bluuebunny/crossref_metadata_2025_split huggingface dataset:
Certain effects of adenoidectomy on eustachian tube ventilatory function.
Authors: Bluestone Charles D. , Cantekin Erdem I. , Beery Quinter C. 
Published: October 2006

AbstractIn an effort to develop a simple and accurate method to identify children in whom adenoidectomy might prevent otitis media, the ventilatory function of the Eustachian tube was assessed by a manometric technique. Nasal pressures during swallowing were also determined in some. The study group consisted of 23 children with otitis media in whom tympanostomy tubes had been inserted. All were judged clinically and roentgenographically to have prominent adenoids. Inflation‐deflation Eustachian tube ventilation studies were obtained in 36 ears that remained intubated, aerated and dry both before and eight weeks after adenoidectomy. Fifteen of the 36 (42 percent) ears had improvement in Eustachian tube ventilatory function postadenoidectomy which was attributed to relief of extrinsic mechanical obstruction of the tube. In the remaining 21 (58 percent) ears in which Eustachian tube function was not improved, mechanical obstruction was not apparent preoperatively. The effect of nasopharyngeal pressures on a pliant Eustachian tube (Toynbee phenomenon) due to obstruction of the posterior nasal choanae by the adenoid mass was suggested as a possible cause of functional Eustachian tube obstruction. In several instances in which preadenoidectomy mechanical obstruction of the Eustachian tube was not demonstrated, the tube appeared to have been made more pliant by the operation. This increase in compliance of the Eustachian tube was attributed to loss of adenoid support of the tube in the fossa of Rosenmuller.From this study, preliminary recommendations for selection of patients for adenoidectomy are the following: 1. Eustachian tube ventilation function tests in a dry, intubated middle ear; 2. if extrinsic mechanical obstruction of the Eustachian tube is present and chronic inflammation is absent, adenoidectomy will probably improve Eustachian tube function. The surgical technique should include adequate removal of the adenoid tissue in the fossa of Rosenmuller; 3. if the Eustachian tube does not appear to be mechanically obstructed, the adenoids should not be removed unless functional obstruction is suspected due to obstruction of the posterior nasal choanae. Adenoid tissue within the fossa of Rosenmuller should not be removed when such circumstances exist; and 4. in the absence of obstructive adenoids to the nasal choanae or Eustachian tube, adenoidectomy probably will not improve Eustachian tube function and could make it worse. A more rational and effective approach to adenoidectomy for the prevention of otitis media in children may be possible through this type of preoperative evaluation.
Surgery for chronic hyperplastic rhinosinusitis
Authors: Friedman William H. 
Published: October 2006

AbstractDavison pointed out in 1953 that his purpose in treating sinusitis was to utilize the smallest amount of surgery that would produce permanent relief of symptoms. By 1963 he had become convinced that extensive disease required extensive surgery. Hyperplastic rhinosinusitis is treated by a variety of surgical techniques including polypectomy, turbinate cautery, submucous resection of the turbinates or nasal septum, anterior ethmoidectomy, and spheno‐ethmoidectomy.Sixty‐eight patients are presented who have undergone bilateral spheno‐ethmoidectomy between January, 1969, and January, 1974. These patients were predominantly allergic, with a high percentage of previous polypectomies and desensitization which failed to control their recurring nasal polyps. Ten patients were lost to follow‐up. Forty‐seven of 68 patients have had no recurrence of polyps in from 12 to 60 months. All patients continued to have mucosal manifestations of allergy or infection, but the recurrence of late polyps was limited to 11 patients.The spheno‐ethmoidectomy technique is utilized, stressing complete removal of the middle turbinate. Kidder has shown an improved rate of polyp control in patients following ethmoidectomy with middle turbinate removal rather than with partial or total preservation of the middle turbinate. Complete resection of the middle turbinate with opening of the sphenoid air sinus permits a thorough exenteration of the ethmoid labyrinth and better control of chronic disease. A complication rate of 5.9 percent is presented and is deemed acceptable, since there were no disabling complications or complications related to poor visualization.
Silent otitis media
Authors: Paparella Michael M. , Shea Don , Meyerhoff William L. , Goycoolea Marcos V. 
Published: October 2006

