bluuebunny/crossref_metadata_2025_split huggingface dataset:
Iontophoresis Treatment
Authors: Lekas Mary D. 
Published: April 2016

Iontophoresis can be used as a method of treating herpes simplex virus and aphthous gingivostomatitis. Idoxuridine has been used for herpes simplex virus, and corticosteroids and antibiotics have been used for aphthous stomatitis. Levamisole hydrochloride has been used for both herpes simplex virus and recurrent aphthous stomatitis.A lidocaine and adrenaline mixture is used with iontophoresis for myringotomy procedures and equalizing tubes. Also, anesthesia of the skin and subcutaneous tissues with lidocaine hydrochloride by iontophoresis are useful for minor surgical procedures (“ouchless surgery”).
Correlation of Pharyngeal Fistulization with Preoperative Radiotherapy, Reduced Serum Albumen, and Dietary Obstruction
Authors: Gullane Patrick J. , Jabbour Joseph M. , Conley John J. , Nealon Thomas F. 
Published: April 2016

The clinical courses of patients on the Head and Neck Service undergoing radical procedures were reviewed in retrospect. Factors that appeared to influence the courses such as preoperative radiotherapy, reduced serum albumen, and preoperative oropharyngeal obstruction were correlated with fistulization rate, flap necrosis, and other complications.The study included 105 radical procedures performed over a seven‐month period. Sixty‐six of these operations included laryngectomies, laryngopharyngectomies, and composite resections.The overall complication rate was 37%, with major complications accounting for 9%. A fistula rate of 20% was found in the pharyngeal group and ranged from 12% in the nonirradiated patients to 44% in the irradiated group.Those patients with preoperative obstruction secondary to tumor bulk had a complication rate of 58%. Patients with reduced serum albumen levels had a higher complication rate of 55% compared with 35% for the group with normal albumen levels.This study suggests that preoperative replenishment of protein, particularly in the obstructed patient or in those with reduced serum albumen levels, would correlate with a more favorable clinical course.
Completion Laryngectomy
Authors: Myers Ernest M. , Ogura Joseph H. 
Published: April 2016

From 1965 to 1975, 452 total laryngectomies were performed at the Washington University Medical Center, St Louis. Forty‐two or 9% were completion laryngectomies. Completion laryngectomy is defined as the removal of the remaining larynx following an antecedent partial laryngectomy. These 42 cases are retrospectively analyzed with regard to original conservation surgery, clinical presentation, histopathology, and salvage rate.The most common indications for completion laryngectomy were (1) local recurrence, (2) local recurrence with associated severe upper repiratory obstruction, and (3) fistula control. The overall salvage rate following completion laryngectomy was 55% (23 patients). The highest rate was in patients with previous hemilaryngectomy (69%), followed by subtotal supraglottic laryngectomy (44%) and partial laryngopharyngectomy (14%). There is a high incidence of stomal occurrences (24% or ten patients) associated with completion laryngectomy, particularly in patients with antecedent hemilaryngectomy.Most indications for completion laryngectomy appear early; however, all patients must be carefully followed up after conservation surgery.
Ossicular Abnormalities in Down's Syndrome
Authors: Balkany Thomas J. , Mischke Robert E. , Downs Marion P. , Jafek Bruce W. 
Published: April 2016

Down's syndrome has been associated with hearing loss and otitis media. Because of difficulty in examination, however, there have been few detailed otologic studies on this population. An understanding of the nature and frequency of ear disease in Down's syndrome is important, since it is common and occurs in more than one in every 600 live births.To define the aural manifestations of Down's syndrome, complete otologic and audiometric examination was performed on 107 consecutive patients. This included micropneumatic otoscopy, pure‐tone and speech audiometry, impedance tympanometry, and, in some cases, electronystagmography. Deficient hearing was found in 64% of these patients, and of these hearing losses, 83% were conductive.Surprisingly, middle ear effusion or tympanic membrane perforation accounted for only 60% of the conductive hearing losses. This finding prompted us to examine five temporal bones of children with Down's syndrome. These histologic sections revealed middle ear abnormalities including fixation and superstructure deformity of the stapes and dehiscence of the fallopian canal. Operative findings in 16 procedures on patients with Down's syndrome and conductive hearing loss support those findings.
Transposition of Infrahyoid Muscles to Replace Intrinsic Laryngeal Muscles: Technique and Long‐Time Observations on Return of Function
Authors: Harvey Joseph E. 
Published: April 2016

