bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epiglottic reconstruction of laryngeal stenosis secondary to cricothyroidostomy
Authors: Kennedy Thomas L. 
Published: October 2006

AbstractTwo cases of laryngeal stenosis secondary to cricothyroidostomy are presented with their management. Both laryngeal injuries involved the glottis and subglottis regions with the second case sustaining total closure of the larynx by scar tissue. Although different surgical procedures were employed, management was successful in each case with one surgical attempt. Total glottic and subglottic reconstruction was necessary in the second case and was successfully handled with a modification of the epiglottic laryngoplasty. The surgical technique is described in detail. Caution is raised concerning the routine use of cricothyroidostomy. Epiglottic laryngoplasty is presented as a simple and encouraging procedure for laryngeal reconstruction of laryngeal stenosis.
Acute epiglottitis in adults: Experience with fifteen cases
Authors: Ossoff Robert H. , Wolff Allan P. , Ballenger John J. 
Published: October 2006

AbstractFifteen adults with acute epiglottitis are discussed. Three required tracheostomy because of delayed diagnosis. There were no deaths.Epiglottitis occurs more often in adults than is generally recognized. The early symptoms of epiglottitis in adults are sore throat and dysphagia. Any patient with acute, painful dysphagia should have indirect laryngoscopy to rule out epiglottitis.Throat and blood cultures were obtained from 14 of our cases. Cultures from only two patients were positive for Hemophilus influenzae, type B; cultures from the other 12 patients did not grow any bacterial pathogens.The primary treatment of adult epiglottitis is intravenous steroids, antibiotics, and humidified oxygen. Observation by the managing physician is mandatory during the first four hours of treatment. Tracheostomy is indicated in progressive disease.
Jet insufflation anesthesia for endolaryngeal surgery
Authors: Rontal Michael , Rontal Eugene , Wenokur Milford 
Published: October 2006

AbstractThe ideal anesthetic in endolaryngeal surgery provides a quiet completely unobstructed larynx in a patient who is comfortable and has respiratory functions maintained. Dissatisfaction with the intubation and venturi techniques has led to the use of a high pressure jet insufflation method. The results of this study have shown that anesthetically this technique is safe for a wide range of patients and endoscopic procedures. Laryngologically, the absence of glottic obstruction has broadened the scope of endoscopic procedures performed under general anesthesia.
Energy dispersive X‐ray analysis of intråcochlear ion shifts produced by anoxia
Authors: Bone Robert C. , Ryan Allen F. 
Published: October 2006

AbstractContemporary understanding of cochlear physiology has changed significantly in the last twenty years, due in large measure to experimental advances based on technological innovations. Since the early 1950's, it has been known that the cochlea is the site of several unique electrical events, among them the endocochlear potential. This potential is known to be biphasic, consisting of both positive and negative components. That the positive component of this potential is oxygen dependent, employs as part of its mechanism an ATP‐driven potassium pump, and is sensitive to several metabolic poisons is well established. It is the second or negative portion of the endocochlear potential about which significant controversy still exists.The importance of the endocochlear potential in contemporary theories of auditory function requires that more be known about its subcomponents in order that deafness be better understood. Measurements of the unique cationic concentrations within the endolymph have been made in the past in order to correlate concentration changes that may occur over time with already known changes in the negative endocochlear potential per se. Practical as well as theoretical shortcomings of studies employing micropipette, resistance measurement and ion‐specific electrode techniques have led to this investigation in which ion concentration changes during prolonged anoxia were investigated by first freeze‐drying the cochleas to be studied to prevent contamination. Second, material recovered and isolated after freeze drying was examined by energy dispersive X‐ray analysis, a highly sensitive and precise method of determining elemental concentration within biological fluids.Relative concentrations of Na+, K+ and Cl− were recorded within the first hour and at subsequent hourly intervals after decapitation of chinchillas. During the time of emergence and subsequent decay of the negative endocochlear potential, no significant change in the relative concentration of K+ or Na+ occurred. At much longer intervals (6 to 8 hours) large changes were measurable by the methods employed.K+ flux or diffusion has, in the past, been thought by many to be the likely source of the negative endocochlear potential. However, observed measurements of the relative concentration of K+ do not correlate with the magnitude of change in the negative endocochlear potential, rendering endolymphatic K+ concentration or flux an unlikely source of the negative endolymphatic potential. Other experimental data suggesting alternate regions within the cochlea such as Reissner's membrane or the organ of Corti, specifically the hair cells or supporting cells as more likely sources of the negative endocochlear potential, are reviewed.
Cryosurgery for the treatment of cancer
Authors: Neel H. Bryan 
Published: October 2006

