bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased cerebrospinal fluid pressure following unilateral radical neck dissection
Authors: Tobin Howard A. 
Published: September 2006

AbstractA case of prolonged increased cerebrospinal fluid pressure, accompanied by papilledema is described in a patient who underwent unilateral radical neck dissection for low‐grade mucoepidermoid tumor of the submaxillary gland. A superior sagittal sinogram revealed a normal sinus and venous system on the opposite side. The patient ultimately recovered completely with no specific therapy. Only two other cases of visual disturbance following unilateral neck dissection have been reported. The similarity to otitic hydrocephalus is apparent, although this patient had a normal spinal fluid cell count and chemistries in contra distinction to the increased protein and lymphocytes seen in otitic hydrocepha lis. The etiology of this patient's CSF hypertension could not be determined, and although no specific therapy was necessary, various forms of therapy were discussed.
Otologic surgery in patients with one hearing ear only
Authors: Chandler J. R. , Freeman Joseph 
Published: September 2006

AbstractOn occasions, the otologist is confronted with the possibility of performing surgery on the ear of a patient with useless or no hearing in the opposite ear. Because any surgical procedure on a patient's ear may result in further loss of hearing or even total deafness in the operated ear, an ill‐advised operative procedure in such a patient may result in a catastrophe. Up to 2 percent of patients undergoing surgery for otosclerosis develop further severe sensori‐neural hearing losses in the operated ear. Idiopathic sudden deafness in patients following stapedectomy can occur for causes unrelated to surgery. Further loss of hearing can also occur after simple myringoplasty and tympanoplasty. Such a possibility must be considered and to a great degree should influence the otologist's decision as to whether or not surgery is indicated, and if so, what is the surgical procedure of choice?A deaf patient can be compared to a blind patient only superficially, and not at all when it comes to any consideration of surgery upon the remaining organ of hearing and vision. Consider the patient with total blindness in one eye who cannot be helped with glasses. Should blindness of any degree affect the remaining eye, an operative procedure which can restore vision may be the only recourse. On the other hand, should the patient with only one hearing ear lose some hearing acuity in that ear, it may always be corrected or helped by the use of amplification. Therein lies the great difference. Total deafness cannot be helped by a hearing aid, and such a catastrophe cannot be risked when any other choice is available. This must be the guiding principle of all otologic surgeons in such instances.
Acute mastoiditis following pseudomonas maltophilia infection: Case report
Authors: Harlowe H. D. 
Published: September 2006

AbstractAcute mastoiditis is now an uncommon finding. The early use of the various antibiotics has made surgical mastoiditis a rarity. A comparatively new pathogen “Pseudomonas maltophilia” was the causative organism in this case.Pseudomonas maltophilia responds only to Garamycin and Polymixin B. Unless one of these two antibiotics is used in its treatment, it will continue to cause a severe infection.
Enlarging the ear canal in intact canal wall tympanoplasty
Authors: Shea John J. 
Published: September 2006

AbstractIn chronic otitis media, the external meatus and ear canal are often small and tortuous. Gill reported that a third of_250_ears with. congenital atresia had chronic otitis media, often unsuspected. Bellucci has emphasized the role of the Eustachian tube in determining the extent of chronic otitis media, so it follows that the small and tortuous ear canal are part of the congenital defects in this disease.Farrior and Caparosa have previously mentioned enlarging the ear canal in intact canal wall tympanoplasty.The usual post‐aural incision is made and the soft tissue of the canal dissected forward off the bone. A first vertical incision is made through the canal wall skin near the annulus, a second through the concha, and the two are connected by a longitudinal incision. The flaps are shifted apart to enlarge the canal, and an elipse of conchal cartilage is excised. The intact tympanoplasty is completed in the usual fashion, and the defect in the drum and canal is closed with a large tongue‐shaped piece of fascia which is brought out over the concha through the second incision. The canal is packed with strips of silk and cotton balls for two weeks.The result is a meatal opening and canal with a trumpet shape and adequate size.
Relapsing polychondritis
Authors: Swain Ronnie E. , Stroud Malcolm H. 
Published: September 2006

AbstractTo date only 55 cases of relapsing polychondritis have been reported in the English literature. The present information concerning the history, clinical and laboratory findings, diagnosis, prognosis, and treatment is reviewed. Two unusual cases of this disease which exemplify the extreme variability of the symptomatology among these patients are presented. While asleep one patient developed a classical “saddle nose” deformity which spontaneously improved within three days. The other patient's disease manifested predominately non‐cartilaginous symptoms and emphasizes the possibility of an auto‐immune or allergic mechanism affecting a molecular target common to both cartilaginous and non‐cartilaginous structures.
Mycosis of the maxillary sinuses
Authors: Iwamoto Hikonojo , Katsura Masumi , Fujimaki Tatsub 
Published: September 2006

