful aid in a teaching laboratory for future otolaryngologists, audiologists and other professionals related to the field of hearing.
Value of Radionucleotide Scanning in the Staging of Head and Neck Carcinoma
Authors: Wolfe Judith A. , Rowe Lee D. , Lowry Louis D.
Published: October 2014

The presence or absence of distant metastases in squamous cell carcinoma of the head and neck is critical in making rational therapeutic decisions. Radionucleotide bone and liver scans are frequently utilized in the initial evaluation of these patients for possible distant metastases. The true value of routine bone and liver scans in the initial staging of primary squamous cell carcinoma of the head and neck is unknown. One hundred eighteen patients with primary squamous cell carcinoma of the head and neck, evaluated during a five-year period, were retrospectively reviewed. Eight percent were stage I, 18% stage II, 21% stage III, 53% stage IV. Because metastatic carcinoma of the head and neck is primarily regional or pulmonary, the low prevalence of liver and bone metastases limits the usefulness of these radionucleotide scans. We conclude that routine bone and liver scanning is not a valuable diagnostic technique in the initial staging of head and neck carcinoma when clinical or biochemical evidence of distant metastases is not present.
Stomal Recurrence following Laryngectomy
Authors: Weisman Robert A. , Colman Marc , Ward Paul H.
Published: October 2014

Recurrent tumor in or around the tracheal stoma following laryngectomy almost always terminates in a fatal outcome. Several investigators have attempted to determine the factors that predispose a patient to stomal recurrence, but their conclusions are not entirely in agreement. The records of 251 consecutive laryngectomy patients treated at the UCLA Hospital between 1955 and 1977 were reviewed. The variables evaluated included type of operation, preoperative tracheostomy, interval from operation to recurrence, presence of neck metastases, performance of thyroidectomy, site of lesion, and control of tumor margins. While certain events, such as preoperative tracheostomy, appeared more frequently than others in the stomal recurrence patients, no single factor or group of factors could explain all the recurrences. It appears that stomal recurrences arise from heterogeneous causes. Good planning and utilization of the principles outlined should reduce the incidence of this dreaded complication.
Neuroanatomical Correlates of Vestibular Function
Authors: Gacek Richard R.
Published: October 2014

Neuroanatomical data revealed by new neuroanatomical techniques over the past decade, have clarified the central connections of the peripheral vestibular sense organs. A knowledge of this information is important in the clinical evaluation of vestibular disorders. The reflex connections of the semicircular canals serve vestibulocerebellar, vestibulo-ocular, commissural, and vestibulospinal pathways. The central connections of the utricular macula are primarily in a descending direction to the motor neurons of the entire length of the spinal cord. These form the basis for vestibulospinal reflexes which are characteristically associated with utricular function. Additional central connections provide the basis for vestibulo-ocular responses to utricular activity. Finally, the saccule has reflex connections both to the upper spinal cord to a minor degree and to extraocular nuclei that serve vertical and oblique eye movements. The minor vestibular group Y nucleus provides a commissural reflex connection for the saccule.
Extracranial Surgical Repair of Cerebrospinal Rhinorrhea
Authors: Calcaterra Thomas C.
Published: October 2014

A spinal fluid leak from the intracranial space to the nasal respiratory tract is potentially very serious because of the risk of an ascending infection which could produce fulminant meningitis. Cerebrospinal rhinorrhea typically stems from a complication of head trauma, and fortunately these leaks tend to heal spontaneously. In a smaller percentage of cases, intracranial lesions or congenital osteomeningeal defects are harbored, allowing spinal fluid to enter the nasal cavity, and patients with this condition rarely heal without operative intervention. Successful repair of a dural defect mandates precise anatomic localization of the leakage site. Although radioisotopes have been a popular method of documenting and localizing a spinal fluid leak, they do not provide the topographic accuracy of intrathecal dyes such as fluorescein. The author not only employs this dye during the preoperative localization of a leak but also uses it intraoperatively to improve visualization of the leakage site and to plan a method of repair. The operating microscope also seems to facilitate visualization of the leak and enables better manipulation of grafts and flaps.
Pendred's Syndrome with Atypical Features
Authors: Bergstrom LaVonne
Published: October 2014

