bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anterior epistaxis: a new nasal tampon for fast, effective control
Authors: Doyle Donald E. 
Published: October 2006

AbstractEpistaxis is the second most common cause of spontaneous bleeding. Of the two categories of epistaxis, mundane and severe, the mundane, usually anterior epistaxis, is the more common. It has been reported that 60% of individuals report at least one episode of epistaxis during their lifetime. Eighty percent of epistaxis occurs in Kiesselbach's plexus, a vascular network in the anterior portion of the nasal septum. We have designed a nasal tampon to control this common variety of epistaxis which is a fast, efficient, and cost‐effective method of anterior epistaxis control.The material used in the manufacture of the device (MerocelTM) has been used for over 5 years by the author, both in treatment of severe epistaxis and as a postoperative nasal packing. The design presented here has been used for anterior epistaxis for 18 months without untoward sequelae and with universal success.
Ineraid® (utah) multichannel cochlear implants
Authors: Youngblood John , Robinson Sylvia 
Published: October 2006

AbstractFor the more than 200,000 individuals in the United States with a bilateral profound sensorineural hearing loss, the cochlear implant offers a means of breaking this barrier of total silence. The pioneers in prosthetic research hoped that direct stimulation of the cochlea might at least give an awareness of sound through the auditory sense.There will be a review of five patients who were consecutively implanted with the Ineraid®multichannel cochlear implant, with 1 year follow‐up. All individuals were postlingually deafened adults and exhibited a bilateral profound hearing loss.
Head and neck malignancies in children: An age‐incidence study
Authors: Robinson Lee D. , Rightmire Joann , Smith Richard J. H. , Torpy Janet M. , Fernbach Donald J. 
Published: October 2006

AbstractOne hundred forty‐seven (147) children under 18 years have been treated for head and neck malignancies at Texas Children's Hospital from 1970 to 1985 and form the data base for this study. In order of frequency, the most common tumors were lymphoma, Langerhans' histiocytosis (LH), rhabdomyosarcoma, neuroblastoma, and other soft‐tissue sarcoma. Children under 2 were most likely to have LH; those from 3 to 5, LH or lymphoma; and those over 5, lymphoma.
The surgical management of epidural mucoceles
Authors: Schaefer Steven D. , Close Lanny G. , Mickey Bruce E. 
Published: October 2006

AbstractMucoceles of the paranasal sinuses extending into the epidural space are both uncommon and difficult to surgically manage. To best overcome the problem of recurrent disease, we have adopted a combined otorhinolaryngologic‐neurosurgical approach which emphasizes removal of as much as possible of the mucocele and marsupialization, or permanent drainage, of the disease site into the nasal cavity. Recently, we have modified this procedure in selected cases to include resection of involved dura and isolation of the epidural space from the nasal cavity. The indications and results of both forms of management are now reported in ten patients.
The use of topical oral antibiotics in head and neck prophylaxis: Is it justified?
Authors: Kirchner J. Cameron , Edberg Stephen C. , Sasaki Clarence T. 
Published: October 2006

AbstractSystemic antibiotic therapy is widely used for prophylaxis in major head and neck surgery, hut the efficacy of topical oral antibiotic therapy has not been adequately investigated. A pilot, placebo‐controlled, double‐blind crossover study using six healthy adult male volunteers was performed to assess the influence of topical clindamycin on oral flora. Samples of saliva were cultured for aerobic and anaerobic bacteria immediately before, and at 1‐ and 4‐hour intervals after, rinsing the mouth with a solution of either placebo or clindamycin. Quantitative analysis demonstrated significantly reduced levels of both aerobic and anaerobic bacteria after use of the topical antibiotic at both the 1‐ and 4‐hour intervals.It is postulated that topical clindamycin, by reducing concentrations of oral flora, may also reduce the incidence of regional infection following major upper aerodigestive tract surgery.
Laryngeal paraganglioma: Update on diagnosis and treatment
Authors: Konowitz Paul M. , Lawson William , Urken Mark L. , Som Peter M. , Breakstone Beth A. , Biller Hugh F. 
Published: October 2006

