bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Tympanic Isthmus: Its Anatomy And Clinical Significance
Authors: Aimi Kenji 
Published: February 2017

The tympanic isthmus is a narrow passage between the tubotympanic cavity and the atticomastoid air space. Obstruction of the tympanic isthmus is frequent in various types of middle ear disease and causes significant air‐diffusion disturbance within the temporal bone pneumatic system.Using large numbers of fresh temporal bone specimens, anatomical boundaries of the tympanic isthmus are defined and pathological variations are investigated. Embryological origin of the isthmus and pathophysiological implications of the tyrnpanic isthmus block are discussed.Among factors that cause obstruction of the tympanic isthmus are mucosal folds variations, inflammatory webs and exudate, retracted tympanic membrane, diseased attic mucosa, and cholesteatoma. Each factor is analyzed with representative specimen photographs.Clinical signs due to tympanic isthmus block often simulate or coexist with symptoms of eustachian tube obstruction. Surgical management of the tympanic isthmus block requires clear recognition of these disease processes.Understanding of the tympanic isthums as an anatomical entity is essential in the management of middle ear and attic disease.
Transoral Laryngeal Surgery Using the CO2 Laser: Laboratory Experiments and Clinical Experience
Authors: Vaughan Charles W. 
Published: February 2017

Since the introduction of the CO2 laser coupled to the Zeiss operating microscope in 1969, it has become apparent that this instrument is without equal for the carefully controlled removal of small laryngeal lesions. It has now also been shown experimentally and with some clinical confirmation that by using the CO2 laser transorally all of the standard types of partial and excisional laryngeal surgery may be accomplished with minimal morbidity and without the use of tracheotomy. The major exception is that replacement of soft tissue is not possible. Therefore, procedures that remove sufficient amounts of soft tissue to compromise the sphincter function of the larynx should not be done transorally with the CO2 laser.The instrument itself is almost deceptively simple to use. However, the unusual surgical approach and the changed appearance of tissue following laser vaporization may confuse the operator until considerable expertise has been gained in the animal laboratory. Nevertheless, the ability of the instrument to excise small or large areas of the larynx transorally with precision and with almost no resultant morbidity makes this effort worthwhile.
Cervical Congenital Arteriovenous Malformation
Authors: Smith Curran J. , Clark Stephen K. 
Published: February 2017

Congenital cervical arteriovenous malformations are unusual lesions. Definitive diagnosis and assessment of the extent of the lesion is best obtained by four vessel cervicothoracic aortography with selective arteriography, rapid phase radiography and subtraction techniques.The futility and even deleterious effects of elective arterial ligation have been repeatedly documented in the literature. It is our opinion that arterial ligation should be limited to control of life threatening hemorrhage or as part of definitive resection.In an attempt to minimize operative hemorrhage, we have successfully utilized the technique of preoperative transcutaneous selective embolization in preparation for total surgical excision. We recommend this technique as an effective means of minimizing operative hemorrhage.
Subclinical Reduction in Airflows after Teflon Injection of Vocal Cord
Authors: Cormier Y. , Kashima H. , Summer W. 
Published: February 2017

Results of intracordal Teflon® injection for symptoms of unilateral vocal cord paralysis have been excellent. There seems to be no significant long‐term foreign body reaction or limitation to maximum airflows. However, acute inflammatory reactions and airflow obstruction have been reported. The objective of the present study was to evaluate the frequency, extent, and duration of airway obstruction following Teflon® injection.Forced inspiratory and expiratory airflows were measured in seven consecutive patients before, 24 hours, and 10 days after Teflon® injection. Significant variable upper airway obstruction, as demonstrated by an increase in the ratio of forced expiratory airflows at 50% Vital Capacity to the forced inspiratory airflows at the same lung volume (VE60/VI,o), was found in each subject. At 24 hours after the injection this ratio increased from a baseline of .098 ± 0.50 (mean ± S.D.) to 1.41 ± 0.67 (P < 0.01), and returned to baseline values in 10 days (0.95 ± 0.14). We conclude that Teflon® injection into a paralyzed vocal cord creates a significant inspiratory airway obstruction that is reversible in 10 days.
Changing Face of Treatment of Peritonsillar Abscess
Authors: Schechter Gary L. , Sly Donald E. , Roper Albert L. , Jackson Robert T. 
Published: February 2017