One of seven cases of Pendred's syndrome studied had mixed hearing loss, bilateral congenital stapes foot-plate fixation, surgically proven unilateral perilymph fistula and delayed fluctuating hearing loss in the unoperated ear. A unifying hypothesis is proposed to link these diversified findings.
Local Immune System of Nasal Mucosa in Inflammation Iga Distribution and Secretory Activity
Authors: Nakashima Tadashi , Hamashima Yoshihiro
Published: October 2014

The local immune system of human nasal mucosa (inferior turbinates and nasal polyps) from 53 humans with chronic inflammation was studied by examining the distribution and secretory activity of IgA using an immunofluorescent technique. Diffuse fluorescence for IgA was observed throughout the connective tissue ground substance in every nasal turbinate and nasal polyp. In mucosa with mild inflammatory changes, most IgA seemed to be produced locally by IgA-producing plasma cells. However, in severely inflamed nasal mucosa, including nasal polyps, plasma cells were relatively fewer in number and the distribution of IgA generally corresponded to the pattern of fibrin deposition. Secretory activity of IgA in the glandular cells of nasal turbinates was well retained. Only in dilated glandular ductules in nasal polyps was the secretory activity impaired.
Middle Ear Gas Composition during Nitrous Oxide-Oxygen Ventilation
Authors: Ostfeld Ervin , Blonder Judith , Crispin Moshe , Szeinberg Arieh
Published: October 2014

The middle ear gas composition during 180 minutes ventilation with nitrous oxide-oxygen mixture was determined in 12 mongrel dogs. The mean relative concentration of N2O in the middle ear (ME) rose to 12, 26.4 and 29.3% after 60, 120 and 180 minutes respectively. During this period, the relative concentration of N2 dropped from a mean of 83.2% in the air-ventilated dogs to 54.8%, without an essential change in the concentrations of O2 or CO2. The elimination of N2O from the ME during 30 minutes of postanesthetic ventilation with O2 was incomplete, an average of 11.4% N2O remaining in the ME. At the same time, the mean relative concentration of O2 reached 19%, higher than the O2 relative concentration normally present in the ME. The results indicate that gas diffusion may occur across the ME mucosa for N2O as well as for O2, producing selective changes in the middle ear gas composition.
Primary Presentation of Malignant Lymphoma in Middle Ear Cleft
Authors: Gapany-Gapanavičius Boris , Chisin Roland , Weshler Zeev
Published: October 2014

An unusual case of histiocytic type malignant lymphoma with primary presentation in the middle ear cleft in a 32-year-old female patient is reported. Despite combined surgical, radiological and chemotherapeutic treatment, the patient expired from a fulminant spread of the lymphoma 14 months after the first clinical manifestation of the disease in the right ear.
Glottic Closure Reflex: Control Mechanisms
Authors: Ikari Taketsugu , Sasaki Clarence T.
Published: October 2014

Reflex glottic closure is a dominant and stable reflex produced by stimulation of the superior laryngeal nerve. Its precise execution is basic to successful sphincteric protection of the lower airway. In exaggerated form, it produces life-threatening laryngospasm. Clearly, reflex glottic closure and laryngospasm are facilitated by: a) expiratory phase; b) decreased arterial partial pressure of carbon dioxide (pCO2); c) increased arterial partial pressure of oxygen (pO2); and d) negative intrathoracic pressure. On the other hand, both reflex glottic closure and laryngospasm are inhibited by: a) inspiratory phase; b) increased arterial pCO2; c) decreased arterial pO2; and d) positive intrathoracic pressure. A clear understanding of laryngeal adductor control is an essential first step in the therapeutic modification of abnormal laryngeal closure and laryngospasm.
Localization of Peroxidase Activity in Tracheal Epithelium
Authors: Watanabe Kensuke
Published: October 2014

The activity of endogenous peroxidase was demonstrated in light ciliated cells, mature goblet cells, and nonciliated serous cells, but not in basal cells, intermediate cells, dark ciliated cells or immature goblet cells of the upper tracheal epithelium of rats, using the diaminobenzidine method for cytochemical demonstration of peroxidase activity. The peroxidase activity was the most intense in the epithelium of the first tracheal ring and gradually diminished at lower tracheal levels, becoming extremely faint in the vicinity of the middle of the trachea. The activity was localized in cisternae of rough-surfaced endoplasmic reticulum (r-ER) including the nuclear envelope, some vesicles and saccules of the Golgi complex, secretory granules, and small apical vesicles. It is believed that the basal cells were transformed into the intermediate cells, and some of the intermediate cells were turned into the ciliated cells, while other intermediate cells were differentiated into the goblet cells. The dark ciliated cells proved to be the immature ciliated cells immediately after the transformation from the intermediate cells. In these cells, peroxidase is not yet produced.
Second-Order Vestibular Adaptation and Cupular Dynamics
Authors: Babin Richard W. , Ryu Jai H. , McCabe Brian F.
Published: October 2014

