bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experience with the sternocleidomastoid myoperiosteal flap for reconstruction of subglottic and tracheal defects: Modification of technique and report of long‐term results
Authors: Friedman Michael , Toriumi Dean M. , Owens Ruth , Grybauskas Vytenis T. 
Published: October 2006

AbstractSubglottic or tracheal reconstruction may be required in cases of subglottic stenosis, invasive thyroid carcinoma, or trauma. The sternocleidomastoid myoperiosteal flap uses clavicular periosteum on a muscle pedicle to provide vascularity. Clavicular periosteum is fibrous, durable, and will conform to the shape of the trachea, forming bone to provide stability to the airway. The procedure is relatively simple and involves single‐staged reconstruction.After 4 years' experience with this flap, we present the results from a series of 11 patients who underwent subglottic or tracheal reconstruction with the sternocleidomastoid myoperiosteal flap. Ten of 11 patients were successfully decannulated. The average time from reconstruction to decannulation was 50.3 days. Follow‐up ranged from 12 to 40 months. We also describe modifications of the initial technique that have been introduced to improve the flap's versatility and effectiveness.
Management of juvenile angiofibromata
Authors: Spector J. Gershon 
Published: October 2006

AbstractTwenty‐eight angiofibromata, treated between 1971 and 1988, were reviewed according to their patterns of invasion, blood supply, treatment modality, and clinical course. All patients were males, and two patients were black. The average age was 14.8 years. Nasopharyngeal masses, epistaxis, and facial asymmetry were the most common presenting symptoms. Tumors extended along predetermined pathways following the vascularity of the external carotid system. CNS extension arose via the superior orbital fissure or direct extension from the sphenoid sinus. Angiography described the neoplastic vascularity, CT with contrast demonstrated tumor location and extracranial extension, and MRI best demonstrated CNS invasion.All lesions were reclassified according to the American Joint Committee staging system. Twenty‐seven patients were operated upon; four with cryotherapy and 23 following embolization. Two tumors recurred and needed additional surgery. One patient with CNS invasion was treated with estrogen and radiotherapy for cure. Tumor staging is not particularly helpful in decision making, because surgery must be individualized according to tumor location and extent. Surgical approaches for specific tumor locations are discussed.
Percutaneous gastrostomy: The stanford experience
Authors: Luetzow Annette M. , Chaffoo Richard A. K. , Young Harvey 
Published: October 2006

AbstractMany techniques have been devised to provide enteral nutrition to the patient with cancer of the head and neck. No single technique will be adequate for all patients, but our experience with percutaneous gastrostomy has encouraged us to recommend it as a valuable alternative to conventional modalities. The charts of 156 patients, identified by computer‐assisted search as having undergone gastrostomy at Stanford University Hospital or Palo Alto Veterans Administration Hospital from 1984 to 1987, were reviewed. Of these, 24 patients with a primary diagnosis of head and neck malignancy underwent percutaneous gastrostomy and form the basis for this study. Parameters evaluated included operation time, type of anesthesia, perioperative complications, and cost. Percutaneous gastrostomy can be performed under local anesthesia or at the time of routine head and neck procedures such as staging endoscopy. Our success with this technique leads us to recommend it as a valuable alternative for providing nutrition to head and neck cancer patients.
Temporal bone pneumatization in cystic fibrosis patients
Authors: Todd N. Wendell , Martin W. Stephen 
Published: October 2006

AbstractCystic fibrosis patients commonly have nasal polyps and sinusitis, but surprisingly are spared from an increased occurrence of otitis media. Twenty cystic fibrosis patients whose ages ranged from 13 to 2G years were studied. Only one of these patients had a history of otitis. Minimal temporal bone pneumatization, as determined by computed tomography, was used as an indicator of childhood otitis. The computed tomography had been done as part of the medical evaluation of their symptomatic paranasal sinusitis.On the average, pneumatization volume was larger for the cystic fibrosis patients than for the normal population (p=0.033, Student's t‐test). That is, these data indicate that cystic fibrosis patients had significantly less otitis than the normal population. Assuming that these cystic fibrosis patients are representative, the data may imply that the gene for good musculoskeletal eustachian differentiation is linked with the gene for cystic fibrosis. The data also imply that poor mucociliary transport does not necessarily induce otitis media.
The role of haemophilus influenzae in the pathogenesis of tonsillar hypertrophy in children
Authors: Brodsky Linda , Moore Linda , Stanievich John 
Published: October 2006

