bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tracheotomy in neonates
Authors: Gibson R. , Byrne J. E. T. 
Published: September 2006

AbstractFifty‐five tracheotomies have been performed on neonates. Forty suffered from respiratory distress syndrome and smaller groups had congenital defects and pneumonia. All tracheotomies were preceded by nasotracheal intubation for about 72 hours. Linear incision of the trachea from the second to fourth tracheal rings, insertion of lateral stay sutures and careful placement of the tube to allow aeration of both main bronchi have reduced complications. Eleven neonates developed pneumothorax as a result of high pressure ventilation; three had pneumonia, and one tracheotomy tube became temporarily” displaced. Fourteen of the neonates with respiratory distress syndrome recovered. Birth weight ranged from 1,200 G upward. Expert nursing is essential to ensure adequate humidification and suction.Neonates are defined as babies aged less than 28 days. This definition applies whether or not the birth is premature. Tracheotomies on young children have been reported in the past: Pickard1 on premature babies; Holinger2 on those younger than 12 months; and Bridges3 on those aged less than five years. In all these papers, both operative and postoperative problems have been stressed. Complications have been emphasized by Oliver, et al.,4 who, in a series of 294 tracheotomies, found all their operative complications and 85 percent of their postoperative difficulties in small infants. It must be assumed that in the past postoperative care especially has been difficult in many centers. Recent years have brought the development of more dependable apparatus for humidification and ventilation, and this has been applied to respiratory tract care in a large variety of conditions which were previously fatal in this age group. The care of such infants and the sophisticated apparatus used in treating them requires adequate numbers of highly‐trained medical and nursing staff available night and day. Such well‐staffed and well‐equipped Intensive Care Units, specializing in the treatment of neonates, are now found in many large hospital complexes throughout the United Kingdom and North America.
Composite auricular graft in laryngeal reconstruction
Authors: Morgenstein Karl M. 
Published: September 2006

AbstractWhen injury to the larynx and/or trachea results in significant loss of tissue, primary closure may predispose to stenosis. Reconstruction of the airway should include the addition of cartilage to maintain the lumen as well as a replacement for interior mucoperichondrium and exterior skin. The auricle provides an excellent source for a composite graft consisting of cartilage with its attached skin on one side and perichondrium on the other.A case is presented in which a 2 cm. defect was successfully closed with such a composite graft.The patient sustained a self‐inflicted wound which removed the lower portion of the thyroid cartilage in the midline, the anterior third of the cricoid cartilage and the anterior third of the first tracheal lumen. Several weeks later a composite graft was taken from the auricle, and a three‐layer closure was accomplished. After an initial period of cyanosis, the graft remained viable and survived in toto.Long term follow‐up showed survival of the graft, normal laryngeal function and normal tracheal diameter.
A new prosthesis for stapes surgery
Authors: Draper W. L. , Herndon John W. 
Published: September 2006

AbstractA new prosthesis for use in stapedial surgery has been described. This prosthesis, which can be made in the operating room in a very short time, at the time of surgery, is easy to construct, to place in position and is effective for regaining hearing. The materials used, the construction of the prosthesis and postoperative audiometric studies have been discussed.
Homograft transplants to the middle ear. A follow‐up report
Authors: Glasscock Michael E. , House William F. , Graham Malcolm 
Published: September 2006

