bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hearing Conservation in Acoustic Neurilemmoma Surgery via the Retrosigmoid Approach
Authors: Smith Mansfield F.W. , Lagger Raymond L. 
Published: November 2015

Hearing conservation in acoustic neurilemmoma surgery is possible in approximately 50% of patients whose tumors measure 15 mm or less in size (medial to the porus acusticus) and whose speech discrimination score in the ear with the tumor is 80% or better. The concepts of total tumor removal and maximum sparing of adjacent normal neural tissue are consistent with efforts to retain cochlear function. A retrosigmoid approach is favored over the middle cranial fossa approach because of the superior exposure and less morbidity. An operating table capable of 35‐degree side rotation is used. It allows the majority of patients with acoustic neurilemmoma to be operated on in the horizontal supine position. The posterior lip of the internal auditory canal is removed to within approximately 1.5 mm of the falciform crest. Tumors not extending to the fundus afford an ideal situation for total removal, early identification of the seventh cranial nerve, and conservation of hearing. The CO2 laser is a useful surgical tool with its properties of vaporization, cutting, and coagulation.
Hearing Preservation—Posterior Fossa Approach
Authors: Cohen Noel L. , Ransohoff Joseph 
Published: November 2015

In patients with acoustic neurinomas protruding less than 2 cm from the porus acusticus and free of the brain stem, hearing can often be preserved. Our neurosurgical/otologic team uses the combined suboccipital/transmeatal approach with the patient in the seated position. This operation has been attempted on 21 patients from 1974 to 1982. Nine had tumors larger than 2 cm that touched the brain stem; one had useful hearing preserved. Of the 12 patients with tumors smaller than 2 cm, hearing at or near the preoperative level was preserved in seven. In one patient, hearing was improved. There have been up to 7 years of follow‐up with no recurrences of the neurinomas or diminution of hearing evident on computed tomographic scan. All had preservation of the seventh cranial nerve, while complications were mild and comparable to the remainder of our 101 patients operated on during the same period. We will review the surgical technique and audiologic results in detail.
Results of Sinusoidal Harmonic Acceleration Test in One Thousand Patients: Preliminary Report
Authors: Hamid Mohamed A. , Hughes Gordon B. , Kinney Sam E. , Hanson Maurice R. 
Published: November 2015

One thousand patients with dizziness were tested by sinusoidal harmonic acceleration with frequencies of. 01,. 02,. 04,. 08, and. 16 Hz. Two hundred fifty (25% of data base) were randomly selected for this study. One hundred forty‐eight diagnoses were confirmed: 66 (45%) patients had a clinical diagnosis of peripheral vestibular dysfunction, 28 (19%) had central vestibular dysfunction, and 53 (36%) had dizziness of undetermined cause. This preliminary study investigated the response patterns of phase (latency), asymmetry (slow phase preponderance), and gain (output/input) as they correlated with each of the above patient groups. The main response pattern was a varying degree of asymmetry with normal or abnormal latency. Persistent abnormal phase pattern indicated permanent vestibular damage and could not be used reliably to differentiate peripheral from central vestibular dysfunction. Asymmetry changed with time and correlated with patients' symptoms. The dynamic pattern of asymmetry could be used to differentiate peripheral from central vestibular dysfunction. Gain was a reliable and essential measure of the sensitivity of the vestibular system and the validity of the rotational response.
Assessment of Facial Reinnervation by use of Chronic Electromyographic Monitoring
Authors: Anonsen C. K. , Trachy R. E. , Hibbert J. , Cummings C. W. 
Published: November 2015

The study of muscle reinnervation has been difficult because of lack of an accurate, reproducible method to monitor return of function. Visual assessment relies on subjective interpretation. Histology provides anatomic, not functional, information. Electromyography and anatomic tracing have been most effective in evaluating physiologic return of muscle function. It has been difficult to assess the timing of functional return electromyographically because measurements are intermittent and electrode placement varies. A method was designed to allow long‐term monitoring of electromyographic (EMG) activity in the facial musculature of the rabbit. Sixteen rabbits were monitored for at least 1 month or until return of normal EMG activity was identified. Various levels of injury (nerve crush, transection without repair, and transection with immediate end‐to‐end anastomosis) were evaluated. EMG evidence of reinnervation was seen in all animals with nerve crush injuries as well as those with anastomoses. Physiologic continuity of the nerves was then evaluated by retrograde transport of horseradish peroxidase. All muscles showing return of EMG activity had uptake of HRP into the appropriate brain stem motor neurons. The denervated muscles showed no HRP uptake. The information gained in this study shows potential for use of this technique in comparing functional return of muscle activity between different reinnervation methods.
Speech performance by patients with multichannel cochlear implants
Authors: Parkin James L. , Dankowski M. Korine 
Published: November 2015