The motor branches to the abductor and adductor muscles of the larynx were dissected unilaterally and Inserted separately into an infrahyoid muscle in six dogs. Sixty days later a strip of muscle nourished only by the nerve's vessels was transposed to replace submucosally extirpated intrinsic laryngeal muscles. After 36 months, three surviving dogs showed normal electrical activity in the transposed muscles but no effective motion of the affected cord.Two dogs were treated similarly except that the entire cross section of the sternothyroid was transposed with vessels intact. At 12 months one of the dogs had essentially normal laryngeal function, which ceased upon section of the nerve. Six dogs had a cross section of the sternothyroid with vessels sutured into the larynx and concurrent insertion of motor branches into abductor and adductor regions of the muscle. At three years, one surviving dog had a normal range of motion on the experimental side and an excellent voice. Histologic sections showed predominantly normal fibers in the transposed muscle.In another group, the sternohyoid was sectioned transversely and sutured to the muscular process of the arytenoid to function as the adductor muscles and received the adductor branch of the nerve. The sternothyroid was sectioned at midlength, the distal end of the proximal segment was turned craniad and sutured to replace the abductor muscle, and it received the abductor nerve. This procedure was abandoned since it embarrassed the blood supply of sternothyroideus, and was replaced with a procedure in which the sternothyroid muscle was sectioned free of the thyroid cartilage and moved dorsally substitute for the abductor muscle.Correlation of visual and electromyographic observations strongly suggests that normal emg potentials may be recorded in reinnervated muscles with little or inappropriate mechanical function, as well as in those with normal function.
Juvenile Spindle Cell Carcinoma
Authors: Potsic William P. , Raney R. Beverly , Buck Billy E. , Fischer Steven W. 
Published: April 2016

Spindle cell carcinoma is an uncommon variant of squamous cell carcinoma that is rarely seen in children. The spindle cell pattern is frequently confused with sarcomas.A case of spindle carcinoma in a 14‐year‐old boy is presented. He is the youngest patient, to the authors' knowledge, with spindle cell carcinoma of the maxilla.Electron microscopic examination is helpful to define the epithelial nature of the spindle cells and can be performed on formalin‐fixed tissue. Electron microscopic examination is essential to formulate an optimal treatment plan.
Malignant Schwannoma of the Trigeminal Nerve
Authors: Karmody Collin S. 
Published: April 2016

Malignant schwannomas are rare in the head and neck, even though benign schwannomas of this area are common. A case of a malignant schwannoma of the fifth cranial nerve with symptoms of otalgia and serous otitis media is described.About 20 such cases have been reported in the literature.
Case Report: Cellular Medullary Carcinoma as Cervical Metastases of Undetermined Origin
Authors: Pearson Bruce W. , Unni Krishnan K. , Sizemore Glen W. , Norman Stanley G. 
Published: April 2016

A healthy 27‐year‐old man with a lump in the lateral midneck was examined. Results of a recent biopsy performed elsewhere indicated amelanotic melanoma. A careful search for a primary integumentary or upper respiratory site of origin, including appropriate roentgenograms and a thyroid scan, was negative.At right radical neck dissection, the pathologic diagnosis was expanded to include anaplastic carcinoma. Subsequent examinations of the head and neck were negative. The neck and upper aerodigestive system were subjected to a full course of radiotherapy.Pathologic study of this tumor was continued. Electron microscopy indicated the tumor was epithelial, possibly of glandular epithelial origin.A tumor nodule reappeared in the right tracheoesophageal groove. Surgery was performed and the nodule was removed. The right thyroid lobe was removed also and submitted for histopathologic study. A solitary microscopic tumor focus, presumably anaplastic thyroid carcinoma, was found within the thyroid. Further pathologic studies were undertaken. Eventually, amyloid deposits were discovered, and a final diagnosis of cellular medullary thyroid carcinoma was established. Further studies of this patient and his family for multiple endocrine adenoma have been negative.
Electron Microscopic Findings in Presbycusic Degeneration of the Basal Turn of the Human Cochlea
Authors: Nadol Joseph B. 
Published: April 2016

