bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral longitudinal temporal bone fractures: A retrospective review of seventeen cases
Authors: Griffin James E. , Altenau Mark M. , Schaefer Steven D. 
Published: October 2009

AbstractThe types of temporal bone fractures, longitudinal and transverse, are reviewed. All cases of bilateral temporal bone fractures at Parkland Memorial Hospital in Dallas over a 10‐year period from 1968 to 1978 are reviewed and discussed by the authors. One hundred sixty patients with the diagnosis of base of skull fractures were studied. Fifty‐nine of these were temporal bone fractures and 17 of the 59 were bilateral. Of all the base of skull fractures, 10% were bilateral temporal bone fractures and 29% of all temporal bone fractures were bilateral. For each case the method of injury, the extent of damage to hearing and facial nerve function, presence of CSF otorrhea, X‐ray findings, and additional complications are summarized and the results discussed. The operative findings of facial nerve decompressions are carefully reviewed. The authors' method of caring for temporal bone fractures is presented.
Progressive sensorineural hearing loss and cochlear otosclerosis: A prospective study
Authors: Freeman Joseph 
Published: October 2009

AbstractThe association of otosclerosis with reduced bone conduction is well known but no experimental or valid clinical relationship has been established to confirm this relationship. The purpose of this presentation is to demonstrate a clinical relationship between otosclerosis and sensorineural hearing loss. Experimental proof will await the accumulation and study of temporal bones of those individuals who, in life, exhibited the clinical relationship to be developed in this dissertation.The material presented is from the author's private practice during the years 1974, 1975 and 1976. Patients presenting the clinical problem of progressive sensorineural hearing loss were examined in depth including diagnostic audiology and polytomography of the petrosa.This thesis shows that a high percentage of such diagnostic problems are due to cochlear otosclerosis, the diagnosis being clinically supported roentgenologically.
Eosinophilic granuloma in the temporal bone
Authors: Sweet Robert M. , Kornblut Alan D. , Hyams Vincent J. 
Published: October 2009

AbstractEosinophilic granuloma is an uncommon granulomatous disease which can affect the temporal bone. Although initially silent, the disease may erode the mastoid cortex, destroy the tegmen and extend into the cranial vault, as well as erode the semicircular canals or cochlea. These lesions almost always become infected and can be confused with chronic otomastoiditis. Equally important, temporal bone involvement may represent only one manifestation of a multifocal disease.Between 1940 and 1978, 19 cases of eosinophilic granuloma involving the temporal bone have been recorded in the Armed Forces Institute of Pathology Registry. Most recently, a 24‐year‐old white boatswain's mate was sent to the National Naval Medical Center for treatment of unifocal disease which originated in his right mastoid bone. He subsequently underwent modified radical mastoidectomy and received 2500 R cobalt therapy to the temporal bone following surgery. His case history is detailed and the problem of eosinophilic granuloma in the temporal bone is reviewed in depth.
Avoidance of early complications following radical neck dissection
Authors: Camnitz Paul S. , Biggers W. Paul , Fischer Newton D. 
Published: October 2009

AbstractMultiple factors are associated with the increased risk of postoperative complications following radical neck dissection. Most significant of these are preoperative radiation and entry into the pharynx. The most common of these complications are discussed, and following is a description of preoperative, intraoperative, and postoperative methods to reduce them.Changes in operative methods and antibiotic coverage were associated with a decrease in wound infection and fistula formation. It is suggested that patients in high risk categories be covered with preoperative, prophylactic gram positive antibiotic coverage, along with Tobramycin.
Panel discussion: Glomus jugulare tumors of the temporal bone. Malcolm D. Graham, Ann Arbor, Mich., Moderator. Chemoreceptors of the head and neck
Authors: Shellhamer Robert 
Published: October 2009