The magnitude of initial response and slope of continued response of 45 neurons in the vestibular nuclei of cats to constant and interrupted accelerations were investigated. Eighty-eight percent exhibited adaptation, the magnitude of which was proportional to the stimulus. Comparison of slope and intercept of the response to continuous acceleration before and after a superimposed inhibitory velocity change suggests that the adaptation phenomenon is unrelated to cupular position.
Plasticity of the Developing Auditory System
Authors: Ruben R. J. , Rapin Isabelle
Published: October 2014

Anatomical, physiological and behavioral data indicate that the auditory system matures from the periphery centrally, ie, centripetally. There is now information which shows that the developing auditory system can be modified by anatomical changes which have their greatest effect during early development. Anatomical, physiological and behavioral changes can also be brought about by the quality of the auditory stimuli which the auditory system experiences. Evidence for the plasticity of the developing auditory system has come from studies of a number of different species. The plasticity of the auditory system is of theoretical and clinical significance.
Myringoplasty
Authors: Sheehy James L. , Anderson Robert G.
Published: October 2014

We reviewed the records of 472 patients who had undergone myringoplasty during an 11-year period at the Otologic Medical Group. There was a statistically significant relationship between the size of the perforation and the degree of hearing impairment, but no relationship between the degree of impairment and the complaint of tinnitus. The majority of operations were performed using the lateral surface fascia grafting technique. Those 168 operations performed postauricularly were successful in closing the tympanic membrane perforation in over 97% of the cases and in reducing the conductive deficit to 10 dB or less in 88%. There were no total sensorineural impairments, although 3 % of the patients developed a high tone sensorineural impairment. Blunting in the anterior sulcus and lateral healing of the graft were very uncommon. Canal skin was used as a graft in 16% of the patients. The graft take results and hearing results were less favorable than with fascia.
Sickle Cell Anemia and Hearing
Authors: Friedman Ellen M. , Luban Naomi L. C. , Herer Gilbert R. , Williams Iola
Published: October 2014

The present investigation examined the effects of sickle cell anemia on threshold hearing. The study included 43 homozygous sickle cell anemia patients, ages 7–18 years, and 23 age-matched controls with documented normal hemoglobin. Both the study and control groups received otologic and audiologic examinations. Bilaterally normal hearing was found in 88 % of the sickle cell subjects. Unilateral or bilateral mild high frequency sensorineural hearing loss was demonstrated in 12 % (5 of 43). The control subjects revealed no hearing loss. The sickle cell group, therefore, exhibited a higher than usual incidence of hearing loss. Further, three of the five subjects with hearing loss evidenced central nervous system involvement, resulting in a probability of < 0.025 that this relation might occur by chance. Periodic hearing evaluations of children with sickle cell anemia should be performed to identify those with auditory complications and those who possibly may have CNS involvement.
Vestibular and Oculomotor Abnormalities in Vertebrobasilar Insufficiency
Authors: Corvera Jorge , Benitez Luis D. , Lopez-Rios Guillermo , Rabiela Maria Teresa
Published: October 2014

The early diagnosis of vertebrobasilar insufficiency in patients with vertigo as their only symptom was attempted using a battery of vestibulo-oculomotor tests. With this testing procedure, we were able to find abnormal vestibulo-oculomotor mechanisms that could account for the vertigo in 41 of 42 patients. These abnormalities, however, did not fall into an easily recognizable pattern that could be considered characteristic of vertebrobasilar insufficiency. The large intersubject variability probably arises from the very different and widespread lesions that occur at the vestibular and neurological levels as a consequence of vertebrobasilar insufficiency.
Carcinoid and Mucoepidermoid Carcinoma of Bronchus in Children
Authors: McDougall J. C. , Gorenstein A. , Unni K. , O'Connell E. J.
Published: October 2014

