bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computed tomography in the evaluation of acquired stenosis in the neonate
Authors: Faw Kenneth , Muntz Harlan , Siegel Marilyn , Spector Gershon 
Published: October 2006

AbstractWe studied the feasibility of computed tomographic evaluation of the neonatal airway. Three neonatal larynges, removed at necroscopy, were examined by computed tomography. Good resolution of soft tissue, cartilage and airway lumen was obtained in these small specimens. On the basis of these findings two neonates with acquired subglottic stenosis were examined by endoscopy, soft tissue airway radiographs, and computed tomography. Measurements of radiation dose revealed that a computed tomographic study delivered 36% of the mean tissue dose of standard image intensifier fluoroscopy. Computed tomography and fluoroscopy both demonstrated the degree and length of this stenosis accurately. An advantage of CT over conventional imaging procedures was better definition of the cross sectional area of the airway.
Allergic aspergillus sinusitis: Concepts in diagnosis and treatment of a new clinical entity
Authors: Waxman Joel E. , Spector J. Gershon , Sale Scott R. , Katzenstein Anna‐Luise A. 
Published: October 2006

AbstractThe clinical features in 15 young adult patients with allergic Aspergillus sinusitis includes a history of asthma, recurrent nasal polyps, and radiographic evidence of pansinusitis. Multiple surgical procedures were performed on 12 patients.The histologic diagnosis is made on the mucinous material which contains eosinophils, fungal hyphae (Aspergillus species), and Charcot‐Leyden crystals. Mycetomas, direct mucosal and soft tissue invasion by fungi, were not observed.Immunologic findings include an immediate cutaneous reactivity to Aspergillus in 60% of patients, total serum IgE elevation in 85%, and serum precipitins to Aspergillus in 85%.A new therapeutic protocol was devised based on the current treatment of allergic bronchopulmonary aspergillosis. Therapy includes wide local debridement, adequate sinus aeration, and the postoperative use of systemic steroids. Seven patients placed on systemic corticosteroids are asymptomatic for a mean of 14 months.Diagnosis of allergic Aspergillus sinusitis requires a high index of suspicion, a confirmatory diagnosis from the inspissated mucus, and an immunologic evaluation prior to the institution of corticosteroid therapy.
Central vocal cord paralysis and paresis presenting as laryngeal stridor in children
Authors: Ross Douglas A. , Ward Paul H. 
Published: October 2006

AbstractVocal cord paralysis or paresis as the initial presenting symptom for intracranial tumors in children are rare. Recently, two pediatric patients who were later diagnosed as having intracranial tumors presented with the symptom of voice changes and stridor. Telescopic examination revealed bilateral vocal cord paresis and paralysis as demonstrated by video recordings. The majority of pediatric brain tumors present with both generalized and localized complaints; however, by discussing these two rare cases, we hope to underscore the importance of a thorough workup of the paralyzed or paretic vocal cords.
Comparison of the erbium‐yttrium aluminum garnet and carbon dioxide lasers for in vitro bone and cartilage ablation
Authors: Gonzalez Carlos , Van De Merwe Willem P. , Smith Michael , Reinisch Lou 
Published: October 2006

AbstractThe in vitro bone‐ and cartilage‐ablation characteristics of the solid‐state erbium:yttrium aluminum garnet laser were compared to those of the carbon dioxide laser. Ablations of fresh, frozen cadaver septal cartilage and maxillary sinus bone were performed using total energies between 1 and 6 J. Specimens were studied using hematoxylin and eosin stain and digitized, computer‐assisted measurements of 35‐mm photographs. Erbium‐yttrium aluminum garnet‐ablated bone averaged 5 μm of adjacent tissue thermal injury, compared with 67 μm with carbon dioxide‐ablated bone. Erbium‐yttrium aluminum garnet‐ablated cartilage averaged 2 μm of adjacent tissue thermal injury, compared with 21 μm with the carbon dioxide‐ablated cartilage. The tissue‐ablation characteristics of the erbium‐yttrium aluminum garnet laser are promising for future oto‐laryngologic applications.
A matched‐pairs comparison of single and multichannel cochlear implants in children
Authors: Chute Patricia M. , Hellman Sharon A. , Parisier Simon C. , Selesnick Samuel H. 
Published: October 2006