AbstractCryosurgery is that branch of cryobiology and surgery which deals with the therapeutic application of cold at profoundly low temperatures (those below 0°C) for the purpose of destroying tissues in selected target sites. The freezing process induces coagulation necrosis and is confined to the tissues within the region of the probe application and the ice ball. The degree and extent of tissue destruction depend largely on the size of the ice ball and the temperatures within it.Various types of equipment and probes are commercially available for cryosurgery, but it was only after the development of reliable, versatile cryosurgical systems cooled by liquid nitrogen that numerous applications for cryosurgery were proposed, including therapy for cancer.In the treatment of cancer, clinical success with cryosurgery has led to the more widespread application of this modality in selected patients. Cryosurgery has been used for readily accessible lesions in specific anatomic areas, most frequently the skin and oral cavity. It is an attractive alternative to extirpative surgery, particularly in the head and neck, where removal of large portions of the mandible or maxilla are often required to control cancer. Therefore, it is not surprising that many of the pioneering efforts in the treatment of cancer have been conducted by otorhinolaryngologists.The full theoretic potential of cryotherapy was somewhat slow to be realized because many early endeavors were directed toward palliation, especially of accessible tumors of the skin and oral cavity, after failure of tumor control by radiation or surgery or both. This limited application during the early period of evaluation reflected a naturally timorous course that was taken by those who introduced the new modality into clinical practice. This period paralleled the development of new apparatus, early clinical trials, and the assessment of the clinical potential of cryosurgery in patients with incurable cancer — those whose conditions were deemed hopeless. Today, cryosurgery is selectively applied for the treatment of patients with tumors involving structures such as bone, oropharyngeal mucosa, temporal bone, skin, brain, retina, prostate, uterine cervix, and tracheobronchial tree.Although general guidelines for the application of cryosurgery to cancer can be gleaned from various clinical reports, the optimal conditions of freezing have not been specifically defined. Animal experiments are necessary to study the variables methodically and in detail. The temporal and physical conditions for cryogenic necrosis of cancer require delineation so that cell death can be predictably and consistently reproduced. This is the thrust of this paper.
The contralateral effects of large tumors on brain stem auditory evoked potentials
Authors: Nodar Richard H. , Kinney Sam E. 
Published: October 2006

AbstractBrain stem auditory evoked potential (BAEP) testing has been demonstrated to be a useful diagnostic tool in the presence of severe or complete sensorineural hearing loss. From a series of 38 patients with tumors in the vicinity of the VIIIth nerve, 13 patients with tumors larger than 2 cm had abnormal BAEP results contralateral to the involved side. The abnormalities observed on the noninvolved side included prolonged peak latencies, reduced amplitudes, poor wave shape and poor response stability. The significance of these findings is twofold: 1. Large tumors may disrupt BAEP test results on the side contralateral to the lesions, 2. Important information may be obtained on patients having complete sensorineural hearing loss on the involved side.
The argon laser in otology
Authors: Dibartolomeo Joseph R. , Ellis Maxine 
Published: October 2006

