bluuebunny/crossref_metadata_2025_split huggingface dataset:
The medical and surgical approach in management of the unilateral opacified antrum
Authors: Eichel Berkley S. 
Published: October 2009

AbstractThe approach to the diagnosis and treatment of the patient with the unilateral opacified maxillary antrum presents a challenging problem. A total of 55 patients have been completely followed over a six‐year period. Medical management, immediate, and delayed surgical intervention are discussed over a broad array of cases. Approximately one‐half of those cases not requiring immediate surgical intervention recovered on medical management alone. The requirements for eventual surgical intervention and the results are discussed in the remaining cases.
Endolymphatic sac valve implant surgery
Authors: Arenberg I. Kaufman , Stahle Jan , Glasscock Michael E. , Shambaugh George E. 
Published: October 2009

AbstractA resurgence of interest in surgery on the endolymphatic sac (ELS), not only for relief of vertigo but also for stabilization or improvement of hearing, has emerged. With the concept of operating early in the course of the disease after the diagnosis is well established, various modifications of existing procedures on the ELS have been utilized in an attempt to improve the overall results. One such major modification is the unidirectional inner ear valve implant modified from the eye valve for glaucoma. This valve implant has produced impressive one‐year results for both hearing improvements and relief of vertigo in patients who were scheduled for labyrinthectomy. Subsequent preliminary reports by several investigators show good to excellent results for the hearing (AAOO — Class B or A) as well as the vertigo without consideration for the stage of the disease. This study presents primarily the step by step technique with drawings and a color atlas to facilitate the correct performance of this surgery.
Endolymphatic sac valve implant surgery: II: The unidirectional inner ear valve implant
Authors: Arenberg I. Kaufman , Newkirk John B. , Stahle Jan 
Published: October 2009

AbstractA unidirectional inner ear valve implant was developed to direct excess endolymph out of the inner ear in the hydropic state (Ménière's disease) into the mastoid cavity. A detailed technical description of the valve implant is presented as well as some technical aspects of the valve implant based on the surgical anatomy of the endolymphatic sac.
Sudden hearing loss in divers and fliers
Authors: Pullen Fredric W. , Rosenberg Gary J. , Cabeza Constance H. 
Published: October 2009

AbstractMany papers have been written about sudden sensory hearing loss and the effect of barotrauma on the inner ear. Fistulae of the round and oval window membranes have been implicated in the great majority of these cases.It has usually been recommended that the patient be treated with conservative therapy, such as bed rest, for a period of as long as 30 days and that the final hearing results are as good or better than those that have been surgically explored and corrected.In our experience immediate surgical exploration and correction of sudden severe or profound sensorineural deafness in the diver or flier is absolutely essential and the excellent results of hearing improvement in this select group certainly corroborates this theory. Other cases with the hearing loss limited to the high frequencies most notably have tinnitus and surgical exploration does not improve the hearing but may improve vertigo if present. Numerous cases are presented to support these supositions.
Pediatric vocal cord paralysis
Authors: Dedo Douglas D. 
Published: October 2009

AbstractPediatric vocal cord paralysis accounts for approximately 10% of all congenital laryngeal lesions. Early detection of these neurogenic disorders is based upon a high index of suspicion and is important to prevent catastrophes during periods of acute respiratory embarrassment. This paper reviews the symptoms, etiology and management of unilateral and bilateral vocal cord paralysis as it pertains to this age group. A case is presented of a neonate with vocal cord paralysis and associated hydrocephalous and meningomyelocele to illustrate many of the problems associated with pediatric laryngeal paralysis.
Schwannomas of the parapharyngeal space and jugular foramen
Authors: Maniglia Anthony J. , Chandler J. Ryan , Goodwin William J. , Parker Joseph C. 
Published: October 2009

