bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preschool Otologic and Audiologic Screening
Authors: Hopkinson Norma T. , Schramm Victor L. 
Published: April 2016

A study of otologic and audiologic screening of preschool children including tympanometry, acoustic reflexes, and pure‐tone screening was carried out at school sites. Subsequent pure‐tone threshold tests and otolaryngologic examinations were carried out in a hospital setting.Complete data are available on 1,335 subjects, ages 3 through 5 years. Results are reported in comparison with those of an earlier Pittsburgh screening study.1 The results of the earlier study showed that loss of hearing sensitivity could not be predicted by the otologic findings, and conversely, the otologic findings could not be predicted by the air conduction thresholds. The results of the present study showed a contribution by tympanometry and acoustic reflexes. The results are evaluated in terms of screening effectiveness in these age groups. One of the recommendations combines an interpretation of certain large negative tympanometric peak pressures (TPP) along with the absence of acoustic reflexes to certain stimuli. The method is more efficient than other aspects of middle ear measurement or of pure‐tone screening.The efficiency of each procedure is documented. Summary matrices are used to show the effectiveness of each test compared to all other tests in the identification of subjects with hearing or middle ear dysfunction. A protocol for screening evaluation and otologic referral is suggested to effect a balance between over‐referral and correct identification.
Sterile Preparation of the External Auditory Canal with Povidone‐Iodine
Authors: Balkany Thomas J. , Berman Stephen A. , Watson William J. 
Published: April 2016

Sterile preparation of the external auditory canal is usually not undertaken, although the external auditory canal provides surgical access for several procedures involving the tympanic membrane, middle ear, and vestibule. This is due to the rarity of postoperative wound infections, as well as difficulty in sterilizing the external auditory canal.Four antiseptic solutions commonly used for operative preparation were tested to determine their potential for sterilizing the external auditory canal. Povidone‐iodine solution was effective in sterilizing 90% of the external auditory canals of children and adults. This simple technique may find clinical use in surgical procedures involving the external auditory canal.
Pediatric Jaw Fractures: Indications for Open Reduction
Authors: Krausen Anthony S. , Samuel Martin 
Published: April 2016

Jaw fractures in children are generally managed without major surgical intervention. Closed reduction usually is sufficient to restore normal anatomy and function. The one inviolate principle is early treatment.During the past three years, four pediatric jaw fractures that required open reduction were treated. This mode of treatment was necessitated by the limitations imposed by pediatric dental anatomy and by the type of fractures encountered. In at least 24 months of follow‐up, no dental problems have been seen.
Fenestration Tympanoplasty: An Adjunctive Technique for Hearing Restoration
Authors: Blatt Irving M. 
Published: April 2016

Two‐staged fenestration tympanoplasty is a form of total tympanoplasty type V that incorporates the mastoidotympanomastoidectomy (radical mastoidectomy) and revives the Lempert horizontal semicircular canal fenestration operation. It is valuable when the usual and customary single or two‐staged tympanoplasty procedures fail to conserve or restore hearing in the operative management of otitic disease.Two‐staged fenestration tympanoplasty is also indicated in audiometric failure tympanoplasties, in oval window surgery failures in the absence of supporting ossicles and in the presence of a fibrosed or sclerosed oval window, and in severe otitic oval window‐round window‐posterior tympanic recess‐tympanic orifice eustachian tube infection, which can only be completely removed by the mastoidotympanectomy.Total tympanoplasty type V as described here has produced serviceable hearing for human conversation and the speech frequencies to the 15‐dB to 25‐dB levels, and a 20 dB average in 19 of 21 patients operated on for a 90% success rate.
Bleomycin
Authors: Lester Eric P. , Matz Gregory J. 
Published: April 2016

Chairman's Comments: The Otolaryngology Drug Capsule, a popular part of the Academy's publication, the Perceived, is being transferred to otolaryngology and head and neck surgery at the request of the editors of the Journal. This capsule is sponsored by the Committee on Drugs—Otolaryngology and represents a continuing effort by its membership.In this issue the clinical pharmacology of the useful antitumor drug, Bleomycin, is reviewed by Eric P. Lester, MD, and Gregory J. Matz, MD, from the University of Chicago.
The Tenacity of The Frontal Sinus Mucosa
Authors: Donald Paul J. 
Published: April 2016