Four patients with bronchial carcinoid and two patients with mucoepidermoid carcinoma of the bronchus are presented. Presenting symptoms of these rare childhood tumors are chronic cough, hemoptysis, repeated bouts of pulmonary infection, and chest pain. Bronchoscopic examination should be considered in patients with these symptoms and is highly reliable in diagnosing these tumors. Surgical resection is the treatment of choice. Bronchial carcinoid and mucoepidermoid carcinoma have an excellent prognosis following conservative surgical resection.
Laryngeal Regulation of Airway Resistance
Authors: McCaffrey Thomas V. , Kern Eugene B.
Published: October 2014

The response of laryngeal airway resistance to pulmonary receptor stimulation was studied in 20 mongrel dogs anesthetized with α-chloralose (80 mg/kg). Stimulation of pulmonary stretch receptors by lung inflation inhibited the phasic variation of laryngeal resistance during respiration and produced a sustained reduction of laryngeal resistance, which was related to lung inflation pressure. Stimulation of pulmonary J-receptors with capsaicin produced apnea and a large increase in laryngeal resistance. Capsaicin produced this reflex when injected into the pulmonary circulation but not when injected into the systemic circulation. Irritant receptor stimulation with histamine hydrochloride produced tachypnea and a reduction in inspiratory laryngeal resistance. Pulmonary receptor reflexes were abolished by dividing the vagus nerves distal to the origin of the recurrent laryngeal nerves. Laryngeal reflexes may be important in the regulation of respiration and the production of physiologic and pathologic alterations in pulmonary function.
Relationship between Condylomata and Laryngeal Papillomata
Authors: Quick Cedric A. , Krzyzek R. A. , Watts Susan L. , Faras A. J.
Published: October 2014

In a survey of 49 papilloma patients accurate maternal condyloma history was obtained in 31 instances and of these, 21 were positive for the presence of condyloma during pregnancy or parturition. Molecular virological studies indicate that positive hybridization could be demonstrated to human papilloma virus 2 in both laryngeal papilloma and condyloma by the Southern blot technique. Immunoperoxidase staining illustrated the presence of virus-related particles only near the surface of the mucous membrane papilloma, which is in contrast to the definite staining of the stratum granulosum and stratum corneum of verrucae. Collectively this provides convincing evidence for an etiological relationship between condyloma acuminata and some laryngeal papillomata. The highly contagious nature of human papilloma virus infection is discussed and the possibility of cesarian section in the presence of active condyloma must be considered.
Adductor Spastic Dysphonia: 1 1/2 Years after Recurrent Laryngeal Nerve Resection
Authors: Aronson Arnold E. , DeSanto Lawrence W.
Published: October 2014

After recurrent laryngeal nerve resection for adductor spastic dysphonia, the voices of 37 patients (ages 39 to 79 years) were assessed 24 hours, 1 month, 6 months, and 1 year after surgery, and those of 33 patients up to 1 1/2 years after surgery. By 24 hours after surgery, 97% of patients had improved and 3% had failed; by 1 month, 97% were still improved while 3% had failed; by 6 months, 92% had maintained improvement while 8% had failed; by 1 year, 68% were still improved but 32% had failed; and by 1 1/2 years, 61% were still improved while 39% had failed. The patients whose voices improved varied from one another in both type and degree of residual dysphonia. The typical postsurgical voice was free of spasm, with some breathiness, hoarseness, and reduced volume being present. The voices of some patients approached normalcy. To most patients, relief from the physical effort to phonate was as important as the improved voice. Continued long-term follow-up studies and careful, collaborative selection of surgical candidates are needed.
Use of the CO2 Laser in Otology
Authors: Williams David J. , Hunter-Duvar Ivan M. , Mitchell David P.
Published: October 2014

There are conflicting reports of the effect on the inner ear of the use of a carbon dioxide (CO2) laser. In four cats, we made middle ear lesions with a CO2 laser. Subsequent evaluation by inverted-phase and scanning electron microscopy revealed no inner ear pathology attributable to the CO2 laser. Apparently, appropriate use of the CO2 laser does not harm the inner ear.
Temporal Bone Histopathology of Necrotizing External Otitis
Authors: Sando Isamu , Harada Takehiko , Saito Reisuke , Okano Yasumasa , Caparosa Ralph J.
Published: October 2014

