bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tympanostomy tubes and otic drops
Authors: Meyerhoff William L. , Morizono Tetsuo , Wright Charles G. , Shaddock Lynn Carlisle , Shea Donald A. , Sikora Michael A. 
Published: October 2006

AbstractOtic drops have been proposed as a form of prophylaxis against the otitis media which follows middle ear contamination by water in patients with tympanostomy tubes. The potential adverse effects of this form of therapy were studied in chinchillas with tympanostomy tubes; 31 chinchillas underwent bilateral tympanostomy tube insertion. Seven animals had a mixture of green dye and Cortisporinotic suspension placed in both external auditory canals 24 hours following the placement of tympanostomy tubes and were sacrificed 30 minutes later for gross examination; 3 of these animals had previous eustachian tube obstruction with Silastic sponge. Twenty‐one animals had Cortisporinotic suspension placed in the right external auditory canal on postoperative days 3, 4, 5, 6 and 7. No otic drops were placed in the left ear. Ten of these 20 animals had VIIIth nerve action potentials measured on postoperative day 17 and the other 11 animals had VIIIth nerve action potentials measured on postoperative day 42 followed by immediate sacrifice for histological examination and scanning electronmicroscopy. The remaining 3 animals had VIIIth nerve action potentials measured 21 days following tympanostomy tube insertion and served as electrophysiological controls.The 8 ears receiving Cortisporinotic drops mixed with green dye from animals with normal eustachian tubes showed staining of the round window membrane at sacrifice, while the 6 ears receiving Cortisporinotic suspension and green dye from animals with eustachian tube obstruction demonstrated no dye in the middle ear. All animals receiving Cortisporinotic drops in the right ear showed an intra‐aural difference in action potentials with the right ear being attenuated by an average of 10.3 dB at 2,000 Hz, 12 dB at 4,000 Hz, 21 dB and 8,000 Hz, and 26 dB at 12,000 Hz. Morphological study revealed hair cell loss in the hook portion of the cochlea in those animals receiving Cortisporinotic drops. It was concluded from this study that, in patients with patent tympanostomy tubes in place, potentially ototoxic topical agents should be used with caution.
Primary tumors of the facial nerve: Diagnosis and management.
Authors: Pillsbury Harold C. , Price Harvey Craig , Gardiner Linda J. 
Published: October 2006

AbstractBenign primary tumors of the facial nerve are frequently misdiagnosed because of variable and subtle clinical manifestations. Three such cases of facial nerve neuroma seen in the past 3 years will be presented. Difficulties in patient assessment including the lack of specificity for topographic testing, as well as the capricious behavior of the facial nerve in these patients will be discussed. The efficacy of diagnostic techniques presently available and in use including computerized tomography and electrodiagnostic studies will be discussed. Diagnosis of these tumors might generally be thought to be straightforward and easier with the advent of new diagnostic techniques, but this has, in fact, not been the case. Techniques for removal and repair will be presented. The combined approach utilizing the mastoid and middle fossa will be presented.
Facial nerve grading systems.
Authors: House John W. 
Published: October 2006

AbstractA comprehensive, accurate, and valid system for reporting results of facial nerve surgery and disease is needed. This study describes and statistically analyzes eight currently available systems for reliability, validity, and ease of use. They are divided into three grading categories: gross scales, regional systems, and specific scales. Botman and Jongkees, May, and Peitersen have proposed five‐point gross scales. Janssen, Smith, Adour and Swanson, and Yanagihara have devised regional systems. Stennert has proposed a specific criteria scale.Fifteen otologists experienced with facial nerve problems used modifications of the existing scales to evaluate videotapes of 12 patients representing the complete range of facial function. The observers' responses were translated back to the original scales. Observers also ranked patients from least to most severe, to obtain an accurate assessment of facial function for patients in the study. A follow‐up questionnaire examined observers' system preferences.Validity is measured by correlating responses to different scales and by comparing responses to each scale with observers' rankings. All scales have good validity except the scales of Stennert and Yanagihara.Consistency of responses is determined by reliability coefficients. Coefficients for all scales are high except for the gross scale, which is moderately reliable, and the Stennert scale, which is unreliable.Results indicate that all scales succeed in evaluating patients with normal function or total paralysis. The regional scales have the highest reliabilities but they also have wide response ranges. Most also assume a level of precision that is unsubstantiated. Gross scales have smaller ranges, which result in greater agreement of responses but lower reliability. Comparisons to more complex scales show that the simpler gross scales convey similar information about patients.The study concludes that a gross scale is the best type of system and proposes a new scale for international acceptance. This system has six categories, includes secondary defects, is designed to clearly differentiate between moderate degrees of dysfunction, and should facilitate interpretation and communication of facial nerve results.
Solving ossicular problems in stapedectomy
Authors: Lippy William H. , Schuring Arnold G. 
Published: October 2006