AbstractSixty‐one cases of laryngeal paraganglioma have been reported in the world literature. Histologic and clinical similarities between this neuroendocrine neoplasm and other organoid laryngeal tumors have led to uncertainty regarding the malignant potential and prognosis of this entity. Immunohistochemical assays have identified biogenic amines and hormonal peptides in these tumors which may prove useful as diagnostic markers. Computed tomography (CT) scanning demonstrates an enhancing lesion and can determine the location and extent of the tumor. The generally small size and constant blood supply of the laryngeal paraganglioma make preoperative angiography unnecessary. Accordingly, intraoperative ligation of the arterial blood supply negates the need for embolization. Partial laryngectomy remains the mainstay of treatment. A case is reported of a patient with a paraganglioma of the larynx who was unsuccessfully treated by laser excision and required surgical resection.
The immunology of tonsils in children: The effect of bacterial load on the presence of b‐ and t‐cell subsets
Authors: Brodsky Linda , Moore Linda , Stanievich John F. , Ogra Pearay L. 
Published: October 2006

AbstractTonsil core specimens of 54 children, (3 to 12 years) with clinical evidence of chronic tonsillitis and/or “idiopathic” tonsillar hypertrophy, were studied for the effect of the magnitude of aerobic bacterial load on tonsil size and the absolute numbers of B‐ and T‐cell subsets. Tonsillar core specimens obtained from ten children with no history of ear, nose, or throat infections and normal appearing tonsils served as controls.The findings of this study indicate that tonsil size was directly proportional to the mean bacterial load in colony forming units/g tonsil (CFU/g) even in the absence of a clinical history of infection (p < 0.01). A mean bacterial load of 2.4 ± 2.1 × 104 CFU/g tonsil was seen in diseased tonsils as compared to 1.6 ± 2.4 × 104 CFU/g tonsil in normal controls (p < 0.01). Hemophilus influenzae (type B and non‐B), Staphylococcus aureus, Streptococcus pneumoniae and Streptococcus pyogenes were the most common pathogens recovered in the largest numbers from diseased tonsils; control tonsils harbored few bacteria in their cores.The absolute number of immunocompetent cells/g tonsil including T‐helper, T‐suppressor and B‐cells (S‐Ig+), were significantly greater in diseased tonsils than in controls (p < 0.001). Increasing microbial load (CFU/g tonsil) correlated with increased numbers of T‐helper (p < 0.01) and B‐cells (p < 0.01).These data strongly support a bacterial etiology for chronic tonsillitis as well as “idiopathic” tonsillar hypertrophy. Bacterial induced proliferation of immunocompetent cells may be one underlying mechanism for chronic tonsillar disease in children.
Paranasal sinus malignancy: A comprehensive update
Authors: Sisson George A. , Toriumi Dean M. , Atiyah Raja A. 
Published: October 2006

AbstractA retrospective analysis of 60 cases of paranasal sinus cancer in patients admitted between 1970 and 1985 was undertaken. Forty‐six tumors originated in the maxillary sinus, and 14 originated in the ethmoid sinuses. Computed tomography, magnetic resonance imaging, and endoscopic sinus examination aided in early diagnosis of sinus cancer. Computed tomography aided in staging tumors; Caldwell‐Luc alone was inadequate for staging tumors invading deeper sites such as the orbits or pterygoid muscle. There were 15 early (T1 or T2) and 31 advanced (T3 or T4) maxillary sinus cancers. Multimodality therapy incorporated radiation, surgery, and chemotherapy. The 5‐year survival rate was 49%. We prefer preoperative radiotherapy for advanced lesions and postoperative radiotherapy for early lesions. The use of preoperative radiation therapy has increased our globe salvage rate. All but one of the patients who developed recurrent disease showed recurrence at the primary site prior to developing regional or distant metastasis. Radiation therapy, combined with aggressive surgical management to remove all tumor, provided the best survival rates in advanced lesions.
Otolaryngologic problems in cardiac transplant patients
Authors: Ganzel Toni M. , Brohm Judy , Nechtman Carl M. , Ganzel Brian L. , Klein Jon B. , Gray Laman A. 
Published: October 2006

