bluuebunny/crossref_metadata_2025_split huggingface dataset:
Routine identification of the facial nerve using electrical stimulation during otological and neurotological surgery
Authors: Silverstein Herbert , Smouha Eric , Jones Raleigh 
Published: October 2006

AbstractWe routinely identify the facial nerve to avoid facial nerve injury during most otologic surgery. Since 1985, we have used a facial nerve stimulator/monitor as an added safety feature in 383 consecutive otologic and neurotologic cases. In our last 30 middle‐ear, 8 retrolabyrinthine vestibular neurectomy, and 14 acoustic neuroma cases we used the monopolar stimulator probe‐tip to determine threshold currents needed to produce facial twitch. Stimulation thresholds varied according to the amount of soft tissue or bone overlying the facial nerve. The stimulator was useful for predicting dehiscences in the bony facial canal during middle‐ear and mastoid surgery. The exposed facial nerve usually stimulated at a level less than 0.1 mA (mean 0.05 mA), and the horizontal facial nerve covered by bone stimulated at 0.25 mA or greater (mean 0.6 mA). The stimulator was also used to predict the amount of bone overlying the vertical facial nerve at the annulus. An approximate relationship of 1.0 mA of threshold current to 1.0 mm of bony covering was found. After acoustic neuroma surgery, the stimulation threshold of the facial nerve at the brain stem helped predict postoperative facial function. Cases with current thresholds of 0.3 mA or less resulted in normal facial function. During ear surgery, routine identification of the facial nerve with the aid of a facial nerve stimulator will help avoid facial nerve injury.
Atrophy of the stria vascularis as a cause of sensorineural hearing loss
Authors: Pauler Margarethe , Schuknecht Harlod F. , White Judith A. 
Published: October 2006

AbstractCorrelations were made between pure‐tone thresholds and computer‐aided cross‐sectional measurements of the stria vascularis on histological sections of postmortem cochleas from 24 subjects who had reliable audiometric records. The criterion for selection was strial atrophy as the predominant pathological change in 17 experimental ears and normal hearing for seven control ears. Losses in the summed cross‐sectional areas of stria vascularis showed a direct correlation with hearing loss. The cause for the strial atrophy is presumed to be a genetically determined predisposition for early cellular decay. The mechanism by which strial atrophy causes hearing loss is speculative.
Internal maxillary artery ligation for epistaxis: An analysis of failures
Authors: Metson Ralph , Lane Ronald 
Published: October 2006

AbstractThe records of 100 consecutive patients undergoing transantral ligation of the internal maxillary artery (DMA) for epistaxis, including 15 patients who developed postoperative bleeding, were reviewed. Preoperative parameters predictive of surgical failure were advanced age, anemia, and a history of hypertension. The causes of postoperative epistaxis, as determined by surgical reexploration or angiography in 12 cases, included failure to identify the IMA in the pterygomaxillary space (6 cases), blood flow through partially closed clips on the IMA (2 cases), bleeding from posterior ethmoid arteries (2 cases), and revascularization of the nasal blood supply (2 cases). The incidence of surgical failure may be reduced by proper techniques of IMA identification and ligation.
Pyoderma gangrenosum involving the head and neck
Authors: Yco Mario S. , Warnock Gary R. , Cruickshank James C. , Burnett John R. 
Published: October 2006

AbstractPyoderma gangrenosum (PG) is a rare pathergy associated with systemic diseases such as ulcerative colitis and polycythemia vera. Its recognition in the differential diagnosis of other ulcerative lesions is important in managing an affected patient. A patient who developed lower extremity, oral, and cervical manifestations of this disease on separate occasions is presented. It is imperative that every clinician be aware of this entity because of the potential untoward effects of delayed or improper treatment including unnecessary surgery. Systemic and intralesional steroids are the treatment of choice.
Adenocaecinomas of major and minor salivary gland origin: A histopathologic review of treatment failure patterns
Authors: Matsuba Howard M. , Mauney Marc , Simpson Joseph R. , Thawley Stanley E. , Pikul Frank J. 
Published: October 2006