AbstractSchwannomas or neurilemmomas are among the most common neoplasms occupying the parapharyngeal space, yet only 107 cases have been previously reported. Neurilemmomas involving the jugular foramen are extremely rare. Only 55 cases have been reported in the world literature.The neoplasm occurred in the parapharyngeal space in three of our patients and in the jugular foramen in another patient. Of the tumors located in the parapharyngeal space, the nerve of origin in one of them was the glossopharyngeal, which is extremely rare. Adequate exposure for complete excision of parapharyngeal space tumors is best obtained through an external incision and should not be attempted transorally.In the jugular foramen case, the neoplasm arose from the vagus nerve high in the neck and extended intracranially in a “dumbbell” shape into the posterior cranial fossa. Total removal was successfully accomplished in one stage, by using a subtotal temporal bone resection — upper neck — posterior cranial fossa approach.Surgical removal is the treatment of choice. Schwannomas rarely recur following complete excision.
The grand biopsy for the “cold” thyroid nodule
Authors: Stucker Frederick J. , Lacher Arthur B. , Hirokawa Ronald H. 
Published: October 2009

AbstractA lobe and isthmusectomy is our standard surgical management for the cold nodule of the thyroid. Experience indicates that the great majority of cold nodules prove benign. It is manifest that the attendant morbidity for this surgery be extremely low.Our experience reviewing thyroid surgery for only benign disease indicates that complications are indeed uncommon. Our surgical management of the cold nodule includes resection of a lobe and isthmus with exploration and palpation of the opposite side. The nerve is routinely identified and preserved. In the past 18 months, we have experienced two minor postoperative complications in 36 consecutive cases of the lobe and isthmus resection for benign disease.
Sinus complications of frontal craniotomy
Authors: Schramm Victor L. , Maroon Joseph C. 
Published: October 2009

AbstractFrontal sinusitis, or inflamatory complications of sinusitis, may occur as a consequence of frontal craniotomy when the sinus has been entered during the craniotomy. This may happen particularly during surgery to treat an aneurysm or to excise a tumor in the sellar area. These complications may also occur if the sinus is entered during routine craniotomy when the sinus is high or asymmetrical, or during reduction of frontal bone fractures. This presentation describes the etiology of such inflammatory complications and describes the approach to treatment of such complications, as well as outlining their prevention.
Longitudinal assessment of eustachian tube function in children
Authors: Beery Quinter C. , Doyle William J. , Cantekin Erdem I. , Bluestone Charles D. 
Published: October 2009

AbstractEustachian tube function was evaluated in 27 children (32 ears) with tympanostomy tubes at 6‐week intervals for 12 to 30 months. Using a modified inflation‐deflation test of passive and active ventilatory function, it was found that the ears had persistent functional obstruction. Most ears exhibited no significant change in tubal function throughout the observation period. There was no difference in the ventilatory function when the nasal airway was congested (other than due to purulent upper respiratory tract infection) and not congested. However, significant seasonal effects on Eustachian tube ventilatory function were recorded: function was poorer in the winter than in the summer. No relationship was found between Eustachian tube ventilatory function and the age of the child.
Maintenance of cochlear function with artificial oxygen carriers
Authors: Wada J. , Paloheimo S. , Thalmann I. , Bohne B. A. , Thalmann R. 
Published: October 2009

AbstractBy means of vascular perfusion via the anterior inferior cerebellar artery with a blood substitute containing the perfluorochemical FC 47 as oxygen carrier, it is possible to maintain normal or near normal levels of the cochlear microphonics and the endolymphatic potential of the guinea pig for periods of 90 min. or longer. Following 60 min. of perfusion with artificial blood, the levels of ATP and 5′AMP in the stria vascularis and the organ of Corti are comparable to those of nonperfused control animals maintained at optimal metabolic conditions. Following the same period of perfusion, the appearance of the organ of Corti is normal, but small vacuoles, presumably deposits of FC 47, are visible in the marginal cells of the stria vascularis. Preliminary experiments concerning the survival time and the revival time of the cochlear potentials, as well as the response to furosemide, ouabain, and mersalyl are presented to illustrate the value of this method in elucidating various biochemical and pharmacological problems of the cochlea.
Otolaryngologic presentation of Tic‐like disorders
Authors: Vogel Daniel H. 
Published: October 2009

