bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative ct scan evaluation for laryngeal carcinoma: Correlation with pathological findings
Authors: Hoover Larry A. , Calcaterra Thomas C. , Walter Gary A. , Larrson Sven G. 
Published: October 2006

AbstractThe advent of newer generation high resolution computed tomography (CT) scanners has revolutionized diagnostic evaluation in head and neck cancer. Since the development of conservation surgical techniques for the larynx, a precise preoperative evaluation of the extent of laryngeal involvement by carcinoma has been of prime importance. No single diagnostic study now yields more information regarding the anatomic extent of tumor than high resolution CT scanning.This study was designed to evaluate the reliability of CT scanning in determining extent of disease at several laryngeal levels by comparing preoperative CT scans with corresponding postoperative pathology obtained by serially sectioning laryngeal specimens. We found very good correlation in the inferior larynx and good correlation in the superior larynx. Determination of cartilage invasion proved very difficult, and scanning was unreliable at all levels when severe postradiation reactions were present.
Honored guest's address. The inverse relationship between cost and prognosis
Authors: Cohn Roy B. 
Published: October 2006

AbstractWhile doctors get the blame for increasing medical costs, studies show that societal, political factors, and medicine's limitations are the culprit.Clinicians (I use the term to distinguish between those M.D.s who work at the bedside and others who are in nonpatient direct care) are well aware of the huge costs associated with serious illness, but it is only recently that many papers are appearing in the medical literature discussing this problem in relation to medical care. In a study published in JAMA (April 10,1981), Steven A. Schroeder, el at., found that high cost illness is really terminal illness in a random sample of 776 adult high‐cost patients. Two years after discharge at least 34% of high‐cost patients had died and these patients accounted for 39% of the hospital charges incurred by the total group studied. Francis Moore and colleagues pointed out in the New England Journal of Medicine (March 12,1981) that this very group of patients also had the highest incidence of complications in the surgical field. In one year they identified 36 such cases at the Peter Bent Brigham Hospital in Boston; the total cost of their care was nearly $2,000,000. While there were unnecessary complications, in this group of patients it is very likely inevitable that the complication rate will be high.Since many authors seem to imply that it is the clinicians who are at fault to a large extent in generating these costs, I would like to point out that the physician‐clinician actually has control over a relatively small percent of the total cost.
Life‐threatening soft‐tissue infections of the neck
Authors: Beck Howard J. , Salassa John R. , Mccaffrey Thomas V. , Hermans Paul E. 
Published: October 2006

AbstractFour adult patients had life‐threatening soft‐tissue infections of the neck. One had Hemophilus influenzae infection, one had Streptococcus pyogenes infection, and two had polymicrobial mixed aerobic and anaerobic infections. Three of the four patients died despite appropriate antimicrobial therapy and surgical intervention. These cases demonstrate the spectrum of serious soft‐tissue infections of the neck in both the compromised and the uncompromised host. Soft‐tissue infections of the neck may be necrotizing or nonnecrotizing. Cellulitis secondary to H. influenzae and β‐hemolytic streptococci is usually non‐necrotizing, whereas necrotizing infections are caused most commonly by synergistic organisms. Potential complications include septic shock, disseminated intravascular coagulation, acute renal failure, adult respiratory distress syndrome, mediastinitis, and pericarditis. Early recognition with aggressive medical and surgical therapy is essential to reduce the mortality.
High septal hemitransfixion for the correction of caudal septal deformities
Authors: Kamer Frank M. , Churukian Michael M. 
Published: October 2006

AbstractHigh septal hemitransfixion has demonstrated superior versatility and reliability in a series of 68 patients for correction of caudal septal deformity. The literature has contained many references to high septal transfixion for use in rhinoplasty to preserve tip support. An alternative application of this approach for repair of caudal septal deformity is herein discussed.
Carbon dioxide laser enucleation of polypoid vocal cords
Authors: Yates Alan , Dedo Herbert H. 
Published: October 2006

AbstractPolypoid vocal cords have routinely been treated by endoscopic vocal cord stripping, often‐times resulting in prolonged hoarseness postoperatively. Submucosal CO2 laser enucleation of the polypoid tissue, with preservation of a mucosal flap on the medial edge of the cord, has proved to be a valuable improvement. The surgical procedure is described and results are presented which suggest that voice quality is better earlier than is the case after vocal cord stripping.
Hyperparathyroidism, hypercalcemia and the otolaryngology head and neck surgeon
Authors: White Irving L. 
Published: October 2006

