bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vertigo caused by basilar artery compression of the eighth nerve
Authors: Benecke James E. , Hitselberger William E. 
Published: October 2006

AbstractVascular compression syndromes in the posterior cranial fossa have become well described clinical entities, especially for the fifth and seventh cranial nerves. Jannetta has proposed vascular compression of the eighth nerve as the etiology of hearing loss, tinnitus, and vertigo in some patients.The case that follows illustrates a clear‐cut example of vestibular symptoms arising from vascular compression of the eighth nerve. The patient involved had disabling peripheral vertigo refractory to medical management. Magnetic resonance imaging documented a tortuous basilar artery compressing the eighth nerve on the involved side. This was confirmed at surgery, and a selective section of the vestibular nerve provided complete relief of disabling symptoms and preservation of hearing.The authors describe the details of this case and the enigma of eighth nerve symptoms due to vascular compression.
Margins of safety with transantral orbital decompression
Authors: Kent Kriston J. , Merwin Gerald E. , Rarey Kyle E. 
Published: October 2006

AbstractThis study involves evaluation of the surgical limits of transantral orbital apex decompression (as described by Ogura) by performing the operation on 17 cadaveric half‐heads. Measurements were then made of the proximity of bone removal to several vital structures including the optic nerve, carotid artery siphon, cavernous sinus, and frontal lobe dura. Entrance into the sphenoid sinus was found to be routine. Adequate decompression requires maximum removal of bone at the orbital apex and incision of the periorbita without damage to the adjacent vital structures. This requires: 1. knowledge of ethmoid and sphenoid sinus anatomy and recognition of anatomic variations, 2. removal of bone under direct visualization, and 3. incisions of the periorbita be made most posteriorly first to prevent prolapse of orbital fat anteriorly which obscures vision of the critical orbital apex periorbita.
Airway reconstruction following laryngotracheal thermal trauma
Authors: Miller Robert P. , Gray Steven D. , Cotton Robin T. , Myer Charles M. 
Published: October 2006

AbstractCare of burn patients is a complex problem for the trauma team involving management of fluid and electrolyte imbalances, infections, and ultimately reconstruction. Patients with burns of the head, neck, and upper thorax present a series of unique problems because of a high incidence of associated upper and lower airway thermal trauma necessitating intubation and ventilatory support.A series of cases requiring laryngotracheal reconstruction following severe burns to the head and neck region is reported. Methods of treatment are discussed as well as modifications of standard burn therapy to decrease the incidence of severe scarring.
Surgical treatment of vertigo with retrolabyrinthine vestibular neurectomy
Authors: Monsell Edwin M. , Wiet Richard J. , Young Nancy M. , Kazan Robert P. 
Published: October 2006

AbstractResults for control of vertigo and preservation of hearing in patients who have had a retrolabyrinthine vestibular neurectomy (RVN) by our group were analyzed retrospectively. This procedure consists of selective section of the vestibular nerve in the posterior cranial fossa. Vertigo was completely controlled in all but two of 31 patients, one of whom required revision surgery to control attacks. Analysis of these two cases suggests that the cause of persistent vertigo is incomplete neurectomy. With our current surgical technique in patients with Meniere's disease, hearing results were not statistically different from our results with surgery of the endolymphatic sac. Control of vertigo was much more successful with the RVN than endolymphatic sac surgery.
Delayed endolymphatic hydrops: A review of 15 cases
Authors: Hicks George W. , William Wright J. 
Published: October 2006

AbstractDelayed endolymphatic hydrops is a disease entity that can be differentiated from Meniere's disease. This condition was first reported simultaneously by Nadol, et al. and Wolfson and Leiberman, with further clarification by Schuknecht. The disease is characterized by a profound sensorineural hearing loss in one ear, with the onset of episodic vertigo from that ear after a prolonged period of time (ipsilateral delayed endolymphatic hydrops) or the development of fluctuating hearing loss and/or episodic vertigo in the opposite ear after a prolonged period of time (contralateral delayed endolymphatic hydrops). This paper is a review of 15 cases of delayed endolymphatic hydrops, eight ipsilateral and seven contralateral. The results of this study indicate that surgical treatment for the ipsilateral form of the disease gave the best results. For the contralateral variant, it appears that medical measures should be the therapy of choice resorting, in the event of their failure, to conservative surgical intervention on what may be the only hearing ear to preserve hearing and control vertigo.
Mycobacterial cervical lymphadenitis: A persistent diagnostic problem
Authors: Alleva Michael , Guida Robert A. , Romo Thomas , Kimmelman Charles P. 
Published: October 2006

