bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric upper airway obstruction due to ectopic thyroid: Classification and case reports
Authors: Chanin Louis R. , Greenberg Lyon M. 
Published: October 2006

AbstractFew clinical situations can be as frightening, challenging, and as rewarding as stabilizing the airway of a child. Most causes of pediatric upper airway obstruction are well recognized, often discussed in the literature, and commonly encountered in practice. However, ectopic thyroid (i.e., thyroid tissue found in places other than its normal location) may be an unusual cause of pediatric upper airway obstruction with which the clinician may not be familiar. The resulting airway obstruction may be slow or rapid in onset, total or partial, and the relationship of the thyroid to the airway may be clear or obscure.Two cases of obstructing ectopic thyroid are presented which demonstrate the spectrum within which this form of airway obstruction may occur. One case is the first reported example in the English literature of pediatric intratracheal thyroid. A review of the literature is also presented.Four types of ectopic thyroid (lingual, sublingual, thyroglossal, and intralaryngotracheal) are illustrated and discussed in relation to their effect upon the pediatric upper airway. The authors also review the developmental anatomy of the thyroid and present two major theories regarding the development of intralaryngotracheal thyroid. The possible etiologies of the other ectopic forms are also discussed.
Beta‐lactamase‐producing bacteria in head and neck infection
Authors: Brook Itzhak 
Published: October 2006

AbstractWe have summarized our experience in recovery of beta‐lactamase‐producing bacteria (BLPB) in head and neck infection (UNI). These HNI include conjunctivitis, serous and chronic otitis media, cholesteatoma, chronic mastoiditis, chronic sinusitis, adenoiditis, recurrent tonsillitis in children and adults, peritonsillar abscess, and retropharyngeal abscess.Beta‐lactamase‐producing bacteria were found in 262 (51%) of 513 patients with HNI; 72% had aerobic BLPB and 57% had anaerobic BLPB. The infections, where these organisms were most frequently recovered, were adenoiditis (85% of patients), tonsillitis in adults (82%) and children (74%), retropharyngeal abscess (71%), and chronic otitis media (57%). The predominant BLPB were Staphylococcus aureus (49% of patients with BLPB), the Bacteroides‐melaninogenicus group (28%), the Bacteroides fragilis group (20%), Pseudomonas aeruginosa (13%), Hemophilus influenzae (5%), and Branhamella catarrhalis (3%). The high incidence of recovery of BLPB in head and neck infections may have important implications on the antimicrobial management of these infections.
Perilymphatic fistula in children with preexisting sensorineural hearing loss
Authors: Pappps Dennis G. , Simpson L. Clark , Godwin George H. 
Published: October 2006

AbstractProgression of preexisting sensorineural hearing loss (SNHL) in infants and children has been considered an indication for fistula exploration: is this approach warranted? On exploring 36 middle ears in 26 such children, we found a perilymphatic fistula (PLF) in four ears (11%). Although there was radiographic evidence of inner‐ear deformity in one half of these children, a definite fistula was found in only four of 18 radiographically abnormal ears explored (22%). Even in the four patients with a history of an “event” that could implicate a fistula such as exertion or barotrauma, a fistula was found in only one.There are a number of possible causes for progression of a preexisting SNHL, and surgical exploration of the middle ear should not be recommended on the basis of progression alone. Instead, exploration for a suspected PLF should be strongly considered when there is also a history of an “event,” and/or radiographic evidence of inner‐ear abnormalities. Even under these conditions, one should be aware that fistulae are not likely to be found.
Comparison of complications following frontal sinus fractures managed with exploration with or without obliteration over 10 years
Authors: Wilson Brian C. , Davidson Bruce , Corey Jacquelynne P. , Haydon Richard C. 
Published: October 2006