AbstractCommon otolaryngologic symptoms such as coughing and sneezing may not be manifestations of disease of the upper respiratory tract. Two cases are reported in which these symptoms were the first evidence of tic‐like disorders. A short discussion of one such disorder, Gilles de la Tourette's syndrome, is presented. The entity of paroxysmal smeezing is also mentioned. It is pointed out that, in the absence of otolaryngologic disease, these disorders may first present to an otolaryngologist for diagnosis.
A new parameter in brain stem evoked response: Component wave areas
Authors: Anthony Philip F. , Durrett Richard , Pulec Jack L. , Hartstone Julie L. 
Published: October 2009

AbstractUsing a newly developed brain stem evoked response (BSER) parameter in preliminary testing, the authors can individually identify the auditory thresholds of 500 Hz, 1000 Hz and 2000 Hz to within 15‐25 db.The authors have developed an accurate method of breaking down the complex BSER curve, using a successive approximation technique, into its individual component curves. Each component curve is thought to represent the isolated electrical activity of one generator site. The component curves are the shape of normal distribution curves. The area under each individual component curve is the new parameter which the authors feel represents the isolated electrical activity of one generator site.Using this parameter a clinical trial was performed. Constant ipsilateral pure tone masking was superimposed upon the stimulus clicks in the test ears of two subjects. The constant ipsilateral masking was superimposed at 500 Hz, 1000 Hz and 2000 Hz. A statistically significant decrease in the area of component wave II (one masking sound caused an increased area) was seen when the pure tone masking sound became at least 15‐25 db louder than the patient's threshold at that individual frequency. These preliminary results give reason to think that a method of quantification of BSER responses has been found. More importantly, a method of identifying individual audiometric thresholds from 500 Hz throughout 2000 Hz to within 15‐25 db has been found. These findings need extensive further testing.
Plastic surgical education for the otolaryngologist
Authors: Webster Richard C. , Smith Richard C. 
Published: October 2009

AbstractOtolaryngology shares responsibility for provision of plastic surgical services involving facial and cervical structures, but many training programs have been weak in this part of the specialty. Some still are.Beginning in 1963 when a national organization was formed, leading facial plastic surgeons and the senior author analyzed the weaknesses and embarked on a program to correct these educational deficits. There was widespread lack of surgical background, woefully inadequate knowledge of soft tissue techniques, and poor understanding of dynamics involved in cosmetic procedures.Annual meetings, international symposia, numerous courses, and extensive videotape and microfiche production, as well as political and academic recognition, have all helped plastic surgical teaching endeavors at both residency and postgraduate levels. However, much remains to be done. Program directors are the “key” people here. Suggestions for future action are presented.
Surgical treatment of hypopharyngeal stenosis in children
Authors: Hamaker Ronald C. , Conley John 
Published: October 2009

AbstractFive cases are presented of severe scarring, in the hypopharynx in children, which did not respond to conservative measures. These patients were treated by excision of the scar tissue and reconstitution of the area by Z‐plasty, local mucosal flaps, regional chest flaps and colon transfer depending upon the severity of the problem. All had rehabilitation undertaken of the structural integrity of deglutive, respiratory, and vocal mechanisms. It is recommended that in this type of problem early rehabilitation is warranted rather than subjecting the child to prolonged gastrostomy and tracheotomy into puberty. When extended, the morbidity has a physical and psychological affect on these children.
Modified asai procedure
Authors: Saunders William H. 
Published: October 2009

AbstractTo develop a method of establishing speech in the patient who could not develop esophageal speech after laryngectomy, a modification of the Asai procedure with a specially designed Silastic prosthesis was used in three female patients.All three patients had immediate return of voice and were pleased initially. Eventually, however, because of complicating factors, all three operations were revised back to the original state and the new method considered as a failure.The reason for this presentation is to stimulate other surgeons to consider the problem further and perhaps to glean from this technique some useful considerations.
Panel discussion: Glomus jugulare tumors of the temporal bone. Malcolm D. Graham, Ann Arbor, mich., moderator. Radiological appearance of glomus tumors
Authors: Wright J. William , Wright J. William , Hicks George W. 
Published: October 2009