AbstractThe most common manifestation of mycobacterial infection encountered in otolaryngologic practice is cervical lymphadenitis. Mycobacterial cervical lymphadenitis, or scrofula, remains a diagnostic and therapeutic challenge because it mimics other pathologic processes, and because of the inconsistent reliability of physical and laboratory findings. Twenty‐five cases of scrofula were treated at our institution from 1973 to 1986. Positive chest x‐ray was exhibited by five (20%) patients. Histologic examination of the excisional biopsy was the most reliable test with 100% positive specimens. This study emphasizes the marked variability in clinical presentation of scrofula and the importance of surgical excisional biopsy for histologic diagnosis.
Ototoxicity of high‐dose cisplatin by bolus administration in patients with advanced cancers and normal hearing
Authors: Kopelman Jeff , Budnick Amy S. , Sessions Roy B. , Kramer Marc B. , Wong George Y. 
Published: October 2006

AbstractOur institution undertook a phase I trial to define the toxicity of high‐dose (150 to 225 mg) bolus administration (every 3 to 4 weeks) of cisplatin in patients with advanced cancers. All patients reported had baseline normal hearing. Hearing levels were measured prior to each course of chemotherapy. Audiological monitoring included conventional assessment of pure tone sensitivity at 500 to 8,000 Hz and assessment of ultra high frequencies (9,000 to 20,000 Hz). After one to two doses, 100% of patients failed to respond at 9,000 Hz and above. In the 2,000 to 8,000 Hz range, repeated administration of the drug effected successively lower frequencies with progressive loss, until a maximum threshold shift or plateau was reached at each frequency between 3,000 and 8,000 Hz. The plateau for cisplatin ototoxicity appears to fall within the moderate hearing loss range (40 to 60 dB HL) in the high frequencies. All patients complained of tinnitus and difficulty understanding speech in the presence of background noise. The pattern of pure tone audiometric alteration is consistent in all patients, all dosages, and each method of administration. The ultra high frequency alteration is prompt and dramatic.
Olfactory esthesioneuroma: A report of 40 cases
Authors: Schwaab G. , Pacheco L. , Marandas P. , Le Guillou C. , Richard J. M. , Micheau C. , Wibault P. , Domenge C. 
Published: October 2006

AbstractOlfactory esthesioneuroma is a rare malignant tumor arising in the olfactory epithelium. Forty cases observed at the Institut Gustave‐Roussy from 1956 to 1987 are reported. This tumor usually grows slowly and is usually local, but it is important to be aware of the possibility of lymph node involvement (17%) and, particularly, of rapid development of distant metastases (25%), usually within 6 months. CT scan, and more recently, NMR have proved to be of value in choosing the surgical approach. In view of the usual point of departure, a combined neurosurgical and transfacial approach seems to be a satisfactory approach for obtaining oncological control of the lesion. The role of chemotherapy is discussed. The main prognostic factors seem to be the size of the lesion, the intracranial extension, and the lymph node involvement.
The sublabial transseptal transsphenoidal approach to sellar and parasellar lesions
Authors: Eisele David W. , Flint Paul W. , Janas Janice D. , Cummings Charles W. , Weymuller Ernest A. , Kelly William A. 
Published: October 2006

AbstractMultiple surgical approaches to the sella turcica have been described. The sublabial transseptal transsphenoidal approach provides a safe, cosmetically acceptable route to the sella with excellent exposure. Since 1976, we have employed this technique for the surgical treatment of pituitary neoplasms and parasellar tumors. The University of Washington experience with the sublabial transseptal transsphenoidal approach to the sella in a series of 253 patients is reported with respect to the otolaryngological aspects of the surgical technique, results, and complications of the procedure. In addition, a literature review of major studies that used this procedure is included, and the reported results and complications are compared to those of the present study.
Clinical effects of alpha‐interferon dose variation on laryngeal papillomas
Authors: Mullooly Virginia M. , Abramson Allan L. , Steinberg Bettie M. , Horowitz Marilyn S. 
Published: October 2006