AbstractCardiac transplantation is now a well‐accepted treatment for selected patients who have end‐stage heart disease. Of the 38 patients who underwent cardiac transplants at our center from August 1984 through August 1987, 27 received consultation for otolaryngologic problems. Eleven patients had sinonasal complications; 8 had laryngotracheal complications; 4 had otologic complications; 2 had oropharyngeal complications; and 2 had a combination of more than one of the above complications. Of these otolaryngologic disorders, 63% were infectious in etiology. Development of otolaryngologic infections generally did not correlate with either higher doses of maintenance immunosuppression or with treatment of an acute rejection episode, which requires increased immunosuppression. Otolaryngologists should be aware of the sinonasal, laryngotracheal, oropharyngeal, and otologic disorders that can occur in cardiac transplant patients.
Toy weapons and firecrackers: A source of hearing loss
Authors: Gupta Deepak , Vishwakarma S. K. 
Published: October 2006

AbstractAlthough acoustic injury as a result of exposure to noisy toys and firecrackers has been reported previously, most of these studies have been conducted on adults. The purpose of this prospective study, conducted at the time of Deepawali, an Indian festival of fireworks, was two‐fold: 1. to measure the acoustic output of representative samples of toy weapons and firecrackers and the intensity level at critical spectator points from the site of emission; and 2. to determine the auditory statue of a cross section of the target population, involving 600 participants from various age groups, before and after exposure to firecracker noise at Deepawali.The average sound level at a distance of 3 m was 150 dB, thus exceeding the damage risk criterion for adults (i.e., 130 dB peak level). An average 30 dB persistent sensorineural hearing loss was found in 2.5% of the target population as a result of toy weapon/firecracker noise during Deepawali. The 9‐to 15‐year‐old age group was most affected. A judicious approach in the manufacture and use of toy weapons and firecrackers, in addition to legal restraints, is advocated.
Severe versus profound sensorineural hearing loss in children: Implications for cochlear implantation
Authors: Brookhouser Patrick E. , Worthington Don W. , Kelly William J. 
Published: October 2006

AbstractThe advent of cochlear implants for children has stimulated interest in the specific sensory deficits and communicative capabilities of children with severe or profound bilateral sensorineural hearing loss. Appropriate management of these children and their families requires an appreciation of the multifaceted developmental and educational challenges confronting deaf children, even after cochlear implantation. Evaluation results from 200 children with bilateral sensorineural deafness (63 severe/137 profound, anacusic, and fragmentary) reveal significant differences between these two subpopulations. Within the profoundly impaired group, important differences were also noted in the children's ability to benefit from conventional amplification, depending on residual hearing at or above 1000 Hz. Strategies for assessing auditory function and aided benefit in severely and profoundly hearing‐impaired children must involve a pediatric test battery, serial evaluations, and parental cooperation/support. When selecting candidates for cochlear implantation, it is inappropriate to categorize severely hearing‐impaired children with those children having profound sensorineural losses. Even profoundly impaired populations are not homogeneous, and rehabilitation potential with conventional amplification must be determined on an individual basis, over time.
The effect of cosmetic rhinoplasty on nasal patency
Authors: Adamson Peter , Smith Oakley , Cole Philip 
Published: October 2006

AbstractFifty patients who primarily desired cosmetic improvement underwent nasal airflow studies using posterior rhi‐nomanometry before and after reduction rhinoplasty. There was no significant difference in nasal resistance before and after surgery. This study demonstrates that neither subjective nor objective nasal obstruction follows reduction rhinoplasty, despite the potential for a decreased cross‐sectional area of the valve region.
Computer‐aided 3‐D temporal bone anatomy for cochlear implant surgery
Authors: Takahashi Haruo , Sando Isamu 
Published: October 2006

AbstractTo define anatomical relationships important in cochlear implantation, computer‐aided three‐dimensional reconstruction and measurement of middle and inner ear structures in six normal temporal bones were performed. Our findings were as follows: 1. When viewed from the posterior hypotympanotomy (facial recess) approach, the inferior 10% to 30% of the round window (RW) membrane was visible in only half the cases. 2. The most inferior portion of the basal turn of the scala tympani was not only inferior but also slightly anteriorly behind the RW membrane in more than half the cases. 3. The shortest distances from the aperture of the RW niche and from the margin of the RW to the stapes head were 2.38 ±0.33 and 2.15 ±0.22 mm, respectively. 4. The distance between the RW and the most inferior portion of the basal turn scala tympani was 5.15 ± 0.34 mm. 5. The direction of the electrode advancement lay at a sharp angle to the inferior part of the RW (mean 31.9 ± 3.6 degrees). 6. The direction from the RW to the most inferior portion of the basal turn scala tympani lay 16.0 ± 5.3 degrees anteroin‐ferior to the direction of the advancement of the electrode to the RW. 7. The distance between the margin of the RW and the basilar membrane of the cochlea was 0.58 ±0.10 mm at the superior aspect of the RW, and was 1.23 ±0.12 mm at the lateral aspect of the RW. 8. Dissecting away less than 1 mm (mean 0.7 ±0.27 mm) of the RW margin inferiorly or infero‐laterally was enough to permit straight insertion of the electrode in most cases.
Lipoinjection for unilateral vocal cord paralysis
Authors: Mikaelian Diran O. , Lowry Louis D. , Sataloff Robert T. 
Published: October 2006

