bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of aerobic and anaerobic microorganisms in chronic suppurative otitis media
Authors: Papastavros Theodore , Giamarellou Helen , Varlejides Stratos 
Published: October 2006

AbstractThis study reports results of cultures of drainage from 119 cases with chronic otitis media. Mixed infections were found to occur 30 times more frequently among cholestcatomatous cases compared to noncholesteatomatous. A significant association was found between prior use of gentamicin ear drops and bacterial resistance to the drug.The role of aerobes and anaerobes in mixed infections of cholesteatomatous ears is discussed. The relevant literature is critically reviewed and the mechanisms of synergistic anaerobic infections of the ear are summarized. The need for animal studies of bacterial pathogenicity and parallel human studies of response to rational medicinal treatment is stressed.
Postoperative evaluation of sleep apnea after uvulopalatopharyngoplasty
Authors: Wetmore Stephen J. , Scrima Lawrence , Snyderman Nancy L. , Charles Hiller F. 
Published: October 2006

AbstractUvulopalatopharyngoplasty (UPPP) is an operation that is frequently performed for the treatment of obstructive sleep apnea (OSA). While UPPP usually eliminates or decreases snoring and often reduces excessive daytime sleepiness, the decrease in the number of episodes of apnea and hypopnea, and the improvement in oxygen saturation (SaO2) have been less predictable. We compared preoperative and postoperative polysomnography (PSG) in 27 patients with OSA and found that no single PSG parameter could accurately reflect the changes in respiration seen after UPPP. We suggest that a combination of indices including the apnea index, the apnea and hypopnea index, the frequency and severity of decreases in SaO2, and the lowest SaO2 be used to assess the effect of UPPP. Using this combination we determined that 30% of our patients were markedly improved, 33% were somewhat improved, and 37% were unimproved. To rely soley on the patient's subjective improvement often results in overestimating the therapeutic results of surgery, whereas to rely only on one PSG parameter may underestimate or overestimate the degree of improvement.
Esophageal perforations: the role of computerized tomography in diagnosis and management decisions
Authors: Endicott James N. , Molony Timothy B. , Campbell Gregory , Bartels Loren J. 
Published: October 2006

AbstractExternal drainage is indicated when a neck abscess results from esophageal or hypopharyngeal perforation.Diagnosis, extent of disease, and timing of abscess drainage have traditionally challenged the surgeon in management of the perforated esophagus or hypopharynx. Diagnosis and management decisions are enhanced by use of computerized tomography (CT) as an adjunctive study.Five specific case presentations feature diagnosis and management.
Bacterial infections of the orbital and periorbital soft‐tissues in children
Authors: Spires James R. , Smith Richard J. H. 
Published: October 2006

AbstractPeriorbital soft‐tissue bacterial infections are relatively common during childhood and with appropriate antimicrobial therapy usually resolve quickly. Orbital soft‐tissue infections, in contrast, are rare and frequently cause serious morbidity. Two hundred forty‐one children with periobital or orbital soft‐tissue infections have been hospitalized since 1962 and constitute the data base for this study. Two hundred twenty‐six children, half under 1 year of age, had periorbital soft‐tissue infections. Response to antimicrobials was prompt and only two children (1%) developed complications. True orbital infections occurred in the remaining 15 children, three of whom were under 6 years of age. Eleven children had orbital cellulitis, 3 had subperiosteal abscesses, and 1 had cavernous sinus thrombosis. Antecedent sinusitis was present in 12 cases and, in seven, effective treatment required surgical drainage in addition to intensive antimicrobial therapy. Three children (20%) developed significant complications.
Comparative study of otologic surgery in outpatient and hospital settings
Authors: Dickins John R. E. 
Published: October 2006

AbstractThe results of nine years' experience with 1,750 otologic surgical procedures are reviewed; 1,110 of these procedures were performed in an outpatient surgical setting and 640 procedures were performed in a general hospital. The results and complications are compared between these two settings. This study includes tympanoplasty, stapedectomy, mastoidectomy, labyrinthectomy, and other otologic procedures. The study is not concerned with minor procedures such as myringotomy. A detailed analysis of results for each type of procedure compares hearing results, graft take rates, and the occurrence of complications in both outpatient and inpatient settings. No significant differences are seen between the results or complications of outpatient and inpatient procedures, thus supporting the use of outpatient surgical settings for most standard otologic procedures.
Cartilage grafting in facial reconstruction with special consideration of irradiated grafts
Authors: Donald Paul J. 
Published: October 2006