AbstractAchieving optimal clinical control of recurrent respiratory papillomatosis with prolonged treatment with human leukocyte (alpha) interferon appears to be dose‐related and often requires individualized dosage elevation. Six of eight patients in this study needed a maximum dose of 18 × 106 IU/week for part of the therapy period to achieve better disease control. The strong correlation found between dosage and response suggests that it is the interferon causing the effect on disease expression, not just the unpredictable nature of the disease.An effect on papilloma growth was observed in all patients during IFN therapy. Three patients were able to be tapered off IFN with only minimal recurrence seen in one patient. No toxic side effects were observed.
Rhinocerebral mucormycosis: Results of aggressive surgical debridement and amphotericin B
Authors: Ochi James W. , Harris Jeffrey P. , Feldman Jeffrey I. , Press Gary A. 
Published: October 2006

AbstractRhinocerebral mucormycosis is a fulminant, devastating fungal disease. The use of amphotericin B, combined with aggressive surgical debridement, has increased survival rates from approximately 20% to 70%.Eleven patients with this rare disease have been treated over the past 6 years. Therapy with amphotericin B was begun in all patients as soon as the diagnosis of mucormycosis was suspected. Seven patients underwent aggressive surgical debridement; all seven had disease involving the sphenoethmoidal complex, requiring external ethmoidectomy with or without sphenoidotomy. Six patients had maxillary sinus disease, requiring Caldwell‐Luc antrostomy or maxillectomy. Three patients required orbital exenteration. Surgery was performed within 24 hours of diagnosis on all but two of our patients.Despite prompt diagnosis, aggressive surgical debridement, therapy with amphotericin B, and correction of metabolic acidosis, our mortality rate was 82%. Rhinocerebral mucormycosis remains a rapidly progressive, frequently fatal disease.
The transoropalatal approach to the atlantoaxial‐Clival region: Considerations for the head and neck surgeon
Authors: Harris Jeffrey P. , Godin Michael S. , Krekorian Terry D. , Alksne John F. 
Published: October 2006

AbstractThe transoropalatal approach to the atlantoaxial‐clival area provides excellent exposure for neurosurgical decompression and fusion procedures. The technique has been effectively applied in the treatment of bony and soft tissue abnormalities of the anterior spinal region. Although this approach is safe and reliable, it is not part of the otolaryngologist's usual surgical armamentarium.In the present study, we describe the case histories of five patients who underwent resection of the odontoid process for cervicomedullary compression. Neurological compromise was manifested by progressive upper and/or lower extremity paresis in all patients. In each patient, a transoropalatal approach was used. The surgical technique is discussed, and the prevention of possible sequelae, including velopharyngeal incompetence and palatal or pharyngeal wound dehiscence, is addressed.
Management of bilateral acoustic tumors
Authors: Glasscock Michael E. , Woods Charles I. , Jackson C. Gary , Welling Bradley 
Published: October 2006

AbstractBilateral acoustic tumors (Neurofibromatosis 2) have now been shown to arise in patients with gene abnormalities separate from those with von Recklinghausen's disease (Neurofibromatosis 1), The management of patients with this disease has long posed a particularly challenging problem for the neurotologist. This retrospective study reviews our series of 38 patients and updates a previous report. Thirty‐four patients underwent surgical excision of tumors on one or both sides. Hearing conservation was attempted in 20 with hearing preservation possible in eight. Recent advances in understanding the hereditary etiology of this disease, changing methods for diagnosis, preferred surgical techniques, and guidelines for appropriate patient management are discussed.
Speech restoration and complications of primary versus secondary tracheoesophageal puncture following total laryngectomy
Authors: Maniglia Anthony J. , Lundy Donna S. , Casiano Roy C. , Swim Scott C. 
Published: October 2006

