bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awake evoked electromyography recording from the chronically implanted rat
Authors: Widick Mark H. , Tanabe Tetsuya , Fortune Scott , Zealear David L. 
Published: October 2006

AbstractInvestigation of the effects of various factors on nerve regeneration has been compromised by the lack of an accurate and objective technique which can monitor dynamic changes in the status of nerve‐muscle innervation over the entire course of regeneration. The approach of evoked electromyography (EEMG) was adopted to obtain temporal and quantitative data during nerve regeneration. Initially, transcutaneous nerve stimulation and percutaneous muscle recording was performed, but the approach was abandoned because of the high intertest variability (20% average deviation) and requirement for anesthesia during testing. A new approach using chronically implanted stimulation and recording electrodes was adopted in an attempt to circumvent these problems. Initial acute studies performed in the hindlimb of the anesthetized rat identified stable EEMG recording sites with sciatic nerve stimulation. In a second study conducted in chronically implanted unanesthetized unrestrained animals, EEMG recording from these sites demonstrated remarkable stability with an average intertest variability of only 5%. Preliminary results have been obtained with this technique in monitoring the progression of hindlimb reinnervation following crush and transection nerve injuries.
Glomus vagale: Paraganglioma of the vagus nerve
Authors: Urquhart Andrew C. , Johnson Jonas T. , Myers Eugene N. , Schechter Gary L. 
Published: October 2006

AbstractReview of the experience of a single institution with a rare tumor may give inadequate and biased information. In an effort to better understand issues related to diagnosis and subsequent management of paraganglioma of the vagus nerve, review of the experience at two university medical centers was undertaken.A review of the records of all patients with a diagnosis of vagal paraganglioma at the University of Pittsburgh and the Eastern Virginia Medical School was undertaken. Presenting signs and symptoms, treatment, and subsequent outcome were assessed.Data on 19 patients with vagal paraganglioma were available. The most common initial finding was a neck mass. Forty‐seven percent (9/19) had vocal cord paralysis at presentation. Angiography was beneficial in helping to make the diagnosis and in identifying synchronous tumors. History of familial paraganglioma was present in 47% (9/19). Multiple paragangliomas were diagnosed in 53% (10/19) cases in our study. Of the patients with familial vagal paraganglioma, 89% (8/9) had multiple paraganglioma. All patients treated with surgery had postoperative vocal cord paralysis.Elective management of patients with bilateral vagal paraganglioma is a special dilemma. Radiation therapy of selected “operable” patients may be indicated because of the potential for bilateral vocal cord paralysis in these patients and its attendant sequela.
Intraoperative monitoring of auditory function: Experimental observations and new applications
Authors: Wazen Jack J. 
Published: October 2006

AbstractThe three different methods of intraoperative monitoring, namely, auditory brainstem response evaluation (ABR), electrocochleography (ECoG), and direct eighth nerve compound action potentials monitoring are reviewed. Both ECoG and direct eighth nerve monitoring surpass the ABR in their ability to provide fast, almost instantaneous, large, reproducible potentials in response to click stimuli. Changes in the amplitude and the latency of these potentials alert the surgeon of an impending eighth nerve injury. Human clinical observations revealed instances of persistence of the ECoG despite a total eighth nerve section in the cerebellopontine angle. Animal and human experiments were conducted to evaluate the effectiveness of ECoG and direct eighth nerve monitoring in hearing preservation. Twelve cats underwent progressive sectioning of the eighth nerve with simultaneous monitoring of changes in their ECoG and direct eighth nerve potentials. ECoG thresholds were obtained intraoperatively in eight patients undergoing surgery for conductive hearing loss. The results of these experiments suggest that recording directly from the eighth nerve is a more accurate technique during cerebellopontine angle and eighth nerve surgery. ECoG, however, appears to have a promising role in the intraoperative monitoring of middle ear reconstruction procedures under general anesthesia.
Carcinoma in situ of the glottic larynx
Authors: Myssiorek David , Vambutas Andrea , Abramson Allan L. 
Published: October 2006