AbstractThe search for the perfect facial implant for reconstruction of the face continues. Cartilage, once thought to be an undesirable graft material because of its propensity for absorption, has regained popularity in the past decade. Various preparation techniques have been employed to ensure graft sterility and diminished absorption. An improved understanding of cartilage structure and physiology has shed considerable light on the host‐graft relationship.Gamma irradiation is a time‐honored method of preservation. An experiment was undertaken to investigate the physiology of irradiated cartilage grafts following prolonged implantation on the facial skeleton of sheep and dog. Merthiolate® preserved grafts were used as controls.Direct observation, histochemical techniques, autoradiography, and transmission electron micrography were used to determine chondrocyte viability and matrix composition.It was surprising to note that following implantation of 16 to 72 months, complete resorption was seen in 87.7% of the irradiated grafts and in 43.8% of the Merthiolate®stored controls. Many of the grafts acquired chondrocytes from the host and produced new proteoglycan matrix as well as undergoing some degree of ossification. A comparison to the clinical situation in humans is made.
Extended experimental and preliminary surgical findings with autologous fibrin tissue adhesive made from patient's own blood
Authors: Siedentop Karl H. , Harris David M. , Ham Kevin , Sanchez Ben 
Published: October 2006

AbstractA surgical tissue adhesive can be made from the patient's own blood. We have been refining the procedures for manufacturing autologous fibrin tissue adhesive to facilitate its use in the operating room and to increase its bonding strength. Fibrin tissue adhesive efficacy depends on fibrinogen concentration. We found that fibrinogen precipitation using the ammonium sulfate method produced the highest concentration. Bonding power was compared with that of the commercial glue 10 minutes and 30 minutes after glueing two pieces of 1 x 1 cm2 human dura together. Bonding strength of the autologous product was close to that of the commercial product. Comparisons of fibrinolysis inhibition time of autologous fibrin tissue adhesive and commercial glue in experiments on rats over a period of one hour to six days after subcutaneous injection are described.Preliminary surgical experiences using autologous glue in middle ear surgery are presented.
Indications for tracheoesophageal puncture speech rehabilitation
Authors: Mcconnel Fred M. S. , Duck Sigsbee W. 
Published: October 2006

AbstractMany methods of speech rehabilitation after total laryngectomy have been attempted and abandoned. As experience increased with the tracheoesophageal puncture technique, we found it to be a reliable and reproducible form of speech rehabilitation when certain criteria are met. This study reviews our experience and analyzes the reasons for failure in those populations. Factors analyzed include the evidence of hypopharyngeal stenosis, patient education, XRF, and the flanged prosthesis versus the nonflanged prosthesis. The indications for this type of speech rehabilitation procedure are presented based on our findings.
Prognostic implications of perineural spread in squamous carcinomas of the head and neck
Authors: Soo Khee‐Chee , Carter Richard L. , O'Brien Christopher J. , Barr Lester , Bliss Judith M. , Shaw Henry J. 
Published: October 2006

AbstractThe occurrence and prognostic implications of perineural spread were examined in 239 patients with mucosal squamous carcinomas of the head and neck. Perineural spread was demonstrated in resections from 64 patients (27%), the majority having primary tumors at one of three sites: buccal cavity, larynx, and pharynx. Perineural spread near nodal metastases was uncommon. There was no evidence that perineural involvement was more commonly associated with large tumors or less differentiated ones. No association was established between perineural spread and coexistent lymph node deposits in the surgical resections. Perineural spread was, however, shown to be a statistically significant prognostic factor for an increased incidence of subsequent locoregional recurrence and for decreased survival.
Prospective screening for multiple tumors of the upper aerodigestive tract: A simple routine procedure
Authors: Lau W. F. , Siu K. F. , Wei W. , Lam K. H. 
Published: October 2006