AbstractThe use of lasers in microsurgery is now an accepted procedure. As we learn more about the absorption properties of biologic tissue, we can use different electromagnetic wave lengths to accomplish surgical alteration of these tissues. The electromagnetic wave length of the Argon laser is compatible for surgical alteration of the soft tissue and bone of the middle and inner ear. Thirty patients requiring external ear canal or middle ear surgery were treated using the Argon laser during the course of the surgical procedure. The treatment of soft tissue pathology included tympanoplasty with fascia graft, control of bleeding, lysis of adhesions, and myringotomies performed using the Argon laser. Osseous disease of the external canal was removed and stapedectomy was performed, using the Argon laser on 15 patients.A review of the physics of laser energy and its application in otology is presented. The results of this investigative study demonstrate the advantages of the Argon laser in otologic microsurgery.
Primary chordoma of the maxillary sinus
Authors: Shugar J. M. A. , Som P. M. , Krespi Y. P. , Arnold L. M. , Som M. L. 
Published: October 2006

AbstractA case of primary chordoma of the maxillary sinus is presented. The embryology of the notochord is reviewed and it is suggested that the frequently used adjective “ectopic” is a misnomer. The literature of primary paranasal sinus chordomas is reviewed and the clinicopathological features described. It is emphasized that these lesions can mimic other benign and malignant processes both clinically, radiographically and histologically. The treatment and prognosis is more favorable than the more common craniocervical chordoma.
Malignant fibrous histiocytoma of the frontal sinus
Authors: Schaefer Steven D. , Denton Richard A. , Blend Benjamin L. , Carder Henry M. 
Published: October 2006

AbstractThe first case of malignant fibrous histiocytoma of the frontal sinus is reported. The aggressive nature of the tumor despite its relatively benign histologic pattern and value of electron microscopy are emphasized. Ultrastructural examination reveals a progression of several principal cell types, lending support to the multi‐potent mesenchymal cell origin of these malignancies. These cells may have arisen from the supporting stroma of the ectodermally derived respiratory epithelium of the paranasal sinuses. Wide local excision is currently the primary mode of therapy. The value of radiation therapy or chemotherapy in this tumor is unproven.
The overall management of salivary gland disorders
Authors: Eichel Berkley S. , Bray David A. , Kaplan Harold J. 
Published: October 2006

AbstractTwo studies are reported in an attempt to give a broader interpretation of the management of salivary gland disorders. One study analyzes 232 patients seen over a six year period and divides the grouping into parotid, submaxillary, and accessory salivary gland disorders. The numbers and percentages of patients who underwent surgery are reported along with a pathological break‐down of the various lesions encountered. Eighty‐five (36%) of the 232 patients had a documented surgical procedure. Thirty‐eight of the entire 232 patients had tumor involvement, for a 16% incidence of neoplasia.At the same time 244 patients had various sorts of salivary gland surgery in the four local hospitals. Of these, 210 had either a parotidectomy or submaxillary gland excision. A surgical and pathological breakdown of the 117 neoplastic lesions fairly well corresponds to most of the published series, but fails to relay the overall picture that the head and neck surgeon encounters in dealing with salivary glands.
The incidence of neoplastic versus inflammatory disease in major salivary gland masses diagnosed by surgery
Authors: Gallia Louis J. , Johnson Jonas T. 
Published: October 2006

AbstractWhat is the incidence of non‐neoplastic disease when dealing with masses of the major salivary glands? A knowledge of this information would aid the physician in making decisions relative to the management of the masses. Furthermore, the expected malignancy rate may need to be adjusted according to the findings of this study.Many reported series of salivary gland neoplasms show the relative incidence of benign vs. malignant neoplasms; however, not every patient with a mass of the salivary gland who comes to surgery is finally diagnosed as having had a neoplasm. Knowing the relative incidence of neoplastic vs. non‐neoplastic salivary gland diseases has important diagnostic, therapeutic, and prognostic implications.Records of all patients who underwent either a parotidectomy or submandibular gland excision from 1975 to the present at the Eye and Ear Hospital of Pittsburgh were reviewed; 73% of the parotidectomies performed were done for neoplastic disease. A patient with a parotid mass has a likelihood of 1:10 of having a malignancy. Similarly, on a population basis, 1 submandibular mass in 12 will be malignant.
Assessment of cobalt 57 tagged bleomycin as a clinical aid in staging of head and neck carcinoma
Authors: Cummings Charles W. , Larson Steven M. , Dobie Robert A. , Weymuller Ernest A. , Rudd Thomas G. , Merello Augusto 
Published: October 2006