AbstractTwo hundred twelve patients were treated for facial or skull trauma at the West Virginia University Hospital between the years 1977 and 1987. Sixty‐she of these patients had frontal sinus or nasofrontal duct trauma. Follow‐up information was obtained on 64 of these patients through clinic visits, chart review, questionnaires to patients and physicians, and telephone calls to the patients. Follow‐up greater than 1 year was obtained on 52 patients. Sixty‐four patients were managed either with a frontal sinus obliteration or with an open exploratory procedure. The incidence of complications occurring in the past 10 years after each of these procedures is compared. Because the indications for each procedure vary somewhat, data is presented on fracture etiology, associated injuries, specific fracture location, fracture displacement, severity of injury, and associated cerebrospinal fluid leaks.
Utilizing angiogenic agents to expedite the neovascularization process in skin flaps
Authors: Hom David B. , Baker Shan R. , Graham Linda M. , Mcclatchey Kenneth D. 
Published: October 2006

AbstractThe revascularization of a skin flap after flap transposition is an important step in flap survival. This study investigates the efficacy of certain angiogenic agents to expedite the neovascularization process and to increase the viability of skin flaps. Eighty‐four island skin flaps were designed on the auricles of 42 New Zealand White rabbits to achieve 90% necrosis over a 7‐day period. Thirty‐six flaps were treated with Endothelial Cell Growth Supplement (ECGS) or Endothelial Cell Growth Factor (ECGF) at several concentrations topically or immersed in Gelfoam. The remaining flaps were used as normal saline controls. Flap viability and peripheral neovascularization were documented by polar planimetry, angiography, and histological analysis.The flap viability of the ECGS‐Gelfoam(r)‐treated flaps was 100% greater than their normal saline‐Gelfoam controls (p = .021). Flap angiograms demonstrated increased vascular ingrowth among the treated flaps compared to the controls. This study suggests that angiogenic agents can expedite flap neovascularization and have the potential to increase flap viability.
Cochlear hypoxia and the compound action potentials
Authors: Hildesheimer Minka , Muchnik Hava , Rubinstein Moshe 
Published: October 2006

AbstractA relatively restricted area, including the ear, was perfused in guinea pigs with hypoxic blood having a pO2 of 10, 20, and 30 mm Hg, respectively. The changes induced to the cochlear action potentials were analyzed and the results compared with those obtained in a previous study in which the guinea pigs were rendered hypoxemic by ventilating them with air entrapped in a closed circuit from which the CO2 was continously absorbed. The changes induced to the cochlear action potentials by both methods were very similar. However, while using the territorial model for inducing hypoxia, 75% of the animals showed a threshold shift at a blood pO2 of 20 mm Hg and with the general model all the animals showed a threshold shift at 25 mm Hg blood pO2. In other words, if the hypoxic condition affected the whole body, other factors such as a slight, but continuous tendency to acidosis with significant increase in blood lactic acid concentration could join the oxygen deficit in affecting cochlear function.
Evoked accelerometry: A sensitive and accurate method for evaluating facial nerve function using a portable device
Authors: Zealear David L. , Korff Marjorie , Herzon Garrett D. 
Published: October 2006

AbstractA new electrodiagnostic technique has been developed which can be used to monitor facial nerve function. The technique has been termed “evoked accelerometry” (EAC) and is administered by a portable DC powered device. In performing a test, the device stimulates the facial nerve and then measures the evoked muscular response by a small accelerometer sensor affixed to the face with suction. The magnitude of the response is displayed as a digital readout on the device meter. The degree to which a reading is subnormal indicates the extent of nerve degeneration. In a study of normal participants the stimulus‐response characteristics of the EAC technique were found to be similar to those of ENoG, indicating the clinical efficacy of the technique. However, evoked accelerometry was found to be more sensitive than ENoG (i.e., detectable response of 0.3% to 0.6% vs. 1.8% to 5.2%) and more accurate than ENoG (average error of 6.8% v.s. 13.9% to 20.7%).
Retropharyngeal abscess in children: A retrospective and historical analysis
Authors: Thompson Jerome W. , Reddk Phyllis , Cohen Seymour R. 
Published: October 2006

AbstractThe charts of 65 pediatric patients with the diagnosis of retropharyngeal abscess were reviewed. These represented a 36‐year experience with the disease. The findings were compared with those documented at the turn of the century and were also compared with findings over the last four decades. The data suggests that retropharyngeal abscess may be occurring later in childhood and may not always be preceded by a major detectable infection. Classic diagnostic findings of retropharyngeal bulge and neck stiffness were present in less than half of the patients. Gram‐negative and anaerobic organisms are being documented on culture more frequently than in the past. We theorize that liberal use of oral antibiotics prior to admission may have brought about these changes.
The membrane rupture theory of meniere's disease — is it valid?
Authors: Brown Dale H. , Mcclure Joseph A. , Downar‐Zapolski Zbigniew 
Published: October 2006