AbstractThe role of specific bacteria in the pathogenesis of tonsillar hypertrophy in children in unknown. To determine the effect of specific bacteria on the presence and nature of tonsillar hypertrophy (measured both clinically and by tonsil weight), quantitative aerobic bacteriology was performed on 54 tonsil‐core specimens from 54 children undergoing tonsillectomy for chronic tonsillitis and/or tonsillar hypertrophy. Twelve tonsil‐core biopsies from 12 children with no history of tonsil disease served as controls.Haemophilus influenzae (HI), Streptococcus pyogenes (SP), Streptococcus pneumoniae (SPn), and Staphylococcus aureus (SA) were the most common microorganisms cultured from diseased tonsils. Few bacteria were cultured from the cores of controls. HI was cultured as the dominant aerobic bacteria in 15 of 54 tonsils (27%). For HI alone, the number of bacteria/gram tonsil showed a significant positive correlation to tonsil weight (p<0.05). Fourteen of 15 (94%) tonsils with HI were found in patients with clinical tonsillar hypertrophy, while only 6 of 10 patients (60%) with SP and SPn had tonsillar hypertrophy. Of the 38 tonsils removed for obstructive symptoms (clinical hypertrophy), 14 of 38 (37%) cultured HI as the dominant microorganism, whereas only 6 of 38 (16%) cultured SP. Neither the type of HI (b us. non‐b) nor the presence of beta‐lactamase production had a significant correlation to tonsil weight, bacterial load or the number of B‐ or T‐cell subsets.The number of T‐helper (T), T‐suppressor (T) and B‐cells (per gram/tonsil) was markedly greater in all diseased tonsils than in controls. For both HI and SP the total number of bacteria/gram tonsil correlated positively to the number of T cells (p<0.003 and p<0.007, respectively). In patients with HI type b (HI‐b), the tonsil weight correlated to an increase in T and B‐cells (p<0.004 and p<0.007, respectively). An increased presence of the T and B‐cells in the HI‐b tonsils (and not in tonsils with HI non‐b) suggests a differential response by the tonsil to these distinct but related bacteria.The above data strongly support an etiological role for HI in the pathogenesis of tonsillar hypertrophy in children. Alterations in the relationship between T and T cells may affect normal B‐cell function and be implicated in this phenomenon. Clinical implications for pathogenesis, antimicrobial therapy, and future directions for research are discussed.
New imaging techniques in diagnosis of cerebrospinal fluid fistula
Authors: Nicklaus Pamela , Dutcher Paul O. , Hengerer Arthur S. , Kido Daniel K. , Nelson Curtis N. 
Published: October 2006

AbstractThe localization of a cerebrospinal fluid fistula producing cerebrospinal fluid otorrhea can be very difficult. However, the exact anatomic localization of the bony defect is important when selecting the surgical approach to repair. Case reports of two patients in whom spontaneous cerebrospinal fluid otorrhea occurred following pressure equalization tube placement for middle‐ear effusion are presented. Nuclear magnetic imaging supplemented CT scan findings, providing noninvasive localization of the defect. Preoperative impressions were confirmed at surgery. In addition to discussing the use of magnetic resonance imaging in evaluating cerebrospinal fluid otorrhea, the literature will also be reviewed.
Comparison of benefit from vibrotactile aid and cochlear implant for postlinguistically deaf adults
Authors: Skinner Margaret W. , Binzer Susan M. , Smith Peter G. , Holden Laura K. , Fredrickson John M. , Holden Timothy A. , Juelich Margaret F. , Turner Beverly A. 
Published: October 2006

