bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computerized Axial Tomography in the Assessment of Thyroid Cartilage Invasion by Laryngeal Carcinoma: A Prospective Study
Authors: Nathan Marshall D. , Gammal Taher El , Hudson James H. 
Published: April 2016

The purpose of this study was to assess the value of computerized axial tomography (CAT) in canine larynges that exhibit controlled surgical defects, and in 18 patients with biopsy‐proved epidermoid carcinoma of the larynx who were studied prospectively.Five canine larynges with sequential surgical defects of 0 mm, 5 mm, 10 mm, and 15 mm were studied by CAT in order to evaluate our ability to identify defects in the thyroid cartilage. A 5‐mm collimator with overlapping sections at 3‐mm intervals and a 13‐mm collimator with 5‐mm overlapping sections were both used for each stage of the experiment. Results show significantly improved resolution with the 5‐mm collimator compared with the 13‐mm unit. In the human study group, results demonstrated excellent (100%) soft‐tissue tumor site correlation.It appears from this study that we still lack a highly reliable radiographic technique for evaluating preoperatively with accuracy the integrity of the thyroid cartilage in the patient with carcinoma of the larynx.
Squamous Cell Carcinoma in Solitary Laryngeal Papilloma
Authors: Yoder Milton G. , Batsakis John G. 
Published: April 2016

This case report of a 20‐year‐old white woman is the youngest patient with a documented squamous cell carcinoma in a solitary nonirradiated laryngeal papilloma. It is rare for malignant degeneration of solitary squamous cell papilloma to occur in a patient under the age of 40.This case is also unique in that most solitary laryngeal papilloma with or without neoplasm occur in males. Most reported malignant neoplasms in squamous papilloma have been previously treated with irradiation. Because approximately 2% to 3% of solitary laryngeal papilloma have malignant neoplasms, adequate biopsy of the lesion and thorough histologic examination must always be done.
Current Status of Muscle Biopsy in Facial Paralysis
Authors: Crumley Roger L. 
Published: April 2016

The six abnormalities found in pathologic muscle biopsies are described and discussed. Those changes which are indicative of nerve denervation or muscle regeneration are tabulated.Muscle biopsy, as it relates to facial paralysis, must still be considered, for the most part, an experimental tool. In certain puzzling situations, eg, neonatal facial paralysis, it can be of value as an adjunct to nerve excitability and electromyographic tests.
Posterior Glottic Laryngeal Stenosis
Authors: Bogdasarian Ronald S. , Olson Nels R. 
Published: April 2016

Posterior glottic laryngeal stenosis most commonly results from endotracheal intubation and less commonly from external trauma or from infection. Following extubation, the patient may have immediate or delayed onset of symptoms of airway obstruction. Often, as in bilateral vocal cord paralysis, voice symptoms are minimal.Indirect laryngoscopic examination usually establishes the diagnosis. Movement of the arytenoids is seen but is limited, and is reflected in poor mobility of the vocal cords. Direct laryngoscopic examination and palpation of the arytenoids for passive mobility confirms the diagnosis and rules out vocal cord paralysis from recurrent laryngeal nerve injury. With the establishment of stenosis, scarring and web formation occurs over the posterior cricoid lamina and may extend into one or both cricoarytenoid joints and into the interarytenoid muscle. Scar contracture in the posterior commissure causes medial fixation of the vocal processes of the arytenoid cartilages. When caused by endotracheal intubation, the initial injury is usually to the mucosa of the posterior cricoid lamina, vocal processes of the arytenoids, or both. Perichondritis may ensue, its location and severity determining the ultimate functional extent of scarring. When airway obstruction results, treatment is by laryngofissure, scar resection, grafting, and stenting. If bilateral cricoarytenoid joint fibrosis is discovered, arytenoidectomy, and in some cases laryngeal lumen augmentation, is invariably required to reestablish the airway, with probable detrimental effects on voice quality. Five of ten patients are presented to illustrate the etiology, pathogenesis, symptoms, management, and sequelae of this problem.
Auditory Evoked Responses Obtained by Cross‐Correlation: A Preliminary Report
Authors: Dobie Robert A. , Clopton Ben M. 
Published: April 2016

