bluuebunny/crossref_metadata_2025_split huggingface dataset:
Selection of patients and choice of operation for orbital decompression in graves' ophthalmopathy
Authors: Desanto Lawrence W. , Gorman Colum A. 
Published: September 2006

AbstractUntil the fundamental cause of the orbital problem associated with Graves' disease is better understood and can be prevented or reversed, some patients will need palliative orbital decompression. Of the available methods of orbital enlargement, the transantral ethmoidal decompression and the transfrontal operation seem most useful because of the amount of bone that can be removed by either approach.Transantral decompression is an appropriate operation for those patients with serious bilateral disease who would otherwise be treated systemically with corticosteroids. It also is of value as a preliminary step to extraocular muscle surgery after the orbital process has stabilized in those patients with exophthalmos and extraocular muscle myopathy and diplopia. Cosmetic decompression by this route is practical but total rehabilitation may also require upper lid and rectus muscle surgery.Forty patients with Graves' ophthalmopathy were treated by transantral decompression in the period July, 1969, to July, 1972. Seventeen of these had optic nerve dysfunction and visual field defects, papilledema, or choroidal folding. Fourteen patients had proptosis without optic neuropathy and six of these had corneal ulceration. Five patients had decompression specifically as a preliminary to eye muscle surgery and four patients had decompression for purely cosmetic reasons.The transfrontal decompression is ideal for patients with unilateral exophthalmos and when orbital exploration is needed. The transfrontal operation can salvage vision in the occasional patient with serious disease that is not palliated by transantral decompression.Orbital decompression is a more conservative approach to palliation than is high‐dose long‐term systemic steroid therapy. Orbital decompression has effectively controlled the optic neuropathy of Graves' disease without serious complications from the operation and without risking the potential side‐effects of long‐term high‐dose steroid therapy.
Argon laser microsurgery: Its advantages and applications in otolaryngology
Authors: Hobeika Claude P. , Rockwell R. James 
Published: September 2006

AbstractPulsed lasers and continuous wave lasers were used experimentally in our laboratories. Because of their characteristics lasers are best suited for microsurgery. The Argon laser offers definite advantages: 1. a very small spot size; 2. selective destruction of tissues with red pigments; 3. in depth effect; and 4. it can be incorporated into the optical system of a standard operating microscope.The vocal cords of 24 mongrel dogs were exposed to different doses of argon laser irridation. The animals were sacrificed at intervals of up to 45 days. In all animals the destructive lesion was dose related, predictable and well circumscribed. Minimal edema followed the irradiations. Healing was complete by the third post irradiation week. The vocal cords were covered with normal looking mucosa. Scarring was minimal and muscle fibers and cartilage unaffected.
Evaluation of the air caloric test as a routine examination procedure
Authors: Capps Mary Jayne , Preciado Manuel C. , Paparella Michael M. , Hoppe Wayne E. 
Published: September 2006

AbstractThe nystagmus responses of normal subjects to air and water caloric irrigations of comparable temperatures were compared. Irrigations of 0° air for 60 sec were found to produce nystagmus responses equal in amplitude, frequency and eye‐speed to those evoked by irrigations of 5 cc of ice water. Ice water produced significantly longer responses than did 0° air (mean difference = 11.6 sec). Responses to bithermal air stimuli of 24° C and 50° C were compared to those produced by 30°C and 44° C water. No significant differences were found between the cool stimuli for any of the measures. The warm stimuli produced responses of equal eye‐speed, but the water responses were significantly greater than those of air when the measures of total amplitude, frequency and duration were compared; thus, air stimulation was the preferred method of performing the standard caloric test, since the air responses were equal in reliability to those of water and because of the advantages of the use of air, which include greater convenience, patient tolerance, applicability, and flexibility.
Cryosurgery of respiratory structures. I. Cryonecrosis of trachea and bronchus
Authors: Neel H. Bryan , Farrell Kenneth H. , Desanto Lawrence W. , Payne W. Spencer , Sanderson David R. 
Published: September 2006

