bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computerized Axial Tomography in the Preoperative Evaluation of an Angiofibroma
Authors: Duckert Larry G. , Carley Richard B. , Hilger Jerome A. 
Published: February 2017

Computerized axial tomography (CAT) of the head provides the otolaryngologist with an effective diagnostic tool. This technique is particularly useful when used in the preoperative evaluation of head and neck pathology and may be used to define the extent of disease and to direct the surgical approach.The case of a 16‐year‐old male with an extensive angiofibroma involving the paranasal sinuses and nasopharynx is presented as an example of CAT in preoperative planning of the surgical procedure. Computerized tomography was used initially to define the tumor margins. Serial CAT scans were also obtained at intervals during the patient's preoperative estrogen therapy. Evidence was obtained which suggests CAT may be used to monitor the effects of preoperative hormone management of angiofibromas and in the definition of the optimal time for surgery. In the case presented the final CAT scan provided a detailed and accurate description of the tumor margins which were confirmed at surgery. Our experience with a case of an extensive nasopharyngeal angiofibroma demonstrates the CAT scan to be a useful objective diagnostic method for preoperative planning.
The Osteotomy in Rhinoplasty
Authors: Farrior Richard T. 
Published: February 2017

The purpose is to assist the surgeon in the selection of modifications for nasal osteotomies.Details of the technique include: 1. Incision for osteotomy made perpendicular to the pyriform rim and modified incisions, intraoral or through the Weir incision. 2. Rasping of the lateral nasal vault prior to any osteotomies. 3. Removal of a modified beveled wedge of bone prior to the medial osteotomy, unroofing the bony dorsum to a higher level. 4. The medial osteotomy done prior to either the lateral or the intermediate osteotomy. The intermediate osteotomy is performed prior to the lateral. 5. “Complete” and “fading” medial osteotomies are utilized as indicated. 6. The lateral osteotomy may be relatively straight and low depending then on a transverse fracture or may be high and curved meeting the fading medial osteotomy. 7. A sub‐periosteal tunnel with the osteotome guard external to the bone is preferred to a submucosal tunnel.
Diatrizoate Meglumine (Hypaque) Treatment for Sudden Hearing Loss
Authors: Emmett John R. , Shea John J. 
Published: February 2017

During the 24 month period ending in December 1978, 31 patients with sudden idiopathic sensorineural hearing loss were treated with vasodilators and Hypaque.Fifteen patients met the treatment criteria of being treated within the first month following onset, no vertigo, and the hearing loss was not complete. Twelve patients (80%) had complete return of their hearing. Two patients (13%) had partial return of their hearing, and 1 patient (6%) had no response to treatment.Of the 16 patients treated who did not meet the criteria, 6 patients (38%) had complete return of their hearing. Eight patients (50%) had partial return of their hearing and 2 patients (12%) had no return of their hearing.
The Surgical Treatment of Ménière's Disease
Authors: Shea John J. , Emmett John R. , Mooxe Robert E. 
Published: February 2017

Ménière's disease is more common than was generally believed in the past. Stahle has calculated the incidence of Ménière's disease in Sweden. Using the same incidence for the United States, there ought to be 97,000 hospitalized inpatients with Ménière's disease of all ages in the whole population. The increased understanding of inner ear physiology and pathology during the past decade has changed the indication for operation towards an early intervention for preserving the hearing function.For the purposes of analyzing results, patients with Ménière's disease were divided into the following classes according to the hearing loss only: 1. Near normal hearing (no more than 10 db loss at 500, 1,000, 2,000). 2. Ascending audiogram, fluctuating (500 more than 10 db more than 2,000). 3. Flat audiogram, fluctuating (500 not 10 db different than 2,000). 4. Flat audiogram, non‐fluctuating (500 not 10 db different than 2,000). 5. Other, more extreme hearing loss, non‐fluctuating (2,000 10 db more than 500).In this study, 33 patients with early Ménière's disease had a subarachnoid endolymphatic shunt operation. Two patients belonged to Class 1 and 31 patients to Class 2. All had well‐visualized vestibular aqueducts on polytomography and most had a positive glycerin test done in conjunction with transtympanic electrocochleography.During the first postoperative year, two patients in Class 2 improved to Class 1 (normal hearing). The other 29 in Class 2 remained in Class 2. None was worse as regards hearing. Most were completely relieved or improved as regards vertigo.Early surgical drainage in Ménière's disease is effective and safe and should be performed prior to irreversible dilatation of the membranous labyrinth. Patients in Classes 3, 4, and 5, with excessive and widespread hydrops of the membranous labyrinth, should have a vestibular nerve section.
Retromastoid Microsurgical Approach to Vascular Compression of the Eighth Cranial Nerve
Authors: Leclercq Toussaint A. , Hill Charles L. , Grisoli Francois 
Published: February 2017