AbstractThe Membrane Rupture Theory states that the acute attack of Meniere's disease occurs when endolymph, with its high potassium ion concentration, escapes into the perilymph and surrounds the first‐order neuron. Initially, this causes partial depolarization of the nerve and an increased resting discharge, followed by complete depolarization. Clinically, one would expect an initial irritative nystagmus (toward the affected side) followed by a paralytic nystagmus (toward the unaffected side). To confirm this, the guinea pig perilymphatic space was perfused with an artificial endolymph solution. The results confirmed an irritative/paralytic sequence of nystagmus that differs from the pattern of spontaneous nystagmus observed with ENG monitoring during the acute attack of Meniere's disease. Early in the attack, one observes a paralytic nystagmus followed by a secondary nystagmus beating toward the affected side (similar to an irritative nystagmus) as the patient recovers. This raises questions about the validity of the Membrane Rupture Theory.
Vasculae decompression of the cochlear nerve in tinnitus sufferers
Authors: Meyerhoff William L. , Mickey Bruce E. 
Published: October 2006

AbstractAn estimated 40 million Americans suffer from tinnitus, and approximately 20% of these sufferers feel that the quality of their life is significantly impaired by this symptom. Despite thorough evaluation, the underlying etiology in the majority of these patients remains obscure or conjectural. Most of these patients will, however, benefit from consultation and avoidance of caffeine, nicotine, and salt, while others require biofeedback, amplification, masking, and even psychotherapy. On rare occasions, physicians are presented with a patient complaining of unilateral tinnitus of undetermined etiology who, in spite of a thorough evaluation and all conventional therapies, continues to be severely handicapped by that symptom. Early findings suggest that these patients may be suffering from vascular loop compression of the cochlear division of the eighth cranial nerve. When patients are carefully selected, retrosigmoid decompression of that vascular loop has provided gratifying relief.
Pseudotumor of the head and neck masquerading as neoplasia
Authors: Weisman Robert A. , Osguthorpe J. David 
Published: October 2006

AbstractFour unusual cases of pseudotumor, which had clinical and radiographic findings suggesting neoplasia, are presented. One involved the maxillary sinus, destroying the lateral wall, and extending to the infratemporal fossa and the orbit. The second presented as an enlarging lacrimal gland tumor with ipsilateral parotid adenopathy, and the third as a large parapharyngeal mass that was diagnosed as a lymphoma on aspiration cytology. The fourth case documented the rare occurrence of a congenital pseudotumor, manifesting as proptosis in a neonate and thought to be a fibrosarcoma on frozen section study. Aggressive pseudotumors must be distinguished from malignancy to avoid unnecessary surgery or irradiation. Some cases can be distinguished from neoplasms by their dramatic response to oral steroid therapy, and others by characteristic features on CT or MRI. Due to the diverse cellular proliferation, aspiration cytology is infrequently helpful and diagnosis can be difficult on frozen section study. An approach to the diagnosis and management of pseudotumors is detailed.
Paeanasal sinus disease with intracranial extension: Aspergillosis versus malignancy
Authors: Sarti Edward J. , Blaugrund Stanley M. , Lin Pi Tang , Camins Martin B. 
Published: October 2006

AbstractAspergillus is a fungus with world‐wide distribution and a common endogenous contaminate of the upper respiratory tract. It has become an increasingly recognized pathogen in the paranasal sinuses. In its pathologic state it presents in one of several forms that may represent a continuum of the disease: allergic, noninvasive, invasive, and fulminant. The progression and prognosis of this disease depends on the location and immunologic status of the patient.This case represents the fourth reported case of a nonimmunologic compromised patient with intracranial extension of aspergillosis. The patient presented with unilateral pansinusitis and radiographic evidence of orbital and anterior cranial fossa invasion. This case illustrates the difficulty of establishing the diagnosis of invasive aspergillosis and differentiating it from neoplastic entities. Radiographs and photomicrographs will be presented to establish this premise.
Clinical and laboratory characteristics of focal laryngeal dystonia: Study of 110 cases
Authors: Dds Andrew Blitzer, , Briny Mitchell F. , Fahn Stanley , Lovelace Robert E. 
Published: October 2006