AbstractAbility to successfully accomplish parathyroid surgery, as well as to understand the pathophysiology of parathyroid disease and hypercalcemia, is essential to the Otolaryngology Head and Neck surgeon (who must treat parathyroid disease), because of the more frequent identification of parathyroid adenomata and parathyroid hyperplasia (with their inherent hypercalcemia). Today many more cases are recognized because of hypercalcemia identified by now routine multiphasic biochemical screening tests.The etiology of hypercalcemia is discussed in considering the differential diagnosis of pseudohypoparathyroidism, and true hyperparathyroidism of parathyroid hyperplasia and parathyroid adenomata.Pseudohypoparathyroidism, secondary to ectopic elaboration of parathormone‐like substance is treated medically. Parathyroid hyperplasia can sometimes be controlled medically, but the only definitive trentment for hyperplasia and parathyroid adenomata is surgery, to the extent indicated, in these often critically ill patients with this multisystem disease. Medical, as well as surgical treatment, is described.A patient is described who demonstrated in a slowly moving montage all the classic history and findings of severe hyperparathyroidism in successive phases to her ultimate demise, manifesting neurological, renometabolic, skeletal, cardiovascular and gastrointestinal multisystem symptoms which arc described.The complete relief of the acute symptoms following excision of a massive parathyroid adenomata is described and the spectacular pathologic specimen is demonstrated.This patient's course is compared with that of a typical case of pseudohypoparathyroidism.
Otologic involvement in late syphilis
Authors: Steckelberg James M. , Mcdonald Thomas J. 
Published: October 2006

AbstractIn 38 patients with cochleovestibular dysfunction and no cause other than syphilis (congenital in 15, acquired in 23), there was no characteristic pattern to the dysfunction. Sensorineural hearing loss was present in all (bilateral in 82%, unilateral in 18%), and 42% had episodic rotatory vertigo. Only 24% had the classic triad of symptoms of endolymphatic hydrops. The impairment was less in the first 5 years of hearing loss than in subsequent intervals; the average impairments were comparable in the second through fifth decades.
ANTERIOR HYPOTYMPANIC APPROACH FOR GLOMUS TUMOR OF THE INFRATEMPORAL FOSSA.
Authors: Farrior Jay B. 
Published: October 2006

AbstractThe anterior hypotympanic approach to the infratemporal fossa permits direct exposure of glomus jugularc and glomus tympanicum tomors of the middle ear, hypotympanum and petrous apex with the preservation of normal structures and hearing. Smaller glomus tumors arising in the middle car extend anteriorly along the paths of least resistance into the hypotympanum and petrous apex to involve the carotid canal and, only later in the course of disease, extensively involve the jugular bulb, neck, or mastoid air cell system. Clinical experience demonstrates that this approach can effectively cure or control small glomus tumors in selected patients. In patients with more extensive disease, the surgical field may be expanded by removing the mastoid tip with facial nerve mobilization to remove the jugular bulb and posterior tumor extensions while preserving middle ear function and hearing.
Mastoidectomy for acquired cholesteatoma: Follow‐Up to 20 years.
Authors: Cody Thane D. R. , Mcdonald Thomas J. 
Published: October 2006

AbstractThe results of 423 mastoidectomies for acquired cholesteatoma were reanalyzed 6 years after the first analysis. The mastoidectomies were placed into three groups: open‐cavity, 135 modified radical and 37 radical; obliteialvd‐cavity, 60 modified radical and 20 radical in which the mastoid cavities were obliterated with pedicle muscle grafts; and inlacl‐canal‐wall, 69 complete and 102 complete with opening of the facial recess. The following observations were made.1. The cholesteatoma failure rate increased: for the open‐cavity group, from 6% to 7%; obliterated‐cavity group, 16% to 18%; intactcanal‐wall group, 35% to 45%.2. The precholesteatoma (retraction pocket) failure rate in the open‐cavity and obliterated‐cavity groups did not change. In the intact‐canal‐wall group, recurrent cholesteatomas developed in 8 cases initially classified as precholesteatomu failures. In 9 initially classified as successful, retraction pockets developed and 7 of these went on to recurrent cholesteatomas. Consequently, despite the progressive increase in formation of retraction pockets, the overall incidence dropped from 20% to 16%.3. Failure due to chronic or frequent recurrent infection did not change in the open‐cavity and intact‐canal‐wall groups. However, in the obliterated‐cavity group, it increased from 4% to 5%.4. The overall failure rate increased: open‐cavity group, 18% to 19%; obliterated‐cavity group, 29% to 30%; intact‐canal‐wall group, 60% to 66%.
Office diagnosis of sinus disorders: The role ofultrasound scanning.
Authors: Mabry Richard L. 
Published: October 2006