AbstractDetection of a second primary at the time of initial work‐up of patients with head and neck cancers has an important bearing on management planning. In a 12‐month period, a series of 105 patients with an index head and neck primary (skin malignancies excluded) of the squamous cell type were subjected to the following screening procedure. Under topical anesthesia, with the patient in the sitting position, a small‐size flexible bronchofiberscope (Olympus B3R) was introduced through the nose. As the scope was advanced, the nasal cavity, nasopharynx, oropharynx, hypopharynx, and larynx were examined. The tracheobronchial tree was also examined if the chest x‐ray showed abnormal findings. The endoscope was then passed down to examine the esophagus, with oxygen insufflated via the biopsy channel at a rate of 1 liter per minute.The index primary sites included the tongue (20), alveolus (7), floor of mouth (2), palate (4), buccal mucosa (3), hypopharynx (17), and larynx (52). There was little patient discomfort and no complication. Nine patients (8.5%) were found to have simultaneous primary tumors including two patients with triple primaries and one with quadruple lesions. The additional tumors were in the following sites: esophagus (6), tonsil (2), floor of mouth (1), nasopharynx (1), bronchus (1), palate (1), and oropharynx (1). The treatment plans were changed in all nine patients with the discovery of multiple tumors.It is concluded that the panendoscopic screening in the manner described is simple, safe, and convenient and the information is contributory to treatment planning.
Combined rotary door flap and epiglottic laryngoplasty for reconstruction of large laryngotracheal defects in dogs
Authors: Eliachar Isaac , Levine Sam , Broniatowski Michael , Sebek Bruce , Tucker Harvey M. 
Published: October 2006

AbstractReconstruction of large laryngotracheal defects may require simultaneous application of more than one surgical technique. This paper reports the advantages gained by combining epiglottic laryngoplasty with the myocutaneous sternohyoid muscle rotary door flap. The two procedures complement each other in achieving structural and functional rehabilitation of extensive defects in the larynx and trachea. Avoidance of intraluminal stents and use of a tracheostomy procedure that does not require an indwelling cannula have yielded improved results.
Magnetic resonance imaging of the fetal temporal bone
Authors: Isaacson Glenn , Mintz Marshall C. , Sasaki Clarence T. 
Published: October 2006

AbstractMagnetic resonance imaging (MRI) is a powerful new tool for the study of human anatomy and pathology. By various MRI techniques, the structure of the middle and inner ears of aborted 20‐week fetuses is defined and compared to gross anatomic sections. MRI's potential for evaluating temporal bone development and diseases of the ear is discussed.
Plastic bronchitis
Authors: Liston Stephen L. , Porto Dennis , Siegel Leighton G. 
Published: October 2006

AbstractPlastic bronchitis is an uncommon disease of children characterized by the formation of long, branching bronchial casts. Of three children with such bronchial casts, one developed status asthmaticus and coughed out a complete cast of the tracheobronchial tree. One other child also had a course of desensitization for allergies. Two children presented with what was originally thought to be pneumonitis, but when chest x‐rays were taken, one child was suspected of having an inhaled foreign body, and the other had complete opacification of one lung. When these two children were examined bronchoscopically the tracheobronchial tree was found to be filled with white, cheesy material. This material was extremely hard to remove bronchoscopically as the material was too soft to grab with forceps but too thick to suction. The material extended all the way down into the tertiary bronchi, and in one child multiple bronchoscopies were necessary to remove this material, and even so he developed bronchiectasis. The pathologic examination of these casts showed layers of inspissated mucus and inflammatory cells.
Urogenital tract carcinoma metastatic to the head and neck
Authors: Hessan Howard , Strauss Melvin , Sharkey Francis E. 
Published: October 2006

AbstractA 9‐year review of our experience with head and neck metastases from 845 urogenital tract tumors of the kidney, prostate, bladder, testicle, spermatic cord, penis, urethra, and ureter was performed. Thirty‐one (3.7%) of these tumors developed metastases to the cervical and supraclavicular lymph nodes, scalp, thyroid gland, thyroid cartilage, parotid gland, retroorbit, mandible, nasal cavity, and paranasal sinuses. Unusual cases and a review of the literature are presented. The frequency of such metastases to the head and neck from various primaries, diagnostic application of current immunohistochemical methodology, and therapeutic alternatives are emphasized.
Correlation of fine needle aspiration biopsy and ct scanning of parotid masses
Authors: Berg Howard M. , Jacobs Joseph B. , Kaufman David , Reede Deborah L. 
Published: October 2006