AbstractFifty‐four cases of adenocarcinoma of major and minor salivary gland origin were seen between 1960 and 1980. Fifty of these were treated definitively. Planned surgery combined with radiation was the initial treatment for 22 patients (44%), surgery alone for 16 (30%), and radiation alone for 13 (26%). Of the patients receiving surgery with curative intent, 82% underwent complete resections (i.e., negative margins). Cervical lymph node involvement was present in 23% of cases, and 73% of these patients died of their disease within 3 years. Distant metastases developed in 37% of patients, with a median time of 1 year; 93% of these patients died within 3 years.Histologic grading was performed using objective criteria. Thirty‐four percent of tumors were well‐differentiated, 27% moderately differentiated, and 39% poorly differentiated. Patients with well‐differentiated adenocarcinomas tended to survive disease‐free longer and developed fewer distant metastases than those patients with moderately or poorly differentiated tumors.
Superselective embolization of laryngeal hemangioma
Authors: Konior Raymond J. , Holinger Lauren D. , Russell Eric J. 
Published: October 2006

AbstractDiffuse upper respiratory hemangiomas are extremely rare lesions. Unlike the much more common congenital subglottic hemangiomas, diffuse upper respiratory hemangiomas do not resolve spontaneously and may prove quite recalcitrant to conventional forms of therapy.Superselective embolization, a highly successful technique for the management of head and neck vascular lesions, was used to effectively control an obstinate laryngotracheal hemangioma. Superselective embolization appears to provide yet another viable therapeutic option in the management of laryngeal hemangiomas.
Use of stents in laryngotracheal reconstruction in children: Indications, technical considerations, and complications
Authors: Zalzal George H. 
Published: October 2006

AbstractThe keys to successful outcome in surgical repair of laryngotracheal stenosis in children are choice of surgical procedure, including possible need for stenting; choice of type and length of stent; and duration of stenting. Choosing the appropriate method for stenting requires considering consistency of stenosis, altered anatomy, size, location, and stability of grafts when used for surgical repair and host tissue healing factors.Possible stents that can be used include endotracheal tubes, Silastic® sheet rolls, Montgomery T‐tubes, and laryngeal stents. This study investigates the effectiveness of the Aboulker stent, an increasingly popular stent for use in children. Indications and associated technical considerations for using the stent in 18 cases are reviewed. Postoperative care and follow‐up, directed against infection and towards securing the stent in its original location, and management of complications are discussed.
A statistical study of ENoG test error
Authors: Raslan Wasim F. , Wiet Richard , Zealear David L. 
Published: October 2006

AbstractElectroneurography (ENoG) is currently the most sophisticated and objective test available for assessing nerve degeneration in patients suffering from facial nerve paralysis. However, the test requires considerable experience before error due to intertest variability can be brought within reasonable limits. In a statistical study on normal participants, the error associated with two conventional recording techniques—optimized lead placement (OLP) and standardized lead placement (SLP)—was determined to be 17.8% and 20.7%, respectively. A significant increase in error was observed with the OLP approach (22.9%) if responses could not be monitored oscilloscopically, a common situation in patients with severe degeneration. In a final study, however, a previously unreported factor was found to significantly reduce test error: recording electrode size. In particular, unconventionally small recording electrodes (3 to 7 mm) produced as much as 4% less error when administering the technique.
Embolization: An adjunctive measure for removal of carotid body tumors
Authors: Ward Paul H. , Liu Chen , Vinuela Fernando , Bentson John R. 
Published: October 2006

AbstractSmall carotid body tumors that do not encircle the internal carotid artery are excised with relative ease and minimal risk by the conventional subadventicial approach. Large carotid body tumors frequently encircle the internal and external cartoid arteries, and extensive bleeding often complicates the resection, increasing the risk of carotid artery rupture and damage to major cranial nerves. Recent improvements in surgical techniques and selective embolization have lessened the risks of surgical excision, decreased the blood loss, and diminished the time required for resection. Experiences in the resection of carotid tumors with and without embolization are compared. Early resection of carotid body tumors, before involvement of the internal carotid artery and carotid bulb, is advocated.
The caldwell‐luc procedure: Institutional review of 670 cases: 1975–1985
Authors: Defreitas Junior , Lucente Frank E. 
Published: October 2006