In our series of 10 patients, the age ranged between 31 and 69 years. Seven patients were followed for from 1–2½ years. Complaints consisted of tinnitus, vertigo, or both. Vegatative symptoms consisting of nausea or vomiting were minimal or absent. Audiometry revealed a varying neurosensory loss. Vestibular hypoexcitability was a common finding. Good discrimination appeared to indicate a vascular loop rather than hydrops. The neuroradiologic work‐up was unremarkable.Treatment consisted of neurovascular decompression of the VIIIth nerve by microdissection. The approach used was a retromastoid incision with a bony removal limited to 20 mm. Cerebrospinal fluid withdrawal and lateral decubitus positioning permitted visualization of the VIIIth nerve without retraction of the cerebellum. Lack of bleeding, rapidity of procedure and benign postoperative course are emphasized.The results on tinnitus and vertigo were satisfactory. No additional deficit was created by surgery. If the symptoms are significantly disabling, microsurgical exploration is indicated.
The Percentage of Cells in DNA Synthesis in Epidermoid Carcinomas of the Head and Neck: A Preliminary Report
Authors: Cinberg James Z. , Chang Tsueng H. , Bases Robert , Molnar John 
Published: February 2017

The in vivo study of cell kinetics of squamous carcinomas of the head and neck is in its infancy. One cell kinetic parameter, the labelling index (LI), the percentage of cells actively replicating DNA, was estimated in carcinomas of the oral cavity (10), larynx (6) and pharynx (5) by an histochemical immunoglobulin technique developed recently in our laboratory: the antinucleoside antibody technique (ANIP‐LI). Data from earlier experiments using autoradiography (3H‐thymidine) have established that the enzyme‐antibody and isotopic techniques are equivalent.The LI ranged from 1 to 30 with a mean of 13 in this group of tumors. The LI could not be evaluated for 14% (3/21) of the specimens. The 3 patients with tumors not suitable for ANIP‐LI had received a full course of radiotherapy and/or chemotherapy before they had entered our study. The higher the LI of the tumor, the greater the liklihood that the surgical stage would be higher than the clinical stage, most often as a result of clinically unrecognized lymph node metastasis. However, the number of tumors sampled was inadequate for a statistical trend to be identified.The potential for the LI to be useful in the formulation of improved therapeutic strategies awaits the accumulation of more data from studies currently in progress.
Prognostic Indicators in Chemotherapy for Head and Neck Carcinoma: Alkaline Phosphatase Levels
Authors: Katz Arnold E. , Hong Waun Ki , Bhutani Rakesh , Berman Leonard D. , Blanchard Gordan J. , Koff Raymond S. , Shapshay Stanley M. , Strong M. Stuart 
Published: February 2017

Serum alkaline phosphatase (AP), total bilirubin, total protein, serum albumin, and serum glutamic oxaloacetic transaminase (SGOT) were determined in 55 patients with biopsy proven carcinoma of the head and neck prior to their induction chemotherapy with cis‐platlnum and bleomycin. Of the 55 patients, 40 (73%) exhibited either a complete or partial response (tumor mass decreased by over 50%) to the chemotherapy.Responses were noted more frequently in patients with elevated AP levels. Nine of the 10 patients (90%) with AP levels > 100 mU/m1 experienced a major response; whereas, only 8 of 16 patients (50%) with AP levels < 60 mU/m1 demonstrated a favorable response to the chemotherapeutic agents.The source of the elevated AP levels has not yet been established. Possible sources include liver, bone, kidney, intestinal mucosa, or the tumor itself.Total bilirubin, total protein, serum albumin, and SGOT levels did not differentiate the responders from the non‐responders as accurately as did the AP levels.
Immune Response of Guinea Pig Tympanic Membrane
Authors: Poliquin Jacques F. , Catanzaro Antonio , Robb James , Ryan Allen , Schiff Maurice 
Published: February 2017