AbstractThe tracheoesophageal (TE) fistula with a speech prosthesis has become the method of choice for vocal rehabilitation in many postlaryngectomy patients. Several modifications of the procedure have been described including primary TE puncture at the time of laryngectomy. Fear of increased risk of complications has kept the primary procedure from widespread usage. Our series of 95 TE fistula procedures from 1980 to 1988 revealed 33 to be primary and 62 secondary. Eighty‐five percent (85%) (28 of 33) patients in the primary group achieved long‐term satisfactory speech (1 year or more of follow‐up). Complications occurred in 36% of this group of patients. The success rate for the secondary group was 69% (43 of 62), while the complication rate was 21%. There were no instances of death, sepsis, or media‐stinitis associated with either primary or secondary TE fistula patients. It appears that the primary TE fistula can be performed as safely and effectively as the secondary procedure.
Transcutaneous teflon® injection for paralytic dysphonia
Authors: Mccaffrey Thomas B. , Lipton Richard 
Published: October 2006

AbstractTranscutaneous Teflon augmentation of the vocal cord was performed 21 times in 19 patients with unilateral vocal cord paralysis. The larynx was visualized using flexible fiberoptic video‐endoscopy and, after local anesthesia to the skin over the cricothyroid membrane, an 18‐gauge 2‐inch needle was introduced through the cricothyroid membrane. Under fiberoptic visualization, the needle was inserted into the paralyzed vocal cord through its undersurface. Teflon was injected with a syringe to produce medialization of the vocal cord. The position of the vocal cord and voice quality were monitored throughout the procedure. No complications were encountered. All patients experienced a reduction in breathiness of voice that was rated as a significant improvement by the patient and surgeon. Two patients required reinjection of Teflon for optimal improvement.
Computer‐aided three‐dimensional reconstruction and measurement of the round window niche
Authors: Takahashi Haruo , Sando Isamu , Takagi Akira 
Published: October 2006

AbstractThe goal of this study was to clarify the three‐dimensional shape of the round window niche and to measure this structure three‐dimensionally using the computer‐aided reconstruction method we developed.The equipment used in this study included a personal computer (NEC 98‐XA), a high‐resolution 14‐inch color CRT, a digitizer (Hitachi HDG‐1111), and a printer. We studied five normal temporal bones obtained from five individuals with negative otologic histories, who hod been 5 months and 14, 15, 18, and 59 years old at death.In each case the round window niche was located posteroinferior to the round window. The round window niches had wide openings to the middle ear cavity that became narrower near the aperture; thus, the round window niche seemed to be shaped like a pouch.The maximal diameter of the round window niche was 2.98±0.23 mm. The shortest distance between the aperture of the round window niche and the margin of the round window was 0.66±0.16 mm. The volume of the round window niche, on average, was 4.65±0.67 mm3. The volume of the round window niche was found to be correlated with the area of the round window.
Lateral skull base surgery for cancer
Authors: Krespi Yosef P. 
Published: October 2006

AbstractThe management of malignant tumors of the lateral skull base remains a challenging problem. Sixty‐two patients underwent lateral skull base resection for cancer. Preoperative evaluation included complete neurotologic examination, CT scan, MRI, and carotid angiography. During surgery, the nasopharynx, the posterior maxilla, the infratemporal fossa structures, the mandibular ramus, and the parotid gland were resected en bloc. Reconstruction of the surgical defect was performed using pectoralis and/or rhombotrapezius myocutaneous flaps. Although the overall cure rate was not greatly improved, patients with lateral skull base malignancies now enjoy extended periods of palliation and a better quality of life.
Type II collagen distribution in the ear of the developing chick embryo
Authors: Ishibe Tsukasa , Choe In Seong , Yoo Tai June 
Published: October 2006

AbstractThe localization of type II collagen was immunohistochemically studied in the developing chick ear using monoclonal antibodies. Type II collagen appeared under the basal lamina of the otocyst from developmental stages 14 to 16. In the otic capsule, endolymphatic duct, and semicircular canal membrane, type II collagen appeared in stage 23 or 24. From stages 28 to 29, type II collagen appeared in the primitive columella, endolymphatic sac, and fibrocartilaginous plate. Type II collagen was first observed in the crista ampullaris, basilar membrane, macula sacculi, and utriculi in stages 30 and 31. Type II collagen was not detected in the endolymphatic sac beyond developmental stage 37 and the amount of type II collagen in the otic capsule and columella decreased after stage 40. The wide distribution of type II collagen in the inner ear throughout the development of the chick embryo suggests that this collagen may act as a basic structural component of the ear.
The endoscopic teflon® keel for posterior and total glottic stenosis
Authors: Langman Alan W. , Lee Kelvin C. , Dedo Herbert H. 
Published: October 2006