Histopathological examination of the temporal bone of an individual with necrotizing external otitis revealed severe inflammation with necrosis in the subcutaneous granulation tissue in the external auditory canal. Erosion of the bony walls of the canal had created a defect in the anterior wall, through which infection spread to the preauricular region. The lateral part of the middle ear cavity was also filled with granulation tissue and purulent exudate. A dehiscence of the horizontal portion of the facial canal had apparently allowed spread of an inflammatory round cell infiltrate along the facial nerve up to the fundus of the internal auditory canal. The only evidence of inner ear pathology was the presence of eosinophilic fluid material in the perilymphatic spaces of the labyrinth. A review of other reports of cases of necrotizing external otitis seems to show that this is the only instance of this disease in which infection spread from the external canal through the tympanic membrane to the middle ear and thence to the internal auditory canal.
Nature of Blood-Labyrinth Barrier in Experimental Conditions
Authors: Juhn S. K. , Rybak L. P. , Prado S.
Published: October 2014

The blood-labyrinth barrier is a concept that has evolved based on marked difference in chemical composition between perilymph and blood. Studies reported here have been designed to manipulate physiologic, metabolic, and pharmacologic conditions in experimental animals in order to determine the characteristics of this regulatory mechanism. Tracer studies of uptake of sodium, calcium, and albumin from blood into perilymph showed that these substances penetrate into inner ear fluids quite slowly. Injections of ototoxic substances (kanamycin, furosemide) show limited transport of these agents into perilymph. Another ototoxic agent, ethacrynic acid, was found to transiently reduce the transport of sodium into perilymph. Administration of an osmotic agent (urea) resulted in a parallel but delayed elevation of perilymph concentration. The possible role of alteration of blood-labyrinth barrier in inner ear disorders has been discussed.
Myringoplasty with Fascial Stakes
Authors: Rediano H. , Englender M.
Published: October 2014

Myringoplasty reinforced by fascial stakes was performed in 87 ears. Small tongue-like fascial projections or “stakes” were used to keep the fascial graft in position. No foreign material was introduced into the middle ear cavity to support the graft and the drum. The technical details of this procedure are described and analysis of the results is presented.
Endoscopic Findings in Sarcoidosis
Authors: Armstrong John R. , Radke Jan R. , Eichenhorn Michael S. , Kvale Paul A. , Popovich John
Published: October 2014

Flexible fiberoptic bronchoscopy was performed in 101 patients with sarcoidosis, and the endoscopic findings were analyzed and correlated with radiographic stages and diagnostic bronchial biopsy. Endoscopic findings included bronchostenosis (26% of patients), mucosal nodularity (64%), hypervascularity (38%), and mucosal edema (55%). The only correlation between these findings and the radiographic stage was the presence of mucosal nodularity observed in 73% of stage I (14/19 patients), decreasing to only 48% in stage III (15/31 patients). Bronchial biopsy yield was 58% for stage I, 62% for stage II, and 46% for stage III, with overall yield of 57%. However, the addition of bronchial biopsies increased the diagnostic yield of the bronchoscopic procedure from 73 % for transbronchial biopsies alone to 88% when the two procedures were combined. In the presence of endobronchial stenosis, mucosal nodularity and hypervascularity, bronchial biopsy yield was 91 % vs 37% when these were absent. We conclude that the endoscopic characteristics, with the exception of nodularity, do not correlate with radiographic stages. Bronchial biopsy yield is higher in those patients with mucosal nodularity, increased vascularity, and bronchostenosis. Bronchial mucosal biopsy also improved the overall diagnostic yield when it is obtained in conjunction with transbronchial lung biopsy.
Esophageal Cancer Research in the People's Republic of China
Authors: Huan-Hsing Wu
Published: October 2014

Esophageal cancer, which accounts for 21 % of all cancer deaths in China, has been the subject of epidemiology studies in the three areas of the country where the disease is most prevalent. In the area of the highest mortality rate, the first field research unit was established to study cancer in high-risk areas. The investigations of this unit for the last 20 years are discussed, including the design and implementation of the studies. The geographic, dietary and cultural factors in the etiology of esophageal cancer are examined. The results of the studies and the clinical applications are explored.
Esophageal Hiatal Hernia in Infants and Children
Authors: Fearon Blair , Brama Israel
Published: October 2014