The authors present the results of their experiment on the immune response of the guinea pig tympanic membraneTM.The first step was to develop an antiserum in the rabbit from the guinea pig tympanic membrane (RAGPTM). The lamina propria was used and IgG was identified as the main constituent of this antiserum. In their initial experiment, the RAGPTM IgG seemed to be specific to the acellular connective tissues of the respiratory tract and TM.The experiment presented here is concerned with the immune response of the guinea pig tympanic membrane. The animals were sensitized by intracardiac injection with the antiserum, and within one hour the right TM was traumatized in diverse fashions (bacteriological, chemical, mechanical traumas). The left TM served as a negative control. Animals were sacrificed at 24 hours, 7 days and 21 days. Immunofluorescence staining, complement studies (C3) and immunoperoxidase techniques were used on the TM.It appears that the GPTM can be antigenic in the rabbit. The right TMs of the sensitized guinea pigs reacted differently in the sense that there seems to be homing of the RAGTM IgG to the site of trauma and that the complement participates in the reaction at least in the first week. The lamina propria of the TM is the site of the immune response.This work will need more elaborate studies but allows us to address different questions concerning the possible role of the combination of trauma and sensitization in conditions clinically involving the TM and middle ear.
The Surgical Closure of Nasoseptal Perforations
Authors: Goodman Wilfred S. , Strelzow Victor V. 
Published: February 2017

Although nasoseptal perforations are uncommon — becoming even more so with early diagnosis and treatment of nasal trauma along with continuing refinements in septal surgery — a myriad of suggested techniques continue to exist for their closure. The conventional success rate is often unacceptably low so that Silastic® prostheses are now being used to relieve the symptoms of septal perforation.The successful surgical closure of perforation of the nasal septum is still difficult. This treatment has been greatly facilitated by the use of the external rhinoplasty, without compromising the airway or causing cosmetic deformity. Supportive autogenous graft material is used routinely, while the perforation is closed using bilateral, bipedicled mucoperichondrial flaps.This paper omits a complete discussion of etiology. The indications for surgical correction are discussed in detail. The main contraindication to attempting correction is the size and the position of the perforation. The paper is based on 7 years' experience during which period 18 patients have had this surgery. The technical details of the operation are described with the aid of diagrams and photographs.
Auditory Distortion
Authors: Reiter David 
Published: February 2017

The auditory system responds to pulsatile energy flow from the environment. Compression and rarefaction of gaseous molecular mass is transduced into electromechanical forms, in order to produce an effect at the cortical level. For energy input to have consistent meaning, transduction must preserve information coded within the pattern of energy flow.Distortion, or alteration of the original form, occurs in many ways throughout the chain of generation/transmission/reception/interpretation. Parameters of energy flow are discussed, and distortion of each parameter is presented in a context which permits the development of a distortion‐based analysis of common clinical problems in otolaryngology.
History Of Medicine Jean Marc Gaspard Itard — 1774–1838
Authors: Chalat Ned I. 
Published: February 2017

Here is the history of French physician and otologist, Jean Marc Gaspard Itard (1774–1838). As physician for the Institute for Deaf Mutes in Paris, Dr. Itard became responsible for the care and civilization of the “wild boy of Aveyron,” also known as, “The Wild Child” of the Truffaut movie. Their encounter became the first carefully recorded effort to train a culturally deprived individual on a one‐to‐one basis, or perhaps on any basis.Dr. Itard's work leads directly through Dr. Sequin and Dr. Montessori to us today. If we now stand on the threshold of restoring hearing by implantation to the totally deaf, then the results we expect and the training programs we must follow will naturally take us back to the work of this physician of the French Revolution.
Juvenile Laryngeal Papilloma: Histologic And Photometric Evaluation Of Atypia
Authors: Bjelkenkrantz Kaj , Olofsson Jan , StÅL Olle , GröNtoft Otto 
Published: February 2017