AbstractAuditory capabilities of Nucleus 22® multichannel cochlear implant users were compared to those of matched 3M/House® single‐channel users. Six children who received either the 3M/House or Nucleus 22 cochlear implants were separated into three matched pairs. Group 1 consisted of two postlinguistically deafened adolescents, group 2 consisted of two prelinguistically deafened school‐age children, and group 3 consisted of two perilinguistically deafened preschoolers.Participants were evaluated using auditory comprehension and discrimination tasks as indicated by the 3M/House and Nucleus 22 protocols. However, only tasks common to both were included here. While the 3M/House single‐channel device has been under an IDE for children under the age of 18 years since 1984, the Nucleus 22 multichannel implant only recently became available for this age group. Thus, short‐term evaluations at 6 months and 1 year postimplanta‐tion have been used for comparison.Two of the three groups indicated that the multichannel users performed as early as the 6‐month level; the children in the third group performed equally. These results indicate that multichannel cochlear implants show great promise in deaf children.
Percutaneous feeding gastrostomy in patients with head and neck tumors: A 5‐year review
Authors: O'Dwyer Timothy P. , Gullane Patrick J. , Awerbuch David , Ho Chia‐Sing 
Published: October 2006

AbstractSince the beginning of this decade major advances have taken place in the alimentation of patients with tumors of the head and neck. Gauderer and Ponsky described a percutaneous method of gastrostomy and, in 1983, a number of radiologists, including the senior author, described a percutaneous radiologic method using the Seldinger technique to create a feeding gastrostomy. This method is ideally suited for patients with advanced tumors of the head and neck because it requires neither endoscopy nor general anesthesia. Over the past 5 years, 55 patients with tumors of the head and neck have undergone this procedure. Eighty‐one percent of the patients had advanced disease at initial presentation. One patient (1.8%) had a procedure‐related death and another patient (1.8%) had a complication that required a laparotomy. Three patients (5.4%) had minor complications that required minimal medical attention. None of the patients required general anesthesia and an endoscopy was not required. Patient discomfort during the procedure was minimal.
Objective tinnitus in benign intracranial hypertension: An update
Authors: Sismanis Aristides , Butts Frank M. , Hughes Gordon B. 
Published: October 2006

AbstractPreviously, the authors reported that objective pulsatile tinnitus can be the major or only manifestation of benign intracranial hypertension. This report updates the authors' experience with 31 patients managed over the past 7 years.Benign intracranial hypertension should be suspected in all patients with pulsatile‐objective tinnitus, especially when the patient is a young, obese female with headaches and/or visual disturbances. Papilledema and small ventricles or an empty sella on computerized tomography are almost diagnostic. The diagnosis is confirmed by elevated spinal fluid pressure on lumbar puncture. In such patients, angiography is not indicated. Furosemide and acetazol‐amide are very effective. Ligation of the internal jugular vein is contraindicated.
Primary extracranial meningiomas of the head and neck
Authors: Friedman Craig D. , Costantino Peter D. , Teitelbaum Benjamin , Berktold Robert E. , Sisson George A. 
Published: October 2006

AbstractExtracranial meningiomas comprise approximately 2% of all meningiomas. Primary extracranial meningiomas are even less common. This report details our experience with these unusual tumors from 1972 to 1989. The diagnosis, surgical management, and significant histopathologic features are discussed. The correlation of primary extracranial meningiomas with neurofibromatosis type II and a treatment algorithm are presented.
Rationale for elective neck dissection in 1990
Authors: Friedman Michael , Mafee Mahmood F. , Pacella Bernard L. , Strorigl Terri L. , Dew Linda L. , Toriumi Dean M. 
Published: October 2006