Although prior to 1950 esophageal hiatal hernia (EHH) in children was a seldom recognized entity, it has since then become well known. The symptoms in children are considerably different from those in adults. The cause of EHH is still somewhat in doubt. The term gastroesophageal reflux (GER) is often applied as a diagnosis where the diagnosis is uncertain. The authors have reviewed case histories of 56 patients admitted to the Hospital for Sick Children, Toronto, from 1972 to 1980. A comparison is made with 101 cases admitted between 1952 and 1960. It is our firm belief that all patients with symptoms of GER should be esophagoscoped for definitive diagnosis as well as for assessment of the esophagus. Because there is a high rate of respiratory complications in infants and children with GER, bronchoscopy should be carried out concurrently with the esophagoscopy. Infants with GER are at risk from the possibility of aspiration and it is possible that an unknown number of sudden infant death syndrome is due to this factor. The majority of patients with EHH can be managed by a medical regime. Those with esophageal strictures are treated by dilatation but many require surgical correction.
Observations on Central Neurologic Etiology for Laryngeal Dysfunction
Authors: Ward Paul H. , Hanson David G. , Berci George
Published: October 2014

Observations of patterns of laryngeal dysfunction in patients with known as well as unrecognized neurological disease have provided the basis for a new classification. Representative patients are used to describe typical patterns of laryngeal dysfunction which occur with afferent and efferent (upper motor neuron, extrapyramidal, cerebellar and nuclear pathways) neurological disorders. The value of cinephotography in documenting and avoiding the pitfalls of brief indirect laryngoscopy is emphasized as a factor in achieving a correct diagnosis in patients with laryngeal diseases of central origin.
Laryngotracheal Reconstruction in Children
Authors: Cotton Robin T. , Evans John N. G.
Published: October 2014

Congenital and acquired subglottic stenosis is a commonly encountered problem in the pediatric population. In acquired cases endotracheal intubation is responsible for its development in the great majority of cases, but high tracheotomy, laryngeal burns, external neck trauma, and tumors, both intrinsic and extrinsic, are occasionally seen. The management of mature subglottic stenosis in children remains a controversial issue. The prevailing attitude of otolaryngologists is to perform a tracheotomy and hope for decannulation after one or two years, due to the expected growth of the larynx. Unfortunately, some of the acquired lesions are so severe that often no lumen is demonstrable. In such cases no amount of growth will allow extubation. A variety of endoscopic methods, such as dilation with or without resection using diathermy or laser, are certainly helpful in the early phases of wound healing while the scar tissue is soft and pliable. To deal with the mature, hard, fibrous, unresponsive scar various authors have proposed differing laryngotracheal reconstructive techniques. The authors discuss a unique experience of laryngotracheal reconstruction in 103 children. They define their indications for the three procedures that are most widely used, and address the issue raised by opponents of laryngotracheal reconstruction in children, namely the consideration that laryngeal growth potential may be adversely affected by such external operations. The authors have evidence that this has not occurred in 35 cases followed for a minimum of five years.
Tympanostomy Tubes: The Conservative Approach
Authors: Naunton R. F.
Published: October 2014

The clear advantage accruing from the use of tympanostomy tubes in the treatment of otitis media with effusion is immediate improvement in hearing; there are also disadvantages entailed, such as scarring of the drum, risk of continuing otorrhea and interference with the patient's normal physical activities. All possible forms of medical treatment should be exhausted (antihistamine decongestants, politzerization) before resorting to tympanostomy tubes. There is a small group of children with severe chronic nasal obstruction and otitis media with effusion for whom adenoidectomy is likely to be required.
Bioinert Ceramic Implants in Middle Ear Surgery
Authors: Jahnke Klaus , Plester Dietrich
Published: October 2014

The suitability of different ceramic materials for reconstructive middle ear surgery was examined in extensive animal experiments. Since 1978 we have used more than 250 aluminum oxide ceramic implants for ossicular chain reconstruction. The excellent tolerance of this bioinert material was confirmed. The ease and precision with which these implants can be drilled during the operation is especially advantageous. The indications and techniques for the use of the aluminum oxide ceramic implants are described. Our short-term results stimulated the further development of bioinert ceramic implants and our surgical techniques. The special characteristics of bioactive ceramics are such that they can form a tight bond to osseous bone. They are intended for filling bone cavities (porous tricalcium phosphate ceramic) and for reconstruction of the posterior canal wall.