AbstractIn April, 1967, we performed our first transplant of a homograft tympanic membrane in a case of chronic ear disease. This work was presented in a “Preliminary Report” in January, 1968. The purpose of this paper is to give our experience (almost five years) with this technique of tympanoplasty.Our initial investigation was fraught with many difficulties. At the beginning of the project there were no clear cut legal priorities for obtaining and using cadaver material. No specific or generally accepted preservation solution was available, and the best method of storage was yet to be determined.The aim of the series was to develop a method of grafting the drum in patients with chronic ear disease. In addition, it was our hope that by incorporating the intact ossicles as well we would be able to increase the hearing in those difficult cases in which all ossicular remnants had been destroyed.While our original results were encouraging, the long term evaluation has been somewhat disappointing. The overall take rate for the drums has dropped to 65 percent. Hearing results are approximately the same as for any standard tympanoplasty procedure, no worse, but certainly no better.Since the beginning of our series other investigators have begun to use the technique with considerable more success. Perkins has been able to raise the take rate to 90 percent (acceptable) by using a buffered Formalin solution. The passage of the Uniform Donor Act has made homograft tissues more available and opened the way for the new national ear bank programs.While our experience has been disappointing, we feel we did help to stimulate interest in this procedure and that many of our failures have since been corrected by other investigators. We feel the future is good for homograft transplants to the middle ear and will continue to improve on our own techniques as well as those of others.
Current concepts of frontal sinus surgery: An appraisal of the osteoplastic flap‐fat obliteration operation
Authors: Sessions Roy B. , Alford Bobby R. , Stratton Cary , Ainsworth Jerry Z. , Roswell N. M. , Shill Otto 
Published: September 2006

AbstractThe osteoplastic flap‐fat obliteration operation has been utilized in a variety of clinical problems (osteomas, chronic infection, mucocele, extensive trauma) for the past eight years. The experience suggests that in carefully selected patients it is an effective operative procedure for the surgical control of these problems. Two failures, which were probably preventable, occurred in the 53 patients operated upon by this technique. Long term animal experiments and clinical experience support the merit of using fat as an obliterating material in the infected sinus. The only unfavorable long term result in otherwise successful patients has been the forehead embossment that has occurred over the frontal sinus osteoplastic flap area.
The present day spectrum of pediatric bronchoesophagology
Authors: Turtz Myles G. , Tucker Gabriel F. 
Published: September 2006

AbstractWe have presented an overview of the Jackson service at St. Christopher's Hospital for Children as a reflection of current pediatric bronchoesophagology in a pediatric center. As a model for study we have given our statistics for a 12‐month period; July 1, 1970, to June 30, 1971. During this period of time there were 906 procedures: 626 for airway problems and 280 for esophageal problems. Airway distress acute, chronic or recurrent, accounted for much of our airway endoscopy, although in the year reviewed not one case of croup required bronchoscopy. Caustic ingestion remained our major indication for pediatric esophagoscope. Endoscopic foreign body removed accounted for less than 6 percent of all procedures. Complications were minimal.Although a considerable amount of the work was “traditional” pediatric bronchoesophagology, much of it was for diagnosis and treatment of problems encountered only rarely by our predecessors. Advances in pediatrics, neonatology, pediatric surgery and its subspecialties have created a large population of children formerly lost but now salvageable. A significant factor in this enhanced salvage rate is the assistance of the broncho‐esophagologist.
Cervical lymphadenopathy secondary to toxoplasmosis
Authors: Karlan Marc S. , Baker Daniel C. 
Published: September 2006

AbstractAcquired lymphadenopathic toxoplasmosis is an insidious disease with protean manifestations. It usually follows a benign course. It is caused by a protozoan parasite, Isospora alias Toxoplasma. Infection is contracted by ingestion of raw encysted meat or ingestion of the oocyst found in cat litter. There is a large infected human population with a relatively high infection rate. The diagnosis is suggested by a nonspecific symptom complex, lymphadenopathy associated with a relative lymphocytosis, atypical lymphocytes, and a negative. heterophile antigen test. The microscopic findings of eosinophilic histiocytes further suggests toxoplasmosis. High serologic titers are considered most conclusive in diagnosing this usually self‐limited infection. Three cases in which biopsy was warranted are presented.
Facial paralysis in children. A review of 150 cases
Authors: Alberti P. W. , Biagioni E. 
Published: September 2006