Thirteen patients were implanted with multichannel cochlear implants between April 1,1984 and February 25,1985. The patients are fitted with the sound processor unit 4 to 6 weeks postsurgery. One patient had a single‐channel unit replaced with a multichannel implant. She reported improved sound quality. All patients use their implants daily and all patients would undergo implantation again (based on their current performance). Evidence exists that continued use leads to improved performance. Patient S.S. progressed from auditory‐only scores of 12% and 24% to 100% and 100% in 4 months. The average open set auditory‐only performance of six patients in the first 4 months on a spondee word list was 22%. The average of eight patients—more than 4 months post sound processor—is 44%, indicating improvement with use. Patients perform better when combining auditory input with visual input than they do with lip reading alone. The multichannel implant is well tolerated and accepted, and results in speech performance improvement.
Mechanical Properties of Septai Cartilage Homografts
Authors: Glasgold Mark J. , Kato Y. Pedro , Christiansen David , Hauge Joy A. , Glasgold Alvin I. , Silver Frederick H. 
Published: November 2015

The compressive mechanical properties of untreated and chemically and physically treated nasal septum homografts were determined. Mechanical properties of control, saline‐, thimerosal (Merthiolate)‐ and Alcide‐treated specimens were similar. At high strains, the stiffness of treated cartilage ranged from 12.8 to 22.5 MPa and was unaffected by storage time. In comparison, irradiated and freeze‐dried nasal septum exhibited stiffnesses of 35 and 37.5 MPa, respectively, after approximately 1 month of storage. These values of stiffness were significantly different from controls at a 0.95 confidence level. On the basis of these results, it was concluded that Alcide and Merthiolate treatment did not alter the compressive mechanical properties of cartilage and that a combination of these treatments may adequately sterilize and preserve nasal septum homografts.
Recurrent Laryngeal Nerve Paralysis Associated with Thoracic Aortic Aneurysm
Authors: Teixido Michael T. , Leonetti John P. 
Published: November 2015

The association of vocal cord dysfunction with thoracic aortic aneurysm (TAA) has been noted in the cardiovascular and otolaryngologic literature.1–6 A retrospective review of 168 cases of TAA was performed in order to: (1) define the natural history of associated recurrent laryngeal nerve paralysis (RLNP) and (2) propose mechanisms for the development of RLNP in operated and nonoperated aneurysms. Of 168 aneurysms, 5% manifested hoarseness secondary to RLNP. All had type I aneurysms. Only one patient regained vocal cord function after surgical treatment of the aneurysm. RLNP developed as a sequela of TAA repair in 12% of the patients managed surgically. RLNP associated with TAA type III repair had a higher incidence of recovery than paralysis that occurred after TAA type I repair (40% vs. 0% recovery). Sixty‐six percent of all patients with permanently paralyzed larynges in this series attained glottic competence sufficient to avoid Teflon injection, and 27% of all RLNP associated with TAA in this series required Teflon injection for aspiration, severe dysphonia, or both. Seventeen percent of the patients with vocal cord paralysis associated with TAA recovered within 12 months. Aneurysm classification and pertinent anatomic relationships are discussed with reference to various mechanisms of recurrent laryngeal nerve paralysis.
Head Shape and Abnormal Appearance of Tympanic Membranes
Authors: Stolovitzky J. Pablo , Todd N. Wendell 
Published: November 2015