AbstractThree unusual ossicular problems encountered in stapedectomy are: floating stapes footplate, partial absence of the incus long process, and otosclerosis combined with a fixed malleus. The surgical techniques advocated in solving these problems are: placing a Robinson prosthesis on the floating footplate, utilizing the Lippy modification of the Robinson prosthesis for the problem incus, and performing only a stapedectomy for malleus fixation and otosclerosis. The hearing results in 242 cases were quite satisfactory and no patient had a further sensorineural loss.
The quix test
Authors: Hart Cecil W. 
Published: October 2006

AbstractProfessor Doctor F. H. Quix, of Utrecht, was a keen student of macular function, who published extensively at the beginning of this century. He described many useful tests for otolithic function, and one in particular has continued to be fairly widely used.The so‐called “Quix Test” is performed with the patient standing, feet slightly apart, arms outstretched, index fingers extended, and the examiner assumes a similar mirror‐image posture, such that the fingertips almost touch. The patient is then requested to close his eyes, and the index fingers are observed for drift. The lateralizing value of this sign of vestibular disease is discussed.
Congenital hypoplasia of the depressor anguli oris muscle in the differential diagnosis of facial paralysis
Authors: Millen Steven J. , Baruah J. K. 
Published: October 2006

AbstractFacial paralysis presents an interesting diagnostic challenge. Etiologies ranging from facial nerve neuromas and CPA tumors to inflammatory disease and traumatic injuries need be considered and evaluated. However, an asymmetric facial appearance may result from abnormalities of facial musculature as well as facial innervation. Two cases of congenital hypoplasia of the depressor anguli oris muscle, a child and an adult, are reviewed to examine its presentation and diagnostic differentiation from other forms of facial paralysis. Photographs presenting the facial deformity and electrodiagnostic studies will be reviewed.
Expansion hyoidplasty: A potential surgical procedure designed for selected patients with obstructive sleep apnea syndrome. Experimental canine results
Authors: Patton Timothy J. , Thawley Stanley E. , Waters Robert C. , Vandermeer Peter J. , Ogura Joseph H. 
Published: October 2006

AbstractSome patients with “idiopathic” obstructive sleep apnea syndrome have an inspiratory, circumferential, passive collapse of the hypopharyngeal lumen as the mechanism of airway obstruction. Permanent tracheotomy has offered documented dramatic resolution of the airway obstruction with reversal of the associated cardiopulmonary sequelae. Tracheotomy is not, however, without psychological and physical complications detracting from its use. In hope of developing a surgical alternative, the expansion hyoidplasty was conceived. The hyoid bone is transected just medial to each lesser cornu. The trisected hyoid bone is then held in an expanded position by a permanent stainless steel brace. The greater cornua with attached middle constrictor and hyoglossus are moved laterally, while the body of the hyoid with attached geniohyoid and genioglossus shift the base of tongue anteriorly. The procedure is potentially reversible. Twenty dogs were studied pre and posthyoid expansion. Superior hypopharyngeal pressure‐volume and closing pressures were obtained on 10 dogs. The pressure‐volume studies demonstrate a consistent expansion of the superior hypopharynx. The average drop in pressure varied from 2.9 to 12.4 cm H2O in different animals. All posthyoid expansion dogs showed an average increase in closing pressure ranging from −4.4 to −28.3 cm H2O. Deglutition and laryngeal competence were not grossly effected. These results support the continued experimentation towards implementation of the expansion hyoidplasty in humans.
Significance of apparent intratympanic meningiomas
Authors: Rietz Daniel R. , Ford Charles N. , Kurtycz Daniel F. , Brandenburg James H. , Hafez Gholam R. 
Published: October 2006