A number of persons in other surgical disciplines express a blatant disregard for the potential dangers of frontal sinus mucosal entrapment. Although bone removal is universally recommended by the otolaryngologic proponents of ablative procedures in the frontal sinus, no comprehensive explanation has been proffered to justify this dictum.To this end, 27 cats had simple excision of the frontal sinus mucosa to see if it is necessary to bur away the inner table of bone to completely eliminate all vestiges of mucosa. Mucosal regrowth was seen in 72%, and suppurative infection, in 17% of the sinuses. Burring away of the frontal sinus inner table must then be considered as an essential part of any ablative procedure of the frontal sinus.
Ganglioneuroma of the C4, C5 Interspace
Authors: Norris Charley W. 
Published: April 2016

Neurogenic tumors in the neck region are relatively infrequent with the exception of those involving the cranial nerves. A case of a ganglioneuroma or neurofibroma involving the nerve root of C4, C5 interspace is reported. The tumor appeared as a mass within the neck with a slight amount of pain in the shoulder and upper arm upon palpation. Surgical exploration revealed a mass superficial to the foramen and erosion of the foramen. Roentgenograms taken in the region demonstrated an extradural mass that was subsequently removed by laminectomy. Postoperatively, the patient did quite well. Surgical excision is the treatment of choice. Preservation of the nerve should be accomplished if at all possible.
Multiple Simultaneous Paragangliomas of The Head and Neck in Association with Multiple Retroperitoneal Pheochromocytomas
Authors: Bogdasarian Ronald S. , Lotz Preston R. 
Published: April 2016

A patient in whom multiple, familial, catecholamine‐secreting head and neck paragangliomas and retroperitoneal pheochromocytomas were identified is reported. There were at least nine primary and possibly five recurrent neoplasms, the most reported in a single patient.In patients with family history of pheochromocytoma or paraganglioma or with multiple tumors, careful laboratory and angiographic studies are indicated to discover additional lesions.
Malignant Parapharyngeal Schwannoma (Neurilemmoma)
Authors: Shapiro Myron J. , Rickert Robert R. 
Published: April 2016

A malignant parapharyngeal neurilemmoma developed in a 45‐year‐old woman who had had a benign solitary neurilemmoma removed from the same area nine years previously. Incomplete excision was achieved through a mandibulotomy approach.Malignant schwannoma usually is associated with neurofibromatosis and has a poor prognosis, spreading along the nerve of origin or by blood stream. Small localized tumors should be treated aggressively by surgery.The possibility that a previously benign schwannoma underwent malignant transformation must be considered.
The Significance of Lysosomal Enzymes in Middle Ear Effusions
Authors: Bernstein Joel M. , Villari Elizabeth M. , Rattazzi Mario C. 
Published: April 2016

Although lysosomal enzymes have been demonstrated in middle ear effusions by several investigations, the exact source of these enzymes and the role they play in the maintenance and progression of otitis media with effusion have not been thoroughly studied.The source of lysososmal enzymes in middle ear fluids and their possible role in the inflammatory process in otitis media with effusion are explored.
The Role of Bacterial Enzymes in Inducing Inflammation in the Middle Ear Cavity
Authors: Lowell Seth H. , Juhn S. K. 
Published: April 2016

Current knowledge of the pathophysiology of bacterial infections is elementary. The initial events leading to the invasion of host tissues are a matter of conjecture for many bacterial organisms. This is particularly true for pneumococci, the most frequent causative organisms of acute otitis media.Bacterial enzymes may account for the initial disruption of host tissues, and this study explored their role in the infectious process. As a first step, pneumococcal cultures were analyzed, and significant levels of the enzymes lipase and hyaluronidase were demonstrated. Secondly, the presence of these enzymes in middle ear effusions was explored in an animal model of acute otitis media. The enzymes reached peak levels at seven days. The third and most important portion of the study examined the significance of these enzymes in producing inflammation and alterations in the middle ear cavity of normal experimental animals. This portion was a histologic comparison of temporal bone specimens and demonstrated that marked acute and chronic changes can be induced by placing solutions of these enzymes in the middle ear cavity. This study concludes that bacterial enzymes play an important role in the induction of acute otitis media.
The Penetration of Gentamicin and Neomycin into Perilymph Across the Round Window Membrane
Authors: Smith Bruce M. , Myers Martin G. 
Published: April 2016