AbstractCarcinoma in situ (CIS) is part of the histopathologic spectrum of laryngeal disorders where invasive squamous cell carcinoma is the endpoint of cellular disarray. Few reports consider prognostic indicators that predict which lesions become invasive. Forty‐one patients with CIS of the glottic larynx were analyzed for risk factors that would predict invasive cancer. Anterior commissure involvement by CIS resulted in 92% conversion to invasive squamous cell cancer compared to 17% of lesions limited to the mobile fold. Epidermal growth factor receptors were also analyzed and were found not to be helpful in predicting invasion. Lesions of the mobile fold should be removed endoscopically and the patient should be observed closely for recurrence. Anterior commissure involvement that is inaccessible to complete laser ablation should be radiated, and the patient should be observed carefully.
Functional loss of the horizontal doll's eye reflex following unilateral vestibular lesions
Authors: Foster Carol A. , Foster Brian D. , Spindler John , Harris Jeffrey P. 
Published: October 2006

AbstractThe doll's eye reflex represents the vestibulo‐ocular reflex (VOR) elicited by high‐acceleration head rotation. After complete unilateral vestibular lesions, the ipsilateral, horizontal doll's eye reflex is replaced by a series of “catch‐up” saccades. These cause permanent symptoms of blurred vision and dizziness during ipsilateral turns. We compared normal controls and patients with complete surgical lesions or canal paresis of up to 9 years duration via electronystagmography (ENG) to determine the usefulness of the doll's eye test as a diagnostic test for complete vestibular lesions. This test was found to be more sensitive in diagnosis of such lesions than head‐shaking nystagmus, rotatory directional preponderance, and spontaneous nystagmus. It is also useful to document VOR function in patients in whom caloric irrigation is contraindicated.
DNA Content and regional metastases in patients with advanced laryngeal squamous carcinoma
Authors: Wolf Gregory T. , Fisher Susan G. , Truelson John M. , Beals Theodore F. 
Published: October 2006

AbstractAbnormal DNA content of cancer cells in a primary tumor is thought to reflect the altered proliferative capacity of that cancer and overall patient prognosis. Recently, increased DNA content has been associated with early tumor recurrence in patients with advanced laryngeal cancer. To determine if DNA content correlates with a tumor's metastatic behavior, 94 previously untreated patients with stage III (n = 54) or stage IV (n = 40) squamous carcinoma of the larynx were prospectively studied. The adjusted DNA index (aDI) of the primary tumor was measured by computerized cytomorphometry, and correlations with regional metastases, number of positive nodes, extracapsular spread, and pattern of relapse were determined. Median follow‐up was 35 months. Of 94 patients, 73 underwent neck dissection. Positive nodes were found in 51 patients (70%) and three or more positive nodes were found in 31 patients (42%). High aDI (>.024) was significantly associated with the presence and number of histologically positive nodes (P = .016). Among patients with high aDI, 19 (50%) of 38 had three or more nodes positive compared to 12 (21%) of 56 of those with low aDI. Median aDI levels in patients with three or more nodes were significantly higher than in patients with 1 or 2 nodes (P = .003). Time to recurrence was shorter in patients with high aDI (P = .0078). These findings provide further evidence that increased DNA content is associated with more aggressive laryngeal cancers having high rates of multiple lymph node metastases and worse overall prognosis.
Voice changes in acromegaly
Authors: Williams R. G. , Richards S. H. , Mills R. G. , Eccles R. 
Published: October 2006

AbstractThe fundamental frequency of 14 patients undergoing hypophysectomy was studied. Eight patients had acromegaly, 3 had a prolactinoma, and 3 had nonfunctioning adenomas. The fundamental frequency of 22 normal, healthy volunteers was measured for comparison. In addition, the external size of the larynx of all patients and volunteers was measured and a relationship between external laryngeal size and the mean fundamental frequency was identified in the volunteers. The mean fundamental frequency in patients with acromegaly was significantly lower than the other 6 patients undergoing hypophysectomy and, in addition, was also lower than the 22 normal volunteers. Postoperatively the fundamental frequency of the acromegalic patients increased rapidly to within the expected normal range. Patients with acromegaly have a lowered fundamental frequency which is most likely due to altered vocal cord mass and elasticity, which is a reversible change. Patients with acromegaly can expect a rapid and complete return of normal fundamental frequency within 2 weeks of surgery to remove the pituitary adenoma.
Trends in the management of alcohol withdrawal syndrome
Authors: Newman James P. , Terris David J. , Moore Michelle 
Published: October 2006