AbstractFour postlinguistically deaf adults were evaluated presurgically with a one‐ or two‐channel vibrotactile aid and postsurgically with a multichannel, multielectrode, intracochlear implant. Although the vibrotactile aid provided awareness of sound and enhanced flow of conversation, benefit to lipreading was small on videotaped tests and speech tracking. Scores on recorded, sound‐only speech tests were not significantly above chance except in discrimination of noise from voice. With the cochlear implant, benefit to lipreading was significantly greater than with the vibrotactile aid, and scores on sound‐only tests were significantly above chance. Communication was markedly better with the implant than with the vibrotactile aid. In counseling those who get no benefit from a hearing aid, the results of this study provide data on the amount of benefit one‐ or two‐channel vibrotactile aids provide postlinguistically deaf adults who are subsequently implanted.
Evaluation of five different cochlear implant designs: Audiologic assessment and predictors of performance
Authors: Tyler Richard S. , Abbas Paul , Tye‐Murray Nancy , Gantz Bruce J. , Knutson John F. , Mccabe Brian F. , Lansing Charissa , Brown Carolyn , Woodworth George , Hinrichs James , Kuk Francis 
Published: October 2006

AbstractThe audiologic performance of 54 postlingually deafened adults wearing cochlear implants was uniformly evaluated. The participants had 9 months' or more experience with one of five different cochlear prostheses (Los Angeles Single Channel (N = 11), Vienna Single Channel (N = 4), Melbourne Multichannel (N = 18), Utah Multichannel (N = 19), San Francisco Multichannel (N = 2). The multichannel designs enabled participants to recognize more environmental sounds, provided more speech reading enhancement, and enabled most users to understand limited speech in the sound‐only condition, compared to the single‐channel implant group.
Antimicrobial prophylaxis in ear surgery
Authors: Jackson C. Gary 
Published: October 2006

AbstractThe purpose of this research was to assess the efficacy of prophylactic antibiotic administration in ear surgery over a wide range of cases. Additional objectives include the assessment of the relative effect of patient age, duration of operation, preoperative condition, and the success of tympanoplasty.Prospectively, in a controlled study, 4,000 patients were studied employing cephalosporin and oxacillin as prophylactic antimicrobials. No statistically significant difference in postoperative otologic infection rates was observed. This conclusion was unaltered by the operative duration, patient age, or preoperative condition. Grafting success was not improved.Antimicrobial prophylaxis in ear surgery cannot be recommended.
Analysis of immunocompetent cells following inner ear immunostimulation
Authors: Takahashi Mitsuaki , Harris Jeffrey P. 
Published: October 2006

AbstractImmunohistochemical methods were used to investigate the development of inner ear immunocompetent cells in healthy, BALB/c mice over a 3‐week period as a result of a secondary inner ear response against keyhole limpet hemocyanin. Antibodies against murine macrophages and granulocytes (anti‐Mac‐1), T‐cells (anti‐Lyt‐1, anti‐Lyt‐2), and immunoglobulins (anti‐IgM, anti‐IgG, anti‐IgA) were used. Mac‐1 positive (Mac‐1) cells were observed at 6 hours post‐challenge in the endolymphatic sac and cochlea and rapidly increased in both sites. Lyt‐1 cells gradually increased in the endolymphatic sac after challenge, peaking at 2 and 3 weeks post‐challenge. In the cochlea, Lyt‐1 cells were detected at 1 day post‐challenge and then increased. Lyt‐2 cells were detectable in the endolymphatic sac and the cochlea by 3 weeks post‐challenge. The predominant immunoglobulin‐bearing cell in the endolymphatic sac was IgG, followed by IgM, with IgA seen late in the response. We conclude that the inner ear has the capacity to mount an immune response through the accumulation of the needed immunocompetent cells for antigen processing, antibody production, and modulation of the response through T‐helper and suppressor cell activity.
Minor salivary gland tumors of the lip and buccal mucosa
Authors: Weber Randal S. , Guillamondegui Oscar M. , Byers Robert M. , Palmer J. Mark , El‐Naggar Adel , Mcneese Marsha D. 
Published: October 2006