AbstractSpastic dysphonia is a syndrome often, producing a strain‐strangle voice. We have previously classified most of these patients as having focal laryngeal dystonia, a disorder of central motor processing. In a study of 1,280 cases of dystonia registered at the Dystonia Clinical Research Center at the Columbia‐Presbyterian Medical Center, we found 110 patients who had vocal cord involvement.These patients had historical information evaluated for age of onset (mean 34.6 years), duration of symptoms (mean 13.8 years), sex (1.4:1 female to male) family history (positive in 23%), and primary (66%) and secondary (34%) etiology; neurological evaluation for other dystonic involvement (25% with segmental cranial involvement, 23% with generalized dystonia) or tremor (irregular 23%, regular 6% on EMG).Treatment options were evaluated and included speech therapy, psychotherapy, biofeedback (with limited success), systemic medication (limited success except in abductor cases), nerve section (with late failure rate), and the use of botulinum toxin (improvement in all 34 injected patients).
Site of upper airway obstruction in patients with idiopathic obstructive sleep apnea
Authors: Chaban Roman , Cole Philip , Hoffstein Victor 
Published: October 2006

AbstractWe developed a technique to determine the site of upper airway obstruction in patients with idiopathic obstructive sleep apnea (OSA). This technique is based on the analysis of inspiratory airflow pressures at various levels of the pharyngeal airway during sleep. Pharyngeal pressure was measured by a moveable Millar catheter pressure transducer. The catheter's position in the airway was localized radiographically. Ten patients with OSA were tested: five patients were found to have upper airway obstruction at the level of the soft palate, and five had upper airway obstruction at the base of the tongue. We concluded that measuring airway pressures at multiple sites along the airway is useful in localizing the site of obstruction in patients with OSA, and may have important implications in terms of the patient's response to surgical treatment.
Neoplasms of the vagus nerve
Authors: Green J. Douglas , Olsen Kerry D. , Desanto Lawrence W. , Scheithauer Bernd W. 
Published: October 2006

AbstractA tumor of the vagus nerve often, is discovered unexpectedly at operation. We report 36 of these rare neoplasms in 35 patients. The majority of the tumors presented as a mass in the upper cervical or parapharyngeal region. Usually the mass was asymptomatic. The following types and frequencies of neoplasms of the vagus nerve were noted: paragangliomas, 50%; neurilemmomas, 31%; neurofibromas, 14%; and neurofibrosarcomas, 6%. Surgical resection, with preservation of the vagus nerve when possible, is the treatment of choice. The clinical features, diagnosis, management, and prognosis of the tumors are presented. Special problems that occur with vagal neoplasms include postoperative dysfunction, catecholamine secretion, and intracranial or skull‐base extension.
Acupuncture for the alleviation of tinnitus
Authors: Thomas M. , Laurell G. , Lundeberg T. 
Published: October 2006

AbstractThe present study describes the effect of acupuncture in 12 patients with tinnitus. The patients were referred from the Department of Audiology, Karolinska Hospital, where their hearing and tinnitus were assessed. None of the patients had benefited from previous treatment for tinnitus.The selection of acupuncture points depended on the individual and was, to a limited extent, based on traditional Chinese medicine (TCM). Local points such as Si 19, Sj 17, and Sj 21 were fairly standard; distal points took into account associated problems of the patient, but were also points recommended in TCM for tinnitus.Ten treatments were attempted within a 6‐ to 12‐week period. The treatments were carried out weekly or biweekly, depending on the availability of patient and acupuncturist.Six patients had transient effects and noise reduction. However, no positive long‐term results were obtained. Similarities between the experience of tinnitus and of pain are discussed in light of these findings.
Dedication
Authors: Carpenter Anna‐Mary 
Published: October 2006