In linear systems analysis, a system is often studied by determining its response to impulsive stimulation. Alternatively, the system's response to continuous noise may be measured; cross‐correlation of input and output then yields a function identical to the impulse response. This approach has been extended to auditory evoked responses, using vertex potentials as the system output. Although the auditory system, viewed as a brain stem evoked response generator, is highly nonlinear, replicable cross‐correlograms were obtained in a series of guinea pigs. Stimulus artifact was ruled out by comparison of these responses with autocorrelograms of the noise stimulus. Responses decreased in amplitude with decreasing stimulus intensity. Experiments involving brain stem lesions and anoxia suggested that the short‐latency cross‐correlogram reflects cochlear microphonic, auditory nerve, and brain stem contributions.Study of bioelectric potentials by cross‐correlation with noise input allows data acquisition continuously, without the limitations in stimulus repetition rate and dynamic range imposed by impulse (eg, click) analysis. This approach may prove useful in both experimental and clinical settings.
Retrosigmoid Removal of Acoustic Neuroma: Experience 1978–1988
Authors: Harner Stephen G. , Beatty Charles W. , Ebersold Michael J. 
Published: April 2016

The need to preserve hearing during acoustic neuroma removal has rekindled interest in labyrinth‐sparing procedures. This review of 11 years' experience with the retrosigmoid approach to acoustic neuroma removal includes 335 procedures in 332 patients. There were no intraoperative deaths; two patients died in the postoperative period. The facial nerve was preserved in 86.3% of procedures, and auditory function was preserved in 45 procedures (34% of those tumors were 2 cm or smaller). Postoperative complications occurred in 101 procedures, the most common being cerebrospinal fluid otorhinorrhea in 40 cases; 25 of these required secondary surgery. Meningitis occurred 16 times and aspiration 8 times; all other complications were less frequent. Tumor removal was incomplete in eight procedures; In only one of these cases has tumor recurred. The six recurrences usually were identified 5 or more years postoperatively. This has prompted us to follow patients for 7 years postoperatively. Major changes in our management include the use of the supine position and of electrophysiologic monitoring. Advantages of the approach are: (1) wide access to the tumor, (2) applicability to all tumor sizes, (3) potential to preserve facial and auditory function in all cases, and (4) ability to change procedure without sacrificing labyrinth. This review confirms our confidence in this approach to acoustic neuroma removal.
Dynamic Posturography Findings in Central Nervous System Disorders
Authors: Voorhees Richard L. 
Published: April 2016

Dynamic posturography provides functional, selective testing of three sensory modalities for maintenance of balance: Vestibular, visual, and somatosensory. Sensory receptors in vertical semicircular canals and utricles, via the vestibulospinal tract, mediate a disconjugate response to the legs, enabling synchronized reciprocal stabilization of the body for control of motion. The patient is systematically exposed to different combinations of useful and conflicting visual, vestibular, and support surface input. The effect of each on stability is appraised. Early posturography reports dealt primarily with sensory organization test (SOT) results. Improved software for movement coordination (MC) tests offer greater identification of problems involving the central nervous system. One hundred fifty‐one patients were studied over a 9‐month period. Central disorders were present in 31 cases (20.5%) and 90.3% of these were abnormal in sensory organization tests (SOTs). Abnormal movement coordination (MC) results occurred in 80.6% of central nervous system (CNS) disorders. SOTs 4, 5, and 6 in combination were abnormal in 35.5%, and 70% of these cases were also abnormal in MC responses. False‐positive responses occurred in less than 4% of cases. Posturography offers a significantly high detection rate in CNS disorders causing dysequilibrium. Long loop latency reflexes, as they relate to maintenance of balance, appear important in the pathophysiology of abnormal SOT and MC responses.
Combined Pterional‐Anterolateral Approaches to Cranial Base Tumors
Authors: Smith Peter G. , Grubb Robert L. , Kletzker G. Robert , Leonetti John P. 
Published: April 2016