AbstractThe accurate diagnosis of sinus disorders has traditionally depended on history‐taking, physical examination, and sinus radiographs. Other helpful tools include transillumination, sinus irrigation, and direct sinoscopy. Ultrasound scanning to define and follow the course of sinus disorders, although used for years in Europe, has only recently been introduced in this country. It is characterized as an inexpensive, non‐invasive diagnostic aid which does not carry the risk of ionizing radiation. This paper discusses the use of ultrasound scanning in the management of sinus disorders commonly seen in office otolaryngologic practice, comparing it to other diagnostic modalities, and pointing out its advantages and shortcomings.
Extracranial presentation of craniocervical chordoma.
Authors: Berryhill Bruce H. , Armstrong Beverly W. 
Published: October 2006

AbstractChordomas are rare tumors of notochordal origin which arise in the sacral, vertebral, and craniocervical areas. Most patients with craniocervical chordomas have either neurological or ophthalmological symptoms. A patient presented with a parotid mass which was initially diagnosed as benign mixed tumor. One and one‐half years later, this patient was found to have an extensive intracranial tumor which was diagnosed as chordoma. Treatment consisted of subtotal surgical excision and radiotherapy. This case demonstrates an unusual presentation of an unusual tumor and the difficulty that may arise in diagnosing these tumors.
Transsphenoidal approach to the sella: The johns hopkins experience.
Authors: Kennedy David W. , Cohn Edward S. , Papel Ira D. , Holliday Michael J. 
Published: October 2006

AbstractThe transsphenoidal hypophysectomy has become a relatively frequent procedure in recent years, with the otolaryngologist playing a major role in its renewed popularity. This paper reviews the evoluation of pituitary surgery, duscusses the surgical technique currently used, and reviews the results and complications of 114 cases over a 13‐year period.Of the 129 procedures performed at Johns Hopkins Hospital between 1970 and 1983,114 charts were available for review. Twelve of these were palliative hypophysectomies and 102 were for sella tumors. Sixty‐eight patients were treated with surgery alone, and 34 received surgery and postoperative irradiation. Significant complications such as CSF rhinorrhea, diabetes insipidus, meningitis, septal perforation, anosmia, and visual field defects are discussed. The mortality rate for the series was 1.7%.These results are compared with those of previously published series and the differences are discussed in detail. In analyzing these data we feel that the transseptal, transsphenoidal hypophysectomy has become a safe and effective therapy for sella lesions.
Supraorbital rim approach to the anterior skull base
Authors: Johns Michael E. , Kaplan Michael J. , Park Tae Sung , Jane John A. , Cantrell Robert W. 
Published: October 2006

AbstractAdvances in the surgical approach to the anterior skull base have resulted in increased opportunity for the cure of tumors involving these structures. This paper describes a modification of the frontal craniotomy technique which allows excellent access to the anterior cranial fossa and orbit. This technique results in the en bloc removal of a bone flap which incorporates the orbital roof, superior orbital rim, and frontal bone. We have utilized this approach in 5 anterior skull base tumors (2 esthesioneuroblastomas, an angiofibroma, a case of orbital invasion by an aggressive inverted papilloma, and a squamous cell carcinoma of the ethmoid complex).This approach has the advantage of excellent exposure, clear visibility in the placement of chisel cuts, and less brain retraction than conventional techniques. It is the approach of choice for orbital tumors.
Lateral mandibulotomy: A technique of exposure for penetrating injuries of the internal carotid artery at the base of the skull
Authors: Dichtel William J. , Miller Robert H. , Woodson Gayle E. , Feliciano David V. , Hurt Julian 
Published: October 2006