AbstractThere is a traditional view that chronic otitis media and chronic mastoiditis must exist in the presence of a tympanic membrane perforation. Based on a human histopathological study of 123 temporal bones with chronic otitis media out of 333 temporal bones with all forms of otitis media pathology, only 24 patients (36 ears) had symptoms of otological disease recorded on their charts and only 19.5% of these had an associated tympanic membrane perforation. Unsuspected findings of chronic otitis media (active or inactive) are occasionally confirmed at exploratory tympanotomy. Such quiet chronic pathological findings in the middle ear have occurred in association with endolymphatic hydrops and cochlear end organ lesions suggesting the possibility that silent chronic otitis media may help explain sensorineural hearing loss, vertigo, and tinnitus for certain patients.We put forth the hypothesis that clinically undetectable silent otitis media in neonates and infants might help explain why certain children are otitis media prone. Our otopathology laboratory includes 111 ears harvested from neonates and infants (average age 8 months). Histological analysis revealed normal findings in some, whereas significant numbers of others show all forms of otitis media, including purulent otitis media, chronic otitis media, serous otitis media, and mucoid otitis media, with occasional overlap of types.Clinical implications will be discussed wth emphasis on silent otitis media and its relationship to the pathogenesis of otitis media and silent chronic otitis media and its possible role in causing insidious labyrinthine changes.A significant outcome of this study was the marked degree of unresolved mesenchyme in the clinically manifest otitis media group or silent otitis media group as compared to a control group. This association and role of mesenchyme is discussed relative to the pathogenesis of infantile otitis media.
Surgical correction of goldenhar's syndrome
Authors: Mathog Robert H. , Leonard Myer S. 
Published: October 2006

AbstractGoldenhar's syndrome is a variant of hemifacial microsomia — one of the more common congenital syndromes of the first and second arch. The Goldenhar's type is characterized by varying degrees of underdevelopment of craniofacial structures. The major deformities involve the mandible and the ear; but they also include the orbit and vertebral column, specific defects pathognomonic of this condition. Medical management requires reconstructive surgery of which treatment must take into consideration the timing of surgery and the effects of surgery upon the growth and development of the poorly formed structures.This paper presents a discussion of the pathogenesis and the favorable and unfavorable factors affecting the selection and timing of surgery. The literature is reviewed and two additional cases are added with an evaluation of the effects of early reconstruction. A single‐stage procedure, utilizing rib autograft, is described for correction of the defective hemimandible, glenoid fossa, and zygoma. The results are evaluated by means of photographs and radiographs with a follow‐up period of at least one and one‐half years. The data suggest a remodeling of the grafts to resemble normal structures, and a downward growth of the maxilla to fill a space created by the reconstruction of the mandible and expansion of the lower portion of the face. Mupltiple stages of surgery as well as unnecessary delays in performing surgical procedures are challenged by the report.
Mass management of otitis media in Zaire
Authors: Mahoney Jack L. 
Published: October 2006

AbstractIn 1976, 4, 281 cases of otitis media with otorrhea were treated in the otorhinolaryngology department at Mama Yemo hospital, the 2,000‐bed major medical center in Kinshasa, Zaire. Topical aluminum acetate (Burow's solution) on ear wicks of cotton was placed against the ear drum into the ear canal and changed daily as an effective method of mass control of this disease without antibiotics. The results were comparable to those from 0.3% topical gentamycin ophthalmic solution (Garamycin®), but were obtained with considerably less expense in an area where economic considerations are essential.
Granulomatous laryngitis of unknown etiology
Authors: Haar Jean G. , Chaudhry Anand P. , Kaplan Howard M. , Milley Paul S. 
Published: October 2006