AbstractDepending upon the stage of pathogenesis, some glomus tumors demonstrate characteristic radiographic findings which permit a presumptive diagnosis of this type of tumor. Three factors are helpful in interpreting multidirectional tomography of the temporal bone when a glomus tumor is suspected. The tumor shows a predilection for bony erosion of the carotid crest and hypotympanum. It tends to destroy bone in its path by small lobulated invasions producing a fairly well demarcated border of crescentic shaped translucencies. In contradistinction to other tumors and infections, glomus tumors tend to spare the lateral wall of the attic and the ossicular chain even when the tumor is fairly well advanced in size.
Nasal surgery and airway resistance
Authors: Kosoy Jerome 
Published: October 2009

AbstractThis study investigates the effects of surgery and bronchodilatation on nasal and pulmonary resistance. The plethysmograph is evaluated as a clinical tool for nasal flow studies. The method of adapting the plethysmograph to measure nasal resistance is presented.Discriminant Function Analysis considers the effects of surgery and bronchodilatation on 15 variables. The statistical analysis of 38 cases demonstrates the benefits of improved nasal airway for pulmonary airway resistance.A review of the literature points out many of the difficulties in measuring nasal airflow. The plethysmograph emerges as an available easily adapted clinical tool that overcomes many of the short‐comings in earlier techniques and in rhinomanometry.The rhinologist is offered further insight into the nasopulmonary relationship and the use of the plethysmograph to document the effects of nasal surgery.
Autogenous vaccine treatment of juvenile laryngeal papillomatosis
Authors: Stephens Charlene B. , Arnold Godfrey E. , Hardy Cheryl L. , Butchko Gregory M. 
Published: October 2009

AbstractSeventeen cases of juvenile laryngeal papillomatosis have been seen and treated with microlaryngoscopy, removal of papillomas, and administering of autogenous vaccine. Holinger's original findings could be confirmed. The operation frequency of 9 patients was significantly reduced, 5 were improved, and 3 unchanged. In no case was an undesirable reaction to the vaccine observed. Electron microscopy showed no virus‐like particles in the papilloma but a section of a vulvar wart did show the virus.
Adverse effects of lidocaine and methylparaben on tracheal ciliary activity
Authors: Mostow Steven R. , Dreisin Robert B. , Manawadu Bingumal R. , Laforce F. Marc 
Published: October 2009

AbstractThe effect of standard concentrations of lidocaine HC1 and methylparaben (preservative) on the ciliary activity of ferret tracheal rings in organ culture was assessed. Pure lidocaine concentrations as low as 0.5% caused complete ciliostasis which was reversible after removal of the drug. One percent and two percent effects were not completely reversible. Pure methylparaben concentrations as low as 0.06 mg/ml paralyzed cilia; and, at concentrations of 0.5 mg/ml or higher, adverse effects were not completely reversible. When lidoacine and methylparaben were combined at the same ratio used in commercial preparations, their ciliotoxic effects were additive. These data suggest that topical respiratory anesthesia may result in prolonged ciliary paralysis.
Benign eccrine cylindroma of the external auditory canal.
Authors: Wilson Ralph S. , Johnson Jonas T. 
Published: October 2009

AbstractThe benign eccrine cylindroma is one of a number of histologically different tumors of the external auditory canal that have been grouped by some as “ceruminomas.” The eccrine cylindroma, malignant apocrine gland tumors, and the adenoid cystic carcinomas of salivary gland origin are distinctly different histologically and in natural history and prognosis. Therapy should, therefore, be tailored to the specific tumor.A patient is presented who developed an asymptomatic external auditory canal mass that was initially incompletely excised. A recurrence five years later again proved to be a benign eccrine cylindroma of sweat gland origin. Successful and adequate treatment was local excision with a cuff of normal tissue.A variety of tumors originating from the adnexal skin structures may appear in the external auditory meatus and canal. Treatment must include biopsy and close consultation with the pathologist. The term cylindroma has been loosely applied to both benign and malignant glandular neoplasms but its usage should be restricted to the specific benign eccrine cylindroma herein described. A rationale of therapy is presented.
Keratosis obturans and external auditory canal cholesteatoma
Authors: Piepergerdes James C. , Kramer Bernard M. , Behnke Ernest E. 
Published: October 2009