AbstractThe in‐patient records at the Hospital for Sick Children were reviewed for the 10‐year period 1960 to 1970. All charts in which were coded a primary diagnosis of Bell's palsy, facial paralysis or paresis, or a secondary diagnosis of facial nerve functional disturbance were pulled and reviewed. As there was no out‐patient diagnostic index in that period, it proved impossible to identify the numbers or diagnosis of patients with the physical sign of those who were not admitted to the hospital.There were 150 patients in whom a facial nerve disorder was recorded. The distribution and a broad etiological classification is shown in Table I. It will be seen that there were significantly more lower motor neurone than upper motor neurone lesions, although it is likely that many upper motor neurone facial pareses were not recorded because they formed but a small part of a more serious generalized neurological disorder.The upper motor neurone pareses which were recorded had a variety of causes. The infections included meningitis and Guillain‐Barré syndrome. Three of the four infective cases made a complete recovery, as did all of the traumatic cases. In one of the hydrocephalic children the facial paresis diminished as the primary lesion responded to treatment. The presence of an upper motor neurone facial paresis is therefore not necessarily a sign of irreversible disease.Trauma due to birth injury, accident or motor vehicle injury was the most common cause of lower motor neurone paresis. The birth injuries usually cleared spontaneously. Bell's palsy was the next most common cause of facial palsy. The sexes were equally affected and the age distributions even throughout childhood. Bell's palsy in children, as in adults, may not clear spontaneously, and should be treated with respect.Facial palsy caused by acute inflammatory disease responds in most instances to antibiotic treatment, although simple mastoidectomy may be necessary. The outcome in this group is excellent. The remarkably few cases of facial palsy complicating chronic middle ear disease are a reflection of the changing pattern of disease.Operative causes were surprisingly mainly due to parotid surgery, and the indication for surgery was always excision of parotid hemangioma. In a 10‐year period there were only two facial palsies attributable to temporal bone surgery.There is a need for a detailed prospective study of all children with a facial paralysis and particularly the Bell's palsy group. Only in this way will accurate figures be obtained about the prognosis and thus allow appropriate regimens to be established.
Ultrastructure of the round window membrane
Authors: Bellucci Richard J. , Fisher Edward G. , Rhodin Johannes 
Published: September 2006

AbstractThe round window membrane presents the only non‐osseous wall of the labyrinth. Electron microscopic study of the round window membrane was undertaken in order to determine whether it could act as a route of transmission from the middle to the inner ear.In the cat round window membrane three layers can be identified. The tympanic surface is composed of a single layer of flat cells resting on the basal lamina. Multiple desmosomes and tight cell junctions are present. The intermediate layer contains supporting elements collagen and elastic tissues. The labyrinthine layer is composed of a single layer of long squamous cells which lie end to end on the basal lamina.The absence of intracellular organelles and microvilli, and the lack of basal lamina involutions into the epithelial cells preclude the presence of an active transport mechanism. The tight cell junctions also seem to present a barrier to free diffusion across the membrane.The chemical agents which have been observed to pass from the middle ear into the inner ear may have done so by diffusion through the round window membrane after altering the cell junctions; however, a readily accessible route of transmission through the round window membrane does not appear to be present.
Acoustic neuroma: Primary arising in the vestibule
Authors: Wanamaker Harold H. 
Published: September 2006

AbstractAs more information on acoustic tumors is accumulated, it is apparent that the lesions may have several sites of origin. A case of an acoustic tumor arising primarily in the vestibule is presented. This case, which has been followed for seven years, supports the proposed theory that the tumor may develop from the nerves to either the saccule or the utricle.
Selective vestibular ablation in monkeys by laser irradiation
Authors: Wilpizeski Chester , Sataloff Joseph , Doyle Colin , Leonard James , Behrendt Thomas 
Published: September 2006