AbstractCritical assessment of head and neck cancer with respect to staging has, on occasion, been disappointingly ineffective. We have attempted to correlate the incidence of measureable uptake of cobalt 57 tagged bleomycin by primary squamous cell carcinoma and metastatic cervical lymph nodes. Forty‐six cases have been evaluated with respect to histopathological confirmation of the suspected metastatic disease. We have found that this diagnostic measure increases our acumen in staging of head and neck cancer.The relevance of the Co‐Bleo scans as a diagnostic aid is reported in 46 cases. Malignant tumors greater than 2 cm in size appear to demonstrate active uptake of the imaging agent. Small tumor size and excess background radioactivity contribute to the false‐negatives (17%). Inflammatory conditions or benign tumors of the salivary apparatus may result in minimal uptake, thus, a false‐positive result (10%). An increase in the radioactivity of the Co‐Bleo may enhance the benefits of this procedure in the search for an undiagnosed primary, as well as undiagnosed local or distant metastases.
A multiple‐channel cochlear implant: An evaluation using open‐set cid sentences
Authors: Clark Graeme M. , Tong Yit Chow , Martin Lois F. A. 
Published: October 2006

AbstractA multiple‐channel cochlear implant and speech processor have been used in two postlingually deaf adult patients with a total hearing loss, to enable them to perceive varying degrees of running speech. The results have been confirmed with open‐set CID everyday sentence tests. Using the implant alone, the patients obtained 8% and 14% scores with prerecorded material, and 34% and 36% scores for “live” presentations. This was equivalent to the perception of 35% of connected discourse. When the implant was used in conjunction with lipreading, improvements of 188% and 386% were obtained over lipreading alone, and the scores were 68% and 98% which were equivalent to the perception of 60% and 95% of connected discourse.
Ear disease in patients with wegener's granulomatosis
Authors: Kornblut Alan D. , Wolff Sheldon M. , Fauci Anthony S. 
Published: October 2006

AbstractFrom a group of 60 patients with histologically‐proven Wegener's granulomatosis managed at the National Institute of Allergy and Infectious Disease, approximately 45% were found to have disease that involved the ears. The majority of these patients had either recurrent or persistent serous otitis, resulting from eustachian tube dysfunction as a consequence of nasopharyngeal inflammations. Other pathologies included suppurative otitis, cholesteatoma, facial nerve paralyses, temporal bone grnnulomata, and sensory hearing losses. The presentation and management of these changes and their relationships to underlying disease are described in selected case reports, and a general philosophy of patient management is presented.
Postauricular undersurface tympanic membrane grafting: A follow‐up report
Authors: Glasscock Michael E. , Jackson C. Gary , Nissen Alan J. , Schwaber Mitchell K. 
Published: October 2006

AbstractThe authors review 1,939 chronic ear surgeries in which 1,556 underwent some form of tympanic membrane grafting. The overall take rate was 93%. There was no selection of cases with regard to presence of infection, cholesteatoma, polyps, or granulation tissue at the time of surgery. There appeared to be no difference in the take rate based upon age of the patient, presence of infection, or cholesteatoma. Autogenous and homograft fascia performed well and there was no significant difference in take rate. Complications were minimal and were related more to the disease process than the grafting technique per se.In addition to reviewing the long‐term follow‐up of the original technique the authors present a method of dealing with tympanic membrane retraction pockets. Called a cartilage tympanoplasty this procedure incorporates a large piece of full thickness tragal cartilage with attached perichondrium into the substance of the tympanic membrane.With 2 years follow‐up at this writing, this procedure has markedly reduced postoperative retraction pockets and recurrent cholesteatoma.
Evaluation of orbital cellulitis and results of treatment
Authors: Schramm Victor L. , Curtin Hugh D. , Kennerdell John S. 
Published: October 2006