AbstractGlomus bodies of the temporal bone and base of the skull are examples of non‐chromaffin paraganglionic organs uncommonly observed in the head and neck, the largest of which is the carotid body or glomus caroticum. This paper reviewed observations on the gross and microscopic morphology of the carotid body, glomus jugulare, glomus vagale and glomus tympanicum. Historically, a review was given of the structure and location of those organs which have been documented in the literature and emphasized the associations observed between them and the vascular system (hence, glomi) and with nerves (hence, ganglia or paraganglia‐chromaffin and nonchromaffin). Conceptualization of these bodies on a functional basis has led to alternative use of less commonly used terms such as chemoreceptor cells and chemoreceptor bodies, APUD or Amine Precursor Uptake‐Decarboxylating cells). Receptor tissue paraganglia have been described which, when they occur as tumors at the skull base, involve cranial nerves (vagus, glossopharyngeal and branches), vascular structures such as the carotid and ascending pharyngeal arteries, the jugular veins and their branches and tributaries. Paraganglia also occur with intracranial, intratemporal and intracerebral extensions. The gross anatomy of the skull base—the pharyngeal wall and the nerves and vessels—was reviewed. Emphasis was placed on the anatomy of the jugular foramen, jugular bulb and posterior cranial fossa, and on the tympanic canaliculus and carotid canal and their respective contents. The potential for their association with the middle ear was cited.Adequacy of terminology variously employed was discussed. The conclusion was made that, consistent with the relationship borne between these bodies and vessels, the use of the term glomus bodies (and their tumors), and described as well by location, e.g., glomus jugulare, glomus tympanicum is preferred. Consistent with the relationship borne between these bodies, and their tumors and nerves, the use of the term non‐chromaffin paraganglion (‐oma = the tumor) is appropriate and as described by location e.g., nonchromaffin paraganglioma vagale.
Panel discussion: Glomus jugulare tumors of the temporal bone. Radiation of glomus tumors of the temporal bone
Authors: Cole James M. 
Published: October 2009

AbstractIn a study done at the Geisinger Medical Center in 1976, the results of treatment of 30 cases of glomus tumors involving the ear were reviewed. All 8 cases of glomus tympanicum were controlled with surgery and all of the cases of glomus jugulare treated with high voltage radiotherapy were controlled for from 2 to 12 years. Currently, the length of control extends to 15 years and there have been no late recurrences. Three additional cases showing unusual features of glomus jugulare are presented.
Congenital cytomegalovirus and hearing loss: Clinical and experimental observations
Authors: Davis Gustave L. 
Published: October 2009

AbstractThe effects of congenital cytomegalovirus infection vary from severe central nervous system destruction to asymptomatic viuria. Yet children with the latter have a high incidence of unsuspected hearing loss. Histopathology of temporal bones from children who die with cytomegalic inclusion disease shows viral infected cells in non‐sensory endolabyrinthine epithelium. Experimental mouse cytomegalovirus causes an age related cranial neuronitis and perilabyrinthitis. Immunopathologic localization of different viral antigens in experimental inner ear infections shows differential vulnerability of labyrinthine structures to infections. Adaptation of such techniques to human temporal bone, pathology could yield information regarding pathogenesis of viral labyrinthitis. The development of a human cytomegalovirus vaccine may eliminate the risks of this congenital infection.
The surgical management of recalcitrant malignant external otitis
Authors: Raines John M. , Schindler Robert A. 
Published: October 2009

AbstractAggressive medical management and surgical debridement is curative in most cases of malignant external otitis. Recently, four patients with this condition were treated at the University of California, San Francisco, who did not respond to conventional therapy. In each case, appropriate intravenous antibiotics, diabetic management, and extensive excision of involved tissue failed to eradicate the infection. Progression of the disease was evidenced by any one of the following: 1. Persistence of granulation tissue in the external auditory canal, 2. Development of cranial neuropathies during treatment, 3. Other signs or symptoms of active infection for more than two weeks after institution of therapy. Any one of these criteria was considered an indication for more radical surgical intervention. In three patients, the operative procedure consisted of a subtotal temporal bone resection to gain access to the primary focus of infection and provide adequate drainage. The common finding in each case was an abscess cavity in the soft tissues at the base of the skull. A description of the clinical course and surgical management of malignant external otitis forms the basis of this communication.
Effectiveness of the CO2 laser in experimental tympanic neurectomy
Authors: Lima José A. , Wilpizeski Chester R. 
Published: October 2009