Juvenile papillomas are the most common proliferative laryngeal lesion in children. Atypia may be present but is difficult to interpret owing to the basically benign character of the lesion. A histologic and clinical classification of 23 cases of juvenile laryngeal papillomas was performed following the criteria suggested by Quick and co‐workers in 1979 and intended to enable the clinical course to be more accurately predicted.The various histologic types of papillomas were characterized by single‐cell microdensitometry. The photometric study verified the increase in the relative width of the proliferative zone with the degree of atypia. Severe atypia was the only histologic type associated with hypertetraploid nuclei.The frequent occurrence of mild atypia was unrelated to the clinical course. The moderate and severe degrees of atypia were more common during periods of relatively frequent operations. Severe atypia was rare but in one patient it heralded the development of invasive carcinoma.
Nasolacriminal Dysfunction
Authors: Powell James B. 
Published: February 2017

This investigation describes the normal function of the lacrimal drainage system of the eye. The intent of the presentation is to illustrate by clinical examples and pertinent literature, those alterations of normal function occurring from obstruction, trauma, or neoplasm. Sixty‐nine patients with lacrimal dysfunction are included; 19 are offered in detail to illustrate principles of surgical management. It is not within the scope of this discussion to examine any condition which may cause primary hyperlacrimation or hypolacrimation, but to discuss: 1. the role of trauma as a cause of lacrimal drainage dysfunction. 2. the role of surgery in the prevention of lacrimal dysfunction, and 3. the role of surgery in the restoration of function.Among 18 patients with non‐traumatic obstruction treated by silicone stenting, previous multiple dilatations treatment was associated with a higher rate of failure than in those patients not previously treated by multiple dilatations. Forty percent of 96 patients with facial fractures of the medial orbit had obstructive nasolacrimal symptoms; 79% of the 96 patients' symptoms cleared spontaneously; 15% required treatment. No incidence of significant iatrogenic trauma (requiring surgical treatment) was found in reviewing 1292 cases of rhinoplasty, rhinoseptoplasty, blepharoplasty, or sinus surgery.Normal function and physiology are reviewed. From the experiences of 69 patients emerge clinically proven methods of surgical management of lacrimal system obstruction. These methods are defined and then compared and contrasted to traditional methods and concepts. When there is disagreement or no consensus, alternate theories are discussed in attempting to explain those clinical conditions which seem to defy accepted principles.This presentation includes cases which have been managed by surgeons other than the author and who have been trained in fields other than otolaryngology. The cases offered in detail have been managed by the author.
High Resolution CT Scanning for Detection of Cholesteatoma and Complications in the Postoperative Ear
Authors: Voorhees Richard L. , Johnson Dexter W. , Lufkin Robert B. , Hanafee William , Canalis Rinaldo 
Published: February 2017

Otologists who prefer intact canal wall surgery for removal of cholesteatoma recognize a 12–25% return rate. Revisions often indicated to correct hearing loss are frequently negative for recurrent cholesteatoma.To determine the reliability of a noninvasive method of diagnosing recurrent disease and possible complications, 40 patients previously operated on for cholesteatoma using the intact canal wall technique were scanned with a General Electric 8800 scanner. Second procedures were performed on 24 patients and findings compared with preoperative film interpretations. Scans correctly predicted no significant masses in 6 patients and cholesteatoma recurrence in 11; the remaining 6 with diffuse soft tissue changes were incorrectly diagnosed. Focal areas of bone erosion were detectable in 3 cases, indicating active or potential complications. Scans were reliable in detecting cholesteatoma depending upon the pathology.
Mucin Impaction Tumor of The Paranasal Sinuses: A New Clinical Entity?
Authors: Wenig Barry L. , Sciubba James J. , Zielinski Benjamin Z. , Stegnjajic Arsen , Abramson Allan L. 
Published: February 2017