Advanced tumors of the paranasal sinuses, parotid gland, orbit, para pharynx, and cranial cavity may invade the infratemporal fossa by direct extension or through natural anatomic pathways. The inability to control disease involving this region is reflected by the unacceptably high recurrence rates for both intracranial and extracranial neoplasms. Between 1983 and 1986, a pterional (or subtemporal) approach was combined with such conventional anterolateral procedures as a mandibulo‐pharyngectomy, maxillectomy, orbitectomy, and parotidectomy in 13 patients with advanced skull base lesions. The tumor origin was extracranial in ten cases and intracranial in three patients. Seven of the neoplasms were malignant and six were histologically benign. Complete tumor removal was achieved in all patients. Repair of the ablative defect was achieved with a temporalis myogenous flap in ten patients, and primary closure or distant myocutaneous flaps in the remaining three patients. Postoperative complications included three lateral nasocutaneous fistulae secondary to temporalis myogenous flap necrosis and isolated cases of stroke, cerebral edema, pneumocephalus, and cerebrospinal fluid rhinorrhea. Twelve patients are alive without evidence of disease at a mean interval of 25 months. The remaining patient died from lung metastases 11 months after surgery.
Measurement of Human Nasal Ciliary Motility Using Computerized Microphotometry
Authors: Phillips P. Perry , McCaffrey Thomas V. , Kern Eugene B. 
Published: April 2016

A new computerized technique for the assessment of human nasal ciliary beat frequency is described. Thirty normal volunteers underwent nasal cytologic brushing to obtain ciliary samples. In each subject, 150 ciliary beats were analyzed from each of 50 separate ciliated cell clusters. The ciliary beat frequency for each area was determined with fast Fourier transformation. The results were plotted on a histogram to determine the ciliary beat distribution. The mean frequency for these samples was 11.29 Hz, with a standard deviation of 0.96 Hz. The median frequency for these samples was 11.25 Hz. These results show a marked improvement over hand‐counting microphotometry techniques because of the much larger sampling size and elimination of much human error. We believe this method of ciliary analysis represents a significant advancement in the evaluation of ciliary function and should assist in the diagnosis of patients with congenital and acquired forms of ciliary dysmotility.
Physiologic Status of Regenerated Hair Cells in the Avian Inner Ear following Aminoglycoside Ototoxicity
Authors: Tucci Debara L. , Rubel Edwin W 
Published: April 2016

Regeneration of avian inner ear hair cells has been demonstrated after administration of aminoglycoside and after acoustic trauma. However, no published study to date has documented functional recovery of these regenerated sensory receptor cells. Newborn chicks were treated with gentamicin sulfate (50 mg/kg/day) for a total of either 5 (n = 10) or 10 (n = 76) days. Evoked potential thresholds were obtained one day after the 5‐day treatment, or at intervals between one day and 20 weeks after the 10‐day treatment course, and compared to thresholds of age‐matched control animals. A significant hearing loss, predominantly in the high frequencies, was present after as few as 5 days of drug administration. The magnitude of hearing loss continued to increase, especially at lower frequencies, as survival increased from 1 day to 5 weeks after gentamicin treatment. Sixteen‐to‐20 weeks after treatment, partial recovery of thresholds was evident. These findings demonstrate that functional recovery does occur in the avian inner ear following aminoglycoside administration. Recovery occurs at all frequencies, but predominantly at low and middle frequencies, leaving significant residual high‐frequency threshold elevation. Recovery lags 14 to 18 weeks behind anatomic evidence of hair cell regeneration, which was demonstrated in one study by 2 weeks after comparable administration of gentamicin.
Endolymph pressure in Meniere's disease
Authors: Shea John J. 
Published: April 2016