AbstractFungus infection of the maxillary sinus has been considered a rare disorder; recently, however, such cases have been reported in increasing number.The authors have recently observed five cases of mycosis of the paranasal sinuses. Three of these cases showed the clinical symptoms and signs of swelling and pain in the cheek area and epistaxis and aroused suspicion of maxillary cancer. Of the remaining two cases one was misdiagnosed as maxillary cancer with pulmonary metastasis and radiation therapy without preliminary tissue diagnosis given because of the poor general condition of the patient. On improvement of the patient's condition exploratory maxillotomy and mucosal biopsy revealed mycotic invasion; in the other, chronic bacterial maxillary sinusitis was suspected, but exploratory sin‐usostomy showed mycosis.The authors emphasize an apparent increasing frequency of mycosis of the paranasal sinuses and the fact that the symptoms and signs of mycotic invasion may duplicate those of early malignancy of this area.
Juvenile nasopharyngeal angiofibroma
Authors: Wilson W. R. , Miller D. , Lee K. J. , Yules R. B. 
Published: September 2006

AbstractThis paper contains a review of the gross pathology and histopathology of juvenile nasopharyngeal angiofibroma and a review of the theories of origin of this tumor. The relative merits of hormone therapy, carotid arteriography, external and interstitial radiation therapy, cryosurgery, and various surgical approaches are discussed.A plan for the management of these tumors has been developed:1. Estrogen therapy is begun one month pre‐operatively, if it is to be used.2. The patient sees a prosthodontist so that he may have a temporary plastic plate made which will fit onto the teeth in such a manner that it will hold a transpalatal flap in place following surgery, without disturbing the suture line.3. Arteriography is scheduled only if there is evidence of intracranial extension or an extensive recurrence.4. Radon seeds, usually 10 in number and 1 me in size, are ordered for the day of surgery.5. Liquid nitrogen is made ready for use with a closed cryo‐probe system.6. The expected blood loss and the possible use of planned hypotensive anesthesia are discussed with the anesthesiologist. An adequate supply of blood is to be available in the operating room at the start of the resection of tumor.7. A plan is made for a transpalatal or transantral approach, or both, or occasionally for a lateral rhinotomy approach. Rarely has a transmandibular pterygoid approach been found necessary.The combined transpalatal‐transantral approach is described in detail. Two. cases are presented.
Premalignant changes in the vocal cord
Authors: Robbett William F. 
Published: September 2006

AbstractThe subject of premalignant changes in the vocal cords encompasses a very extensive scope; therefore, only two aspects are discussed in this presentation.The two most common clinically identifiable entities that progress to invasive carcinoma are examined, namely, keratosis and carcinoma in situ.The treatment of keratosis and carcinoma in situ is probably the most provocative subject in laryngeal disease. There is a great difference of opinion as to the action or inaction to be taken when these conditions are identified in the larynx.Keratosis may appear in two forms: delineated keratosis and diffuse keratosis. They_have distinct‐Glinical appearances and have a different potential for malignant progression.The treatment of carcinoma in situ is a very controversial subject. The value and advisability of treating this disease with irradiation is questioned.The use of microlaryngeal surgery has been a valuable aid in the identification and delineation of both of these diseases of the vocal cords.The second part of this presentation discusses the role of the submucosa in intraepithelial and early invasive carcinoma of the vocal cord.Some interesting investigative studies have been performed in the study of the role of the stroma in epidermal carcinogenesis. These observations suggest the possibility of stromal elements being of pathogenic importance in the origin of epithelial tumors.The very rapid reappearance of carcinoma_ in situ in the regenerated epithelium of the vpcal cord after complete mucosal removal is suggestive of some extra‐epithelial stimulus. Both vocal cords being exposed to the same extrinsic irritants, carcinoma in situ will frequently appear only in the regenerated epithelium of the vocal cord that first evidenced the disease. Multicentric foci of carcinoma is mentioned but not discussed in the presentation.
An immunological concept for bell's palsy — Experimental study
Authors: Mcgovern Francis H. , Konigsmark Bruce W. , Sydnor J. Brantley 
Published: September 2006