We examined 187 males to evaluate the hypothesis that short‐headed persons more often have otitis media than long‐headed persons. The subjects were seen as part of routine health screening before attending recreational summer camp. The photographic appearance of each tympanic membrane was judged on two separate occasions by an otolaryngologist who categorized them as “normal”, “abnormal”, or “cannot determine”. The repeatability of the categorizations was fair: kappa = 0.44. Only the tympanic membranes categorized identically twice were used for data analysis. The left‐right symmetry of the tympanic membrane categorizations was fair: correlation coefficient phi = 0.42. Subjects categorized as having bilaterally normal tympanic membranes were considered to have not had previous otitis media (N = 95). In contrast, subjects categorized as having at least one abnormal tympanic membrane were considered to have had previous otitis media (N = 13). Head length and width, measured by calipers, and the cephalic index (width divided by length) × 100 were determined for each person. On the average, the cephalic index of the normal subjects was lower than that for the subjects with otitis media (t = 3.06, p < 0.005). These data support the suggestions of Pautow (1925) and Worley et al. (1987): dolichocephalic persons have otitis media less often than do brachycephalic persons. Though this association is not useful in clinical care of the individual patient, it may be considered a weak external manifestation of the different cranial base and eustachian tube anatomy found in persons with otitis media.
Pressure‐Equalization (PE) Tubes in Treatment of Otitis Media: National Survey of Otolaryngologists
Authors: Heald Melinda M. , Matkin Noel D. , Meredith Keith E. 
Published: November 2015

This study was designed to describe those indicators for the insertion of pressure‐equalization (PE) tubes given highest priority by board‐certified otolaryngologists. An original questionnaire was mailed to 1000 board‐certified otolaryngologists practicing in the United States. The respondents rated the relative importance of 22 indicators on a 6‐point scale. These indicators were grouped into four categories: Medical History, Physical Examination, Audiologic Evaluation, and Related Indicators. With a return rate of 52.7%, approximately 1 of every 9 board‐certified, practicing otolaryngologists in the United States was represented in the study. The five indicators with the highest ratings were: “persistence of fluid for 3 or more months per episode,” “presence of speech‐language delay,” “presence of bilateral conductive hearing loss of 20 dB or more,” “total number of episodes of otitis media,” and “lack of response to suppressive antibiotic therapy.” Additional analyses of the data yielded information regarding characteristics of the responding physicians and the self‐generated indicators.
Rhinectomy: Timing and Reconstruction
Authors: Teichgraeber John F. , Goepfert Helmuth 
Published: November 2015

Cancer of the nasal skin is usually well‐circumscribed, superficial, and has an excellent prognosis. However, a small number of aggressive lesions require a partial or total rhinectomy. We retrospectively reviewed patients seen at the M.D. Anderson Cancer Center between January 1, 1970, and December 31, 1980, for nasal cancer. There were 147 patients identified as requiring full‐thickness nasal resections, of whom 68 (46.3%) required a hemi‐ or complete rhinectomy. Lesions requiring extensive rhinectomy usually involved the ala or were recurrent multicentric, squamous cell carcinomas greater than 4 cm. These patients had significantly poorer prognoses than the group in general. Recurrence developed in 45 patients (30.6%), and two thirds of all recurrences were seen within 2 years. In this series, the histology of the malignancy and its size, in the case of large basal cell carcinomas, were both predictive of a poor prognosis. Only the primary site was significant in predicting recurrence, whereas tumor size and histology were significant predictors of the need for an extensive rhinectomy. Delayed reconstruction is recommended in patients who are in poor health and have large recurrent lesions that are multicentric or involve the ala or dorsum. The timing of reconstruction is individualized, but a 2‐year wait after surgery is recommended. Prosthetic rehabilitation is a good interim measure.
Endoscopic sinus surgery: Outcome in 155 cases
Authors: Matthews Brian L. , Smith Lee E. , Jones Robert , Miller Chase , Brookschmidt Joni K. 
Published: November 2015