AbstractMeningioma is the most common tumor of the central nervous system, but it has only been reported in 79 patients to involve the temporal bone. The 4 cases presented here show striking clinical similarity to a subgroup of 20 meningiomas reported to be entirely intratympanic; however, in each instance the extent, origin, and potential of the disease was not initially evident.Precise histopathologic diagnosis may be aided by electron microscopy. Current concepts of embryology lend credence to the possible role of arachnoid endothelial cells in the pathogenesis of intratympanic meningioma.An advanced intracranial meningioma may be overshadowed by the hearing loss, tinnitus, and otalgia calling attention to an intratympanic component. The clinician should remain suspicious of intracranial disease even after excision of an apparently well circumscribed intratemporal lesion. Progessive sensorineural hearing loss and persistent otalgia portend recurrent or intracranial disease. Follow‐up for at least 10 years with judicious use of CT scans is suggested.
Endolymphatic mastoid shunt for treatment of meniere's disease: A five year study
Authors: Goldenberg Robert A. , Justus Molly A. 
Published: October 2006

AbstractThe endolymphatic mastoid shunt seems to be an effective treatment for those patients whose Meniere's disease is refractory to medical and/or supportive treatment. This series is composed of 48 patients who were followed for up to 5 years postoperatively, with 1 year being the minimum follow‐up period; 81% of these patients obtained a satisfactdory relief of their vertigo. The morbidity of the procedure is low with no severe or total hearing loss reported in this series. Surgery should not be recommended until the symptoms have caused severe incapacitation; however, this delay must be tempered by the desire to operate while the hearing is still fluctuating. One of the most important factors in the surgical success may be the exact identification and exposure of the sac at the time of surgery, regardless of the specific shunt technique used. Shorter duration of symptoms and lack of fluctuant hearing loss may be preoperative factors which predict a less satisfactory surgical result. While the endolymphatic shunt procedure is effective in the majority of cases, the patient should be prepared for a secondary procedure if necessary.
Tracheoesophageal speech: Vocal rehabilitation after total laryngectomy
Authors: Singer Mark I. 
Published: October 2006

AbstractTreatment of laryngeal cancer has evolved over nearly 100 years and includes many methods to conserve the function of speech. It was understood from the inception of total laryngectomy that diversion of exhaled pulmonary air into the pharynx or esophagus would produce satisfactory speech. The effect on safe deglutition of the phonatory fistulae limited the wide applicability of these techniques.The introduction of a silicone bivalve device for use in a tracheoesophageal tunnel permits large numbers of laryngectomees to use tracheoesophageal speech. Acoustic, intelligibility, and aerodynamic studies arc described for four laryngectomees and reveal that this method more nearly approximates normal laryngeal speech than conventional esophageal speech. The criteria for contemporary treatment of laryngeal carcinoma are not altered by this rehabilitative method, and expected survival rates are not likely to be affected. The findings and analysis of this method of alaryngeal speech rehabilitation may have important implications for future therapy of laryngeal carcinoma.
Selective application of ct in the management of laryngeal trauma
Authors: Schaefer Steven D. , Brown Orval E. 
Published: October 2006

AbstractThe clinical course of five patients with varying degrees of laryngeal trauma are presented to illustrate the predictive value of computed tomography (CT) in the management of laryngeal trauma. Computed tomography visualizes well the laryngeal skeleton, soft tissues and airway in the injured larynx. Cost effectiveness of CT scanning is an important consideration, and the authors have chosen their case examples to restrict this examination to selected patients.
Histologic findings in a larynx reconstructed by a nasoseptal autograft after partial laryngectomy
Authors: Laurian N. , Zohar Y. , Turani H. 
Published: October 2006