AbstractAs one of a series of investigations to evaluate the efficacy and safety of CO2 lasers in otologic microsurgery, squirrel monkeys were subjected to tympanic neurectomies by means of vaporizing Jacobson's nerve in the promontory region. Air and bone conduction hearing acuity was measured by computer‐averaged pure tone evoked responses and behavioral audiometry before and after laser surgery. A moderate (avoidable) conductive loss was found as a consequence of the surgical approach selected, but no significant sensorineural loss was apparent. Thus, there would appear to be no adverse cochlear side effects as a result of using this instrument in the middle ear. The laser neurectomy procedure, however, was no more effective for the clinical purposes for which it was proposed than those techniques reported by several other investigators.
Patterns of deafness in newborns
Authors: Simmons F. Blair 
Published: October 2009

AbstractThe Crib‐o‐gram neonatal hearing screening project has detected 42 babies with handicapping degrees of hearing loss, mainly sensorineural. In apparently normal newborns the incidence is 1:1000 births. For graduates of the sick baby (intensive care) nursery, it is 1:52. Intrauterine and neonatal anoxia occurred in 73% of the latter group and was clearly the most common risk factor. Aminoglycosides had no obvious effect. The correlation between specific items in the medical histories and threshold pure tone audiograms was poor and unpredictable for any individual child. In general, anoxia tends to be associated with increased high‐frequency hearing loss. Hearing losses were asymmetrical in 43% and probably progressive in 32% (average increase, 33 db). Only one child may have developed the hearing loss after hospital discharge, thus indicating that most, if not all, early childhood deafness is present in the neonatal period.
Electromyographic biofeedback training with patients exhibiting a hyperfunctional voice disorder
Authors: Stemple Joseph C. , Weiler Ernest , Whitehead William , Komray Raymond 
Published: October 2009

AbstractBaseline EMG measures of general laryngeal area muscle tension while speaking and during silence were taken from a group of 21 normal subjects and 7 subjects diagnosed through indirect laryngoscopy as having vocal nodules. In an attempt to reduce their baseline scores, the vocal nodule patients underwent 8 EMG biofeedback training sessions followed by a 2‐week follow‐up session.Sophisticated listeners then judged the qualities of the voices produced during the baseline and follow‐up sessions. Measures of sound pressure levels for the speech samples were also taken to determine their effects on EMG scores.Results of the statistical analyses revealed that significant differences in general laryngeal area muscle tension while speaking and in silence exist between normal and pathological subjects; and that subjects with vocal nodules could significantly reduce these tension levels with EMG biofeedback training.A positive correlation was then found between the EMG measures and the judgments of voice qualities. No correlations were found between EMG measures and sound pressure levels.
Multiple oncocytic papillary cystadenomas of the larynx: A case report
Authors: Lejeune Francis E. , Putman Harrison C. , Yamase Harold T. 
Published: October 2009

AbstractA patient had multiple oncocytic cysts of the larynx and, concurrently, epidermoid carcinoma of the larynx. Total laryngectomy for the epidermoid carcinoma made it possible to carefully examine and histologically document the multifocal and oncocytic nature of the lesions. The authors interpret the findings to represent both hyperplastic and metaplastic processes.
Traumatic pneumocephalus
Authors: Jacobs Joseph B. , Persky Mark S. 
Published: October 2009

AbstractThis paper presents an unusual case report and comprehensive review of pneumocephalus. The pathogenesis of this finding is explained with the intracranial variations in meningeal anatomy adjacent to the anterior and posterior paranasal sinuses. The effectiveness of prophylactic antibiotics in treating meningeal tears should not lead the physician into a false sense of security. The watchful waiting attitude must be tempered with the knowledge of increased morbidity and mortality in prolonged pneumocephalus. Statistics reinforce the policy of opting for surgical repair of persistent intracranial air after one week. The increasing role of the otolaryngologist and extracranial approaches to the base of the skull becomes evident in the management of these cases.
Unilateral hearing loss in children
Authors: Brookhouser Patrick E. , Worthington Don W. , Kelly William J. 
Published: October 2009