AbstractInjection of Teflon® paste is a commonly accepted procedure to improve the caliber of voice in unilateral vocal cord paralysis. There are several drawbacks to Teflon injection, among them respiratory obstruction (from overinjected Teflon) and unsatisfactory voice quality (Teflon causes stiffness of the vocal folds).This paper is a preliminary report on lipoinjection instead of Teflon injection into a paralyzed vocal fold. Fat appears to impart a soft bulkiness to the injected cord, while allowing it to retain its vibratory qualities. It is autologous material and can be retrieved if excessively overinjected. The fate of autologous fat injected into a paralyzed vocal cord remains unknown. Most of the literature on lipoinjection concerns repairs of depressed scars or breast augmentation. Our longest follow‐up has been 12 months. Three patients have had this procedure, and the results appear to be very encouraging.
Malignant nerve sheath tumors of the head and neck: A combined experience from two university hospitals
Authors: Bailet Jeffrey W. , Abemayor Elliot , Andrews James C. , Rowland John P. , Fu Yao‐Shi , Dawson Douglas E. 
Published: October 2006

AbstractMalignant schwannoma is an aggressive neoplasm whose cell of origin and histologic characteristics remain controversial. Despite advances in diagnostic techniques, the natural history of this tumor remains uncertain. The charts of all patients with malignant schwannoma who were treated at the UCLA Center for the Health Sciences and the University of Iowa Hospital and Clinics were retrospectively reviewed. Sixteen patients received surgery and radiotherapy in combination or as sole therapy. Irrespective of treatment modality, prognosis was poor with an overall survival of 15%. Recent advances in imaging and histologic techniques that assist in establishing the diagnosis and delineating tumor location are discussed. In addition, the literature pertaining to malignant schwannoma of the head and neck is reviewed.
Clinical assessment of postural stability following vestibular nerve section
Authors: Cass Stephen P. , Kartush Jack M. , Graham Malcolm D. 
Published: October 2006

AbstractLittle is known about the recovery of postural control in patients following acute vestibular loss. This paper reports on the results of moving‐platform posturography to assess the recovery of postural stability in 24 patients following vestibular nerve section. Posturography was abnormal prior to surgery in 17% of the patients. Seven days following surgery, 44% of the patients demonstrated vestibular deficit patterns, while 56% of the patients had normal posturography. Posturography was normal in all patients 1 month following surgery. Abnormal posturography was subsequently noted in 21% of the patients between 3 and 20 months following surgery. Each of the patients with abnormal preoperative posturography subsequently demonstrated abnormal late postoperative posturography. These results suggest that perioperative posturography may be useful in the evaluation and counseling of patients considering ablative vestibular surgery.
Preservation of the facial nerve in the management of recurrent pleomorphic adenoma
Authors: Samson Michael J. , Metson Ralph , Wang C. C. , Montgomery William W. 
Published: October 2006

AbstractWhether to preserve or sacrifice a facial nerve involved with benign neoplasm is one of the most difficult intraoperative decisions confronting the head and neck surgeon. We reviewed 21 cases of recurrent pleomorphic adenoma treated with subtotal excision and facial nerve preservation, followed by postoperative radiation therapy. Of the 17 patients with microscopic residual tumor at completion of surgery, 16 (94%) remain free of recurrence with an average follow‐up of 5.9 years. Only one of four patients (25%) with a large postoperative tumor load remains free of disease. Facial nerve function is normal in 20 of 21 patients. Preservation of the facial nerve with postoperative irradiation should be considered as an alternative to nerve sacrifice in selected cases of recurrent pleomorphic adenoma.
Site of airway obstruction in patients with obstructive sleep apnea before and after uvulopalatopharyngoplasty
Authors: Metes A. , Hoffstein V. , Mateika S. , Cole P. , Haight J. S. J. 
Published: October 2006