AbstractAlcohol use among head and neck cancer patients is common. Alcohol withdrawal (especially delirium tremens) poses significant potential morbidity to postsurgical patients. Treatment with newer benzodiazepines (BZDs) such as lorazepam and midazolam has become more widespread, and mortality rates from severe alcohol withdrawal have decreased in recent years.The authors retrospectively studied 102 patients with a diagnosis of alcohol withdrawal, including 20 patients undergoing surgery for cancer of the head and neck. There were 81 men and 21 women, with a mean (± standard deviation [SD]) age of 52.3 (±16.1) years. Many of these patients (46%) were treated with more than one BZD or other neuroleptic, while 49% received single agent therapy of either chlordiazepoxide (26%) or lorazepam (23%). Delirium tremens occurred in 12% of all patients undergoing withdrawal and in 10% of head and neck cancer patients, with a mortality rate of 9% and 0%, respectively.Single agent use was successful in greater than 95% when either lorazepam or chlordiazepoxide was used. Instances of combination treatment where older BZDs were used yielded a 69% success rate. The higher complication rate and lower treatment success with combination treatment was multifactorial.Optimal management of the alcohol withdrawal syndrome requires an understanding of its pathophysiology and the principles of its prevention along with a familiarity of BZD pharmacokinetic drug profiles. The authors present a treatment plan which is cost‐effective, keeps morbidity low, and should allow a continued decreasing trend in mortality rates from delirium tremens.
Management of traumatic hypopharyngeal injuries
Authors: Fetterman Bruce L. , Shindo Maisie L. , Stanley Robert B. , Armstrong William B. , Rice Dale H. , Armstrong William B. 
Published: October 2006

AbstractViolation of the hypopharynx by external penetrating trauma is an uncommon occurrence that may lead to life‐threatening infectious complications if not recognized promptly and treated appropriately. A retrospective review of 48 such injuries seen during a 10‐year period showed that flexible fiberoptic endoscopic examination is the best screening tool for recognition of a possible hypopharyngeal mucosal violation. Direct laryngopharyngoscopy is the best method of definitively diagnosing the injury. Size of the visualized mucosal violation alone is not sufficient information on which to base the decision for medical management versus surgical intervention (i.e., immediate exploration and drainage). Rather, the size, exact site of injury, and mechanism of the injury must be considered to have equal importance. Associated vertebral body fractures may negatively influence acute outcome if diagnosis and treatment of the hypopharyngeal injury are delayed by the cervical spine injury.
A tissue‐culture model for the study of canine vocal fold fibroblasts
Authors: Broadley Caroline , Gonzalez Debra A. , Nair Rhada , Koriwchak Michael J. , Ossoff Robert H. , Davidson Jeffrey M. 
Published: October 2006

AbstractA tissue‐culture model has been developed for the study of fibroblasts from the canine vocal fold. Laryngeal tissue (lamina propria) obtained from euthanized dogs is rinsed, cut into 1‐mm3 pieces, and incubated in 5% carbon dioxide at 37° C. A confluent monolayer is established within several days. Detectable levels of elastin in the tissue culture supernatant are measured by an indirect enzyme‐linked immunosorbent assay. Various external agents have been shown to affect elastin production. The effects of KTP laser irradiation, hydrocortisone (1.3 μmol/L), transforming growth factor‐β (10 ng/mL), and human leukocyte elastase have been measured. Thus the canine vocal fold fibroblast tissue culture is established as a model for further investigations to improve wound healing and to understand the wound‐healing process following laryngeal microsurgery.
Amplification of mitochondrial DNA from archival temporal bone specimens
Authors: Simpson Thomas A. , Smith Richard J. H. 
Published: October 2006