AbstractA 21‐year‐old man was admitted for odynophagia and hoarseness of four months duration. He smoked one and a half packs of cigarettes a day and occasionally inhaled marijuana. Indirect laryngoscopy revealed a massive swelling of the entire epiglottis, aryepiglottic folds, and arytenoids. The histopathologic diagnosis of chronic but active nonspecific inflammation was made. Combined antibiotics and steroid therapy gave temporary relief. He was readmitted several months later with progressive shortness of breath, dysphagia, and hoarseness. Biopsy of the epiglottic tissues showed multiple noncaseating epithelioid granulomatous lesions consistent with sarcoidosis. All pertinent laboratory tests failed to establish a definitive diagnosis. The patient eventually underwent supraglottic laryngectomy. He has been symptom‐free for 20 months following surgery.
Pathology of vascular sensorineural hearing impairment
Authors: Belal A. 
Published: October 2006

AbstractCirculatory disorders, which are well documented in most parts of the human body, are not well documented in the inner ear, although they are expected to occur. It has been previously shown that experimental occlusion of the labyrinthine artery in animals results in severe degenerative changes, fibrosis, and new bone formation in the cochlea. Accordingly, this paper presents presumptive evidence that depriving the human cochlea of its blood supply after surgical removal of an acoustic tumor results in severe degenerative changes that progress to total ossification of the cochlear spaces. This paper also discusses similar changes seen in temporal bones of two patients with sudden sensorineural hearing impairment.Based on these observations, the author concludes that occlusive arterial disease, whether thrombotic, embolic, or spastic, plays a role in some sudden sensorineural hearing losses. Cochlea ossification, detected by polytomography, suggests a vascular etiology of the hearing impairment.Treatment with vasodilator drugs and anticoagulants is justified in these cases until a better diagnostic protocol is developed to eliminate other causes.
Size of the mastoid air cell system in children with middle ear effusion
Authors: Lindeman Pontus , Shea John J. 
Published: October 2006

AbstractThe mastoid air cell system probably functions as an air reservoir. Among adults with chronic otitis media a small mastoid air cell system is prevalent In cases of chronic non‐purulent middle ear effusion among children, the reports have been contradictory concerning the size of the mastoid air cell system. In the present investigation, white children with long‐standing problems of middle ear effusion have been examined by means of X‐rays of the mastoid process in the lateral projection and the size of the air cell system measured by planimetry. The size of the air cell system was found to be significantly smaller in comparison with normal white children.
Etiology of otitis media with effusion: Antihistamines—decongestsnts
Authors: Peerless Sidney A. , Noiman Allen H. 
Published: October 2006

AbstractIn an attempt to find a causative factor for the increased incidence of otitis media with effusion, a detailed study of 50 cases was conducted. This study included 50 cases of non‐purulent otitis media with effusion requiring ventilating tubes without tonsilloadenoid pathology. A study of these cases revealed an interesting pattern which suggests that antihistamines and decongestants may be causative or precipitating factors in the etiology of otitis media with effusion. A pilot study on the effects of these drugs on mucociliary activity was conducted and revealed further evidence that antihistamines and decongestants interfere with normal mucociliary activity which probably is a factor in abnormal Eustachian tube physiology.
Bone destruction due to the rupture of a cholesteatoma sac: A pathogenesis of bone destruction in aural cholesteatoma
Authors: Kaneko Yutaka , Yuasa Ryo , Ise Ikuo , Iino Yukiko , Shinkawa Hidbichi , Rokugo Masaaki , Tomioka Sachiko , Shibahara Yoshihiro 
Published: October 2006

AbstractSevere bone destruction in a cholesteatoma is one of the characteristic clinical features. To clarify the mechanism of bone destruction in cholesteatoma, the matrix of cholesteatoma and the attached bone, obtained during middle ear surgery, was observed by light microscope. Rupture of the epithelial lining in a cholesteatoma and the escaping contents (keratin), which gave rise to intense characteristic granulations in subepithelial tissue, were found. Furthermore bone destruction was always found at the site of subepithelial tissue of cholesteatoma. From these facts, the escape of contents from the sac of cholesteatoma into the subepithelial layer is considered to be an important factor in the mechanism of bone destruction.
Separation of the larynx and trachea for intractable aspiration
Authors: Baron Barry C. , Dedo Herbert H. 
Published: October 2006