AbstractAlthough extirpative surgery is the mainstay of treatment of tumors of the trachea and bronchial tree, other methods for cure or palliation of neoplasms in these structures should be explored. The present study was designed to assess, in dogs, 1. the pathophysiologic effects of complete circumferential cryonecrosis of a segment of trachea, and 2. the feasibility of performing cryosurgery within the distal tracheobronchial tree through a bronchoscope.Eleven mongrel dogs weighing 16 to 20.5 kg were used. Each dog was anesthetized with intravenous pentobarbital. Under clean conditions, a segment of cervical trachea consisting of 10 rings (two through 12) was exposed and completely mobilized through a midline incision in eight dogs. A segment of trachea consisting of five to six tracheal rings was frozen by applying the probe tip to the anterior and lateral surfaces of the trachea and by suspending the posterior wall on the shaft of the cryoprobe tip. Each probe application lasted two minutes. This effected cryonecrosis of the entire circumference of a 15 to 18 mm segment of trachea. The probe was applied to the same site three times (repetitive freezing) and complete thawing was allowed between freezes. Copper constantan needle thermocouples embedded in 25‐gauge needles were inserted into the tracheal wall, and recordings of temperature changes within the target areas were made continuously with a penline recorder during freezing and thawing.A probe 0.6 cm in diameter and 55 cm long was developed for transbronchoscopic cryosurgery. In three dogs, several focal areas including the anterior and posterior trachea, carina, main stem, and segmental bronchi were frozen. Each site was frozen repetitively (three times for two minutes each).All 11 dogs survived the procedures and resumed normal activity within 12 hours of operation. Necrosis was localized, reproducible, and followed by prompt regeneration of mucosa. The gross architecture of the trachea and bronchus was not permanently altered, and there was no local or regional infection, except in one dog in which a tracheal stricture developed. This was attributed to persistent infection around a permanent suture placed at operation for the endoscopic identification of the target area. The study indicates that trachea and bronchi may be safely frozen by application of a cryoprobe either to the external surface or to the mucosal surface.
Management of choanal atresia in the newborn
Authors: Weseman Chester M. 
Published: September 2006

AbstractBilateral congenital choanal atresia carries a high risk of brain damage due to hypoxia. Proper management requires early diagnosis, preferably in the delivery room, where temporary measures such as inserting an oral airway or a gavage tube are usually sufficient to establish satisfactory respiration. Careful observation is essential in the nursery during the period of local and general diagnostic evaluation to prevent repeated, even brief, spells of apnea. If satisfactory ventilation cannot be maintained, and particularly if there are associated serious anomalies, tracheotomy is indicated, rather than an immediate attempt to establish choanal patency.Definitive transnasal surgical correction can be accomplished during the neonatal period. Relatively non‐traumatic perforation of the obstruction with a probe or trocar, as reported by Hough in 1955, is followed by dilatation with appropriate metal sounds, and emplacement of non‐reactive plastic tubing.Excessive cicatrization, which is responsible for many failures of transnasal surgical methods, is further discouraged by the use of anti‐microbial agents to control infection in the choanal area. This can be expected to succeed in most cases if the tubing is maintained until healing is accomplished.
Massive surgery for palliation in malignancy of the head and neck
Authors: Tucker Harvey M. , Rabuzzi Daniel D. , Reed George F. 
Published: September 2006

AbstractSince World War II, major advances in surgical management and life support have made possible operative procedures that could not have been undertaken previously. As a result of these encouraging developments, it has become apparent that the possibilities for palliative surgery now demand our attention and should be considered along with radiotherapy, chemotherapy, cryosurgery, and immunotherapy as suitable management of the patient with advanced malignancy.It should be possible, on the basis of all available information, to excise the primary lesion and all metastases without leaving known tumor. This concept differs from that of “curability” in that it includes lesions which can be removed, but which are statistically not likely to be cured. The surgeon must be reasonably certain that the patient can be reconstructed sufficiently well and that his quality of survival will be superior to the disabilities that would be expected if the local tumor were left uncontrolled. The patient being considered for massive palliative surgery must, of course, be a sufficiently good surgical risk to tolerate the planned procedures.This criterion is not intended to be taken in the medicolegal sense, but rather implies that the patient and his family must fully understand the massive nature of the surgery planned. More important, all concerned must have a realistic expectation as to what can be accomplished.In applying these criteria to carefully selected cases, we have been encouraged to find that most patients are willing to undertake procedures that offer virtually no chance for cure in an effort to obtain the best possible quality of survival for as long as useful life can be prolonged. Morbidity as a result of these palliative attempts has been acceptably low and patient acceptance of these concepts very high.
Pediatric head and neck tumors: A study of 178 cases
Authors: Jaffe Burton F. 
Published: September 2006