Many commonly employed otic drops contain aminoglycoside antibiotics that may be toxic to the inner ear. A variety of chemicals such as ionic solutions, certain anesthetics, and epinephrine have been shown to diffuse across the round window membrane into the perilymph. Twelve adult cats were studied in this experiment. The auditory bulla was exposed and solutions containing gentamicin or neomycin concentrations similar to that commonly used in otic drops were applied to the round window niche for 15 minutes and washed with saline solution. The gentamicin and neomycin concentrations in the round window niche wash and the perilymph were then assayed by a radioenzymatic method.Concentrations of both antibiotics were observed in the perilymph. Thus, the round window membrane is a route through which these ototoxins may gain access to the inner ear.
Follicular Adenocarcinoma of the Thyroid in The Maxillary Sinus
Authors: Cinberg James Z. , Terrife Dessalyn 
Published: April 2016

No reports of metastatic thyroid carcinoma in the maxillary, ethmoid, or sphenoid sinuses can be found in the literature. A woman with severe posterior epistaxis was examined recently. She had undergone a partial lobectomy for a thyroid tumor 16 years previously. Hemorrhagic thyroid tissue was in the maxillary sinus. The results of subsequent examinations indicated thyroid deposits in the lung and spine. The patient received radioactive iodine, 100 MCi. Her lung and spine deposits lysed, and she experienced no further epistaxis. Thyroid carcinoma's ability to metastasize to a paranasal sinus is documented here. Epistaxis after a thyroidectomy for cancer now must be considered an unusual clinical manifestation of metastatic spread, unless otherwise proved. The differential diagnosis of epistaxis must now include thyroid carcinoma metastatic to the sinonasal tract.
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.
Use of Photoplethysmography to Determine The Survival Length of Skin Flaps
Authors: McCaffrey Thomas V. , Woods Robert D. , Kern Eugene B. 
Published: April 2016

Photoplethysmography was used to evaluate 14 skin flaps in the pig. Eight skin flaps were 4×12 cm and were based dorsally. Six skin flaps were 4×18 cm and were based ventrally. All flaps were designed to undergo necrosis of the distal end. After elevation of the flap, blood flow to the skin flaps was estimated immediately by means of intravenously administered fluorescein. Photoplethysmography was used to determine blood flow to the skin flaps at 3, 24, 72, and 144 hours after elevation. Surviving length of the skin flaps was measured at nine days. Fluorescein accurately predicted the surviving length of the skin flaps. Photoplethysmography did not show a decrease in blood flow at the level of fluorescein penetration 3 or 48 hours after elevation. However, 72 and 144 hours after elevation, an abrupt decrease in blood flow was noted by photoplethysmography at the level of eventual skin necrosis.
Use of Photoplethysmography to Determine the Survival Length of Skin Flaps
Authors: McCaffrey Thomas V. , Woods Robert D. , Kern Eugene B. 
Published: April 2016

Photoplethysmography was used to evaluate 14 skin flaps in the pig. Eight skin flaps were 4×12 cm and were based dorsally. Six skin flaps were 4×18 cm and were based ventrally. All flaps were designed to undergo necrosis of the distal end. After elevation of the flap, blood flow to the skin flaps was estimated immediately by means of intravenously administered fluorescein. Photoplethysmography was used to determine blood flow to the skin flaps at 3, 24, 72, and 144 hours after elevation. Surviving length of the skin flaps was measured at nine days. Fluorescein accurately predicted the surviving length of the skin flaps. Photoplethysmography did not show a decrease in blood flow at the level of fluorescein penetration 3 or 48 hours after elevation. However, 72 and 144 hours after elevation, an abrupt decrease in blood flow was noted by photoplethysmography at the level of eventual skin necrosis.
Squamous Cell Proliferative Lesion of the Nasopharynx in a Newborn
Authors: Stillwater Lyle B. , Fee Willard E. 
Published: April 2016