AbstractRecent reports suggest that early onset, severe unilateral sensorineural hearing loss (USNHL) in children may be associated with significant deficits in auditory and psycholinguistic skills and school performance. This report reviews a consecutive series of 324 children and adolescents (202 males, 122 females) with documented USNHL evaluated at the Boys Town National Research Hospital. The left ear was affected in 168 (52%) and the right ear in 156 (48%). Based on speech frequency threshold averages (i.e., 500, 1000, and 2000 Hz), the losses were classified by severity as follows: borderline, 43 (13%); mild, 51 (16%); moderate, 40 (12%); severe, 19 (6%); profound, 31 (10%), and anacusic, 50 (15%). The remaining 90 children (28%) had high frequency losses (i.e, above 2000 Hz). The mean and median age of diagnosis were 8.78 years and 7.75 years. Temporal bone imaging studies, auditory brainstem responses (ABRs), and vestibular evaluations were performed on selected cases. Etiology was uncertain in 34.8% of cases, while hereditary factors (12.6%), head trauma (10.8%), and perinatal risk factors (10.7%) were the most commonly identified etiologies. Thirty‐one percent of the children had scholastic or behavioral problems in school. A concerted effort aimed at early identification and intervention in cases of USNHL is warranted.
Intraoperative infectious disease exposure to otolaryngology operating room personnel
Authors: Benninger Michael S. , Gupta Neeraj , Gilmore Kathleen 
Published: October 2009

AbstractHealth care workers are at risk of exposure to serious infectious diseases. Since the seroconversion rate is approximately 0.4% for human immunodeficiency virus and may be greater than 20% for hepatitis exposure, these risks are substantial. To assess body fluid exposure to otolaryngology operating room personnel, elective operations were prospectively analyzed over 2 months. Statistical evaluation was made between types of cases and length of procedures. Thirty‐eight contaminations occurred in 228 operations with 26 torn gloves, 1 soaked gown, 6 skin scratches, 4 skin punctures, and 1 ocular exposure. Exposure was more likely in cases longer than 3 hours. Independent of procedure length, head and neck operations carried the greatest risk, followed by otologic procedures, as compared to general, endoscopic, pediatric, and elective trauma cases. The impact of potential operative exposure and universal precautions is emphasized.
The learning curve in stapes surgery
Authors: Hughes Gordon B. 
Published: October 2009

AbstractFewer stapes operations are available to train residents and to maintain individual competence. Most residents in the United States perform 0 to 10 cases during training, and produce results which are not as good as expert results, even with close supervision. After graduation, fewer cases are available to achieve expert results in private or academic practice. The authors' conclusions and recommendations are based on his own learning curve. Residents who have below average skills in middle ear surgery, and residents who do not wish to practice otology, should watch but not perform stapes surgery. Program directors, collectively or separately, should develop more formal guidelines for teaching stapes surgery during residency.
Hearing loss and pneumococcal meningitis: An animal model
Authors: Bhatt Samir , Halpin Chris , Hsu Wen , Thedinger Britt A. , Levine Robert A. , Tuomanen Elaine , Nadol Joseph B. 
Published: October 2009

AbstractClinical studies of predisposing factors in the development of hearing loss secondary to bacterial meningitis have produced conflicting results. An animal model of meningogenic labyrinthitis was developed for more precise study of these parameters. Rabbits were inoculated intrathecally with 105 pneumococci to induce meningitis. Hearing thresholds were measured using auditory‐evoked responses to 1 kHz, 10 kHz, and click stimuli before infection and every 12 hours thereafter. Profound deafness occurred in all subjects at an average of 48 hours following infection. The incidence and severity of hearing loss was strongly correlated with the duration of meningitis. Temporal bone histology revealed acute inflammation of all perilymphatic spaces including the cochlear aqueduct. This model demonstrated that the risk and severity of hearing loss increase with the duration of meningitis and suggested that the cochlear aqueduct is an anatomic pathway for the extension of infection from the cerebrospinal fluid to the cochlea. The implications for therapy in humans is discussed.
Magnetic field changes associated with caloric stimulation of the human vestibular organ
Authors: Michelson Robin P. , Vincent Wilbur R. 
Published: October 2009

AbstractCaloric stimulation of the ear produces a shift of the vestibular resting potential. The current produced by the change in this potential produces a corresponding change in the associated magnetic field. A sensitive magnetic detector (second‐derivative gradiometer) was used to detect a large shift in the magnetic field close to the ears of two normal subjects who underwent cold thermic ear stimulation. The shift in the magnetic field tracked the reflex responses in both individuals. This technique could offer a noninvasive direct measure of end‐organ function.
On the pathomechanism of cochlear dysfunction in experimental perilymph fistulas
Authors: Böhmer Andreas 
Published: October 2009