AbstractIn the course of a 5‐year follow‐up of 16 patients who underwent plastic reconstruction of the larynx by a nasoseptal graft after extended frontal and frontolateral laryngectomies, one of them developed local recurrence of squamous cell carcinoma and was totally laryngectomized.Histological studies were made of the grafted cartilage and its mucosal lining. The microscopic findings are reported.
Endoscopic laser repair of posterior glottic, subglottic and tracheal stenosis by division or micro‐trapdoor flap
Authors: Dedo Herbert H. , Sooy C. Daniel 
Published: October 2006

AbstractLaryngeal and tracheal stenosis have been refractory to a wide variety of treatments including dilation, stents, or have required major open operation, e.g., laryngofissure with and without skin or mucosal grafts and segmental resection with larynx release. Adequate airway even when achieved was frequently at the expense of voice quality and significant morbidity or mortality.A new highly successful endoscopic technique is described for the treatment of posterior glottic stenosis (apparent bilateral vocal cord paralysis), subglottic stenosis, and tracheal stenosis up to 1 cm thick. The procedure involves the endoscopic use of the CO2 laser, and a micro‐trapdoor mucosal flap. Ninety percent of the patients in the group studied obtained an adequate airway with good voice quality and no tracheotomy was required in those patients not already having one. In 19 patients there was no mortality and essentially no morbidity.
Retropharyngeal abscess – a ten‐year experience
Authors: Barratt George E. , Koopmann Charles F. , Coulthard Stanley W. 
Published: October 2006

AbstractThe authors present an extensive review of current literature as well as their ten‐year experience in management of patients with retropharyngeal abscesses. Emphasis is placed upon age, sex, type and duration of symptoms, bacteriology, methods of diagnosis, therapy, and complications. The author's series reveals that retropharyngeal abscesses are found in adults, there is a wide spectrum of bacteriological organisms represented, and with appropriate antibiotic and surgical management the majority of patients survive without major residual sequelae.
Role of the mastoid in tympanic membrane reconstruction
Authors: Jackler Robert K. , Schindler Robert A. 
Published: October 2006

AbstractOtologists have long debated the importance of the mastoid in determining the success or failure of tympanic membrane reconstruction. The pneumatic spaces within the mastoid represent an “air reservoir” which can be drawn upon during periods of eustachian tube dysfunction and buffer the middle ear against the development of detrimental negative pressures. Mastoid inflammatory disease, if untreated, may result in recurrent suppuration and graft failure. Small mastoid volume, aside from its well known association with chronic infectious middle ear disease, has been shown to effect adversely graft survival following myringoplasty. In 48 patients undergoing myringoplasty with simple mastoidectomy, neither small mastoid size nor inflammatory mastoid disease significantly decreased the rate of graft healing. This suggests that simple mastoidectomy is an effective means of repneumatizing the mastoid and eradicating mastoid sources of infection. The successful surgical creation of a pneumatized mastoid cavity in communication with the middle ear was confirmed by postoperative computerized tomographic (CT) scans. In failed cases, CT scanning predictably identified residual mastoid disease. Simple mastoidectomy is considered to be a safe and useful adjunct to myringoplasty in selected cases of chronic otitis media with perforation.
Autoimmunity and inner ear disorders: An immune‐complex mediated sensorineural hearing loss
Authors: Veldman Jan E. , Roord John J. , O'connor Alec F. , Shea John J. 
Published: October 2006

AbstractAn immune‐complex mediated form of autoimmune disease is described with the inner ear as one of its target organs. Around 40 dB bilateral sensorineural hearing loss improved on short‐term corticosteroid therapy to normal levels. This case report is presented against the background of a general survey on autoimmunity and inner ear diseases. Cellular and humoral immune reactions may be etiologic moments in an audiovestibular dysfunction of autoimmune character.
Otosclerosis And Otospongiosis: Clinical and histological comparisons
Authors: Parahy Christian , Linthicum Fred H. 
Published: October 2006