Nasopharyngeal tumors in the newborn are exceedingly rare. Typically, initial symptoms are breathing or eating difficulties. A case is presented of a patient in whom bleeding began following diagnostic passage of nasopharyngeal catheters. Surgical excision was required on the third day of life, and histologic review revealed a squamous cell proliferative lesion consistent with squamous cell carcinoma. The infant's postoperative course was uneventful. Specimens from a nasopharyngeal biopsy done six weeks later revealed only reactive lymphoid hyperplasia and at 6 months of age, the child's condition was normal. After review of the available literature and this patient's pathologic condition, it is believed that this lesion represents an otherwise un‐classifiable squamous cell proliferation previously not described.
Tongue Base Minor Salivary Gland Tumor: Report of a Case with Mucoepidermoid and Acinous Cell Components
Authors: Wetmore Stephen J. , Fan Kang 
Published: April 2016

A case of a large (5.5 cm), multilobulated, mucosa‐covered, minor salivary gland tumor of the base of the tongue that displayed morphologic features of both a mucoepidermoid carcinoma and an acinous cell tumor is described. Generally, each of these salivary gland tumors occurs only rarely at this site. A tumor with both these elements has not previously been reported.
Biomechanical Characteristics of the Human Trachea
Authors: Meyers Arlen D. , Bishop Harry E. , Peters Stan 
Published: April 2016

Previous experiments using mercury‐in‐Silastic strain gauges in dogs revealed the trachea to be a dynamic organ. The cartilaginous rings and intercartilaginous membranes are unique in adapting to the physiologic demands of respiration, deglutition, and gravity. Alterations in tracheal biomechanics following segmental tracheal resection were also documented.In the present study, a new device was used to measure the stress‐strain characteristics of the human trachea. The machine can be used to measure tension across trachea rings or the entire trachea. The results of these experiments indicate that the human trachea is a complex biomechanical organ and that it responds distinctively to stress.
Improved Survival Associated with Postoperative Wound Infection in Laryngeal Cancer: An Analysis of Its Therapeutic Implications
Authors: Schantz Stimson P. , Skolnik Emanuel M. , O'neill John V. 
Published: April 2016

A retrospective analysis revealed improved survival rates in laryngeal cancer patients who had postoperative wound infection following total laryngectomy and radical neck resection. The overall five‐year survival rates were 44% in the infection group and 31% in the control group. On further analysis, the beneficial effect of infection was most evident in patients with stage III disease. Seventy‐three percent of these patients with wound infection were alive at five years, compared with 32% of the control group.The protection from recurrent cancer in these patients afforded by the bacterial contamination may be secondary to activated immune mechanisms. The therapeutic implications of our findings suggest that the immune adjuvant is given at the time of surgical treatment rather than when tumor burden is far advanced. Only a few such protocols are under analysis presently.
Factors Influencing Tympanostomy Tube Function and Extrusion: A Study of 1, 127 Ears
Authors: Leopold Donald A. , McCabe Brian F. 
Published: April 2016

Shepard, long polyethylene, and Reuter‐bobbin tympanostomy tubes were studied for longevity in the inferior and anterior quadrants of 1, 127 tympanic membranes. Factors that improved tube functioning time significantly for all or certain tube types included (1) general anesthesia; (2) “virgin” tympanic membranes (Shepard, Reuter‐bobbin), (3) age of 9 years or younger (Reuter‐bobbin), (4) normal or thin tympanic membranes (Reuter‐bobbin), and (5) middle ear fluid (Reuter‐bobbin for all types of fluid).Negative correlations (or those not statistically significant because of such factors as sample size) for longevity of tube functioning time included (1) effect of multiple previous intubations in the same ear, (2) age over 10 years, and (3) quadrant of insertion. No significant difference in longevity was noted between normal patients and those with a repaired or unrepaired cleft palate deformity. The data suggest that the epithelial layer of the tympanic membrane influences the longevity of the tympanostomy tube function.
Surgery for Glomus Tumors at the Skull Base
Authors: Spector Gershon J. , Sobol Steven 
Published: April 2016