AbstractOptimal management of patients with orbital cellulitis depends on how accurately the disease is classified and on the appropriateness with which antibiotics and surgery are used to treat the disease. Therapy must be adjusted on the basis of the extent of the disease. In order to determine the balance of treatment modalities which is most beneficial for certain disease presentations, we reviewed a series of 303 patients with orbital cellulitis. The anatomical and bacteriological etiology of the disease was determined in each case on the basis of the examination, visual acuity, results of sinus radiography, results of culture, ultrasonography, and computerized tomography. To avoid the 5% complication rate that occurred in this series, an evaluation and treatment protocol is recommended.
Lateral sinus thrombosis: A modern perspective
Authors: Teichgraeber John F. , Per‐Lee John H. , Turner John S. 
Published: October 2006

AbstractAt Emory, six cases of lateral sinus thrombosis (LST) were seen over the last ten years — two children and four adults.The picture and bacteriology of LST have changed with the advent of antibiotics as has the usefulness of various diagnostic tests. Less is it a disease of children in association with acute otitis media. More often it is seen in the adult patient after a long history of chronic ear disease. Fever and mastoid and neck tenderness are still universal signs of the affliction. However, rarely patients do present with progressive anemia, emaciation and evidence of septic emboli. Since antibiotics are commonly used during the prodromal ear infection, cultures are often negative. If they do identify an organism, it is usually a mixed flora rather than beta hemolytic streptococcus. Spinal fluid results are variable and seldom is there evidence of increased spinal fluid pressure. Arteriography, venography, and digital subtraction venography are the most reliable tests to prove and delimit the thrombus.Early management involves high dose broad spectrum, intravenous antibiotics including chloramphenicol. Surgical intervention involves a mastoidectomy, exposure of the sinus, incision and drainage, but not necessarily removal of the thrombus. Internal jugular vein ligation should be reserved for those cases in which septicemia and embolization do not respond to initial surgery and intravenous antibiotics.
Acute klebsiella epiglottitis: Considerations for initial antibiotic coverage
Authors: Berthiaume John T. , Pien Francis D. 
Published: October 2006

AbstractAcute epiglottitis due to Klebsiella pneumoniae in an adult patient is described. The patient failed to respond to ampicillin and required cephalosporin therapy as well as surgical drainage. In view of increased resistance of Hemophilus influenzae to ampicillin and because of other possible etiologic agents such as Staphylococcus aureus and non‐Hemophilus gram‐negative rods, consideration should be given for the initial use of one of the recently introduced cephalosporins such as moxalactam or cefamandole in the treatment of adult epiglottitis.
Viral labyrinthitis: Early pathology in the human
Authors: Karmody Collin S. 
Published: October 2006

AbstractThe histologic findings in the temporal bones of three patients who died from viral encephalopathy are presented. Pathology was restricted to the scala media, vestibular labyrinth, and internal auditory canal and was considered to be expressions of viral labyrinthitis. The changes were different degrees of degeneration of the organ of Corti, early encapsulation of the tectorial membrane, degeneration of the stria vascularis, and round cell infiltration of the modiolus and contents of the internal auditory canal. A new finding in the organ of Corti and early stages of cystic degeneration of the stria vascularis are documented. In all cases, the saccule was degenerated with sloughing of the otolithic membrane and vestibular labyrinth was involved in varying degrees.
Significance of tomography in meniere's disease: Visualization and morphology of the vestibular aqueduct
Authors: Hall Stephen F. , O'Connor A. Fitzgerald , Thakkar C. H. , Wylie I. G. , Morrison A. W. 
Published: October 2006

AbstractThe revival of endolymphatic sac surgery has led to many investigations in Meniere's disease, including lateral tomography of the vestibular aqueduct. Contrary to recent literature, we found no difference in the presence and morphology of the vestibular aqueduct when assessed radiologically in a group of Meniere's patients and a control group. Our assessment of this information in regard to etiology and treatment of Meniere's disease is presented.