Changing trends in the treatment of peritonsillar abscess are demonstrated by this retrospective study of 74 patients treated from 1975 through 1980 by a standardized regimen. This included needle aspiration at three points, intravenous antibiotics, hydration, and pharyngeal douches.The patients ' ages ranged from 11 to 73 years. There were 45 males and 29 females. Needle aspiration was positive in 52 patients (70%) and repeat aspiration was necessary in 10% of patients. Tonsillectomy was performed in 42 patients. No recurrent peritonsillar abscesses occurred during the 1 to 5 year follow‐up of the 32 patients who did not have tonsillectomy. Recurrent tonsillitis did occur in 4 of these patients and 3 of them had a past history of recurrent tonsillitis.The authors conclude that treatment of peritonsillar abscess should consist of needle aspiration, intravenous antibiotics and supportive measures. Interval tonsillectomy should be performed only when there is a history of recurrent tonsillitis or previous peritonsillar abscess.
Cervicofacial Mycobacterial Infections Presenting as Major Salivary Gland Disease
Authors: Stanley Robert B. , Fernandez James A. , Peppard Sean B. 
Published: February 2017

Mycobacterium tuberculosis and atypical mycobacterium are well‐known causes of cervical lymphadenopathy, most often presenting without symptoms of systemic infection. These organisms may also directly involve the parenchyma of the major salivary glands and their periglandular or intraglandular nodes. The diagnosis of mycobacterial infections of the major salivary glands, compared to cervical lymph nodes, is equally — if not more — difficult to make. The differential must include the same spectrum of inflammatory and neoplastic diseases as well as lesions unique to the salivary glands.Selected cases are presented and discussed to show that principles established for the treatment of cervical mycobacterial infections must also be applied to major salivary gland infections. In particular, cutaneous fistulas may result from incisional biopsy or incision and drainage of the involved gland. Partial parotidectomy or submaxillary gland excision may be required, followed by multidrug, antituberculous chemotherapy for one to two years. Culturing of the organisms is extremely difficult, and the diagnosis of either mycobacterium tuberculosis or atypical mycobacterial infection must be based on a combination of history and clinical examination, skin testing, histopathology, acid‐fast stains, culture, and response to surgery and antituberculous chemotherapy.
CO2 Laser in Otolaryngology‐Head and Neck Surgery: A Retrospective Analysis of Complications
Authors: Ossoff Robert H. , Hotaling Andrew J. , Karlan Marc S. , Sisson George A. 
Published: February 2017

A retrospective review was conducted of all patients undergoing CO2 laser surgery by members of the Department of Otolaryngology‐Head and Neck Surgery at Northwestern University Medical School from January 1, 1980 through December 31, 1981; 204 cases were identified and all are included in this report.Early in our department's experience with laser surgery, an endotracheal tube fire occurred. This incident precipitated a departmental review of complications associated with the use of the CO2 laser and resulted in the formulation of a laser safety protocol. All patients in this group were treated under the directives of this protocol; the operative complication rate was low.This retrospective analysis of complications associated with the use of the CO2 laser under a strictly applied protocol demonstrates the relative safety associated with judicious use of this instrument.
Posterior Commissure Stenosis Post Long‐Term Intubation
Authors: Whited Robert E. 
Published: February 2017

A prospective study of 200 patients having long‐term endotracheal intubation has been completed. This study has defined the events in stenosis evolution for the two varieties of scarring in the posterior commissure of the larynx. An overall stenosis incidence of 6% for this long‐term intubated patient population has been found. In the majority of patients the posterior commissure stenosis is a component of more complex injury.The importance of tube tissue interfacing in the posterior commissure and the role of ongoing movement of both a shearing and blunt nature is of increasing significance as intubation time lengthens. Changing the character of this interface by the addition of a small posterior air cushion on the endotracheal tube can minimize ongoing trauma in the posterior endolarynx.
Carcinoma Of the Mobile Tongue: Incidence of Cervical Metastases in Early Lesions Related to Method of Primary Treatment
Authors: Bradfield John S. , Scruggs R. Pickett 
Published: February 2017