AbstractBetween 1944 and 1985, 50 patients with minor salivary gland tumors of the lip and buccal mucosa were treated at M. D. Anderson Cancer Center: 19 with lip and 31 with buccal mucosa tumors. The male‐to‐female ratios were 2.8:1 for lip and 1:2.9 for the buccal mucosa tumors. Patient age at presentation ranged from 18 to 98 years with a median of 55 years. Treatment consisted of surgery alone for 28 patients, radiotherapy in 9 patients, and combined therapy for 13. Adenoid cystic carcinoma was the predominant histologic type, accounting for 21 (42%) tumors. Risk for recurrence was influenced by histology, the presence of perineural invasion, and the location of the primary tumor. Six patients developed recurrent disease; all six had adenoid cystic carcinoma. The therapeutic approach and the rationale for combined treatment of these neoplasms are discussed.
Normal auditory brainstem response in patients with acoustic neuroma
Authors: Telian Steven A. , Niparko John K. , Kemink John L. , Graham Malcolm D. , Kileny Paul R. 
Published: October 2006

AbstractAuditory brainstem response testing has been a major breakthrough in audiologic screening for acoustic neuroma because of its high degree of sensitivity. Although it is not uncommon for other cerebellopontine angle masses to present with normal ABR findings, reports of eighth nerve tumors with false‐negative auditory brainstem response tests are quite rare. A series of 120 acoustic neuromas resected at the University of Michigan was reviewed and revealed two such patients. These two patients presented with asymmetric sensorineural hearing loss and unilateral tinnitus and were found to have completely normal auditory brainstem response. The diagnosis of acoustic neuroma would have been delayed if a comprehensive evaluation had not been pursued.
Hemorrhagic tonsillitis
Authors: Levy Simon , Brodsky Linda , Stanievich John 
Published: October 2006

AbstractEleven patients with acute and/or chronic tonsillitis, who presented with a spontaneous tonsillar hemorrhage are reported and discussed. Two patterns of hemorrhage were noted: 1. diffuse, parenchymal bleeding and 2. localized bleeding from dilated surface vessels.Pharyngeal culture for group A bela‐hemolytic Streptococcus was positive in six patients (55%). Monospot, heterophile antibodies, complete blood cell count, prothombin time, partial thromboplastin time, and viral studies did not consistently demonstrate any abnormality. Two patients, however, did have an elevation in liver enzymes. In five patients, the bleeding stopped spontaneously; in five patients the bleeding was controlled with local chemical cautery. In two patients, Avitene® was used for hemostasis. One other patient's bleeding was controlled by electrocautery while the patient was under anesthesia for endoscopic evaluation of hemoptysis. Two patients required blood transfusions; one of these patients had a history of factor IX deficiency.Four case histories are discussed in detail to illustrate the varied clinical presentation and some pitfalls in diagnosing and managing this rarely reported complication of tonsillitis. Possible mechanisms for the pathophysiology include increased tonsillar blood flow, necrosis of tonsillar surface cells, and trauma to dilated surface vessels. No common bacterial or viral etiology could be determined in this rare, but potentially serious, complication of tonsillitis.
Histopathology of bell's palsy
Authors: Liston Stephen L. , Kleid M. Stephen 
Published: October 2006

AbstractThe histopathology of the facial nerve 1 week after the onset of Bell's palsy is reported. The entire nerve was infiltrated by inflammatory cells. Myelin breakdown, axonal changes, and edema were present, suggesting viral neuritis. The role of decompression in this disease process is discussed.
Facial nerve function following irradiated cable grafts
Authors: McGuirt W. Frederick , Welling D. Bradley , Mccabe Brian F. 
Published: October 2006

AbstractFacial nerve cable grafting preceding postoperative radiation therapy in patients undergoing facial nerve resection for malignant disease remains controversial. Twelve cases of postoperatively irradiated facial nerve cable grafts are reviewed in detail. Of nine patients with long‐term evaluations, all have shown some return of facial nerve function, with seven having moderate to excellent return of function, as documented on videotapes and shown in still photographs.We conclude that cable grafting is the treatment of choice, even though postoperative radiation therapy is planned. Cable grafting should almost always result in facial function that is clearly superior to the function provided by static or dynamic slings.
Changes in Pharyngeal Properties After Uvulopalatopharyngoplasty
Authors: Wright Stanley , Zamel Noe , Haight James , Hoffstein Victor 
Published: October 2006