AbstractBell's palsy is considered by many authorities to be an ischemic paralysis. The mechanism is thought to be a primary vasoconstriction of the vasa nervorum supplying the facial nerve within the fallopian canal and a secondary ischemia induced by the bony canal. The factor precipitating the vasospasm is the proclivity of certain individuals toward segmental arteriolar spasm.In our work.on experimental ischemic facial paralysis, another explanation for the etiology of Bell's palsy presented itself. We observed that dogs sensitized to horse serum showed a greater paralytic response and more marked histopathologic changes after the intrafallopian injection of saline than non‐sensitized dogs. Subsequent investigations using a more potent antigen seemed to strengthen the idea that the experimental paralysis we have accomplished in these dogs is the result of an immunologic or hypersensitivity reaction.In these experiments using adequate control dogs, the animals were sensitized with intravenous horse serum and with a Freund's. adjuvant — horse serum mixture. The presence of horse serum antibodies was demonstrated in the serum of three dogs. The fallopian canal was injected with a combination of solutions: saline solution, Ringer's solution, distilled water, horse serum and the dog's serum. At the end of two weeks, the degree of paralysis was recorded, the nerve was removed and was sent for histopathologic examination.The significant degree of paralysis and the major histopathologic changes were seen in the sensitized dogs injected with saline or Ringer's solution or horse serum.The mechanism of the paralysis is postulated to be an initial antigenantibody reaction with a complement fixation, a degranulation of mast cells producing vasoactive components, an increased capillary permeability, edema, vasospastic phenomenia, and subsequent trophic changes in the nerve. In addition, the edematous neuropathy is severely affected by the compression of the nerve by the bony canal wall.We suggest that these events observed experimentally may be related to the changes seen in Bell's palsy, and Bell's palsy is caused by a localized immunologic or hypersensitivity reaction.
Symposium on prophylaxis and treatment of middle ear effusions.: I. The morphological basis for understanding middle ear effusions.: An electron microscopic, cytochemical, and autoradiographic investigation
Authors: Lim David J. , Viall John , Birck Herbert , St. Pierre Ronald 
Published: September 2006

AbstractAn attempt was made to elucidate the cytological nature of the defense mechanisms of the normal middle ear with special emphasis on the secretory system.Autoradiography was performed with the use of isotope‐labeled glucose in order to determine the rate of glucose uptake by middle ear cells, particularly by secretory cells. Mucus‐secreting glands in the guinea pig eustachian tube incorporated a large amount of glucose, while the demilune cells (serous) incorporated only a moderate amount. Some simple squamous epithelium of the bulla also took up a large amount of glucose. Since the mucous blanket of the bulla was labeled after only one hour, it is speculated that these flat cells are of the secretory type.A cytochemical demonstration of the enzyme acid phosphatase was done in order to determine the localization of this lysosomal enzyme in the middle ear cells. A strong reaction was consistently noted in the cytoplasm of both light (mucous) and dark (serous) secretory cells. This reaction appears to take place on the outer surface of the secretory granules, but, occasionally, it takes place inside the granules. The strongest reaction was noted in the lysosomal bodies. A weak reaction was frequently noted in the nuclear chromatin of the secretory cells.An immunofluorescent study demonstrated the presence of immunoglobulin‐producing cells in the eustachian tube and in the guinea pig middle ear mucosa. Fluorescein‐labeled cells (round cells) were numerous, particularly in the eustachian tube near the glands.It can be suggested from the foregoing that the middle ear is provided with mucociliary, enzymatic, and immunological (secretory and serum) defense systems.The pathological characteristics of human serous otitis were also reviewed. Evidence was shown of an increase in the number of secretory and ciliated cells, of free macrophages, and of the round cells of the submucosal connective tissue. Evidence of the free escape of transudate through intercellular spaces of the epithelial cells and capillary wall damage in the submucosal layer was also noted in pure serous effusion cases. These changes are identical to those that take place in inflammatory reactions. The middle ear effusion, therefore, can be looked upon as the result of enhanced middle ear defense mechanisms occurring in different phases.
Symposium on meniere's disease.: I. Meniere's disease: Results of a two and one‐half‐year study of etiology, natural history and results of treatment
Authors: Pulec Jack L. 
Published: September 2006

AbstractThe results of a two and one‐half year study of 120 patients with Ménière's disease has revealed multiple but specific etiology for 36 percent of the patients: 1. allergy, 14 percent; 2. congenital or acquired syphilis, seven percent; 3. adrenal pituitary insufficiency, six percent; 4. myxedema, three percent; 5. stenosis of the internal auditory canal, three percent; and 6. trauma, acoustic or physical, three percent.Emotional or psychiatric factors are not involved in etiology of this disease. The vestibular and cochlear aqueduct on both temporal bones of patients with Ménière's disease could not be visualized in a significantly greater number than a normal control group suggesting an anatomic predisposition to the development of Ménière's disease. Preliminary immunologic viral investigation suggests the possibility of viral etiology in the remaining group considered idiopathic. Medical treatment with vasodilators is effective in many cases. The endolymphatic subarachnoid shunt operation was the treatment of choice for patients unresponsive to medical treatment and it is effective in controlling symptoms in 62 percent of cases. It is hoped that this study will encourage other investigators to criticize and help intensify our efforts to solve the questions remaining about Ménière's disease.
Symposium on meniere's disease.: Ii. Metabolic aspects of meniere's disease
Authors: Powers W. Hugh 
Published: September 2006