AbstractPreoperative evaluation of parotid tumors still poses difficult problems for the head and neck surgeon. The complex anatomy of the parotid space leads to difficulty in localizing these tumors. In addition, physical examination will rarely determine whether a parotid lesion is benign or malignant. High resolution CT scanning with contrast and fine needle aspiration can provide enough preoperative information to enable the surgeon to counsel his patient concerning possible risks and the extent of surgery that may be indicated. We are able to determine tumor location, multiple or bilateral masses, associated adenopathy, and often specific tumor histology. Forty‐two parotid aspirates and 26 CT scans were reviewed and correlated with their postoperative pathology specimen. Parotid aspiration cytology was found to be a highly accurate and safe procedure for preoperative determination of parotid pathology. However, the CT scan was specific only in defining the anatomic localization and extent of a parotid mass.
Comparison of the microbiology of recurrent tonsillitis between children and adults
Authors: Brook Itzhak , Foote Perry A. 
Published: October 2006

AbstractThe microbial flora of recurrently inflamed tonsils removed from 25 children with recurrent episodes of tonsillar pharyngitis were compared to flora of tonsils removed from 23 adults suffering from similar illness. More bacterial isolates per tonsil were recovered in adults (10.2 per tonsil) than in children (8.4 per tonsil). The difference between these groups was due to a higher recovery rate in adults of Bacteroides melaninogenicus group (1.6 isolates per adult, 0.8 per child) and Bacteroides fragilis group (0.4 per adult, 0.2 per child). Conversely, Group A beta‐hemolytic streptococci were isolated in seven (28%) children as compared to their isolation in one (4%) adult. More isolates of beta‐lactamase‐producing organisms (BLPO) per tonsil were recovered in adults. Forty‐three BLPO were detected in 21 (91%) of the 23 tonsils removed from adults (1.9 isolates per patient) as compared to 31 isolates in 16 (64%) of the 25 tonsils removed from children (1.2 isolates per patient) (P=0.04). These findings suggest that the etiology of recurrent tonsillitis in adults may differ from that in children. The differences in the tonsillar flora may be due to the effect of many more courses of antimicrobials given over the years to adults and the changes in tonsillar tissue that occur in this age group.
Methylene blue infusion for intraoperative identification of the parathyroid glands
Authors: Gavilan Javier , Gavilan Cesar , Tomas Manuel D. 
Published: October 2006

AbstractIdentifying the parathyroid glands is of fundamental importance in thyroid and parathyroid surgery. We found that intravenous infusion of methylene blue was beneficial in intraoperative identification of the parathyroid glands in patients undergoing surgery for hyperparathyroidism as well as total and bilateral subtotal thyroidectomy. The technique is safe and easy to use, and it clearly reduces the operative time. We suggest that it be used routinely in thyroid and parathyroid surgery.
Sphenoid sinus mucocele masquerading as a skull base malignancy
Authors: Shikowitz Mark J. , Goldstein Mark N. , Stegnjajic Arsen 
Published: October 2006

AbstractMucoceles of the sphenoid sinus are rare. Only occasional reports have appeared in the medical literature since they were first described by Berg in 1889. The sphenoid sinus lies deep within the skull at the crossroads of 13 sensitive structures. The presence of a sphenoid sinus mucocele may be accompanied by a wide variety of signs and symptoms depending upon which of these structures are involved. The majority of these lesions are initially misdiagnosed as malignancies leading to increased patient morbidity and possible mismanagement.We present two cases of sphenoid sinus mucoceles which presented with a variety of neurological signs and symptoms. The radiographic findings were felt to be consistent with skull base malignancies. The diagnosis was corrected only after surgical exploration of the sphenoid sinus revealed a mucocele.
Acoustic neuroma surgery: The results of hearing conservation surgery
Authors: Glasscock Michael E. , McKennan Kevin X. , Levine Samuel C. 
Published: October 2006