During the streptomycin perfusion/shunt of the lateral semicircular duct operation for Meniere's disease, the lateral semicircular duct is exposed by removal of the bone of the lateral semicircular canal. Before perfusion with streptomycin and creation of a shunt in the lateral semicircular duct, the pressure in the lateral semicircular duct is measured while eiectrocochieography is being recorded. In most ears with Meniere's disease, the pressure necessary to indent the lateral semicircular duct is 2 to 3 mm of water. The pressure is more in those ears with a large negative summating potential than in those with a normal negative summating potential. The pressure is less after the shunt in the lateral semicircular duct is created and the negative summating potential returns to normal. In some ears with the classic picture of Meniere's disease, the endolymph pressure is normal and there is a normal negative summating potential. Presumably, one should not create a shunt in the lateral semicircular duct in ears with normal pressure.
The dorsal rat flap: A discussion of the model and the salutary effect of cimetidine on flap survival
Authors: Angel Michael F. , Wanebo John , Bardakjian Vatche , Amiss Lester R. , Morgan Raymond F. 
Published: April 2016

Failure of skin flaps remains a significant clinical problem. The dorsal rat flap, a reliable experimental model, was used to test the efficacy of cimetidine in treating a falling flap. Flaps were elevated in 45 rats divided into three equal groups. Group 1 was a saline control group. Group 2 received cimetidine 250 mg/kg three time a day for 7 days postoperatively, and Group 3 received cimetidine for 1 day before surgery, and then as in Group 2. Necrosis was assessed on the seventh postoperative day. Group 2 had 31.1 ± 1.3 (mean % ± SEM) necrosis, significantly better than saline control animals (p < 0.01) and pretreated animals (p < 0.05). These results suggest the usefulness of cimetidine in ischemic flap surgery.
Stomal recurrence after laryngectomy: Interrelated risk factor study
Authors: Rubin Jennifer , Johnson Jonas T. , Myers Eugene N. 
Published: April 2016

This study was designed to identify pathogenic factors in recurrent carcinoma at the tracheal stoma. The charts of 444 patients with laryngeal cancer who were treated surgically between 1976 and 1988 revealed stomal recurrence in 15 (3.4%). Eighty percent of the patients with stomal recurrence had tumors in the subglottis. In comparison to patients with different sites involved this was significant (p < 0.001). Other variables examined and analyzed included primary stage, previous treatment, neck pathologic status, neck treatment, age, sex, postoperative adjunctive therapy, and timing of tracheotomy. Tumor involvement of the subglottis is the single most important variable in stomal recurrence of carcinoma. Previous conservation laryngeal surgery and preoperative/emergency tracheotomy are not related to stomal recurrence of carcinoma. Mean length of survival for patients with stomal recurrence of carcinoma in our series was 8.9 months. Two patients were successfully treated with extensive surgical resection. The dismal prognosis of stomal recurrence of carcinoma suggests that management of this condition should focus on prevention. Treatment of patients with tumors of the subglottis should include attention to the paratracheal region and superior mediastinum, in conjunction with laryngectomy immediately after initial diagnosis.
Thermochemotherapy in inoperable head and neck cancer
Authors: Davis R. Kim , Gibbs Frederic A. , Sapozink Michael D. , Farver Max , Harker Graydon 
Published: April 2016