AbstractMetabolic dysfunction is one of many factors mentioned as a primary or contributing cause of Ménière's disease. This evaluation consists of three parts: thyroid studies, five‐hour glucose tolerance test, and adrenal and pituitary tests.Ninety‐eight patients with Ménière's disease are evaluated with an FTA absorption test, neuro‐otologic, allergic, and metabolic studies. The results of the metabolic evaluation are reviewed.Thyroid function is evaluated with the thyroxine (T4) free index test and the serum‐bound thyroxine (T4) test of Murphy‐Pattee. Although 27 percent had low normal or hypothyroid findings, it was of clinical significance in only 17 percent of the patients.The five‐hour glucose tolerance test was used to diagnose hyperglycemia and hypoglycemia.Thirty percent of the 70 patients evaluated had an abnormal five‐hour glucose tolerance test. The 19 patients (28 percent) with a hypoglycemic curve were almost equally divided among a flat glucose tolerance curve, a reactive hypoglycemia curve, and chemical or latent diabetic curve. A manifest diabetic curve was present in two patients. Hypoglycemia was not a primary factor in Ménière's disease but was an important contributing cause in 12 patients that responded to a combination of dietary, allergic or endocrine therapy.The symptoms of Ménière's disease often become manifest during periods of stress. The adrenal pituitary axis plays a vital role in man's reaction to stress. For this reason, hypoadrenal function was suggested as an etiology in some patients with Ménière's disease.In this study two tests were used to measure adreno‐cortical reserve: ACTH plasma cortisol stimulation test and insulin stimulation test.Sixty of the 98 patients were evaluated with the ACTH plasma cortisol stimulation test, and one‐third had a lowered adrenocortical reserve. Further endocrine studies are being performed to determine the presence of a specific endocrine problem.After evaluation of 98 patients with Ménière's disease, we concluded the following:1. The five‐hour glucose tolerance test is helpful in identifying hypoglycemia, which may be a contributing factor in Ménière's disease.2. Non‐myxedematous hypothyroidism may play an important role in some patients with Ménière's disease.3. Further endocrine studies will be necessary to determine the significance of the lowered adrenocortical reserve as shown by the ACTH plasma cortisol stimulation test.
Otological problems of the alaskan native population.
Authors: Weymuller Ernest A. , Reed David G. 
Published: September 2006

AbstractThe Alaskan Otological Fellowship of the New York Eye and Ear Infirmary operates at the Alaskan Native Health Facility in Mt. Edgecumbe, Sitka, Alaska. It is a division of the Health Education and Welfare Program. The Fellowship is now in its fourth year.The area we service is approximately 35,000 square miles. All villages and schools in the area have been screened for otological care and for possible hearing aids.The incidence of otitis media and its complications is 13 percent in the Eskimo and 9.1 percent in the Indian. These percentages are those reported in the Southwest Native. There is no ready explanation of the preponderance of otologic disease in this group.In the first three years, 360 procedures were performed on 310 chronically diseased ears. Following is a breakdown of these procedures:Myringoplastys 165Simple Mastoidectomies 25Simple Mastoidectomy with Myringoplasty 66Mastoidectomy with Type III Tympanoplasty 17Modified Radical Mastoidectomy 26Radical Mastoidectomies 36Miscellaneous Procedures 25It is the opinion of the authors that the choice of procedure is much more limited in this group than in an urban community. It must be remembered that aftercare and follow‐up is more difficult in these areas.It has been our policy to use conservative procedures. Elimination of the disease is the first consideration, and conservation of hearing is secondary. A dry ear is of the utmost importance, and for this reason, modified radical and classical radical mastoidectomies are more frequently performed. Types IV and V tympanoplastys are not considered feasible.
Dacron prosthesis in frontal sinus surgery.
Authors: Barton Richard Thomas 
Published: September 2006

AbstractThis is a report of 34 cases of chronic frontal sinusitis in which a modified Lynch external frontal sinusotomy was performed successfully, using a Dacron Woven Arterial Graft (Bard) to maintain a naso‐frontal communication. In none of the patients was it necessary to remove the prosthesis later. The patients have been generally symptom‐free for periods up to 17 years after the surgery.It is proposed that whereas the Goodale osteoplastic obliterative operation is the procedure of choice in the presence of relatively low‐grade infection, it is less satisfactory in patients with uncontrolled infection; also, in those instances of pan‐sinusitis, wherein the ethmoid labyrinth is infected or involved by a mucocele, this technique is preferred rather than combining an osteoplastic frontal operation with a transantral ethmoidectomy as has been recommended.From the patient's point of view, the postoperative complaints registered with this Dacron tube technique are occasionally bothersome crusting, odor, and discharge. These symptoms have been easily relieved by short courses of antibiotic therapy.