AbstractBetween the years of 1978 and 1986 attempts have been made to save the hearing in 47 patients with unilateral pathologically confirmed acoustic neuromas. The middle fossa approach has been used in 32 cases and the suboccipital approach in 15 cases. Our review demonstrates an advantage using the suboccipital approach to excise most of these tumors. The success rate is higher (47% vs. 31%) and complications fewer using the suboccipital route. Despite these findings the middle fossa approach may be preferable in selected tumors located laterally in the internal auditory canal.In an effort to better select patients for hearing conservation surgery, an analysis of preoperative data (demographics, audiometry, evoked auditory response testing, and tumor size) was performed. Although certain guidelines have evolved to more accurately select hearing conservation surgery candidates, we are still unable to do so reliably. Preoperative auditory brain stem response testing, however, may evolve as a useful indicator for a successful hearing operation. The findings of our preoperative data analysis, surgical results, and complications are reviewed.
Anterior extraoral approach to the atlas and axis
Authors: Nachlas Nathan E. , McAfee Paul C. , Johns Michael E. 
Published: October 2006

AbstractA transcervical extraoral approach was utilized to achieve exposure to the upper cervical spine in five patients, four of whom required bone graft placement. Excellent exposure was achieved in all patients, and the postoperative course was uncomplicated. The anterior extraoral approach is a reliable technique in treatment of pathology of the atlas and axis.
Presentation and management of postcricoid hemangiomata in infancy
Authors: Goldsmith Manning Miles , Strope Gerald L. , Postma Duncan S. 
Published: October 2006

AbstractPhillips and Ruh (1912)1 were the first to describe a congenital hemangioma of the larynx. Sweetser2 subsequently classified laryngeal hemangiomata into infantile and adult types and noted differences in incidence, location, and symptoms. According to Sweetser, the infantile form is less common, is almost always subglottic, and presents with stridor which may be intermittent. The adult form is somewhat more common, is generally supraglottic, and often presents with hoarseness or dysphagia.We present what we believe is the first reported case of a postcricoid hemangioma in an infant. A review of hemangiomata of the aerodigestive tract is presented and treatment is discussed.
Bone resorption in cholesteatoma: Epithelial‐mesenchymal cell interaction and collagenase production
Authors: Moriyama Hiroshi , Honda Yoshio , Huang Cheng Chun , Abramson Maxwell 
Published: October 2006

AbstractClinical evidence has shown that chronic otitis media with cholestentoma causes greater bone resorption than otitis media without cholesteatoma. What is the role of the epithelium and its products on the morbidity of cholesteatoma? We have studied the mechanism of collagenase production in cultures of rat epidermal cells and skin fibroblast‐like cells under various conditions. The epithelial cells significantly induced mesenchymal cells to produce collagenase. We conclude that interaction between epithelial cells and fibroblast‐like cells enhances production of collagenase. This enhancement of proteolytic activity may be crucial in the series of molecular events resulting in bone resorption associated with cholesteatoma.
Vestibular ototoxicity of gentamicin assessed by the recording of a short‐latency vestibular‐evoked response in cats
Authors: Elidan Josef , Lin John , Honrubia Vicente 
Published: October 2006

AbstractThe short‐latency vestibular‐evoked response (VsER) and the auditory brain stem response (ABR) were recorded with scalp electrodes in four cats before, during, and after systemic administration of gentamicin. The VsER was altered and later disappeared in three cats, and in one cat it became asymmetric, typical of a unilateral vestibular lesion. In all cats the ABR was unaffected and remained normal through the end of the experiment 4 months later. Histopathological examination of the temporal bones of three cats showed severe damage to the vestibular end‐organ, particularly in the summit of the cristae, but in lesser amounts in the hair cells on the slopes of the cristae and in the maculae. In one cat, the pathological condition was greater in one ear, corresponding to the asymmetry in the VsER records.This new method of inducing and recording the VsER has been demonstrated by the present study to be an effective tool for experimentally assessing vestibular end‐organ and nerve function in animal models. Furthermore, these results indicate that the VsER is generated in the vestibular labyrinth, most probably by the cristae of the semicircular canals.