AbstractAspiration becomes an intractable problem for some patients who have lost normal neurological function of the glottis. Over the long term, a cuffed tracheotomy tube is inadequate. Several methods have been developed to relieve this problem surgically. These include the use of muscle flaps, tracheoesophageal anastomosis, and use of an epiglottic flap. In this paper, we discuss these previous surgical attempts to alleviate aspiration and present our own technique, which involves creation of a tracheostome and closure of the larynx at the level of the first tracheal ring. This has been used with success in three patients. We feel this technique is less complex and results in less surgical trauma to the larynx, important factors when dealing with critically ill patients. This_ technique is theoretically reversible by re‐anastomosing the trachea to the cricoid cartilage after excising the first tracheal ring.
Antral‐ethmoidal decompression of the orbit in graves' disease: Ten‐year experience
Authors: Calcaterra Thomas C. , Thompson Jerome W. 
Published: October 2006

AbstractThe orbital manifestations of Graves' disease usually comprise the most distressing component of this inadequately understood disease entity. Patients with optic neuropathy, exposure keratopathy, or disfiguring proptosis can be helped considerably by decompression of the swollen orbital tissues into the maxillary and sinus cavities. Experience with 104 patients personally operated by the senior author and analyzed by chart review and patient questionnaire indicates that antral‐ethmoidal decompression is a successful form of therapy, generally free of serious complications. It is now employed earlier in the course of Graves' ophtholmopathy than in the past.
Extended hemilaryngectomy for T3 GLOTTIC CARCINOMA WITH PRESERVATION OF SPEECH AND SWALLOWING
Authors: Pearson Bruce W. , Woods Robert D. , Hartman David E. 
Published: October 2006

AbstractTotal laryngectomy is often applied in the treatment of invasive squamous cell carcinomas that fix one side of the larynx. The major drawback, of course, is loss of the voice. In many instances, however, preservation of the uninvolved portion of the larynx is compatible with adequate tumor margins, and the preserved laryngeal remnant, although it cannot be reconstituted to allow breathing, can readily be used for voice.The principle involved is the creation of a valved tracheopharyngeal shunt, which functions as a neoglottis during expiration but constricts to close during swallowing. To accomplish this the recurrent laryngeal nerve and the myomucosal segment of intrinsic glottic musculature to which it is attached is preserved on the uninvolved side. The myomucosal segment is formed into a mucosal lined tube by releasing the soft tissues from the cartilage. The diameter and flaccidity of the tube is augmented by incorporating a flap of hypopharyngeal mucosa. Safe performance of this operation depends on careful preoperative evaluation and laryngoscopic verification and a close‐working relationship with an interested surgical pathologist.The first 7 consecutive cases in which this management program has been applied are presented in review. The patients, ranging in age from 58 to 69 years old, had T3 grade 2 or 3 invasive squamous cell carcinoma. The average hospitalization was 13 days. The longest follow‐up is 5 years.Clear surgical margins, local control of the disease, and satisfactory voice without significant aspiration have been achieved thus far in each case. The average subglottic pressures measured at the tracheotomy were 25 ± 6 cm. of water (threshold opening) and 43 ± 20 cm. of water (for phonation).Whether these encouraging initial results can be widely duplicated will probably depend on the care with which cases are selected. The dangers of applying this surgery to patients with extensive submucosal spread will be obvious to experienced laryngologists.
Thyroid carcinoma
Authors: Friedman Michael , Skolnik Emanuel M. , Baim Howard M. , Becker Stephen P. , Katz Arthur H. , Mantravadi Rao V. P. 
Published: October 2006