AbstractThis report is based on 178 pediatric patients diagnosed with head and neck tumors in a 10‐year period at the Children's Hospital Medical Center in Boston, Mass. A statistical comparison was made with two other publications limited to pediatric head and neck tumors, and the similarity in rank‐order was clearly noted except in a few isolated instances.Malignant tumors of the neck occurred in 104 children. From newborn to six years, the most common neck tumors were neuroblastoma, lymphosarcoma, and rhabdomyosarcoma. From ages seven to 13 the most common neck tumors were Hodgkin's disease, lymphosarcoma, and thyroid tumors. From ages 14‐21 the most common neck tumors were Hodgkin's disease, lymphosarcoma, and squamous cell carcinoma.Malignant tumors of the head occurred in 74 children. Each anatomic site of the head was analyzed to determine what tumor cell was present when a mass lesion occurred. These data may help the physician to make more accurate clinical diagnoses.A general discussion of the methods of treatment are also presented, including surgery, radiation therapy, chemotherapy and a new modality, cryosurgery.
Lymphatics in middle ear effusion
Authors: Galich Richard 
Published: September 2006

AbstractSerous middle ear effusions frequently fail to resolve, long after the causative inflammatory‐obstructive process of the tympanum and eustachian tube have cleared. A disruption of the normal subepithelial connective tissue and lymphatic function is postulated. An animal experiment is described which demonstrates an ability of particles, in the size range of transudate proteins, to cross the tympanic mucosa and be cleared by a healthy functioning lymphatic system.
A high placed jugular bulb in the middle ear: A clinical and temporal bone study
Authors: Overton Stephen B. , Ritter Frank N. 
Published: September 2006

AbstractAnatomically, the superior boundary of the jugular bulb lies below the floor of the hypotympanum of the middle ear space. In a rare instance, it can extend upward, elevate the floor of the hypotympanum and present in the middle ear. This elevation is an anomaly well known but rarely witnessed or documented in the literature. This may result in serious hemorrhage at the time of surgery if unrecognized by the surgeon and if it is injured during temporal bone surgery.Two hundred fifty‐seven histologically prepared temporal bones were examined microscopically for anomalous positions of the jugular bulb. This survey represents 189 patients. Thirteen temporal bones were found in which the jugular bulb extended into the middle ear space above the inferior rim of the bony annulus. Although this anatomical variation occurs infrequently in the general population, a 6 percent incidence of high placed jugular bulb in the middle ear was found in the temporal bones studied in this series.
Electronystagmographic comparison of acute idiopathic and herpes zoster facial paralysis
Authors: Adour Kedar K. , Doty Howard E. 
Published: September 2006

AbstractElectronystagmographic findings in idiopathic facial paralysis have been adduced by some as evidence for a vascular etiology; others, on clinical grounds, hold that it is a viral disease. Electronystagmographic abnormalities appeared in 43 percent of 28 patients with idiopathic, and 42 percent of 19, with herpes zoster facial paralysis. The only observed difference between the two types of facial paralysis was evidence for more widespread neural involvement and a greatly heightened percentage (56 percent versus 8 percent) of denervation, in the herpes zoster group. The clinical findings indicate that idiopathic facial paralysis is a polyneuropathy involving the Vth and VIIIth cranial nerves. Its protean manifestations and clinical similarity to a disease known to be viral in origin, appear to support the hypothesis that it is also a viral disorder.
Mucocele of the sphenoid sinus with sudden blindness
Authors: Blum Mitchell E. , Larson Alvin 
Published: September 2006