AbstractThe Caldwell‐Luc procedure, which has long been fundamental in the treatment of perisinus disease, has undergone increasing scrutiny when used for inflammatory antritis. Individual morbidity rates of less than 10% to greater than 40% have been reported. To assess the data from our own institution, a retrospective study of 670 Caldwell‐Luc procedures was undertaken.Patients ranged in age from 10 to 82, with a mean age of 42.9 years. There were 271 males and 325 females. Parameters studied included symptoms, physical findings, operative techniques, surgical findings, length of hospitalization, and postoperative complications.Immediate postoperative complications included facial swelling in 89% of patients, cheek discomfort in 33%, significant hemorrhage in 2.9%, and temperature elevation in 12.1%. Long‐term follow‐up ranged from 2 years to 10 years. Overall complication rates in 464 patients included facial asymmetry (3), facial numbness or paresthesia (42), oroantral fistulas (5), gingivolabial wound dehiscences (7), dacryocystitis (12), devitalized tooth (2), recurrent sinusitis (56), and recurrent polyposis (25). A revision antrostomy was required in 37 patients, a revision Caldwell‐Luc in 22 patients, an intranasal sphenoethmoidectomy in 17, and root canal therapy in 2 patients. The most frequent complication was recurrent nasal obstruction, occurring in 28% of patients. Overall complication rates tended to increase with a longer follow‐up period.
Neurotization of pectoralis major myocutaneous flap by the hypoglossal nerve in tongue reconstruction: Clinical and experimental observations
Authors: Katsantonis George P. 
Published: October 2006

AbstractRecently, neurotization has been proposed for providing mobility to the pectoralis major, or other myocutaneous flap in lingual reconstruction following total glossectomy. The development of an active tongue‐like structure may offer the patient higher potential for rehabilitation of speech and deglutition. The purpose of this thesis is to report experimental and clinical observations on neurotization of the pectoralis major myocutaneous flap.The pectoralis major myoflap of 16 rats was reinnervated by either a hypoglossal nerve pedicle of hypoglossal‐genioglossus muscle neuromuscular pedicle. Functional flap reinnervation was confirmed in eight of the 16 animals. The author's clinical experience with reconstruction of the tongue utilizing neurotized pectoralis major myocutaneous flap is presented.
Management of neurovascular complications in extended skull base surgery
Authors: Leonetti John P. , Smith Peter G. , Grubb Robert L. 
Published: October 2006

AbstractCombined oncologic approaches to the skull base now permit resection of extensive basicranial neoplasms. Despite advances in microsurgical techniques, disabling or life‐threatening complications are still encountered in such surgery. Successful management of these sequelae is dependent upon meticulous intraoperative care and compulsive postoperative clinical assessment.Perioperative neurovascular complications were recorded in 164 consecutive skull base procedures. The most frequent severe complication was cerebral edema, which occasionally required surgical intervention. Dysphagia was the most common complication noted in the late postoperative period.Based upon this review, the management and methods found to minimize the incidence of various perioperative neurovascular complications related to extended skull base surgery are described.
Phonatory characteristics following surgical treatment of severe polypoid degeneration
Authors: Bennett Suzanne , Bishop Sandra G. , M. Lumpkin Samuel M. 
Published: October 2006

AbstractThis paper summarizes the results of our research into the efficacy of phonosurgery. Our study group consisted of 25 women whose severe, bilateral polypoid degeneration was managed surgically by one of the following methods: Hirano's technique, mechanical stripping, or CO2 laser enucleation. We found that all three procedures improved the voice. Surgery increased the average speaking fundamental frequency level substantially and improved the phonationnl range. Listeners' judgments about the appropriateness of vocal pitch and severity of hoarseness also changed positively following surgery. No one method was clearly better than another in improving the voice. However, patients treated using Hirano's method experienced the most rapid return of functional voice use, probably because the procedure is less traumatic and promotes more rapid healing than mechanical stripping or laser removal.
Human endothelial cell growth factors derived from thyroid anaplastic cell carcinoma
Authors: Itoh Kazunori , Fukuda Katsunori , Matsuzaki Tsutomu , Takao Sonshin , Ohyama Masaru 
Published: October 2006