One hundred thirty‐eight patients receiving initial treatment for squamous cell carcinoma of the mobile tongue from 1960 to 1978 were reviewed to determine the frequency of cervical metastasis in early carcinoma (T1N0 and T2N0).Occult cervical node metastasis in an elective neck dissection or subsequent neck recurrence in an initially negative neck was found in 14.5% (9/62) of patients staged T1N0 and 30.6% (11/36) of patients staged T2N0.Refinement of the staging system demonstrated that 9.7% (3/31) of patients with a primary lesion less than or equal to 1.0 cm and a clinically negative neck (T1aN0) subsequently developed a cervical metastasis. Patients with primary lesions greater than 1.0 cm but less than or equal to 2.0 cm (T1bN0) had twice the risk of occult cervical metastasis (19.4% or 6/31).The crude 5‐year survivals in Stage I for radium alone, partial glossectomy, and partial glossectomy with neck dissection were 64%, 58% and 75% respectively and in Stage II were 31%, 66% and 71% respectively. Local‐regional failure is the principal mechanism of failure In patients treated locally particularly in Stage II.
Acute Epiglottitis: Current Management
Authors: Schloss Melvin D. , Gold John A. , Rosales Jose K. , Baxter James D. 
Published: February 2017

Two hundred and sixty‐one cases of acute epiglottitis treated at the Montreal Children's Hospital between 1951 and 1980 are reviewed. Clinical features of the disease are described. Treatment protocol at a major children's hospital is presented. Statistics related to age, season and sex are analyzed.The authors compare nasotracheal intubation and tracheostomy as primary treatment. Bacteriology and antibiotic treatment are updated.
Cuff Induced Tracheal Injury in Dogs Following Prolonged Intubation
Authors: Belson Thomas P. 
Published: February 2017

As the newer high volume low pressure endotracheal tube cuffs have replaced the high pressure cuffs commonly used in the past, there has been a marked decline in the incidence of severe complication due to cuff injury. Studies have shown, however, that the respiratory epithelium of the trachea at the cuff site undergoes squamous metaplasia following prolonged intubation with low pressure cuffs.An experimental model utilizing the canine trachea has been developed to study cuff induced squamous metaplasia and the present study was undertaken to determine the effect of the induced squamous metaplasia on tracheal mucous velocity as well as to determine whether the induced epithelial changes are reversible following removal of the cuffed tube.
Ciliary Dyskinesis: The Immotile Cilia Syndrome
Authors: Parker Gregg S. , Mehlum David L. , Bacher-Wetmore Bea 
Published: February 2017

In the past 5 years much has been learned about the syndrome of ciliary dyskinesis, commonly referred to as immotile cilia syndrome. This syndrome appears to be a congenital defect in the ultrastructure of the cilia, which results in one of three basic defects: lack of dynein arms, absence of radial spokes, or transposition of microtubules.Three cases are presented with electron micrographs; they illustrate the diverse clinical presentations of this disease entity as well as some of the structural abnormalities. The normal and abnormal anatomy of the cilia is discussed and some explanation is offered as to why these structural abnormalities present with such a variety of clinical expressions.
Histologic Studies on the Fate of Soluble Collagen Injected into Canine Vocal Folds
Authors: Ford Charles N. 
Published: February 2017

Collagen is an essential component of the functionally important layered structure of the vocal cord. Soluble bovine collagen appears to be suitable for injection into vocal folds to correct glottic insufficiency. Clinical trials and preliminary laboratory studies with the canine larynx indicate that injectable collagen is safe, effective, easily injected, and well‐tolerated. Bovine collagen softens scar tissue, attracts the ingrowth of host fibroblasts, and allows the eventual replacement of the implant by new host collagen. This study examines the fate of collagen injected into canine vocal folds.Two forms of soluble bovine collagen, differing only in the amount of chemically induced cross‐linkage, were injected into vocal folds of dogs; the animals were then killed at 12‐week intervals for 1 year. Gross and histologic examination showed that both substances tended to be resorbed when injected deeply in the vocalis muscle, but persisted when injected in the plane of the vocal ligament — a site normally composed of dense collagen. The invasion of the implant by active host fibroblasts and the secondary deposition of new host collagen were evident in histologic sections. Examination with polarized light confirmed the presence of birefringence characterizing host collagen. The invasion of fibroblasts and deposition of new collagen in the implant were seen with electron microscopy. Cellular invasion seemed to progress more rapidly in the cross‐linked preparation. Injected collagen did not evoke a foreign body reaction in any specimen studied, and was well‐tolerated during replacement by host tissue.
Small Cell Carcinoma of the Larynx: Results of Therapy
Authors: Baugh Reginald F. , Wolf Gregory T. , Krause Charles J. , Beals Theodore F. , Forastiere Arlene 
Published: February 2017