Three human temporal bones with presbycusis affecting the basal turn of the cochlea were studied by light and electron microscopy. Conditions in two ears examined by light microscopy were typical of primary neural degeneration, with a descending audiometric pattern, loss of cochlear neurons in the basal turn, and preservation of the organ of Corti. Ultrastructural analysis revealed normal hair cells and marked degenerative changes of the remaining neural fibers, especially in the basal turn. These changes included a decrease in the number of synapses at the base of hair cells, accumulation of cellular debris in the spiral bundles, abnormalities of the dendritic fibers and their sheaths in the osseous spiral lamina, and degenerative changes in the spiral ganglion cells and axons. These changes were interpreted as an intermediate stage of degeneration prior to total loss of nerve fibers and ganglion cells as visualized by light microscopy.In the third ear the changes observed were typical of primary degeneration of hair and supporting cells in the basal turn with secondary neural degeneration. Additional observations at an ultrastructural level included maintenance of the tight junctions of the scala media despite loss of both hair and supporting cells, suggesting a capacity for cellular “healing” in the inner ear. Degenerative changes were found in the remaining neural fibers in the osseous spiral lamina. In addition, there was marked thickening of the basilar membrane in the basal turn, which consisted of an increased number of fibrils and an accumulation of amorphous osmiophilic material in the basilar membrane. This finding supports the concept that mechanical alterations may occur in presbycusis of the basal turn.
Evidence for Intracochlear Impedance Changes Following Ethacrynic Acid Administration
Authors: Himelfarb Mordechai , Kroin Jeffrey , Strelioff David 
Published: April 2016

The effects of intra‐arterial 30‐, 40‐, and 50‐mg/kg doses of ethacrynic acid upon cochlear function in guinea pigs were studied for periods of three to five hours. Cochlear potentials recorded in the first turn included the endocochlear potential, whole nerve response, cochlear microphonics, and summating potentials in scala media, scala tympani, and scala vestibuli. Evidence of organ of Corti damage at 50 mg/kg was found in addition to electrical impedance changes in the cochlear membranes at all dose levels.
A Review of the Use of Avitene in Otolaryngologic Surgery
Authors: Johnson Leland P. 
Published: April 2016

Chairman's Comments: Control of hemorrhage is a problem familiar to all otolaryngologists, whether the bleeding occurs post‐tonsillectomy, from spontaneous epistaxis, or from major head and neck surgery. Operating room aids in obtaining hemostasis include pressure, hot packs (to accelerate the coagulation process), ligatures, hot cautery, electrocoagulation, and a variety of pharmaceutical products. This latter group is reviewed by Leland P. Johnson, MD, from the Division of Otolaryngology at the University of Utah, particularly microfibrillar collagen hemostat (Avitene). Dr Johnson brings the uses and abuses of this expensive but often invaluable material into sharp focus. This information is prepared under the sponsorship of the Committee on Drugs—Otolaryngology of the American Academy of Otolaryngology.George A. Gates, MD
Dysphagia in Laryngectomized Patients
Authors: Jung Timothy T. K. , Adams George L. 
Published: April 2016

Records of 226 laryngectomies performed at the University of Minnesota Hospitals and Minneapolis Veterans Administration Hospital from 1967 to 1976 were surveyed, yielding 36 patients with significant dysphagia. The majority of these patients were treated with combined therapy of preoperative radiation followed by surgical intervention. They were evaluated by esophagographic and endoscopic examinations. Among this group of patients, 16 had a benign pharyngeal stricture, 14 had recurrent tumor, two had lower esophageal stricture, and four had malignant esophageal carcinoma.Early detection of recurrent tumor is often difficult in a firm, woody radiated neck. Dysphagia may be the first sign of recurrence preceding obvious detectable recurrent tumors by several months. A barium swallow may show signs of early recurrence that may not be detectable by endoscopic examination. The radiographic evidence of recurrent tumor is described.
Meniere's Disease: Treatment with the Endolymphatic Subarachnoid Shunt, a Review of 125 Cases
Authors: Brackmann Derald E. , Anderson Robert G. 
Published: April 2016