AbstractElective neck dissection has long been a subject of debate among surgeons. The proponents of elective neck dissection base their rationale on studies that show a 30% incidence of occult disease in those situations for which elective neck dissection is recommended. One hundred eighty‐two patients with advanced stages of squamous cell carcinoma of the head and neck were studied. All patients had preopera‐tive computed tomography or magnetic resonance imaging, and all patients had some form of radical neck dissection. The sensitivity of clinical exam was compared with the sensitivity of computed tomography or magnetic resonance imaging in ability to detect nodal disease. The sensitivity of clinical exam alone was 71.7%, while the sensitivity of computed tomography or magnetic resonance imaging was 91.1%. Based on physical exam alone, there would be a 39% rate of occult disease; if computed tomography or magnetic resonance imaging data is combined with physical exam, the occult disease rate would drop to 12%. All centers performing elective neck dissection must reassess their rationale or restudy their occult disease rate with computed tomography or magnetic resonance imaging.
Mechanisms of Middle ear aeration: Anatomic and physiologic evidence in primates
Authors: Eden Avrim R. , Gannon Patrick J. , Laitman Jeffrey T. 
Published: October 2006

AbstractProper aeration is a prerequisite for normal middle ear function in all terrestrial mammals. Our previous studies in primates provided anatomic evidence of neural circuits between the middle ear, brain, and eustachian tube by which central respiratory neurons can control middle ear aeration. Yet mechanisms that regulate middle ear aeration remain poorly understood. This study extends our research by examining maturation of these neural circuits, and investigating their underlying physiology. Ultrastructural examination of tympanic nerves, the afferent limb of the neural circuit, in an age‐graded series of cynomolgus monkeys (Macaca fascicularis) showed substantial differences between newborn, young, and adult animals. These included a twofold increase in average myelin thickness, and greater than threefold increase in the ratio of myelinated to un‐myelinated fibers from newborn to adult animals. These marked developmental changes may translate into functional differences in regulation of middle ear aeration in young animals, and possibly explain the extraordinarily high incidence of middle ear disease in early childhood. In physiologic experiments, bilateral electromyographic responses were recorded from eustachian tube muscles, the efferent limb of the neural circuit, in adult monkeys after ipsilateral stimulation of the tympanic nerve. Response latencies were 9 to 28 msec, similar to those of other multi‐synaptic bilateral brainstem reflexes. These physiologic data strongly suggest a concept of active control of middle ear aeration by respiratory neurons in the brain.
Tamoxifen Therapy In Patients With Recurrent Laryngeal Squamous Carcinoma
Authors: Urba Susan G. , Carey Thomas E. , Kudla‐Hatch Vickie , Wolf Gregory T. , Forastiere Arlene A. 
Published: October 2006

AbstractTwelve patients with recurrent, advanced laryngeal carcinoma were treated with tamoxifen hormonal therapy. Rationale was based on previous in vitro data identifying estrogen receptors and progesterone receptors in some laryngeal carcinoma cell lines. Four patients received tamoxifen, 10 to 20 mg by mouth twice a day; eight received 40 mg by mouth four times a day. The drug was well tolerated at all dose levels. There were no clinical responses. Two patients' tumor tissue was assayed for estrogen and progesterone receptors. One was negative for both, and the other was indeterminate for estrogen receptors and negative for progesterone receptors. A review of literature and a discussion of the possible reasons for the negative results are presented.
Effect of age on nasal cross‐sectional area and respiratory mode in children
Authors: Warren Donald W. , Hairfield W. Michael , Dalston Eileen T. 
Published: October 2006

AbstractAlthough nasal cross‐sectional size has been reported for adults, no information is available concerning the effects of age on nasal area and breathing mode in children. Determination of the effect of age on nasal size is necessary in order to define nasal airway impairment in children. The purpose of this study was to determine mean nasal cross‐sectional size in children between the ages of 6 and 15 years. One hundred two children were assessed during resting breathing. The pressure‐flow technique was used to estimate nasal cross‐sectional size, and inductive plethys‐mography was used to assess nasal‐oral breathing. The results indicate that nasal airway size increased approximately 0.032 cm2 each year. Mean nasal cross‐sectional area increased from 0.21 ± 0.05 cm2 at age 6 to 0.46 ± 0.15 cm2 at age 14. The percentage of nasal breathing also increased with age.
Supraglottic laryngectomy for intermediate‐stage cancer: U.T. M.D. Anderson cancer center experience with combined therapy
Authors: Lee K. , Goepfert Helmuth , Wendt Charles D. 
Published: October 2006

