bluuebunny/crossref_metadata_2025_split huggingface dataset:
Craniofacial dysjunction: Otolaryngological point of view
Authors: Spector Gershon J. , Alonso William A. , Berkowitz Wallace P. 
Published: September 2006

AbstractSince Le Forte's experiments in the 19th Century, craniofacial dysjunction (Le Forte III fracture) has been recognized as a serious facial injury. A multidisciplinary approach to the management of these patients is often required by concurrent injuries to the eye, brain, chest, abdomen and extremities. The otolaryngologist is particularly equipped to deal with the problems of hemorrhage and upper airway distress, as well as with the functional and cosmetic repair these injuries require. This paper reports the management of craniofacial dysjunction in 26 patients during a three‐year period. Facial damage in the majority of cases was more extensive than that originally described and classified by Le Forte as Type III. Most cases resulted from automobile collisions. Males in the third decade of life predominated. Four patients died before care could be instituted. All patients had severe epistaxis, midfacial flattening and malocclusion, and six required emergency tracheostomy. Marked comminution of the nasal bones and septum was present in all. Fractures of the maxillary sinus were common and 16 of 22 survivors sustained nasofrontal injury, with pseudohypertelorism noted in all. Abrasions and lacerations to the face occurred in 12. Frontal sinus fractures were present in 15 cases and mandibular fractures in six. Other findings included seven with skull fractures, eight with fractured teeth, three with lacrimal sac and duct tears, two with severe intraocular damage, six with CSF rhinorrhea and 15 with diplopia. Repair of the facial fractures was initiated within the first 10 days following injury. All patients required intermaxillary fixation of the dental arches. No instance of delayed malocclusion resulted. When feasible, internal cranial suspension was employed, but in three severely comminuted fractures, external traction utilizing a special head cap was necessary. Frontal sinus obliteration with fat by osteoplastic technique was necessary in 10 patients. Fifteen patients had orbital floor explorations. Delayed findings included epiphora in two cases, diplopia in one, pseudohypertelorism and a flattened nose in three; jagged facial scarring in one, and CSF rhinorrhea in one. Individual follow‐up periods varied from one year to three years. It is the management of these delayed findings during the long follow‐up period that this paper particularly emphasizes.
Evaluation of surgical techniques on nasal tip projection
Authors: Bortnick Eugene 
Published: September 2006

AbstractOne of the most distressing complications of rhinoplasty is the settling of the nasal tip leading to a fullness in the supratip area, the so‐called “polly‐beak” deformity.An evaluation of the anatomical factors was carried out in the live patient and had two objectives in mind: to define the elements of nasal tip support and to evaluate some of the more popular surgical methods which are used to maintain or augment tip projection.The three elements of tip support, commonly destroyed during rhinoplasty, are the relationship between the upper and lower lateral cartilages, the fibrous union of the tip cartilages with the septum, and the lowering of the nasal skeleton secondary to hump removal.Since sacrifice of the superior margin of the alar cartilages is performed in most rhinoplasties, the fibrous overlapping relationship of the upper and lower cartilages is necessarily destroyed. Preservation of relationship of the mesial crural feet to the septum helps to maintain tip support without the necessity of cartilage struts and columellar sutures.When a complete transfixion incision is employed, the most effective method to augment tip projection is by the division of the alar cartilages and the re‐approximation of the medial portions in the midline.
Homograft tympanic membrane in cats
Authors: Carder George A. , Cody D. Thane R. , Weiland Louis H. 
Published: September 2006

AbstractA total of 91 cats were evaluated to determine the effectiveness and nature of closure of total tympanic membrane perforations with homografts preserved in buffered formaldehyde, 70 percent alcohol, benzalkonium in Tis‐U‐Sol (1:750 solution), or Cialit (1:5,000 aqueous solution). Controls consisted of unoperated ears, ears with partial and total perforations that were not grafted, ears in which the total tympanic membrane was removed and immediately replaced, and ears grafted with fresh homograft tympanic membranes.The study revealed that the removal of the tympanic annulus was necessary to prevent spontaneous regrowth of a new tympanic membrane. The percentage of successful closures of tympanic membrane perforations according to the preservative was formaldehyde 50 percent, alcohol 50 percent, benzalkonium 45 percent, and Cialit 30 percent. The rate of successful closures with fresh autograft tympanic membranes was 40 percent and with fresh homografts 25 percent. The homografts preserved in formaldehyde or alcohol were more rigid and easier to handle than were those preserved in benzalkonium or Cialit.The histologic findings were similar in ears that had developed a new tympanic membrane after grafting with preserved homograft tympanic membranes and in ears with fresh homografts or autografts. The graft served as an inert scaffold for the new tympanic membrane to grow across. Gelfoam used in the middle ear to support either a homograft or an autograft became incorporated into the new tympanic membrane and was associated with a foreign‐body reaction. There was, however, no evidence of an immunologic reaction to the homograft.
Malignant hyperthermia in the otolaryngologic patient
Authors: Pollock Richard A. , Turner John S. 
Published: September 2006

AbstractMalignant hyperthermia is a pharmacogenetic disorder initiated by exposure to a variety of anesthetic agents. The reaction has assumed major importance to the otolaryngologic surgeon because: 1. approximately 20 percent of all reported reactions have occurred during anesthesia for ENT surgical procedures; 2. the disorder is being reported with increasing frequency; and 3. mortality associated with the reaction is greater than 60 percent. Susceptible patients appear to have a disorder of muscle, but because genetic penetrance and expression are limited, manifestations are often mild, and physical manifestations variably present. The authors suggest an approach leading to early detection of the susceptible patient.
Facial paralysis in fractures of the petrous bone
Authors: Fisch U. 
Published: September 2006