AbstractInjuries to the internal carotid artery are rare but are frequently fatal or associated with significant neurologic sequelae. Exposure for surgical repair of penetrating injuries to the internal carotid artery at the base of the skull is difficult because of the overlying ramus of the mandible and the facial nerve. In the past, these injuries have been treated by techniques such as occlusion of the artery with a Fogarty balloon catheter, or subluxation of the temporomandibular joint to gain access to the arterial injury.Based on techniques previously reported for extirpation of parapharyngeal space tumors, we describe lateral mandibulotomy for exposure of penetrating carotid artery injuries at the base of the skull. The technique affords relatively rapid and adequate exposure of these injuries allowing ligation, or in selected cases, arterial repair.
Reconstruction of the stenotic hypopharynx and cervical esophagus without total laryngectomy
Authors: Goodwin W. Jarrard , Lundy Donna S. , Livingstone Alan S. 
Published: October 2006

AbstractReconstruction for severe stenosis of the hypopharynx, laryngeal inlet, and/or cervical esophagus is a challenging problem for the surgeon and his patient who want to avoid total laryngectomy. We reviewed the case records of eight patients and the relevant published literature in an effort to define the requirements for success and the causes of failure.A variety of surgical techniques were used. Seven of 8 patients eat a normal or near normal diet. Two of 4 patients, who sustained laryngeal damage at the time of initial injury, required total laryngectomy because of persistent aspiration. The 2 remaining patients and the 4 patients, who did not sustain laryngeal damage at the time of injury, speak with a good voice. Total laryngectomy should be reserved for those patient who cannot be rehabilitated following optimal reconstruction.
Normal speech for patients with laryngeal webs: An achievable goal
Authors: Mcguirt W. Frederick , Salmon James , Blalock David 
Published: October 2006

AbstractNormal speech as well as an improved airway is now an achievable goal in the treatment of laryngeal webs. Seven acquired webs and 3 congenital webs were seen at the North Carolina Baptist Hospital/Bowman Gray School of Medicine. The speech of 6 patients was tested preoperatively and again postoperatively: speech was considered normal postoperatively in 5 patients without the need for speech therapy; normal in the sixth patient after 6 sessions of speech therapy. The authors' preferred method of treatment is development of an endolaryngeal mucosal flap with a variable beam CO2 laser under operating microscopic control.
Biology of tumors and head and neck cancer chemotherapy
Authors: Gussack Gerald S. , Brantley B. Alton , Farmer Joseph C. 
Published: October 2006

AbstractThe management of advanced squamous cell carcinomas of the head and neck has shown disappointing results with surgery and radiation alone. Chemotherapy offers a third method of managing these patients. A background of basic tumor biology and cell cycle kinetics is essential in designing an effective head and neck chemotherapeutic protocol. The principles of the cell cycle, stem cell regulation, and doubling times are discussed. The kinetic classification of chemotherapeutic agents and experimental hypotheses of clinical relevance arc reviewed.
Snoring: Surgical vs. nonsurgical management
Authors: Fairbanks David N. F. 
Published: October 2006

AbstractEighteen children were treated for snoring. Surgical removal of enlnrcd tonsils and/or adenoids resulted in prompt and total elimination of snoring in 17 of these patients. One child required nasal and sinus surgery to gain relief from snoring.Eighty‐three adults were interviewed, examined, and treated for snoring. Correction of anatomical abnormalities in the nose, soft palate, uvula, and pharynx achieved elimination of snoring in 72% of surgically treated cases. By contrast, nonsurgical remedies achieved snoring elimination in only 5% of patients (controls). Tracheostomy was required in 10% of snoring adults — those who proved to have severe obstructive sleep apnea syndrome.Snoring is due to the combined effect of several anatomic and physiologic abnormalities in the nasal and pharyngeal segments of the airway. It may be amenable to surgical therapy when the severity of the problem warrants it.
Surgical treatment for malignant exophthalmos of endocrine origin
Authors: Hanabury Mark R. , Cole T. Boyce , Clark Charles E. , Chandler Arthur C. 
Published: October 2006

AbstractEndocrine exophthalmos is a poorly understood disease process thought to be related to a dysfunction of the thyroid‐pituitary axis. Initial therapy for symptomatic endocrine exophthalmos is medical. Failure to respond to medical management is heralded by progressive exophthalmos, exposure keratitis, and decreasing visual acuity. The pathophysiologic processes involved and an historical review of the various surgical procedures used are discussed. The results of 28 patients surgically decompressed by a transantral transethmoid approach are presented. Preservation or improvement in visual acuities were observed in all but one patient. Diplopia was generally not improved and may be worsened in some patients.
Reconstruction of post‐traumatic sinus osteomyelitis
Authors: Lekas Mary D. , Welch Paul T. 
Published: October 2006