AbstractWe reviewed the records of all patients with previously untreated squamous cell carcinomas of the supraglottic larynx who presented to The University of Texas M. D. Anderson Cancer Center from 1974 to 1987. Of 404 patients, 60 (15%) underwent supraglottic laryngectomy and functional anterior neck dissection as a primary modality of therapy; these patients were studied. Fifty of the 60 patients (83%) received adjunctive postoperative radiotherapy. Tumor‐free survival was 96% at 2 years and 91% at 5 years. There were no local failures, 4 regional failures, and 3 distant metastases. Second cancers, mostly of the lung, occurred in 9 patients (15%). Three patients required completion laryngectomies for intractable aspiration. Analysis of deglutition and tracheal decannulation rehabilitation revealed a higher incidence of complications in patients who underwent arytenoidectomies.
Allogeneic (homograft) reconstruction of the mandible
Authors: Lowlicht Roger A. , Delacure Mark D. , Sasaki Clarence T. 
Published: October 2006

AbstractReconstruction of the tumor‐ablated patient remains one of the most challenging problems for the head‐and‐neck surgeon. Various methods have been described, including alloplastic reconstruction, free vascularized flaps, osteo‐myocutaneous flaps, and allogeneic reconstruction with particulate marrow grafts. Sixteen patients who have undergone homograft mandibular replacement at the Yale New Haven Hospital are described. Eighty‐one percent of these grafts were successful in restoring form and function to a high degree of patient satisfaction. Eleven of the sixteen patients had radiation therapy after initial tumor surgery; 91% of these grafts were successful.
The predictive value of tumor classification compared with results of the british institute of radiology fractionation trial in the treatment of laryngopharyngeal carcinoma
Authors: Wiernik George , Hopewell John W. , Rezvani Mohiaddin , Alcock Christopher J. , Fowler John F. , Haybittle John L. 
Published: October 2006

AbstractData from a clinical trial involving 734 patients have shown the value and the deficiencies of the current Union Internationale Contre le Cancer's tumor, node, and metastasis classification system for prognostic purposes. The tumor‐category classification provides a good discriminant for both nodal involvement and survival; however, the previous node classification system only discriminated between node‐negative and node‐positive patients, as nodal fixity was not found to be a discriminator. The current anatomical site classification is ambiguous for some laryngeal and pharyngeal subsites, and modifications to the present system based on prognostic values are proposed. A difference in patient age between tumor categories has been shown, and various differences in incidence and survival data for the sexes have been demonstrated. Differences in observed and expected survival rates are related to continued late deaths from tumor. Multivariate analyses have shown that stage grouping is the most powerful prognostic discriminator, followed by anatomical site and age.
So‐Called branchiogenic carcinoma is actually cystic metastases in the neck from a tonsillar primary
Authors: Micheau Christian , Klijanienko Jerzy , Luboinski Bernard , Richard Jean 
Published: October 2006

AbstractIn 1974, we reported on six patients with squamous cell carcinoma arising in the tonsillar area who presented with a characteristic form of cystic nodal metastasis.This study reports on an additional 21 patients with this entity. Treatment of these patients included removal of the cystic metastasis with or without radical neck dissection and irradiation of Waldeyer's ring.Two patients have died of unrelated disease and two were lost to follow‐up, but the remainder are alive without disease 2 months to 12 years following initial diagnosis.We believe that cystic metastases from tonsillar squamous cell carcinomas have often been mistaken for either primary squamous cell carcinomas of branchiogenic origin or with branchial cleft cysts. The distinctive histological features of cystic metastases reviewed after its correct identification can lead to the discovery of an unsuspected primary lesion and result in specific treatment options.
Argon laser phototherapy of human malignancies using rhodamine‐123 as a new laser dye: The intracellular role of oxygen
Authors: Castro Dan J. , Ward Paul H. , Fetterman Harold R. , Foote Christopher S. , Saxton Romaine E. , Markley John , Castro Donna J. 
Published: October 2006