AbstractMucocele of the sphenoid sinus is a rare condition that usually presents with frontal and retroorbital headache of a constant unrelenting nature. Ophthalmoplegia that is progressive and blindness that is usually gradual in onset, but may be sudden, may complicate the illness. Chronic inflammation or congenital goblet cell cysts are the suspected etiologies. Diagnosis is made by X‐ray evidence of a sphenoid sinus mass that may destroy the floor of the sella turcica. The most important X‐ray studies are the AP and lateral tomograms. Our case represents the first case of sudden blindness reported with this condition and also presents a relatively new surgical approach to the sphenoid sinus. Other surgical approaches are also discussed.
Surgical management of combined cervical tracheo‐esophageal defects
Authors: Pearson Bruce W. , Harrison D. F. N. 
Published: September 2006

AbstractThree rather complicated cervical tracheo‐esophageal problems and their appropriate management, are described. In each case, a tracheal defect required repair. In one case, fascia lata was used to close a defect in the posterior tracheal wall. In another, this type of repair was unsuccessful in one‐stage closure of a large tracheo‐esophageal fistula. A 7 cm defect of esophagus in heavily irradiated tissues was successfully reconstituted with transposed colon. The co‐existing postirradiation tracheo‐esophageal fistula was repaired at an earlier stage to ensure that the patient's recovery from the laparotomy would not be complicated by aspiration pneumonitis. Thoracotomy was not required, but resection of the clavicular head and mobilization of the origin of the sternomastoid were used to improve the transcervical exposure of the superior mediastinum.In the second case, a tracheal defect that involved the tracheal cartilage was repaired by sleeve resection and end‐to‐end anastomosis. In revision surgery of chronic cervical tracheal and subglottic stenosis, one can anticipate massive local scar formation. The densely fibrosed common wall between the trachea and the esophagus should be left completely with the esophagus and only the lateral and anterior remnants of the trachea excised to avoid iatrogenic recurrent nerve paralysis or inadvertent perforation into a traction diverticulum of the esophagus. One should anticipate the use of the laryngeal drop procedure to make up the tracheal defect. The suprathyroid tissues will be virgin, whereas the previous tracheal procedures will have reduced the length attainable below from tracheal remobilization. Suturing the chin toward the chest is an effective and well‐tolerated prophylactic measure that prevents both extension of the neck after the operation and undue tension on the tracheal anastomosis.In the third case, closure of a vertical tracheal‐esophageal fistula and repair of a tracheal defect were undertaken simultaneously. The procedure involved mobilizing the larynx from its hyoid attachments, dropping the larynx, and bringing the margins of the esophageal defect together transversely, as in a pyloroplasty. This application of the laryngeal drop procedure, not previously described, was effective.
Ethmoid sinus surgery
Authors: Kidder Thomas M. , Toohill Robert J. , Unger June D. , Lehman Roger H. 
Published: September 2006

AbstractThe literature on ethmoiditis was reviewed emphasizing the diagnostic and therapeutic aspects of the disease.The records of 47 patients with chronic inflammatory nasoethmoid disease, treated by polypectomy and intranasal ethmoidectomy, were reviewed to determine the effectiveness of the operative procedure.There has been follow‐up of two years or more on 26 patients. The records were analyzed with attention to etiologic factors, diagnostic criteria, surgical procedure and results.We have found that the preoperative sinus roentgenograms frequently do not reveal the extent and severity of the disease noted at the time of surgery.Our review supports the intranasal ethmoidectomy as an effective procedure for chronic nasoethmoid inflammatory disease, especially with recent emphasis on total resection of the middle turbinate.
Labyrinthectomy: Indications, technique and results
Authors: Pulec Jack L. 
Published: September 2006

AbstractThe patient with unilateral useless hearing and persistent symptoms of labyrinthine vertigo, aural tinnitus, pressure, distortion of sound or efferent involvement of hearing in the opposite normal ear, can benefit from destructive labyrinthectomy. Three techniques to accomplish this end are transcanal labyrinthectomy, postauricular labyrinthectomy and translabyrinthine section of the VIIIth cranial nerve.The acoustic end‐organ is extremely resistant to surgical assault. Residual function following incomplete destruction often subjects the patient to persistent, unpleasant symptoms. The technique to accomplish effectively each of the three procedures is described and the results of 93 operations are reviewed to demonstrate their effectiveness.
Fungal derivatives as antigenic excitants of episodic vertigo
Authors: Wilson William H. 
Published: September 2006