AbstractOsteomyelitis with a fistulous tract of the left fronto‐nasnl area. The patient received an Anzio Beachhead WW II right fronto‐nasal injury repaired with a lucite cranioplasty. A staphylococcal infection involved the remnant of the left frontal sinus with a fistula at the nasion near the orbital ridge. Bone scan revealed increased activity consistent with osteomyelitis. Patient was treated with intravenous oxacillin. The lucite skull prosthesis was removed 2 weeks after admission via the bilateral osteoplastic coronal flap approach with fat obliteration of the residual frontal sinus. The intravenous oxacillin was maintained for 48 days and the patient was discharged. The patient was later readmitted for a cranioplasty using a preformed tantalum plate. The nasal flnnge of the tantalum caused a deformity that did not allow the patient to wear his glasses. His third admission was for reconstruction of the tantalum and nasal deformity via a W‐shaped incision.
Fine‐needle aspiration biopsy: Efficacy in the diagnosis of head and neck sarcoidosis
Authors: Frable Mary Ann Smith , Frable William J. 
Published: October 2006

AbstractThe authors report. The usefulness of fine‐needle aspiration biopsy to establish the diagnosis of sarcoidosis in patients with palpable disease in the head and neck areas. Aspiration biopsy proved to be a simple and quick method for establishing this diagnosis in the eight cases reported in this series. Interpretation of cytologic smears with identification of typical sarcoid‐like granulomas proved to be quite easy. No complications occurred secondary to use of this technique.
Planned preoperative radiation therapy vs. definitive radiotherapy for advanced laryngeal carcinoma
Authors: Kazem Ismail , Broek Paul Van Den 
Published: October 2006

AbstractIn the period 1970‐1980 inclusive, 191 patients with T3T4 laryngeal carcinoma (glottic.: 63 and supraglottic.: 128) received either definitive radiation therapy (RT) (60‐65 Gy in 6‐7 weeks) or planned preoperative radiation therapy (25 Gy in 5 equal daily fractions of 5 Gy) followed by laryngectomy with or without neck dissection (RT+S).Selection for RT vs. RT+S was based on medical operability and/or patient's refusal to undergo surgery. All patients are evaluable with minimum of 2 years observation. Crude 5 and 10‐year survival probability for 32 patients with glottic localization who received RT is 55% and 38% vs. 65% and 65% respectively for 31 treated with RT+S. For 52 patients with supraglottic site who received RT, the 5 and 10‐year survival is 44% and 44% vs. 82% and 60% for 76 patients treated with RT+S.
Reconstruction of the skull base
Authors: Schuller David E. , Goodman Joseph H. , Miller Carole A. 
Published: October 2006

AbstractTumor surgery of the skull base has been increasingly undertaken in recent years. This report involves a series of 18 consecutive patients who have undergone 22 operations at Ohio State University from July 1980 to January 1983 for removal of tumors either adjacent to or through the skull base. A variety of reconstructive techniques such as pericranial flaps, muscle flaps, temporalis fascial grafts, split‐rib grafts, fat grafts, and bone grafts have been found to be reliable. This series also included the successful use of a temporalis myocutaneous flap. The conclusion of this study is that these techniques provide a safe approach to the resection of tumors involving the base of skull.
Meningioma of the parapharyngeal space: A unique extension of intracranial tumor
Authors: Haratake Joji , Ishii Nobuyoshi , Yoshida Akio , Horie Akio , Lin Meiin 
Published: October 2006

AbstractA 45‐year‐old woman with a meningioma growing in the parapharyngeal space is reported. Her initial symptom was a stuffy feeling in the right ear and swelling of the right parapharynx. The parapharyngcal mass was biopsied, and a frozen section diagnosis suggested a paraganglioma. On electron microscopy, however, the tumor cells failed to show secretory granules, and represented a prominent interdigitation of the cytoplasm with occasional desmosomal attachments. Based on these features the tumor was diagnosed as a meningioma. Thereafter a mass lesion in the temporal lobe of the brain was detected by computerized tomography of the brain. The extracranial extension of the meningioma may occur in some occasions, but such cases in which the infiltrative portion in the parapharyngeal space was initially discovered have been rarely reported.