AbstractRecent studies demonstrated that the cationic, mito‐chondrial‐specific dye Rhodamine‐123 (Rh‐123), is an efficient tumor photosensitizer for Argon laser treatment of human cancer cells both in vitro1–4 and in tumors grown as xenografts in athymic mice.5–7 To demonstrate the photo‐dynamic mechanism of action of this reaction, the intracellular role of oxygen and temperature changes in treated cells have to be defined. In the current study, a large panel of human tumor cell lines of diverse histologic origin were tested for in vitro sensitivity to Rh‐123 and the Argon laser (514.5 nm) in oxygen, deuterium oxide (D2O), and nitrogen (N2) environment. Tumor cells in suspension were first sensitized to Rh‐123 (1 or 20 μg/ml for 1 hour), cooled on ice to 4°C, and then exposed to the Argon laser (ΔT = 14 ± 1°C). Cell proliferation measured by [3H]‐thymidine uptake 24 hours after sensitization with Rh‐123 and laser treatment was significantly decreased in tumor cells kept in oxygen and D2O atmospheres. No decrease in DNA synthesis was seen in Rh‐123 and laser treated cells kept in an N2 environment. Control tumor cells treated with Rh‐123 or the Argon laser separately did not show any decreased [3H]‐thymidine uptake in oxygen, D2O or N2 environment. These results provide evidence of a photodynamic process since Rh‐123 sensitization and Argon laser activation occur at nonther‐mal levels of energy and are oxygen dependent. The high effectiveness of this technique of photodynamic therapy with the Argon laser, and low toxicity of Rh‐123 could make its clinical use very attractive for the treatment of superficial malignancies.
Conservation surgery for glomus jugulare tumors: The value of early diagnosis
Authors: Jackson C. Gary , Cueva Roberto A. , Thedinger Britt A. , Glasscock Michael E. 
Published: October 2006

AbstractThe results of‐lateral cranial base surgery for glomus jugulare tumors are gratifying when normal anatomy and function can be preserved. The goal of conservation surgery is to preserve normal ear anatomy and cranial nerve function. In general, conservation surgery is tumor‐size dependent. Thus, excellent states of functional recovery depend upon accurate early diagnosis. This paper reviews the technical aspects of transtemporal conservation skull base tumor surgery while also reviewing our experience with nearly 100 glomus jugulare patients. Adjuvants to early diagnosis will be highlighted from a review of presenting symptoms, clinical signs, and related diagnosis. Our objective is to provoke a high index of suspicion in physicians charged with the responsibility of diagnosing these tumors. Diagnostic guidelines are proposed.
Effects of uvulopalatopharyngoplasty on sleep architecture and patterns of obstructed breathing
Authors: Katsantonis George P. , Miyazaki Sohichiro , Walsh James K. 
Published: October 2006

AbstractIn this retrospective study, 72 obstructive sleep apnea patients with polysomnograms taken before and after uvulopalatopharyngoplasty were evaluated. Postoperative‐ly, there was a significant improvement of sleep architecture and respiratory indices. In addition, a second group of 17 patients also had position recordings with their polysomnograms. Time spent in supine and lateral sleep positions changed postoperatively. There was significant decrease of the apnea plus hypopnea index in the lateral position. This study indicates that there is significant improvement of sleep architecture and respiratory indices in the majority of patients after uvulopalatopharyngoplasty, particularly in the lateral sleep position.
Endoscopic laser surgery for early glottic carcinoma: A clinical and experimental study
Authors: Wolfensberger Markus , Dort Joseph C. 
Published: October 2006

AbstractThe purpose of this study is to define the indications for using the CO2 laser for the treatment of early glottic cancer. For this purpose, 52 consecutive laser resections of Tis to T2 vocal cord carcinomas were studied prospectively. In addition, laser resection was performed in eight human cadaver larynges, which were then examined histologically using whole organ sections. Both tumor size and tumor location had important influences on tumor resectability by laser. All of the Tis, 78% of T1, and one of four T2 carcinomas were successfully treated by laser surgery alone. Of the 10 carcinomas involving the anterior commissure, only four could completely be resected with the laser; of these four, two recurred in the anterior commissure. This finding is corroborated by the histologic study, which clearly shows that anterior commissure resection poses problems. The only laser resection complication of early glottic cancer was persistent hoarseness in one third of the patients. It is concluded that CO2 laser resection is a safe and effective alternative treatment for patients with Tis and T1 glottic carcinoma, provided the anterior commissure is free of tumor.