AbstractDifferentiated thyroid carcinoma was studied with regard to mode of presentation, initial findings, treatment and survival. The classic signs, symptoms, physical and scan findings were found to be present in approximately 70% of the patients. Thirty percent of the patients had either unusual presentations or findings.Prognosis was found to be dependent on age of presentation more than any other factor. The effects of neck metastasis, extracapsular invasion and recurrent laryngeal nerve involvement on long‐term survival are studied in detail.Patients with prior exposure to radiation were found to have more extensive disease and require more extensive surgery but ultimately had the same prognosis for 15‐year cure.Treatment for distant metastatic disease by surgery, radioactice iodine and external radiation all resulted in long‐term survival in certain cases.
Immunosuppression and the development of malignancies of the upper airway and related structures
Authors: Harris Jeffrey P. , Penn Israel 
Published: October 2006

AbstractIn the general population, 90% of the malignancies developing in the upper respiratory tract are squamous cell carcinomas. Analysis of 1081 neoplasms in 1023 renal transplant patients reported to the Denver Transplant Tumor Registry indicates that squamous cell carcinoma reMayns the predominant malignancy which develops in the upper respiratory tract of immunosuppressed individuals. Comparing the incidence of cancers of the oral cavity (excluding lip cancers) in the immunosuppressed population with the general population it is rather similar (3.5% vs. 4%). When lip cancers are included, one sees a great excess of tumors developing in transplant patients (15% vs. 4.6%). Thus the excess of head and neck epithelial malignancies among these patients is confined to neoplasms of the lip.Examination of the 25 patients reported in this study reveals an unusually young age of the patients, the average age being 41.8 years compared with the general population where most head and neck tumors occur in the 55‐65 age group. The average time posttransplantation when cancer developed was 5.3 years, supporting the concept that the more effective the immunosuppressive regimen for prevention of graft rejection, the greater the susceptibility for the development of cancer. Since 90% of transplant patients have serological or clinical evidence of active herpes virus infection, it is possible that this microorganism may play a role in the development of certain head and neck malignancies, especially those involving the lips.
The role of high resolution computerized tomography and standardized ultrasound in the evaluation of orbital cellulitis
Authors: Goodwin W. Jarrard , Weinshall Michael , Chandler James R. 
Published: October 2006

AbstractWe reviewed the records of 22 patients with orbital cellulitis to determine the value of high resolution computerized tomography (HRCT) and standardized ultrasound (US) in their management, In 13 patients, they demonstrated abscess formation and accurately defined its location and extent. The appearance of an abscess did not necessarily mandate immediate surgery. Three patients responded promptly to intensive antibiotic therapy and resolved despite a presumptive diagnosis of orbital abscess. The remaining 10 patients required surgical intervention and abscess formation was confirmed.In patients presenting with good visual acuity and some globe motion we recommended instituting intensive intravenous antibiotic therapy for 36 hours with close monitoring of visual acuity, avoiding surgery unless some impairment of vision is noted. The decision regarding surgery is then made on the time honored basis of response to therapy. Surgery is not necessary in those patients exhibiting prompt significant improvement in local inflammatory signs.
Aspergillosis of the nose and paranasal sinuses
Authors: Romett J. Lewis , Newman Richard K. 
Published: October 2006

AbstractAspergillosis is becoming an increasingly recognized pathogen in the sinonasal tract. The courses of two patients, one seemingly healthy and one with a terminal malignancy, are reviewed. These patients illustrate the clinical course, difficulties in diagnosis, and management of patients with aspergillosis of the sinonasal tract.Aspergillus is a common endogenous contaminant of the upper respiratory tract; however, bacterial sinusitis may trigger its growth and proliferation. Aspergillus fumigatus is the most common species implicated in paranasal sinus disease in the United States. The maxillary antrum is the most commonly involved site in the paranasal sinuses. Originally, aspergillosis was described in healthy patients, but it has become increasingly recognized in the immunocompromised and the chronically debilitated. Paranasal sinus Aspergillus infections are classified as non‐invasive, invasive and fulminant. The treatment is primarily surgical. Antifungal chemotherapeutic agents are used in the treatment of central nervous system involvement and in the fulminant form of the disease.