A variety of uncommon benign lesions occur in the paranasal sinuses and have been reported to masquerade as carcinomas. Nearly all of such cases have been limited to the frontal, sphenoid, and ethmoid sinuses with an isolated report of maxillary sinus involvement. The classic roentgenologic picture is that of bony destruction.Heretofore described destructive lesions of the maxillary sinus include the mucocele, mucous retention cyst, pseudocyst, pyocele and cholesteatoma. This report deals with a previously undescribed entity, the mucin impaction tumor located in a septate maxillary sinus. This inflammatory, non‐neoplastic tumor‐like condition, presents as chronic sinusitis with periorbital edema, malar swelling and tenderness. Radiologic examination reveals total destruction of the bony walls of the nose, of the orbital rim and floor and of the maxillary sinus. The importance of recognizing this lesion lies in its benign nature but destructive capabilities. The destruction may possibly be accounted for by its anatomical origin in the septate sinus.Repeated surgical intervention may also serve to predispose or potentiate development of these lesions. Its resolution after adequate surgical extirpation and its place in the differential diagnosis of antral lesions are worthy of emphasis.
Tympanic Membrane Mobility on Otoscopy as an Indicator of Eustachian Function
Authors: McNicoll William D. 
Published: February 2017

Three hundred and twelve ears in 156 subjects were assessed. All the subjects were recruit volunteers to the Submarine and Diving
branches or the Royal Navy, who were unable to equilibrate their middle ear pressures when exposed to an environment or increased ambient pressure. All these subjects were found to have a deformity or the vomero‐ethmoid suture and underwent submucous resection or the nasal septum to correct their Nose‐Ear Distress syndrome.Six weeks after operation each recruit was re‐assessed otologically: 29 subjects (18.6%) had bilaterally immobile tympanic membranes and 6 subjects (3.9%) had an unilaterally immobile tympanic membrane on performance or the Valsalva and Toynbee maneuvers. Nevertheless, 26 subjects (74.3%) were able to equilibrate their middle ear pressures at a depth equivalent to 10 meters or water. Because or this finding It can be stated that immobility of the tympanic membrane on performance or the Valsalva and Toynbee maneuvers does not necessarily denote the presence of eustachian tube dysfunction.
Surgeon's View of the Skull Base from the Lateral Approach
Authors: Goldenberg Robert A. 
Published: February 2017

This paper presents the surgical anatomy of the skull base and infratemporal fossa. The information has been derived from the author's own experience in surgical and cadaver dissection, standard anatomical references, and selected experience of other skull base surgeons. Because the lateral approach has become the utilitarian method of exposure, the intricate detailed anatomy is demonstrated from this view at five levels of dissection, so the surgeon may gain a practical understanding of the surgical relationship of critical structures.Consistent anatomical landmarks can be used by the surgeon in the location of these critical structures. The styloid process, sphenoidal spine, and middle meningeal artery identify the internal carotid artery as it enters the carotid canal. The bony or fibrous septum that divides the jugular foramen into neural and vascular compartments may be used to better identify nerves IX, X, and XI. The zygomatic root is useful for location of the middle fossa dura. The lateral pterygoid plate leads directly to the foramen ovale.The increased precision of dissection permitted by use of the microscope requires an increased level of knowledge of anatomical structures in this area. It is hoped that the information presented in this paper will assist surgeons in the meticulous and thorough removal of skull base tumors and in the preservation of neural and vascular structures that are presently being sacrificed.
Impact Of Metastases on Nodal Immunoreactivity in Head and Neck Cancer
Authors: Schuller David E. , Koolemans‐Beynen Antoinette R. , Libby Debora H. , Rinehart John J. , Milo George E. 
Published: February 2017

It has been previously demonstrated by the authors that lymph nodes from patients with head and neck cancer are capable of regional immunoreactivity and that this immunoreactivity could be enhanced with certain nonspecific immunostimulants. However, it is unknown how metastases to the neck nodes would affect this immunoreactivity.The purpose of this study is to compare the immunoreactivity of matched node pairs (metastatic versus nonmetastatic) from head and neck cancer patients. The soft agar assay system was the methodology employed. The effect of nodal lymphocytes on tumor growth in soft agar was studied with and without nonspecific immunostimulation in both normal and metastatic nodes from the same location in the neck in 16 patients.The results demonstrate that lymph nodes from head and neck cancer patients are capable of an immune reaction to cancer, and that this immunoreactivity appears to be significantly increased in metastatic lymph nodes with and without the use of specific immunostimulants.