For this retrospective study of endoscopic sinus surgery, charts of 22 patients from a medical center and 133 patients from a private practice (N = 155) were reviewed. Preoperative complaints, clinical findings, computed tomographic evidence of extent of sinus disease, surgical outcome, possible predictors of success, and complications were considered. Indications for endoscopic surgery were persistence of symptoms despite aggressive medical therapy and radiologic evidence of a significant sinus abnormality. Median followup was 12 months. Hemorrhage occurred postoperatively in two patients (1.5%); 17 patients required additional endoscopic surgery. Overall, 140 (91%) patients believed that the surgery was beneficial. Patients with facial pain pre‐operatively showed the greatest improvement. All patients having simultaneous septoplasty (N = 64) had successful outcome. The total number of opacified sinuses was not a predictor of outcome, but opacification of the sphenoid sinus correlated with a poorer outcome. The patients seen at the medical center had poorer results, but had a larger number of opacified sinuses, were more likely to have had previous sinus surgery, and were more likely to have underlying medical conditions contributing to their sinus disease.
The potassium‐titanyl phosphate laser for treatment of turbinate dysfunction
Authors: Levine Howard L. 
Published: November 2015

Patients with nasal turbinate dysfunction most often are seen by the physician with such symptoms as watery nasal secretions, nasal obstruction, congestion, facial pressure, or pain. There will often have been multiple attempts to manage the problem medically and symptomatically with antihistamines, decongestants, antibiotics, nasal cromolyn, and topical or systemic steroid therapy. Some patients will have undergone numerous attempts at surgical therapy, most often with cryosurgery or cauterization. The cause of the symptoms of turbinate dysfunction for most of these patients is either vasomotor rhinitis, allergic rhinitis, or polypoid hypertrophic turbinates. A visible‐wavelength laser with a wavelength of 532 nm, the potassium‐titanyl phosphate laser has been used with nasal endoscopes to perform laser photocoagulation of the nasal turbinates. A description of the technique and early results have been previously reported. This article reports good long‐term results with the technique.
The effects of etidronate disodium on progressive hearing loss from otosclerosis
Authors: Kennedy David W. , Hoffer Michael E. , Holliday Michael 
Published: November 2015

A 2‐year prospective double‐blind study was performed to evaluate the role of etidronate disodium for the treatment of progressive hearing loss in patients with otosclerosis. A pulsed dosage regimen was used during the 2‐year period and the patients were followed up with otologic and audiometric examinations. Although statistically significant differences were not achieved between the study and control groups, the study did reveal a trend toward stabilization or improvement in air conduction thresholds in some frequencies (1000 and 4000 Hz) and in bone conduction thresholds at other frequencies (500, 1000, and 2000 Hz). The incidence of adverse side effects was similar in the treatment and control groups. Although no definite conclusions can be drawn from this pilot study, the findings provide encouragement for performing a larger and longer‐term study. (OTOLARYNGOL HEAD NECK SURG 1993;109:461‐7.)
Formation of mucosal polyps in the nasal and maxillary sinus cavities by infection
Authors: Norlander Tomas , Fukami M. , Westrin K. M. , Stierna P. , Carlsöö B. 
Published: November 2015

Unilateral maxillary sinusitis was experimentally induced in New Zealand White rabbits with Streptococcus pneumoniae serotype 3, Bacteroides fragilis NCTC 9343, and Staphylococcus aureus V8. In another group of rabbits, sinusitis was induced by blocking of the sinus ostium only. Bacteriologic and light microscopic analysis was performed after 5 days to 1 month. Granulation‐like polyps developed after deep mucosal inflammatory trauma initiating fibroblast proliferation, angiogenesis, and epithetlial migration to cover the polyp. In regions of a more superficial trauma—characterized by epithetlial desquamation and fibroblast growth—proliferation and differentiation of basal cells resulted in the formation of microcavities dissecting off edematous polyps. Polyps could be found in all sinusitis groups, irrespective of inducing agent. The cellular events of polyp formation appear to be the result of a continuous inflammatory reaction and are not directly related to the presence of a certain microorganism. Instead, the potential of any microorganism to induce a deep mucosal trauma or epithelial desquamation seems essential for its ability to initiate polyp formation. (OTOLARYNGOL HEAD NECK SURG 1993;109:522‐9.)
Dizziness in aging: A retrospective study of 1194 cases
Authors: Katsarkas Athanasios 
Published: November 2015