A critical review of the results of treatment of 125 patients with Meniere's disease by the endolymphatic subarachnoid shunt is presented. Of the patients, 61% experienced improvement in vertigo. Hearing stabilized or improved in the majority of cases.Detailed analysis of preoperative factors did not enable prediction of the likelihood of success in an individual case. The controversy regarding surgical therapy of Meniere's disease is discussed, and the conclusion that there is a role for endolymphatic sac surgery in the treatment of Meniere's disease is presented.
Corticosteroids in the Management of Laryngotracheobronchitis
Authors: Hawkins Donald B. 
Published: April 2016

Chairman's Comments: A growing body of clinical evidence obtained in a scientific manner is supporting the efficacy of corticosteroids for initial treatment of viral croup. Donald B. Hawkins, MD, a member of the Committee on Drugs—Otolaryngology and a faculty member of the Department of Otolaryngology at the University of Southern California, review the results of these studies in a scholarly manner.Dr Hawkins traces the development of the clinical experience with corticosteroids and clearly points out the differences between controls and treated patients in the respective studies. The Committee urges readers to review the articles and discuss the conclusions with their pediatric colleagues. The increased margin of safety afforded by the administration of corticosteroids to patients with laryngotracheobronchitis should be of interest to all physicians concerned with lowering the risk of airway obstruction in this common clinical disorder.George A. Gates, MD
Rare Tumors of the Cerebellopontine Angle
Authors: Brackmann Derald E. , Bartels Loren J. 
Published: April 2016

In a series of 1,354 cerebellopontine angle tumors treated at the Otologic Medical Croup, approximately 10% were lesions other than acoustic neurinomas. Of the non‐acoustic tumors, the majority were meningiomas, primary cholesteatomas, and neurinomas of other cranial nerves in the posterior fossa. Twenty‐five other lesions were encountered; these rare tumors are the subject of this study.The benign tumors resemble acoustic neurinomas in appearance and in the method of treatment. Malignant tumors are characterized by rapid development of symptoms and are difficult to treat because of invasion of vital structures in the area.
Patient‐controlled analgesia (PCA) in head and neck surgery
Authors: Cannon C. Ron 
Published: April 2016

Patients undergoing head and neck surgery often have significant pain because of the anatomic area involved, the nature of the surgery and trauma associated with the anesthesia and surgery, or the use of packing postoperatively. A patient‐controlled analgesia (PCA) infuser is available that allows the patient to direct delivery of their own analgesia. The physician orders the narcotic analgesic dose to be given, the interval between doses, and the total amount of analgesic to be delivered over 4 hours. The patient simply presses a button connected to the analgesic infuser, which delivers a predetermined intravenous dose of the particular analgesic. The infuser is then “locked out” for an interval of 10 to 15 minutes before the patient can direct another dose of medicine. This system allows the patients to initiate intravenous delivery of their narcotic analgesic, and maintain control of pain, using small incremental doses of the analgesic agent. This PCA pump has been used successfully in a number of patients undergoing various general, head and neck, and facial aesthetic procedures. The general concept of the PCA pump, guidelines for use, and contraindications are presented.
Inhibition of endogenous superoxide dismutase with diethyldithiocarbamate in acute island skin FLAPS
Authors: Freeman Todd J. , Maisel Robert H. , Goding George S. , Cohen James I. 
Published: April 2016