AbstractThe simultaneous ocurrence of otosclerosis and otospongiosis in the same lesion is well documented. The logical sequence of events would seem to be softening and destruction of the bone by the otospongiotic lesion, which is subsequently converted to otosclerosis. Examination of 46 temporal bones had led us to further classify the lession as: 1. an active lession, both otospongiotic and otosclerotic, 2. an inactive lesion, also both otosclerotic and otospongiotic, or 3. a fibrous lession.Hyalinization of the spiral ligament only occure adjacent to active otospongiotic or very large otosclerotic lesions. If the lesion adjacnet to the spiral ligament is inactive, there is no hyalinization. It seems illogical that a hyalinized spiral ligament will return to normal when the lesion changes from active otospongiosis to inactive otosclerosis.Otospongiotic and otosclerotic lesions are found side by side at the periphery of lesions, and both are adjacent to normal bone. These findings have implications concerning the mode of action of sodium fluoride and other medications that are under evaluation for the control of the sensorineural hearing loss due to otosclerosis.
Injectable collagen in laryngeal rehabilitation
Authors: Ford Charles N. , Martin Douglas W. , Warner Thomas F. 
Published: October 2006

AbstractGlottic insufficiency has been successfully managed by Teflonr̀ augmentation of paretic vocal cords over the past two decades. Collagen fulfills the criteria for a suitable bioimplant and is an attractive alternative as it is a normal constituent of the extracellular protein matrix. This study explores the use of modified bovine collagen injected into the canine larynx. Clinical situations are simulated by creating lesions and injecting collagen at different sites. The technique permits precise placement and quantification. Histologic study of the collagen implant fails to show evidence of significant foreign body reaction. The injected collagen appears similar to viable connective tissue and is colonized by host fibroblasts and nourishing capillaries.
Total en bloc resection of the temporal bone and carotid artery for malignant tumors of the ear and temporal bone
Authors: Graham Malcolm D. , Sataloff Robert T. , Kemink John L. , Wolf Gregory T. , Mcgillicuddy John E. 
Published: October 2006

AbstractA technique for single stage totalen blocresection of the temporal bone and infratemporal carotid artery with immediate reconstruction has been described. This formidable procedure requires the collaborative efforts of neurotologic skull base surgeons, neurosurgeons, and head and neck surgeons.Two patients have undergone this procedure; one with squamous cell carcinoma and one with extensive basal cell carcinoma. The quality of life following this procedure is adequate and the cosmetic deformity can be minimized. Longer follow‐up is necessary to determine the value and overall impact of this approach to cancer of the temporal bone on disease free interval and patient survival. Further experience with the technical aspects of this procedure should reduce the operating time, blood loss, and resultant morbidity.
One day VS. two days of prophylactic antibiotics in patients undergoing major head and neck surgery
Authors: Fee Willard E. , Glenn Michael , Handen Cynthia , Hopp Martin L. 
Published: October 2006

AbstractThirty patients undergoing major head and neck sugery were prospectively randomized to receive moxalactam (30 mg/kg) before surgery and for either 3 or 6 doses total postoperatively. Wound infection criteria were carefully specified and serum drug levels were monitored. Overall infection rate was 3%; the single infection occurred in a patient randomized to the 3 dose protocol. There was no statistically significant difference in infection rates between the two groups. Drug serum levels between the groups did not differ and none of the patients developed significant drug side effects.We conclude that short course prophylaxis is equally effective as more prolonged therapy. Our wound infection rate compares favorably with previous studies and supports the use of moxalactam as a prophylactive antibiotic in major head and neck surgery.
Cervical epidural anesthesia for head and neck surgery
Authors: Wittch Donald J. , Berny James J. , Davis R. Kim 
Published: October 2006

AbstractPatients with head and neck cancer frequently suffer from chronic obstructive pulmonary disease and arteriosclerotic cardiovascular disease, making them poor risks for anesthesia. Arrhythmogenic inhalation anesthetics along with assisted ventilation used in general anesthesia further complicate the intraoperative, as well as the postoperative, course.Cervical epidural anesthesia has been employed in a number of cases of breast and upper thoracic surgery at Walter Reed Army Medical Center with remarkable success. It has also been used in chronic pain control. We described the use of cervical epidural anesthesia for a neck dissection. The technique of placing 0.5% Marcaine® at the level of C7‐T1 is described.Indications, limitations, complications, and the potential uses of cervical epidural anesthesia in head and neck cancer patients are discussed.