AbstractArchival temporal bone collections are an invaluable resource for studying the molecular genetics of many types of otopathology. The irreplaceable nature of temporal bone sections makes efficiency of DNA extraction of paramount importance. Several protocols are available for extracting DNA from fresh and preserved tissue. To establish the best protocol for reliably extracting DNA from celloidin‐embedded temporal bone sections, a variety of DNA extraction techniques were tested. Using the optimum protocol, mitochondrial DNA fragments ranging in size from less than 100 base pairs to more than 400 base pairs were amplified, and the authenticity of polymerase chain reaction (PCR) products was confirmed through comparative sequence analysis.
Endoscopic diode laser welding of mucosal grafts on the larynx: A new technique
Authors: Wang Zhi , Pankratov Michail M. , Rebeiz Elie E. , Perrault Donald F. , Shapshay Stanley M. 
Published: October 2006

AbstractEpithelial coverage of a laryngotracheal wound is an important factor in preventing stenosis, and endoscopic transplantation of a free mucosal graft without stents or sutures would be a significant therapeutic advance. In vitro and in vivo canine studies were performed to explore the feasibility of transplantation with a low‐power diode laser (400 mW) enhanced by indocyanine green dye‐doped albumin. The tensile strength of graft adherence in 10 cadaver larynges was strong (35.25 ± 10.39 g). Survival studies in live canine models with a specially designed endoscopic instrument set showed excellent healing at 6, 14, and 28 days. Healing was documented with photography and by histologic examination. Successful endoscopic transplantation of a free mucosal graft should improve results of treatment for laryngotracheal stenosis and laryngeal reconstructive surgery.
How I do it: Head and neck and plastic surgery: Surgical management of the head and neck cancer patient following concomitant multimodality therapy
Authors: Panje William R. , Namon Ari J. , Vokes Everett , Haraf Daniel J. , Weichselbaum Ralph R. 
Published: October 2006

AbstractThe simultaneous use of chemotherapy and radiotherapy (concomitant therapy) has exceptional promise in the treatment of head and neck cancer. In this limited review, seven head and neck cancer patients who underwent prior concomitant therapy and subsequent surgery developed wound‐healing complications that were delayed (22‐day average) in onset. Paranasal sinus and base of skull operations had less significant wound morbidity than those cases requiring simultaneous transgression of the neck and upper aerodigestive tract. The use of arterialized flaps did not in itself prevent wound breakdown. The formation of controlled fistulae, delay of reconstruction, and avoidance of simultaneous neck and upper aerodigestive tract entry are important considerations in avoiding wound‐healing complications after concomitant therapy. In this select group of patients, surgery should be approached with extreme caution and conservatism.
The effect of botulinum toxin type a injection on compound muscle action potential in an in vivo rat model
Authors: Cichon John V. , Mccaffrey Thomas V. , Litchy William J. , Knops Joost L. 
Published: October 2006

AbstractSerial measurements were performed on the compound muscle action potential (CMAP) amplitude and the force generated by the rat lower hind limb flexors to investigate the time course of intramuscular injections of botulinum toxin type A (BOTOX®). Thirty animals were used in this in vivo rat model. CMAP amplitude and muscle force were measured at predetermined intervals for 28 weeks.Compound muscle action potential amplitude and force declined markedly the first 5 to 7 days after injection of BOTOX but recovered in a near linear manner. The response magnitude and recovery rate were dose‐dependent. Recovery of CMAP amplitude preceded recovery of muscle force. No clear evidence of a systemic effect on the untreated leg or a concentration effect was found. CMAP amplitude may be useful in determining optimal timing of repeat injections in treating neuromuscular disorders.
Reconstruction of suboccipital craniectomy defects with hydroxyapatite cement: A preliminary report
Authors: Kveton John F. , Friedman Craig D. , Piepmeier Joseph M. , Costantino Peter D. 
Published: October 2006

AbstractHydroxyapatite cement, a new biomaterial presently under clinical investigation, has been demonstrated to have potentially wide application in cranial reconstruction. We describe our experience with this biologic bone cement in the reconstruction of suboccipital craniectomy defects in seven patients after vestibular schwannoma removal. With up to 2‐year follow‐up, cranial bone integrity has been reestablished in five patients. Dissolution of cement has occurred in dependent areas and appears to be technique related. Cranial bone contour appears dependent on the amount of cement used. The frequency of debilitating postoperative headache was reduced in these patients when compared to patients who had no reconstruction of the craniectomy defect. Reconstruction of the bony defect after suboccipital craniectomy with hydroxypatite cement is not only useful to restore cranial contour, but also appears to reduce some of the functional deficits attributed to this surgical approach.
Laryngopharyngoesophagectomy for advanced hypopharyngeal and esophageal squamous cell carcinoma: The yale experience
Authors: Sasaki Clarence T. , Salzer Stephen J. , Cahow C. Elton , Son Yung , Ward Barbara 
Published: October 2006