Primary small cell carcinoma of the larynx is a rare malignancy with a dismal prognosis. A survey of the long‐term follow‐up from reported cases of small cell carcinoma of the larynx and a review of the recent experience with this tumor at the University of Michigan Hospitals was undertaken to determine if newer treatment approaches incorporating adjuvant chemotherapy were associated with prolonged survival.Median survival for those patients receiving adjuvant chemotherapy was 19 months compared to 11 months for patients treated with surgery and/or radiation therapy alone. Among patients treated initially with primary radiation therapy and adjuvant chemotherapy median survival was 55 months, which was significantly longer than any other treatment regimen (P=0.02). Systemic chemotherapy and therapeutic irradiation appears to offer the least disabling and most efficacious form of current therapy.
Laser Palliation for Esophageal Carcinoma
Authors: Rontal Eugene , Rontal Michael , Jacob H. John , Klass Arthur 
Published: February 2017

The treatment of esophageal carcinoma presents itself or evolves into a palliative situation. The most likely symptom to distress the patient is obstruction. It is necessary to have available a means of alleviating this symptom in a way that will be effective, comfortable, and efficient in terms of time and expense. The Nd:YAG and the carbon dioxide lasers can give this type of palliation.This review of our experience in the cervical and lower two thirds of the esophagus has led us to believe that true palliation can be effected in both areas. Treatment is easier and more straight forward in the lower esophagus. The results in the upper one third require more care, but can be just as rewarding.
Clinical Experience with Injectable Collagen for Vocal Fold Augmentation
Authors: Ford Charles N. , Bless Diane M. 
Published: February 2017

Injectable collagen appears to be safe and effective in treating glottic insufficiency. Fifty‐four patients received vocal‐fold injections of Zyderm Collagen Implant® and their responses were followed for as long as 2 years. Videostroboscopy affords the best assessment of glottic function and correlates well with vocal quality. Maximum phonation time and transglottic airflow are the most sensitive measures of glottic efficiency; follow‐up studies indicate that responses to treatment vary at 1 week, tend to stabilize by 3 months, and show only slight decrement over 1 year.One patient experienced a delayed hypersensitivity reaction, but it did not adversely affect his result. The use of cross‐linked preparations of collagen should decrease the incidence of such responses.Treated patients were divided into diagnostic groups. Patients with bilaterally scarred vocal folds did not appear to respond optimally to collagen injection. Vocal rehabilitation was better if patients had at least one normal vocal fold. The best results occurred in patients with unilateral vocal fold paralysis and pre‐existent bowing or atrophy did not affect these results. Collagen should be injected in the plane of the vocal ligament for best results; if the injection is too deep the implant is resorbed, and if too superficial, vocal‐fold vibration is impaired.
The Relationship of the Herpesvirus Family to Sudden Hearing Loss: A Prospective Clinical Study and Literature Review
Authors: Wilson William R. 
Published: February 2017

The herpesvirus family is associated with sudden hearing loss syndrome and the evidence includes clinical findings (HV‐Z), temporal bone studies (CMV and HV‐Z), and serologic studies.The data presented demonstrate that herpes infections, in association with sudden viral hearing loss, occur as part of a multiple viral infection in 70% of instances. This feature is unique to the herpesvirus infections when compared to other neurotropic viral agents.The study also demonstrates that the variables of viral hearing loss, such as degree of hearing loss, percentage of recovery, or the incidence of vertigo are unaffected by the presence of herpesvirus infection.Mechanisms for inner ear injury may be influenced by temporary alterations in cellular immunity secondary to simultaneous viral infections as well as the native virulence of the infecting herpesvirus.
Fatal and Other Major Complications of Endoscopic Sinus Surgery
Authors: Maniglia Anthony J. 
Published: February 2017