Oxygen free radicals have been implicated in postischemic tissue damage in a variety of experimental models including the island skin flap. Previous studies have demonstrated that supplementing animals with exogenous superoxide dismutase (SOD), a free radical scavenger, improves tissue survival in island flaps. No studies to our knowledge have attempted to inhibit endogenous SOD in a skin flap model. In this experiment 20 control rats demonstrated a 12.00% flap necrosis 7 days after a modified ventral island skin flap was raised. A second group of 20 rats were supplemented with exogenous SOD (50,000 U/kg 30 minutes preoperatively and 12 hours postoperatively) and demonstrated a statistically significant decreased flap necrosis of 5.28%. A third group of 20 rats received diethyldithiocarbamate (DDC, 0.5 gm/kg 12 hours preoperatively), an agent previously shown to inhibit SOD, and demonstrated a statistically significant increased flap necrosis of 19.77%. In a final group of 20 rats the effect of DDC was overcome by supplementation with exogenous SOD, obtaining a flap necrosis of 8.35%. Our results add further support to the importance of SOD and oxygen free radicals in postischemic tissue damage by demonstrating increased tissue necrosis with inhibition of endogenous SOD. This suggests that there is a baseline degree of SOD activity in ischemic areas working to preserve tissue. It appears that the copper‐containing species of SOD found primarily in the cytoplasm plays a pivotal role in preservation of postischemic tissue.
Serial measurement of blood flow in expanded tissue by laser doppler velocimetry
Authors: Canady John W. , Squier Christopher A. , Kelly Kevin M. , Bardach Janusz 
Published: April 2016

This study provides additional information about changes in blood flow in expanded tissue as measured by laser Doppler. Five one‐kilogram albino Hartley guinea pigs were implanted with commercially available hemispheric expanders. The expanders were inflated every 3 days on four successive occasions. Blood flow measurements were taken on each animal just before each inflation, immediately after inflation, and then at 1, 2, 3, 4, and 24 hours after expansion. Measurement of flow changes immediately after each inflation of the expander showed that, initially, blood flow in the tissue overlying the expander recovered quickly, but as the expansion process was continued, the flow did not return to baseline values so rapidly. This might be an indication that tissue expansion in patients could be carried out more rapidly during the initial inflations, with increasing recovery periods between inflations as the expansion process continued.
A study in persons later after stroke of the relationships between social participation, environmental factors and depression
Authors: Zhang Lifang , Sui Minghong , Yan Tiebin , You Liming , Li Kun , Gao Yan 
Published: April 2016

Objective: To explore the impacts of social participation and the environment on depression among people with stroke. Design: Cross-sectional survey. Setting: Structured interviews in the participants’ homes. Subjects: Community-dwelling persons with stroke in the rural areas of China ( N = 639). Interventions: Not applicable. Main measures: Depression (Hamilton Rating Scale for Depression-6), activity and social participation (Chinese version of the World Health Organization’s Disability Assessment Schedule 2.0), environmental barriers (Craig Hospital Inventory of Environmental Factors), neurological function (Canadian Neurological Scale). Results: A total of 42% of the variance in depression was explained by the environmental barriers, neurological function, activity, and social participation factors studied. Social participation, services/assistance, and attitudes/support were directly related to depression; their standardized regression coefficients were 0.530, 0.162, and 0.092, respectively ( p ⩽ 0.01). The physical environment, policies, and neurological function indirectly impacted depression. Depression influences social participation in turn, with a standardized regression coefficient of 0.29 ( p ⩽ 0.01). Conclusions: Depression and social participation are inversely related. The physical environment, services/assistance, attitudes/support, and policies all impact post-stroke depression.
Hydroxysafflor yellow A improves established monocrotaline-induced pulmonary arterial hypertension in rats
Authors: Han Xiaotong , Zhang Yixiong , Zhou Zhou , Zhang Xingwen , Long Yanfei 
Published: April 2016

Objective To evaluate the beneficial effects of hydroxysafflor yellow A (HSYA) on monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH) in rats, and to investigate the main pathophysiological mechanism of HSYA in preventing development of MCT-induced PAH. Methods Four groups (control, control with HSYA treatment, MCT-exposed, and MCT-exposed with HSYA treatment) were evaluated at day 28 following MCT exposure. Haemodynamic measurements, right ventricular hypertrophy, morphometry, inflammatory cytokines and oxidant expression were assessed. Results HSYA significantly reduced haemodynamic changes, right ventricular hypertrophy and morphometric changes induced by exposure to MCT. HYSA also suppressed MCT-induced inflammation and oxidative stress in rat pulmonary tissue. Conclusions Experimental MCT-induced PAH may be reduced by HSYA treatment, and the mechanism may involve suppression of inflammation and oxidative stress.