AbstractThis supplement is dedicated to my dear Professor Dr. Anna‐Mary Carpenter who retired on August 1,1987 after 50 years of active teaching. Her scientific career started in 1938 at the University of Pittsburgh where she was a member of the Pathology Department at the Children's Hospital until 1954 when she joined the Anatomy Department at the University of Minnesota. She became Full Professor in 1963 and remained in that position until 1982, becoming then Professor Emerita. She also served as Professor of Pathology at Indiana University, Northwest Center since 1980, and has lived in Indiana since 1982.In spite of all her degrees, scientific deeds, and international recognition (innovations in diabetes, quantitative morphology, and being first to “section” a pancreas using computer simulation), her greatest achievements have come from her teachings of her discipline. She has trained several generations of graduate students, postdoctoral fellows, and more than 5,000 medical students. Her extraordinary teaching ability and capacity is the result of her profound knowledge and understanding of morphology. Her personal interest and dedication to all of her students gained her the legendary nickname “Ma Carpenter.” Dr. Carpenter represents an exceptional breed of true scholar and scientist. As one of her students and with the conviction of representing all of them, I want to assure her that those true scientific and university values taught for over 50 years are alive and very strong in all of us, that her teachings will persist for generations, and that she will live in our hearts.
Experimental studies on round window structure: Function and permeability
Authors: Goycoolea Marcos V. , Muchow David , Schachern Patricia 
Published: October 2006

AbstractCurrent research and an overall review of 12 years of round window membrane studies is presented. The approach, rationale, and concepts that have evolved from the studies are described. An ultrastructural study of the round window membrane of rhesus monkeys disclosed three basic layers: an outer epithelium, a middle core of connective tissue, and an inner epithelium. Morphologic evidence in monkeys, cats, and chinchillas suggests that these layers of the round window participate in absorption and secretion of substances to and from the inner ear, and that the entire membrane could play a role in the defense system of the ear. Cationic ferritin, horseradish peroxidase, 1‐μm latex spheres, and neomycin‐gold spheres placed in the middle ear of these experimental animals were observed to traverse the round window membrane through pinocytotic vesicles. Three‐micron latex spheres and anionic ferritin were not incorporated by the membrane. Cationic ferritin and 1‐μm latex spheres placed in perilymph were incorporated by the inner epithelial cells, suggesting absorptive capabilities of the round window membrane. Cationic ferritin was observed within the mesothelial cells underlying the scala tympani side of the basilar membrane, suggesting a role for these cells in the inner‐ear defense system. A review of the subject and a general perspective from the author's viewpoint are discussed.
Apneic anesthesia for improved endoscopic removal of laryngeal papillomata
Authors: Weisberger Edward C. , Miner James D. 
Published: October 2006

AbstractDuring a 2‐year period at Indiana University Medical Center, nine patients underwent 51 endoscopic procedures employing the technique of apneic anesthesia for removal of papillomata involving the larynx.The apneic anesthesia technique affords improved visualization of the larynx and subglottis because the view is unencumbered by an endotracheal tube. This unencumbered view allows a more thorough removal of diseased tissue, especially in the posterior commissure and subglottis. In addition, the absence of an endotracheal tube reduces the risk of a fire occurring in the upper airway and eliminates the chance of physically disseminating papilloma particles into the lower tracheal‐bronchial tree or toward the physician—a problem that is inherent in the intermittent jet ventilation technique. No significant complications related to the use of this technique have been encountered; however, the safety of apneic anesthesia is greatly enhanced by using a pulse oximeter and transcutaneous oxygen monitor to continuously monitor arterial oxygen saturation.Details of the apneic anesthesia technique are described, as are the relevant aspects of pulmonary physiology, which must be clearly understood to safely employ this method.
Orbital decompression for optic neuropathy secondary to thyroid eye disease
Authors: Schaefer Steven D. , Merritt James H. , Close Lanny G. 
Published: October 2006

AbstractTo improve our management of optic neuropathy from thyroid eye disease, we have refined the external ethmoidectomy approach, which permits the removal of the medial orbital wall and adjacent floor. We now report our experience with six patients (11 eyes) selected for this surgical technique. These patients are part of a larger population of patients with thyroid eye disease who have been surgically managed by us over the last 6 years.