Endoscopic sinus surgery has become an acceptable technique for the treatment of chronic sinus disease. This report analyzes five complications which came to my attention. Two cases were orbital: 1 bilateral blindness due to damage of the optic nerves, and 1 damage of medial rectus muscle. The other 3 cases were intracranial: two cribriform plate damage with frontal lobe injury and hematoma, and 1 damage of the anterior cerebral artery, resulting in death.This rather novel technique, especially when used by less‐experienced surgeons, has major complications similar to what has been reported with the traditional intranasal sphenoethmoidectomy. Knowledge of anatomy, good training, and meticulous surgical technique are very important. Endoscopic sinus surgery in patients with extensive pathology should be used with caution, especially if general anesthesia is selected or if excessive bleeding occurs. It would be beneficial to otolaryngologists to have previous experience in the traditional technique before adopting endoscopic sinus surgery to their armamentarium. Even then, major complications may occur in the hands of very experienced surgeons. Early recognition and proper management of these complications are of utmost importance in order to minimize disability or prevent death.
Learning from Non‐Linear Ecosystem Dynamics Is Vital for Achieving Land Degradation Neutrality
Authors: Sietz Diana , Fleskens Luuk , Stringer Lindsay C. 
Published: February 2017

AbstractLand Degradation Neutrality is one of the Sustainable Development Goal targets, requiring on‐going degradation to be balanced by restoration and sustainable land management. However, restoration and efforts to prevent degradation have often failed to deliver expected benefits, despite enormous investments. Better acknowledging the close relationships between climate, land management and non‐linear ecosystem dynamics can help restoration activities to meet their intended goals, while supporting climate change adaptation and mitigation. This paper is the first to link ecological theory of non‐linear ecosystem dynamics to Land Degradation Neutrality offering essential insights into appropriate timings, climate‐induced windows of opportunities and risks and the financial viability of investments. These novel insights are pre‐requisites for meaningful operationalisation and monitoring of progress towards Land Degradation Neutrality. © 2017 The Authors. Journal of Land Degradation & Development published by John Wiley & Sons Ltd.
Effect of Salvage Logging and Check Dams on Simulated Hydrological Connectivity in a Burned Area
Authors: Martínez‐Murillo Juan F. , López‐Vicente Manuel 
Published: February 2017

AbstractThis study assessed the effect of a wildfire and different post‐fire practices (salvage logging, skid trails and check dams) and vegetation recovery (eight scenarios) on the hydrological connectivity (HC) in 11 sub‐catchments (SubCs; 330 ha) affected by a wildfire (213 ha) in 2012 in Spain. According to the Landsat 8 Operational Land Imager/Thermal Infrared Sensor images, moderate, high and extreme burn severity affected 42·1% of the area. HC was calculated with an updated version of the Borselli index. Within the burned area (BA), HC increased in all SubCs after the wildfire (PostF‐1), the salvage logging and the new skid trails (PostF‐2), and the development of new gullies (PostF‐3). Check dams reduced connectivity but did not prevent the general trend. Afterwards, the incipient (PostF‐4 and PostF‐5) and future vegetation recovery made slightly decrease HC. In the three forestry SubCs with check dams and large BA (67% of the study area), connectivity markedly increased (11·4%, 18·2% and 22·9%) during the three first post‐fire scenarios. In the three SubCs with urban areas and small BA (5%), HC decreased a little because the linear elements connected the hillslopes between them. In the three SubCs with urban areas and large BA (12%), HC increased less than in the forestry SubCs (3·0%, 8·2% and 9·1%). In the two forestry SubCs without check dams and small BA (16%), the increment of connectivity was low (2·5%, 4·6% and 6·3%). Monitoring of check‐dam siltation and of the actual vegetation regrowth is necessary to minimize the off‐site consequences of high HC. Copyright © 2017 John Wiley & Sons, Ltd.
On the bifurcation results for fractional Laplace equations
Authors: Dwivedi G. , Tyagi J. , Verma R. B. 
Published: February 2017

AbstractIn this paper, we consider the bifurcation problem for the fractional Laplace equation
urn:x-wiley:0025584X:media:mana201600250:mana201600250-math-0001where is an open bounded subset with smooth boundary, stands for the fractional Laplacian. We show that a continuum of solutions bifurcates out from the principal eigenvalue λ1 of the problem
urn:x-wiley:0025584X:media:mana201600250:mana201600250-math-0004and, conversely.