AbstractThirty cases of episodic vertigo of labyrinthine origin with the common denominator of a history of hypersensitivity to fungal derivatives are grouped for study. Verification of the history of specific intolerances to fungal ingestants was accomplished by performing provocative intracutaneous or challenge feeding tests for hypersensitivity to yeast. A positive test response was obtained in each instance. Sixteen of the 30 patients gave a history of hypersensitivity to penicillin and 21 reported an intolerance to ingested, fermented alcohol. An antigenic cross‐reactivity between penicillin, yeast and other fungi is suggested.Ten of the 30 cases qualified as classic Ménière's disease and 14 as vestibular Ménière's disease without auditory involvement. Six fell into the category of benign, positional vertigo.Therapy entailed correction of proven metabolic and endocrine dysfunctions, when present and complete elimination from the diet of all proven allergenic offenders. Hyposensitization therapy for inhalant allergens supplemented the program when indicated.Therapeutic results are classified according to the criteria set forth by the Subcommittee on Equilibrium and Its Management of the American Academy of Ophthalmology and Otolaryngology. Two of the 10 cases of classic Ménière's disease fell into the Class A category with absence of definitive spells of vertigo for the prescribed “10 times the average interval of spells before treatment” plus an improvement in hearing. Three cases fell into the Class B group, experiencing no definitive spells of vertigo but failing to show auditory improvement. Definitive spells persisted in the remaining 5 cases.Allergic management of the vestibular Méniére's group of 14 cases allowed for the classification of 7 as meeting the prescribed requirement of 10 times the average pretreatment interval between definitive attacks. Seven cases of vestibular Ménière's disease failed to obtain relief from definitive spells.Only 1 of 6 cases of benign positional vertigo experienced relief with allergic management. The high failure rate suggests other etiologic factors in this group.It is conceivable that the initial hypersensitization of the patient to penicillin in some instances may be responsible for the eventual antigenic excitation of a perverse labyrinthine response by commonly ingested fungi.Antigenic stimuli may excite episodic vertigo of labyrinthine origin. An acute episode of vertigo may be precipitated by the intracutaneous injection of a predetermined dilution and volume of a specific food antigen or by its ingestion, if the patient is hypersensitive to that food and the labyrinth is in a state of readiness to react.
Nasopharyngeal angiofibroma in the elderly: Report of a case
Authors: Pradillo Juan Andrade , Rodriguez Hector A. , Arroyo Juan Fajardo 
Published: September 2006

AbstractAlthough nasopharyngeal angiofibromas usually occur during puberty and adolescence, thus being considered as juvenile, very rare documented reports describe this condition in old persons. The case of a 62‐year‐old man with a nasopharyngeal angiofibroma successfully resected is presented. It was the only lesion found in an old individual among 283 cases seen during a 20‐year period in a large city hospital.
Panel discussion on glottic tumors. VI. Laryngeal carcinomas
Authors: Ennuyer A. , Bataini P. 
Published: September 2006

AbstractThis study is based upon 214 cases of laryngeal carcinoma treated at the Foundation Curie, Paris, France, from January, 1958, to 1968. The results in terms of five‐year survival have beenBy radiocobalt teletherapy 74/134By surgery and postoperative radiation therapy 29/ 37By surgery alone 32/ 43A statistical study of these results was made by Professor Daudel and demonstrated the absence of significant difference for the groups of tumors classed T1 and in Stage I and II treated either by radiocobalt or by surgery, whether followed or not by radiotherapy. By contrast there was a clearly significant difference in favor of surgery for the group of tumors classified as T2, T3, T4, or in Stage III.This significant difference in favor of primary surgery disappeared if we excluded the patients who died of intercurrent illnesses or of a second cancer not involving the larynx, and when we took into account those cures obtained by surgery in the event of failure of radiation and inversely, of those cures having been obtained by radiation therapy in the event of failure of surgery.