AbstractFollowing bilateral simple mastoidectomy, eight adult squirrel monkeys were subjected to argon laser irradiation (output wavelength of 488 nanometers) of the horizontal or posterior semicircular canals. Penetration of the bony canal wall and damage to the membranous labyrinth was achieved if multiple or superimposed burns were made (one watt bursts with durations from 0.2 to 1 second). The major morphologic effect of the penetrating lesions was a mild to prolific growth of fibrous tissue restricted to the immediate site of irradiation. Endolymphatic ducts were blocked by collapse of one membranous wall against the other, by filling in of the lumen with fibrous growth of the duct walls or by constriction caused by overgrowth of surrounding fibrous tissue filling the perilymphatic space. Blocking of the duct, however, can not account fully for functional vestibular changes following irradiation, because some dysfunction occurred in the absence of any discernible structural abnormality. On the other hand, some function remained when ducts were completely occluded. Except for the control ear animal, all others exhibited slight to moderate ataxia and loss of acrobatic ability for several days after irradiation. No spontaneous nystagmus was detected in any monkey. All animals of our series, even those with no apparent morphological changes, were characterized by at least temporary reduction of caloric‐induced nystagmus, but only two showed complete absence of responses. All monkeys showed a change in the direction of caloric responses from horizontal to rotary or mixed, and vigor of the responses lessened considerably. Monkeys having penetrating lesions of the posterior canal exhibited subnormal postrotatory nystagmus when rotated in a forward direction with vertical canalsplaced in the horizontal plane. Two of the monkeys were trained to track their pure tone detection thresholds by means of an automated, single‐lever conditioned‐avoidance procedure. Bone conduction hearing was normal after irradiation except for a 16 db threshold shift at 2,000 Hz in one animal. On the basis of our experience with squirrel monkeys, there would appear to be no hazardous or life‐threatening side effects of laser surgery of otic structures when done in this manner. Serious consideration should be given by otologists to the experimental application of lasers for human microsurgical purposes.
Interpretation of electronystagmographic results
Authors: Eviatar Abraham 
Published: September 2006

AbstractThis preliminary communication presents 1,101 electronystagmographic results and correlates them with the final diagnosis. The aim of the study is to investigate the contribution made by electronystagmography to the final diagnosis.The diagnostic conclusions were classified into four groups. Within the “Central” group were included all diseases of the central nervous system, acute, chronic or congenital, and also concussion and skull fractures. In the “Peripheral” group, only peripheral vestibular diseases were included. Patients who complained of dizziness and were diagnosed on a purely clinical basis, while all other examinations were within normal limits, were classified in the “Diagnosis Deferred” group. The “Normal” group included only patients free of true vertigo with their physical examination, hearing test and mastoid X‐ray, that were considered within normal limits.Bithermal caloric irrigation was used for stimulation, and the speed of the slow component at culmination was the representative of the intensity of the nystagmic response.
Newer concepts of first branchial cleft defects
Authors: Work Walter P. 
Published: September 2006

AbstractDuplication embryological anomalies of the first branchial cleft are reported. Six cases are presented which were treated since 1963.A classification of these cases is suggested wherein there are Type I and Type II lesions.Type I is of ectodermal origin and is considered a duplication of the membranous external auditory canal. Initial infection and subsequent infection often necessitate repeated incision and drainage. Only one of the five cases of Type I did not show infection. Characteristically, these lesions occur medial to the concha and frequently extend to the postauricular crease. They pass anterior and deep to the ear lobe, superior to the facial nerve, parallel to normal external auditory canal and finally end in a cul‐de‐sac on a bony plate at the level of the mesotympanum. Microscopically, these lesions are cystic, have a squamous epithelium lining, form keratin and may or may not show accessory skin structures. Surgical excision is the treatment of choice. The surgery must be performed during remission from infection and consists mainly of parotid gland and facial nerve dissections. After the lesion is excised, the normal membranous external auditory canal is incised lengthwise, and an iodoform pack is placed in the area of the excised anomaly and brought out externally through the recently incised membranous external auditory canal and the meatus. During the first few days postoperatively, the pack is gradually removed and the bed of the wound repacked if necessary. Such a technique enhances wound healing.Type II are duplication anomalies of the membranous external auditory canal and pinna; they contain skin (ectoderm )and cartilage (mesoderm). These anomalies likewise are usually diagnosed after infection has taken place and after incision and drainage of an abscess at a point below the angle of the mandible. The upward extension of this lesion passes over the angle or horizontal ramus of the mandible. It continues upward passing either lateral or medial to the facial nerve and in rare instances may split its main trunk. It may end inferior to the membranous external auditory canal or form a sinus in that location. The middle ear is normal. Only one case with such anomaly is reported here, but in 1963, Work and Proctor reported five of six cases as Type II anomalies. Wide surgical excision is curative. The facial nerve must be preserved intact.Types I and II anomalies are not associated with pretragal cysts or sinuses.
Nystagmus after experimental cervical lesions
Authors: Igarashi Makoto , Miyata Hideo , Alford Bobby R. , Wright William K. 
Published: September 2006