Glomus tumors of the temporal bone frequently involve the skull base. In the present study, 34% of the tumors occurred with cranial nerve palsies and 15% invaded the CNS.The procedure for surgical resection of glomus tumors of the skull base is described. Results of the procedure included successful surgical resection of 80% of the glomus jugulare tumors and of 94% of the glomus tympanicum tumors. Tumor recurrence and persistence occurred only in the patients with CNS invasion.
Surgical Therapy of Internal Carotid Artery Lesions of the Skull Base and Temporal Bone
Authors: Fisch Ugo P. , Oldring Derald J. , Senning Åke 
Published: April 2016

Five cases of carotid artery lesions at the skull base or temporal bone, treated surgically, are presented. These lesions include mycotic aneurysms and carotid stenosis secondary to angiofibroma and a glomus caroticum. One case demonstrated an anomalous carotid anatomic pattern with a persistent stapedial artery.A description is provided of the technique of subtotal petrosectomy with permanent anterior displacement of the facial nerve, and middle ear obliteration, thus achieving a safe exposure of the temporal course of the internal carotid artery.The cases indicate that cooperation between temporal bone surgeons and vascular surgeons is a prerequisite to successful repair of such lesions, as good recovery in all five cases was achieved. The techniques allow maintenance of carotid flow during and after repair, reducing the potential for neurologic complications or mortality.
Experimental Pneumococcal Otitis Media: A Histopathologic Study
Authors: Meyerhoff William L. , Shea Donald A. , Giebink G. Scott 
Published: April 2016

An animal model for pneumococcal otitis media was studied histologically at varying intervals postinoculation. Histologic changes generally associated with acute inflammation (edema, diffuse infiltration with polymorphonuclear leukocytes, and hemorrhage) occurred early in the disease while the ears were culture positive. Changes generally associated with chronic otitis media (lymphocyte infiltration and osteoneogenesis) occurred later in the course of the disease when the ears were culture negative. Metaplasia of middle ear mucosa and middle ear granulation tissue were observed as early as five days following inoculation.Middle ear granulation tissue was identified in 82% of all cases; cholesteatoma was seen in only one ear. Tympanic membrane perforation did not occur. Labyrinthitis and endolymphatic hydrops were fairly common findings. The former was identified in 56% of ears examined, and the latter, in 45%. These two conditions coexisted in 34% of ears studied, while endolymphatic hydrops alone occurred in 11%.
Drug Therapy of Aspergillus Otitis Externa
Authors: Lopez Leticia , Evens Ronald P. 
Published: April 2016

Chairman's Comments: True mycotic infections of the ear canal are far less common than realized: “swimmer's ear” is often ascribed to a fungus by nonotolaryngologists. However, mycotic infections, especially those due to Aspergillus, are difficult to eradicate and topical drug therapy is an important part of treatment.Lopez and Evens summarize the available literature related to treatment of Aspergillus external otitis in this drug capsule. Their review is interesting and informative. It is remarkable how many medications have been used for this stubborn condition.
Intracranial Abscesses Secondary to Ear and Paranasal Sinuses Infections
Authors: Maniglia Anthony J. , VanBuren John M. , Bruce William B. , Bellucci Richard J. , Hoffman Sanford R. 
Published: April 2016

The death rate of brain abscesses in a recently reported series is high, ranging from 36% to 50% of all cases. This paper reports experiences with ten cases of intracranial abscesses secondary to ear and sinus infections. Six of these abscesses are secondary to otitic infections with three of them located in the cerebellum. Two of the cerebellar abscesses are surgically drained through the temporal bone by the otologic surgeon, with close neurosurgical cooperation.Computerized axial tomography has revolutionized the treatment of intracranial abscesses optimizing the timing for medical and surgical management.