In the Royal Victoria Hospital dizziness clinic, 1194 of 9767 (12.22%) patients were 70 years of age or older on the day of the first visit. There were 750 women and 444 men, with no difference in age distribution (p > 0.9). In 367 (27.04%) cases (percentages given as “cases” refer to the number of diagnoses [N = 1357], not the number of patients [N = 1194]), the symptoms were nonspecific, and the diagnosis was uncertain. In 530 (39.13%) patients, paroxysmal positional vertigo was either confirmed or strongly suspected. In the 241 of 254 (94.88%) confirmed cases, the observed paroxysmal nystagmus was compatible with excitation of the posterior semicircular canal. In 119 (8.77%) patients, the dizziness could not be attributed to neurologic or vestibular disease. Meniere's disease, vestibular neuronitis, vascular episodes, and tumors were next in prevalence. The following conclusions were reached: (1) although no difference was found in age distribution between women and men, dizziness was more prevalent among women, which may be because of the higher survival rate of women; (2) the prevalence of paroxysmal positional vertigo was high, with apparent Involvement of the posterior semicircular canal in most cases (It is strongly suspected that paroxysmal positional vertigo is frequently misdiagnosed as vascular disease in advanced age); and (3) multisensory deficits, drugs, or systemic diseases, common in the elderly, may cause dizziness. Syndromes affecting the vestibular function, however, may be more prevalent in advanced age than is generally estimated.
Larynx Preservation with Combined Chemotherapy and Radiation Therapy in Advanced Hypopharynx Cancer
Authors: Kraus Dennis H. , Pfister David G. , Harrison Louis B. , Shah Jatin P. , Spiro Ronald H. , Armstrong John G. , Fass Daniel E. , Zelefsky Michael , Schantz Stimson P. , Weiss Michael H. , Wang Robert C. , Bosl George J. , Strong Elliot W. 
Published: November 2015

Twenty‐five untreated patients with advanced, resectable squamous cell carcinoma of the hypopharynx, for whom standard treatment would have required total laryngectomy, were treated with one to three cycles of cisplatin‐based chemotherapy with larynx preservation as the goal. Patients with a major (complete or partial) response to chemotherapy at the primary site were treated with definitive radiation therapy, with total laryngectomy reserved for salvage; patients with less than a partial response to chemotherapy had total laryngectomy and postoperative radiation therapy recommended. Four patients had a poor response to chemotherapy and thus were not candidates for laryngectomy. Total largynectomy was required for initial induction chemotherapy failure in five patients and for local recurrence in five others. Three additional patients had unresectable recurrence. Successful larynx preservation was achieved in 32% (8 of 25). With a median follow‐up period of 41 months, the actuarial overall and failure‐free 2‐year survival rates were 44% and 32%, respectively. These preliminary data suggest larynx preservation is feasible in patients with advanced lesions of the hypopharynx. Improved local and regional control must be incorporated into the larynx preservation approach for hypopharyngeal lesions. A prospective, randomized study is necessary for a more valid comparison with conventional therapy, including comparative assessments of survival, morbidity, cost and functional results.
Angiographic Embolization for the Treatment of Epistaxis: A Review of 108 Cases
Authors: Elden Lisa , Montanera Walter , Terbrugge Karel , Willinsky Robert , Lasjaunias Pierre , Charles David 
Published: November 2015

Ninety‐seven patients were referred to the Toronto Hospital (Western Division) between January 1984 and January 1992 for selective angiograpic embolization (108 embolizations, including repeat procedures) to control intractable or recurrent severe epistaxis. Eighty‐one patients (comprising 94 embolizations) were referred on an emergent basis because of failure of conventional conservative therapy, consisting of anterior and posterior packing. The remaining 16 patients (14 embolizations) were referred electively for recurrent epistaxis. A retrospective review of these cases was performed, with long‐term telephone follow‐up achieved in over 95% of cases. Embolization safely controlled active hemorrhage in 88% of the emergent cases. The success rate increased to 90% when two cases in which the source of epistaxis was found to be from the internal carotid artery were excluded (because these vessels could not be safely embolized). Of the patients whose epistaxis was initially controlled by embolization, 82% had no further nosebleeds (follow‐up time ranged from 2 to 82 months; average, 26.8 months). More than half of the long‐term failures were seen in patients with Osier‐Weber‐Rendu disease. Overall, the mortality rate was 0% and the long‐term morbidity rate was 2% (one cerebral vascular accident and one case of skin slough in the territory of the superficial temporal artery).