AbstractEquilibrium disturbances may occur after neck lesions such as whiplash injuries. Abnormal proprioceptive inputs and vascular changes which involve not only the peripheral labyrinth, but also the brain stem are major factors producing these disturbances.Neck proprioceptor ablation was performed in healthy young adult squirrel monkeys by unilateral section of C1, C2 dorsal roots, or by injection of 1 cc of 1 percent Xylocaine® without epinephrine into the unilateral deep neck region.The dorsal root section was histologically confirmed by investigating spinal ganglion and adjacent nerve tissues. The Nauta stained spinal cord cross sections showed neuronal degeneration coming from the dorsal root.No spontaneous nystagmus was observed in the present series after section of the C1, C2 dorsal roots or Xylocaine® injection.After the Xylocaine® deep neck injection, the slow phase eye speed of optokinetic nystagmus declined in either direction in all animals. Slight decline of the quick component was also noticed. The wave form was also changed. The decline of slow phase eye speed partly represents the ablative effect of neck proprioceptors (joints, ligaments, and muscles), although the effect produced through other channels or by systemic toxicity cannot be eliminated. After the left C1, C2 dorsal root section, the slow phase eye speed declined only when there was clockwise stimulation. Statistical studies suggested significant differences between pre‐ and postoperative status. This finding suggested that the cervical input is connected to the oculo‐oculomotor pathway.Immediately after left C1, C2 dorsal root section, a reduction of the slow phase eye speed of postrotatory nystagmus occurred after counter‐clockwise rotation. The randomization test was used, and it was found that the postoperative scores are significantly lower than the pre‐operative scores.After the ablation of C1, C2 dorsal root, subjects failed to demonstrate any significant change in the pattern or numbers of pendular rotation nystagmic responses. On the other hand, three monkeys after Xylocaine® deep neck injection showed some change.The present experimental results indicate that the slow phase eye speed is a proper nystagmic parameter to study the neck proprioceptor contribution to oculomotor function.All animals after unilateral C1, C2 dorsal root section in the present series demonstrated moderate dysequilibrium (measured by the squirrel monkey rail test) confirming that neck injury can produce ataxia. There was no clear postoperative directional dominance of falls. For the diagnosis or investigation of the prognosis of many cervical disorders, bodily equilibrium examination is also important in addition to studying oculomotor function.
Symposium on prophylaxis and treatment of middle ear effusions.: Iii. The pathophysiology of effusion in otitis media
Authors: Lupovich Penn , Harkins Mina 
Published: September 2006

AbstractAn effort to characterize middle ear effusions by biochemical, histologic and physical means was undertaken in order to propose a hypothesis of the pathophysiology of serous otitis media.A group of patients numbering 145 yielded 289 specimens for study. All patients had clinical chronic otitis media. The patient population ranged in age from two months to 14 years.The following measurements were made. Microviscosity, smear with Wright's stain, total protein, glucose, alkaline phosphatase, acid phosphatase, GOT, CPK, alkaline phosphatase isoenzymes.The data indicate that middle ear effusions are locally produced and represent a nonspecific inflammatory response of the middle ear mucosa.