AbstractThis study describes a simple method, based on a movable catheter technique, for use during routine polysomnography to identify the site of obstruction, and this has been applied to 51 patients with suspected sleep apnea. The obstruction was found to be retropalatal in 30, retrolingual in 7, and could not be determined in 14 patients (12 had no sleep apnea, 1 did not sleep, and 1 had central sleep apnea). Twelve of these patients had uvulopalatopharyngoplasty with preoperative and postoperative polysomnograms to determine the site of obstruction. The preoperative obstruction was retropalatal in nine and retrolingual in three. Postoperatively, four patients (one with retrolingual obstruction and three with retropalatal obstruction) no longer had sleep apnea. In the remaining eight patients, the site of obstruction was unchanged from the preoperative one. Several conclusions result: 1. the movable catheter technique offers a simple way to determine the site of obstruction in patients with significant obstructive sleep apnea, 2. most such patients obstruct in the retropalatal region, and 3. preoperative localization of the site of obstruction to the retropalatal region does not seem to improve the surgical outcome of uvulopalatopharyngoplasty.
Hashimoto's thyroiditis and carcinoma of the thyroid: Optimal management
Authors: Sclafani Anthony P. , Valdes Marie , Cho Hyun 
Published: October 2006

AbstractSeveral authors have noted a high incidence of thyroid carcinoma in patients with Hashimoto's thyroiditis (HT), and some have even considered HT a premalignant condition. The authors evaluated all patients with surgically proven HT at Beth Israel Medical Center in New York from 1985 through 1990. Of these 48 patients, 8 (17%) had thyroid carcinoma in addition to HT. No statistically significant difference between patients with and without concurrent carcinoma was noted in the percentage of patients with a dominant mass, irregular thyromegaly, compressive symptoms, suspicious fine needle aspiration biopsies (FNABs), or a cold nodule on thyroid scintigraphy. However, patients with neither a positive FNAB nor a cold nodule were much less likely to have carcinoma than patients with one or both of these tests positive (0% vs. 26%, P±.05). A management scheme for patients with HT is proposed to adequately and efficiently evaluate and treat patients for concurrent thyroid carcinoma.
Nodal size of metastatic squamous cell carcinoma of the neck
Authors: Friedman Michael , Roberts Nancy , Kirshenbaum Gary L. , Colombo James 
Published: October 2006

AbstractThe preoperative use of computed tomographic (CT) scanning continues to be the best diagnostic method for preoperative detection of metastatic neck disease. Current accepted criteria for CT diagnosis of nodal disease are not uniform, although nodal size, nodal grouping, and central necrosis correlate strongly with malignancy. To assess the relationship of nodal size and malignancy, a multicenter study was designed to evaluate the nodes from 100 neck dissections. Sixty‐nine positive neck dissections were analyzed, and every node was measured. The relationship of central necrosis was also compared with node size. Our results showed that CT scanning continues to provide a reliable picture of the histologic status of lymph nodes. Using the criterion of central necrosis or node size larger than 1 cm, only 7% of necks had nodal disease that would have been missed by CT interpretation. This study supports the continued use of preoperative CT evaluation for metastatic neck disease.
Orthotopic laryngeal transplantation: Is it time?
Authors: Berke Gerald S. , Block Robert M. , Sloan Steven , Sercarz Joel , Ye Ming 
Published: October 2006

AbstractThe notion of returning phonatory and respiratory function by transplanting larynges has fascinated and challenged the minds of laryngologists for many years. In the past, the problems of revascularization, tissue rejection, and physiologic vocal fold motion have stymied the success of research in this area. Today, advances in microvascular surgery, graft versus host response, and selective reinnervation have made laryngeal transplantation a theoretical, if not a practical reality. Despite this progress, serious ethical and fiscal considerations remain unresolved. This report will discuss these advances as well as concerns and will present the current UCLA laryngeal physiology laboratory experience with canine laryngeal transplantation.