AbstractThe 5‐year survival rate for patients with hypopharyngeal squamous cell carcinoma invading the upper esophagus is below 25% regardless of therapy. Most patients with advanced disease—unable to eat or breathe—die within 18 months of diagnosis. Because these patients, on average, have a limited time to live, surgical treatment should aim to maximize the quality of remaining life. Essential to this goal are complete tumor removal and rapid return to oral feeding. Furthermore, short hospital stay and low perioperative morbidity are especially important in these patients.We performed total laryngopharyngoesophagectomy (LPE) with gastric transposition in 34 patients with hypopharyngeal and cervical esophageal squamous cell carcinoma. There has been one perioperative death (3%) and 1 temporary fistula (3%). No major mediastinal or intrathoracic complication occurred. On average, patients began oral feeding by postoperative day 10, with return to a full diet and discharge home within 16 days, maximizing both quality and quantity of time remaining outside the hospital.
Nasal inflammation in patients with obstructive sleep apnea
Authors: Rubinstein Israel 
Published: October 2006

AbstractThe purpose of this study was to determine whether nasal inflammation is present in patients with obstructive sleep apnea (OSA). The number of polymorphonuclear leukocytes (PMNs) and the concentrations of bradykinin and vasoactive intestinal peptide (VIP) were quantified in nasal lavage fluid of eight nonsmoking patients with OSA and in six matched controls before sleep and the next morning. The total number of cells and the percentage of PMNs was significantly higher in patients with OSA in comparison to controls before and after sleep (P<.05). Likewise, bradykinin and VIP concentrations were significantly higher in patients with OSA in comparison to controls before and after sleep (P<.05). These findings indicate that nasal inflammation is present in patients with OSA. We suggest that nasal inflammation plays a role in upper airway obstruction in OSA.
Squamous cell carcinoma arising in inverted papilloma
Authors: Lesperance Marci M. , Esclamado Ramon M. 
Published: October 2006

AbstractA retrospective review of all cases of inverted papilloma at the University of Michigan from 1975 to 1992 revealed 51 cases of inverted papilloma. Of these, 14 (27%) had an associated squamous cell carcinoma (SCC). Eight (16%) were metachronous and 6 (11%) were synchronous. At a mean follow‐up of 53 months, the disease‐free survival of patients with carcinoma limited to the nasal cavity and paranasal sinuses was 57% (4/7) compared to 14% (1/7) of those patients presenting with disease extending beyond the nasal cavity and paranasal sinuses. The data also support the lateral rhinotomy approach with medial maxillectomy and ethmoidectomy as a minimum procedure followed by postoperative radiation therapy. The mean interval between the diagnosis of inverted papilloma and development of SCC was 63 months (range, 6 months to 13 years). Therefore, long‐term follow‐up with clinical examination and computed tomography (CT) scan is indicated for all patients with inverted papilloma.
Hearing preservation in acoustic tumor surgery: Results and prognostic factors
Authors: Dornhoffer J. L. , Helms J. , Hoehmann D. H. 
Published: October 2006

AbstractA retrospective study was conducted to assess the hearing results in patients who underwent acoustic neuroma removal via the middle fossa approach. A statistical correlation of results with preoperative clinical and audiological data determined if any prognostic indicators could be associated with successful hearing preservation. Of 93 patients included in the study, useful hearing was preserved in 54 (58%), and hearing was preserved near preoperative levels in 42 (45%). The potential for hearing preservation appeared to be inversely related to the size of the acoustic tumor, with hearing preserved in 39 (60%) of 65 patients with tumors less than or equal to 0.5 cm extension into the cerebellopontine angle. Preoperative hearing levels and electronystagmography seemed to have no prognostic value. However, auditory brainstem response showed that a wave V latency of less than 6.8 msec was associated with an increased chance of hearing preservation, and the presence of vertigo as a preoperative complaint appeared to be a good prognostic indicator of successful hearing preservation.