AbstractUvulopalatopharyngoplasty is a commonly used modality for surgical treatment of snoring and obstructive sleep apnea. Although this procedure is thought to alter pharyngeal properties, its effect on pharyngeal mechanics has not been studied. The acoustic reflection technique was used to measure pharyngeal area at functional residual capacity and residual volume before and after uvulopalatopharyngoplasty in eight patients referred because of loud snoring. We also calculated the lung volume dependence of pharyngeal area, defined as the percent change in pharyngeal area between functional residual capacity and residual volume, normalized to the area at functional residual capacity. This parameter, which may be related to pharyngeal collapsibility, was obtained before and after uvulopalatopharyngoplasty. Preoperative sleep studies showed that one patient had obstructive sleep apnea (apnea index > 10). Uvulopalatopharyngoplasty resulted in a significant increase (p<0.01) in pharyngeal area (from 3.14 ± 0.71 cm1 to 4.25 ± 1.07 cm2) and residual volume (from 2.49±0.53 cm2 to 3.91±0.83 cm2). Following uvulopalatopharyngoplasty, the pharynx became stiffer, as manifested by a reduction in lung volume dependence of pharyngeal area from 19±12% to 8±13% (p<0.05). Six patients, including the patient with obstructive sleep apnea, reported improvement in snoring. Two patients reported worsening in snoring. One of the two was found to have reduction in pharyngeal area and lung volume dependence of pharyngeal area, and an increase in apnea index from 3 to 33. In selected snorers, uvulopalatopharyngoplasty results in improvement in snoring with a concomitant increase in pharyngeal area and a tendency toward lower pharyngeal collapsibility.
Oncogenic Osteomalacia: Exact Tumor Localization by Co-Registration of Positron Emission and Computed Tomography
Authors: Hesse Eric , Moessinger Eckart , Rosenthal Herbert , Laenger Florian , Brabant Georg , Petrich Thorsten , Gratz Klaus F , Bastian Leonard 
Published: October 2006

Abstract
In oncogenic osteomalacia, the causative tumor is almost always difficult to find. A novel diagnostic approach is presented that facilitates a precise and rapid localization of the associated lesion by PET-CT co-registration using the radiotracer 68Ga-DOTANOC.
In oncogenic osteomalacia, the causative tumor is almost always difficult to find. A novel diagnostic approach is presented that facilitates a precise and rapid localization of the associated lesion by PET-CT co-registration using the radiotracer 68Ga-DOTANOC.
Introduction: Oncogenic osteomalacia (OOM) is an uncommon disorder characterized by hyperphosphaturia, hypophosphatemia, decreased vitamin D3 serum levels, and osteomalacia. The paraneoplastic syndrome is exclusively driven by a small somatostatin receptor (sst)-positive tumor that produces phosphatonins, proteins that cause renal phosphate loss. OOM can be cured completely on tumor removal. However, the exact tumor localization is the most challenging step, because the lesion is notoriously difficult to detect by common imaging techniques.
Materials and Methods: A 60-year-old woman complained of severe pain in her back and chest wall, muscle weakness, and reduced physical activity for &gt;1 year. She suffered a metatarsal fracture and presented with hyperphosphaturia and hypophosphatemia. OOM was suspected, and a meticulous search for the tumor was initiated by conventional imaging techniques, sst-mediated imaging using 111In-octreotide scintigraphy, and 68Ga-DOTANOC-based positron emission tomography (PET)-CT co-registration. 68Ga-DOTANOC is a novel radiopharmaceutical compound in which the somatostatin analog octreotide is modified at position 3, chelated with DOTA, and complexed with 68Gallium. 68Ga-DOTANOC has an improved affinity to sst2 and sst5 relative to other radiopeptides.
Results: Whereas common imaging techniques such as CT failed to localize the tumor, 111In-octreotide scintigraphy was able to detect the lesion, but only PET-CT using 68Ga-DOTANOC revealed the exact tumor localization in the right femoral head. On tumor resection, the well being of the patient improved significantly, and biochemical parameters returned to normal.
Conclusions: 68Ga-DOTANOC-based PET-CT is a novel and powerful approach to detect sst-positive tumors in a timely manner and to provide highly resolved images facilitating the development of a therapeutic strategy.