AbstractHuman endothelial cell growth factors were partially isolated from transplanted thyroid anaplastic cell carcinoma propagated in nude mice. Purification was monitored in human umbilical cord vein endothelial cell cultures by (3H)‐thymidine incorporation into DNA. Crude tumor extracts with 0.1 M Tris‐HCl, pH 7.2 were fractionated by ammonium sulfate precipitation. The active materials precipitated by 35% to 50% ammonium sulfate were further purified by Bio‐Rex 70 (Bio‐Rod, Richmond, Calif.) cation exchange chromatography. Active fractions eluted by 0.5 M to 0.7 M NaCl were further analyzed via heparin‐sepharose affinity chromatography. This resulted in separation of one major peak eluted by 0.9 M to 1.2 M NaCl and confirmed to promote human umbilical cord vein endothelial cell proliferations, and three other peaks. The molecular weight determination of the most active fraction performed by high‐pressure liquid chromatography utilizing TSK 2000 gel column indicates 41,000 and 19,000 daltons for the active materials, respectively. Our results demonstrate that the angiogenesis properties of a solid tumor (thyroid anaplastic cell carcinoma), are not composed of a simple mechanism in vivo.
Survival following recurrent malignant melanoma of the head and neck
Authors: Hoyt David J. , Fisher Samuel R. 
Published: October 2006

AbstractA retrospective analysis of 877 patients who had malignant melanoma of the head and neck identified 366 patients who developed recurrent disease. Sex, race, age, histology, Clark level, thickness, ulceration, lymph node status, lymph node dissection, site of recurrence, and time to recurrence were analyzed to determine their effect on survival following the development of recurrent disease. Survival following the development of recurrence was found to be influenced by the site of first recurrence and the age of the patient at the time of recurrence. For a given age, patients who had initial recurrences at distant sites were three times as likely to die following recurrence than patients with local recurrence. Patients who had initial recurrences at distant sites were twice as likely to die following recurrence than patients with regional sites of recurrence (p<0.001).
Bilateral parotid enlargement in HIV‐Seropositive patients
Authors: Tunkel David E. , Loury Mark C. , Goins Martin A. , Johns Michael E. , Fox Cecil H. 
Published: October 2006

AbstractBilateral enlargement of the parotid glands has been noted in five patients who are seropositive for antibody to the human immunodeficiency virus. A characteristic cystic appearance has been noted in these lesions on clinical and radiographic examination. A benign lymphoepithelial infiltrate with cystic degeneration is found in parotid specimens from these patients. The presence of human immunodeficiency virus ribonucleic acid in inflammatory cells infiltrating the parotid specimen was confirmed by an in situ hybridization technique. The clinical manifestations of sicca syndrome were not present nor were opportunistic infections diagnostic for the acquired immunodeficiency syndrome.
Hypopharyngeal reconstruction: A comparison of two alternatives
Authors: De Vries Egbert J. , Johnson Jonas T. , Wagner Robin L. , Myers Eugene N. , Stein David W. , Schusterman Mark A. , Shestak Kenneth , Jones Neil F. , Williams Scott 
Published: October 2006

AbstractGastric pull‐up or free jejunal interposition was used for reconstruction after total laryngopharyngectomy in 31 patients. Complications and functional outcomes of the two methods are compared. Primary swallowing was achieved in 86% of patients after gastric pull‐up and in 82% of patients after jejunal interposition. Patients who underwent jejunal interposition were able to swallow sooner and had a shorter hospital stay than patients who underwent gastric pull‐up. Esophageal tumor recurrence after jejunal interposition was not observed. Hepatic failure occurred in two gastric pull‐up patients, leading to perioperative death in one. Flap necrosis occurred in two jejunal interposition patients and one gastric pull‐up patient. Two additional fistulas occurred in jejunal interposition patients as a result of microvascular complications. Stricture developed in four jejunal interposition patients, requiring revision surgery in two. Minor complications were more common in the gastric pull‐up group. Long‐term speech and swallowing function are compared. Our current choice of jejunal interposition or gastric pull‐up for reconstruction after total laryngopharyngectomy primarily depends on the location of the tumor.
Congenital torticollis: Evaluation by fine‐needle aspiration biopsy
Authors: Gonzales John , Ljung Britt‐Marie , Guerry Tom , Schoenrock Larry D. 
Published: October 2006