AbstractMost cases of posterior commissure stenosis today result from endotracheal intubation. The problem has been very difficult to repair. Posterior commissure stenosis has been treated by repeated dilations, which do not work, and reconstructive measures by means of laryngofissure to excise the scar followed by the placement of round stents alone or round stents in combination with mucosal or skin grafts. This treatment also fails frequently. Some, but not all, cases have been cured with laser surgery via microdirect laryngoscopy. An endoscopically placed Teflon® keel has been useful in the treatment of posterior glottic and total glottic stenosis when laser surgery is not feasible. Nine patients with posterior glottic stenosis, two of whom initially had total glottic stenosis, have undergone placement of the posterior commissure Teflon keel. Six patients had resolution of the stenosis and were decannulated. One required an arytenoidectomy for a fixed cricoarytenoid joint before successful decannulation. Two patients had marked improvement of their laryngeal airway with this approach, but have not yet been decannulated because of fixed cricoarytenoid joints.
Cochlear implantation after transmastoid labyrinthectomy
Authors: Kveton John F. , Abbott Cynthia , Drumheller Geralyn , Cohen Nancy , Poe Dennis S. , April Max 
Published: October 2006

AbstractHearing rehabilitation with an intracochlear prosthesis is well documented in patients who have an intact otic capsule prior to implantation. However, the suitability for implantation of patients who have undergone extensive procedures involving the otic capsule such as labyrinthectomy has not been directly addressed. This report documents a case of a patient deafened by a transmastoid labyrinthectomy who subsequently received a cochlear implant. Postimplantation performance of this patient was compared with the performance of three other postlingual implant recipients. The results suggest that labyrinthectomy is not a contraindication to auditory rehabilitation by a cochlear implant. The implications of implantation in a surgically manipulated otic capsule are discussed.
Giant fibrous dysplasia of the mandible: Surgical management
Authors: Kreutziger Keith L. 
Published: October 2006

AbstractGiant fibrous dysplasia of the mandible (GFDM) represents a far advanced lesion which may be monostotic, polyostotic, a component of craniofacial fibrous dysplasia, a component of Albright's syndrome, or associated with other endocrinopathies. The current philosophy is to consider fibrous dysplasia of the mandible (FDM) as one of a group of lesions classified as fibro‐osseous lesions of the jaws. The natural course and manifestations in the mandible result in GFDM if they are unabated by curative therapy or if stabilization or regression does not occur. A rational therapeutic approach depends upon the extent of the disease at the time of diagnosis. The earlier in the disease process that the diagnosis is made, the more likely that a curative surgical procedure may be undertaken. Complete resection of the diseased mandible should be performed when feasible. A lesser surgical procedure has no curative potential and is performed only as a palliative, cosmetic delaying procedure.
Results of tympanoplasty for congenital aural atresia and stenosis, with special reference to fascia and homograft as the graft material of the tympanic membrane
Authors: Minatogawa Toru , Nishimura Yoshihiko , Inamori Torn , Kumoi Takeo 
Published: October 2006

AbstractThe surgical management of congenital aural atresia is a challenging, complex procedure, and the risks are great. The otologic surgeon is responsible for keeping a patent external auditory canal and for achieving satisfactory hearing.The present report studied hearing changes that occurred after tympanoplasty and the long‐term results of tympanoplasty in 12 cases of congenital aural atresia or stenosis. Patients were followed for more than 2 years after surgery. In four ears, an allograft of the tympanic membrane with an attached malleus was used, with a good graft take and hearing results. An autograft of temporal fascia was used in eight ears. Hearing acuity decreased in six of the eight ears and was maintained in two ears. Three primary surgery patients required revision surgery for postoperative restenosis of the external auditory canal. Some comments have been made with regard to this problem. Emphasis is also placed on the selection of patients for surgery using a thorough audiologic and roentgenologic evaluation.