A combined hyperthermia and chemotherapy approach was used to treat five patients with locally advanced or recurrent squamous cell carcinoma of the head and neck whose tumors had failed to respond to chemotherapy. In two patients, tumor had recurred after initial combined modality therapy (surgery/radiation) and had failed to respond to one course of cisplatin/5‐fluorouracil (cisplatin/5‐FU) chemotherapy. The three remaining patients were enrolled onto a phase II evaluation of induction chemotherapy with cisplatin/fluorouracil for advanced head and neck carcinomas and had failed to achieve a partial remission after one treatment cycle. Palpable cervical tumors were heated to 40° to 42° C for 30 to 40 minutes, during which time cisplatin (100 mg/m2) was infused intravenously. A 5‐day infusion of 5‐fluorouracil (1000 mg/m2/d) followed. Despite less than a partial response to previous cisplatin/fluorouracil chemotherapy alone, two patients had complete clinical resolution of the heated tumor volume with two cycles of the combined thermochemotherapy approach. One patient achieved a partial remission with this approach. The remaining two patients died shortly after the initial thermochemotherapy treatment, as a result of progressive tumor growth. The two complete responders were subsequently treated with radiation (1 patient) and radical neck dissection (1 patient) and remained without evidence of disease 2 and 26 months after the completion of therapy, respectively. The toxicity of this combined modality approach was acceptable and appeared to be no greater than had been experienced during earlier treatment with chemotherapy alone. Further studies using a combination of these treatment modalities for locally advanced head and neck carcinomas are warranted.
New stoma stent applicable in long‐term tracheostomy
Authors: Eliachar Isaac , McDonnell Matthew , Nguyen Dat 
Published: April 2016

As long‐term tracheostomy becomes a more common procedure, the need has arisen for a means of maintaining stoma patency. This article presents a new self‐retained physiologic prosthesis intended for use as a stoma stent in long‐term tracheostomy. It may also be applied in a wide range of short‐term conditions. The concepts and techniques of long‐term tracheostomy are highlighted. Experience in applying this stent in 75 patients with a followup of more than 28 months is presented.
Permeability of the round window membrane to horseradish peroxidase in experimental otitis media
Authors: Kim Chong Sun , Cho Tai Kwon , Jinn Tae Hoon 
Published: April 2016

The permeability of the round window membrane (RWM) was studied by using horseradish peroxidase (HRP) in the different stages of otitis media developed in guinea pigs, and it was compared with normal RWM under transmission electron microscopic examination. The experimental model of otitis media was developed by inoculation of a Pseudomonas aeruginosa suspension. When HRP could penetrate into the inner layer of a normal RWM, the duration of HRP instillation into the round window niche was 10 minutes. The permeability of the RWM in otitis media was as follows: 3‐day animals showed penetration of HRP into the middle layer. In 1‐week animals, HRP had penetrated into the inner layer in all 10 ears. In 2‐week animals, HRP had penetrated into the inner layer in 6 of 11 ears. In 4‐week animals, however, HRP was not seen in 6 of 7 ears. HRP had penetrated through the damaged focus of the epithelial cells by inflammation. These results suggest that any derangement of the epithelial linings could increase the penetration of HRP and also ototoxic materials into the inner ear through the RWM.
Surgical approaches to congenital atresia of the external auditory canal
Authors: Molony Timothy B. , De La Cruz Antonio 
Published: April 2016

During the past 4 years, 22 patients with congenital atresia of the external auditory canal underwent 24 initial operations by either an anterior or transmastoid approach. No attempt at randomization was made, but the two groups were similar in number and pathology (in 14 cases approach was anterior and in 10 cases approach was transmastoid). Followup ranged from 6 months to 4 years. Hearing results were similar in the two groups (71% with air‐bone gap less than 30 dB). There were no instances of facial nerve injury or sensorineural hearing loss. Facial nerve monitoring was used. Complications of stenosis and drainage were more common with the transmastoid approach. In both groups, hearing results were accomplished with the patients' intact ossicles or prosthetic reconstructions. Meticulous soft‐tissue technique, with split‐thickness grafts covering all exposed bone, is the key to preventing stenosis. For the three cases of patients with thick, acellular atresia plates, a different approach was developed. Maintaining proper orientation during the medial dissection is more difficult in these cases. By opening the antrum primarily and identifying the lateral canal, ossicles, and facial nerve, an ear canal can then be created anteriorly with these landmarks in view. An intact canal wall‐like procedure is carried out. Although hearing results are similar, the anterior approach, because of fewer postoperative complications, is now our procedure of choice. Proper orientation and soft‐tissue technique are the keys to successful correction of the congenitally atretic ear canal.