AbstractKeratosis obturans and external auditory canal cholesteatoma (EACC) have previously been considered to represent the same disease process. However, review of the literature and our cases reveal these to be two different clinical and pathological processes. Keratosis obturans presents as hearing loss and usually acute, severe pain secondary to the accumulation of large plugs of desquamated keratin in the ear canal. External auditory canal cholesteatoma presents as otorrhea with a chronic, dull pain secondary to an invasion of squamous tissue into a localized area of periosteitis in the canal wall.The treatment previously recommended for both of these conditions has been conservative debridement of the external canal and application of topical medication. While this remains the treatment of choice for keratosis obturans, surgery may be required to eradicate EACC.
The use of an abdominal pedicle flap in reconstructing nasal tip avulsion
Authors: Abbenhaus James I. 
Published: October 2009

AbstractNumerous flaps are available for reconstruction of the nose. However, most all of these utilize local or adjacent tissue which can result in moderate facial mutilation and scarring. The abdominal pedicle‐radial artery‐nose transfer flap has been previously described by Kilner and Chitrov. Both procedures somewhat compromise the final outcome and thus only portions of each were used in the design of this flap. The size of the flap was determined by doubling the width of the base of the nose and doubling the estimated length of the nose and tubing it. After staged transfer from abdomen to wrist to remaining nose, the distal end is defatted and cut into a three lobed flap for sculpturing the nasal tip and columella.
The effect of prolonged exposure to industrial noise on otosclerosis
Authors: Alberti P. W. , Hyde M. L. , Symons F. M. , Miller R. B. 
Published: October 2009

AbstractMore than 3000 workers referred by the Workmen's Compensation Board of Ontario have been evaluated for pension for industrial hearing loss. They include the normal proportion of otosclerotics, many of whom have had surgical therapy. The operations have been done by a wide variety of surgeons in the province of Ontario, and the results are representative of those which will be obtained in a large section of the Canadian community. The results are significantly worse than generally quoted, and some of the deficiencies are attributable to occupation. These include perilymph fistula from excessive straining and sensorineural hearing loss due to noise exposure. Detailed results will be presented.
First branchial cleft anomalies
Authors: Olsen Kerry D. , Maragos Nicolas E. , Weiland Louis H. 
Published: October 2009

AbstractOur experience with anomalies of the first branchial cleft is reviewed. This includes 38 cases, the largest series collected to date. A new classification is proposed based on the anatomic findings – whether cyst, sinus, or fistula is present. The embryology and pathology of first cleft anomalies are discussed and an approach to the diagnosis and management of these lesions is given. In addition, a patient with a branchial cleft defect involving the middle ear space is reported.
Cerebellar infarction – a presentation of vertigo
Authors: Rubenstein Ronald L. , Norman David M. , Schindler Robert A. , Kaseff Leon 
Published: October 2009

AbstractThe differential diagnosis of acute vertigo includes cerebellar infarction. In the past, a mortality rate of 50% – 80% was reported with cerebellar infarction. This is no doubt related to an inability to accurately diagnose small lesions which carry a better prognosis. The advent of computerized tomography (CT) now permits accurate diagnosis of small cerebellar infarctions.Seven patients admitted with acute onset of vertigo which mimicked a peripheral labyrinthine disorder are presented. In all patients a cerebellar etiology was demonstrated by CT. One patient had been subjected to therapeutic labyrinthectomy; three of seven patients had associated unilateral hearing loss suggesting partial brain stem involvement.The CT findings in cerebellar infarction are often subtle and require careful interpretation. Computerized tomography should be included in the routine work‐up of acute vertigo with any associated neurologic finding to aid in proper diagnosis and effect appropriate treatment.