AbstractThe mechanism leading to hearing impairment in perilymph fistulas was investigated in guinea pigs with perforated round window membranes (RWM) by analyzing alterations of inner ear fluid pressure, changes of auditory function following manipulations to get presumed air bubbles out of the cochlea (“positional audiometry”), and temporal bone sections. The instantaneous loss of normal positive inner ear fluid pressure after RWM perforation had no immediate effect on auditory function. Inner ear pressure was restored 4 days following RWM perforation. “Positional audiometry” was negative in guinea pigs with perforated RWM. All ears in which auditory thresholds had increased had additional iatrogenic lesions at the spiral lamina. Fistulas in the RWM per se do not affect auditory thresholds. The question of the surgical repair of fistulas was not directly addressed; it only can be concluded that there are no direct sequelae of an isolated fistula which induce auditory impairment and which could be prevented by surgical repair of the fistula.
A model for multidisciplinary data collection for cervical metastasis
Authors: Domanowski Gerard F. , Vaughan Charles W. , Zeitels Steven M. , Vincent Miriam E. , Malhotra Chandler 
Published: October 2009

AbstractA system for multidisciplinary data collection for metastatic neck disease is discussed. Information from 87 neck dissections and 3218 lymph nodes is reported to illustrate the strength of the model. Clinical (endoscopic) assessment under general anesthesia, surgical assessment during the neck dissection, and radiographic (computed tomographic scan) assessment were compared with the pathological evaluation. All disciplines stratified the necks by region and node size. This model provides an effective stratagem for multi‐institutional studies.
Nonpalpable occult and metastatic papillary thyroid carcinoma
Authors: Witterick Ian J. , Abel Sharon M. , Noyek Arnold M. , Freeman Jeremy L. , Chapnik Jerry S. 
Published: October 2009

AbstractThe results of palpation, ultrasound, and detailed pathology were compared in 50 patients undergoing total thyroidectomy. Of the 211 nodules recognized by pathology, palpation detected 24% and ultrasound detected 43%. There were 14 patients with palpable papillary carcinomas, and 12 of these 14 had metastatic foci in other portions of the gland. Metastatic foci would have been left in 10 patients if only a lobectomy had been performed and would have been left in 6 patients if only a subtotal thyroidectomy (as defined in this report) had been performed. Of the 33 patients with benign palpable nodules, 5 had occult papillary carcinomas. In 2 of those 5 patients, the occult carcinomas would not have been removed if a less‐than‐total thyroidectomy had been performed. The significance of these occult and metastatic papillary carcinomas is discussed.
Easy bruisability, aspirin intolerance, and response to DDAVP®
Authors: Lekas Mary D. , Crowley James P. 
Published: October 2009

AbstractEasy bruisability raises the issue of bleeding during otolaryngological surgery. Ten female patients with easy bruisability were evaluated by aspirin challenge; clinical history and screening coagulation studies in these patients had revealed no evidence of a bleeding disorder. The baseline Ivy bleeding time (BT) test (4.5 to 9.5 minutes) was found to be normal in 6 patients and prolonged in 4 patients. Following treatment with aspirin, the bleeding time prolonged significantly in the three groups evaluated: normal controls (6.0 ± 1.5 minutes vs. 8.4 ± 2.0 minutes), patients with easy bruisability and a normal baseline (7.8 ± 1.3 minutes vs. 12.0 ± 1.6 minutes), and patients with easy bruisability and an abnormal baseline (11.0 ± 0.7 minutes vs. 14.5 ± 0.9 minutes). Administration of DDAVP® (desmopressin acetate) 0.3 μg/kg normalized the prolonged bleeding times in all groups after 7 days of daily aspirin therapy. Performing bleeding times before aspirin challenge, after aspirin challenge, and after DDAVP therapy following aspirin challenge is both a useful way of confirming aspirin sensitivity in patients with easy bruisability as well as a useful way of documenting improved hemostasis after DDAVP administration.