AbstractFine‐needle aspiration biopsy, used extensively for evaluating head and neck masses in adults, also provides an excellent minimally invasive means of evaluating infants with neck masses and torticollis. Three cases of torticollis involving infants are presented. In each case, fine‐needle aspiration revealed a benign fibrous lesion, ruling out malignancy. The remaining cytologic differential diagnosis between infantile fibromatosis, fibromatosis colli, and calcifying aponeurotic fibrosis is discussed, with mention of the possible causes of and treatment for congenital torticollis. We conclude that fine‐needle aspiration provides a fast and accurate diagnosis of neck masses in infants who have congenital torticollis, thereby avoiding surgical procedures in this very young age group.
Atypical osteomyelitis of the skull base
Authors: Grobman Lawrence R. , Casiano Roy , Goldberg Scott , Ganz William 
Published: October 2006

AbstractMost cases of osteomyelitis of the skull base occur as a result of inadequately treated localized malignant otitis externa. We present four patients with osteomyelitis of the skull base who did not present initially as malignant otitis externa. Increased morbidity may occur when these atypical cases are not promptly recognized and treated.
The predictive efficacy of the müller maneuver in uvulopalatopharyngoplasty
Authors: Katsantonis George P. , Maas Corey S. , Walsh James K. 
Published: October 2006

AbstractFlexible pharyngoscopy with the Müller maneuver has been proposed as a method for selection of uvulopalatopharyngoplasty candidates. In this prospective study, its predictive efficacy has been evaluated in 24 consecutive obstructive sleep apnea patients undergoing uvulopalatopharyngoplasty. FPMM enabled us to accurately predict the uvulopalatopharyngoplasty outcome in 12 of the 24 patients (50%).Although flexible pharyngoscopy with the Müller maneuver appears to be helpful in the selection of candidates for UPP, its distinct predictive efficacy is low.
Repair of orbital floor fractures with marlex® mesh
Authors: Scapini David A. , Mathog Robert H. 
Published: October 2006

AbstractThe best method for reconstructing the acutely fractured orbital floor is controversial. In this review, the outcome of 81 patients with an operatively confirmed pure orbital blow‐out fracture is evaluated with respect to postoperative enophthalmos, diplopia, infection, and extrusion. A Marlex® mesh implant was used to repair 58 of the fractures, with minimal resultant complications. We believe that Marlex® mesh is an ideal implant for use in repairing the early blow‐out fracture.
Neuroaudiologic abnormalities in patients with type 1 neurofibromatosis
Authors: Pensak Myles L. , Keith Robert W. , Dignan Peter St. John , Stowens Daniel W. , Towbin Richard B. , Katbamna Bharti 
Published: October 2006

AbstractAlthough the protean manifestations of neurofibromatosis have been studied for many years, much is yet to be learned about this disease in young children. Specifically, little is known about the prevalence and significance of early neurotologic abnormalities in this population. Our review of the recent literature, however, failed to identify any publication on the use of ABR and acoustic reflex testing in the pediatric neurofibromatosis population.This study reports on a standardized differential diagnostic battery conducted on 44 children diagnosed as having neurofibromatosis. Results of the neuroaudiologic battery indicated that 32% of the children had significant abnormalities on ABR and acoustic reflex dynamic tests. This is a substantially higher prevalence of abnormalities than reported by another group at a recent NIH concensus meeting on neurofibromatosis.Discussion of the implications of these findings regarding evaluation protocols, as well as management for this select patient population, will follow.
Airway complications in the head injured
Authors: Woo Peak , Kelly Glen , Kirshner Patricia 
Published: October 2006

AbstractFifty head‐injured patients who had tracheostomy were followed during rehabilitation by video fiberoptic laryngoscopy examination. Complications of aspiration (23/50), airway stenosis (13/50), and phonation dysfunction (16/24) were followed. Spontaneous resolution of aspiration may require a prolonged course. A majority of patients (37/50) had improvement and could be decannulated. Prognostic factors correlated to eventual decannulation included age, level on the Glasgow Coma Outcome Scale, and type of head injury. Those with poor neurologic improvement and glottic incompetence (13/50) are poor candidates for decannulation. Significant airway stenosis can involve both laryngeal and tracheal sites. Neurologic dysfunction may complicate the decannulation process after airway anatomy has been restored by surgery. Dysphonia resulting from intubation, peripheral laryngeal and nerve injury, or central laryngeal movement dysfunction are common. Preventive maintenance with ongoing evaluation can avoid airway crises such as aspiration pneumonia, hemoptysis, and innominate artery.