AbstractRecording of the summation potential of the facial muscles with surface electrodes from a representative population of motor units after maximal stimulation of the facial nerve trunk (electroneuronography) has been found essential for selecting patients requiring surgery because of facial paralysis associated with a fracture of the petrous bone. The most common site of injury to the facial nerve in 10 transverse and 30 longitudinal fractures of the temporal bone has been found within the labyrinthine segment of the Fallopian canal. The problems encountered in the surgical repair of the facial nerve lesions are reviewed. In order to repair facial nerve injuries associated with fractures of the temporal bone the surgeon must be prepared to use the middle cranial fossa or the translabyrinthine approach in more than 90 percent of the cases.
Long‐standing facial paralysis rehabilitation
Authors: Conley John , Hamaker Ronald C. , Donnenfeld Hyman 
Published: September 2006

AbstractA group of 32 patients with severe facial paralysis from 2 to 30 years and of different etiologies were studied. Various degrees of nerve and muscle atrophy were noted in this group. A new concept relative to the status of the paralyzed face, its nerve and muscle system and their capacity for rehabilitation was acquired.The treatment of long‐standing paralysis has been relegated to fascial stripping, muscle slings, tarsorrhaphies and face‐lift operations. This investigation indicates that the situation is not totally irreversible. The determinant factors are the number of surviving axones and the viability of the facial muscles supplied by them. Regardless of the electrical testing, the facial nerve never totally disappears nor do the facial muscles. On surgical exploration, the facial nerve and the posterior belly of the digastric muscle were always recognizable in varying degrees of atrophy and fibrosis. A range of 20‐90 percent of normal size was noted.Electron microscopy of the nerve and muscles demonstrated axone degeneration still taking place and muscle fibers present in cases 20‐30 years post injury to the nerve. The degree of atrophy and fibrosis was dependent upon the length of the paralysis. It was also noted that the degree of severity was less as the site of injury became more peripheral. This was probably related to the rich extratemporal nerve interconnections from the sympathetics, cervical plexus, and cranial nerves V and IX. These findings verified the existence of a subliminal system which is non‐functional, but in certain instances had the potential for rehabilitation.Some of the most interesting aspects of facial rehabilitation in longstanding facial paralysis are beginning to unfold themselves in the recognized potential of a regrowth of axones in a depleted but not annihilated facial nerve system by nerve crossover and nerve grafting techniques. When the peripheral facial nerve system is absent, nerve implantation into the residual mimetic muscles or transposed masticatory muscles is indicated. The introduction of masticatory muscles into the face to accommodate this neural regrowth, when mimetic muscle potential remains subclinical, adds a new neuromuscular facility in the rehabilitation.
Feasibility of acupuncture as a treatment for sensori‐neural deafness in children
Authors: Rosen Samuel 
Published: September 2006

AbstractPurpose of this study is to test the hypothesis that treatment by acupuncture can decrease the level of hearing loss in profoundly sensori‐neural deafness in children. Acupuncture treatments at sites recommended by Chinese colleagues were given five days per week for three weeks a month for six months. Thirty children received regular acupuncture, to a depth of 13 mm and 10 shallow acupucture, only 1–2 mm. Audiometric tests were performed weekly on each child at 8 points (125–8,000 Hz) plus SAT. At intervals bone conduction, SRT, and other audiometric tests were made. Treatments adhered closely to the recommendations of the Chinese colleagues; however, we set a six‐month pilot study rather than the extensive period (one to four years) which they follow.Comparisons were made of the average level of hearing loss in the two groups at the beginning and at the end of the study at four key frequencies. Although there is a small improvement in seven of the eight averages, this does not represent any practical improvement in hearing. Detailed comparison for each of the 40 subjects fails to reveal any consistently maintained improvement.
Cell proliferation kinetics in tumors after treatments
Authors: Barendsen G. W. 
Published: September 2006

AbstractAnalysis of data on cell reproductive death, cell proliferation kinetics, tumor volume responses and tumor eradication probability after single and fractionated doses of radiation given to experimental tumors, can yield several conclusions which may be relevant for the interpretation of clinical data: 1. considerable differences are observed among various cell types with respect to intrinsic radiosensitivity, but no specific differences are demonstrated for cells from tumors as compared to cells from normal tissues; 2. cell survival curves measured by in vitro cloning techniques for cells irradiated in an experimental rat rhabdomyosarcoma are consistent with the observed probability of tumor eradication, and 3. after a sufficiently large dose of radiation and after two weeks of fractionated treatments, important changes in cell proliferation kinetics have been observed with respect to cell cycle, cell production rate and cell loss rate, which may significantly influence the time of recurrence as well as the probability of attaining tumor eradication.
Carcinogenesis of laryngeal carcinoma
Authors: Saffiotti Umberto , Kaufman David G. 
Published: September 2006

AbstractExperimental models have been developed for the induction of carcinoma of the larynx and for the study of its pathogenesis. The hamster has been the animal of choice. Polynuclear hydrocarbons, administered intratra‐cheally, induce mostly squamous cell carcinomas. Diethylnitrosamine given systemically induces papillary tumors; some other N‐nitroso‐compounds given topically or systemically also induce laryngeal tumors, including carcinomas. Cigarette smoke inhalation induces preneoplastic and early neoplastic lesions of the larynx, including some invasive carcinomas. In vivo and in vitro methods have been developed for the morphological and biochemical study of target tissues in respiratory epithelial carcinogenesis to identify critical pathogenetic steps and their inhibition. These methods are now applicable to the in vitro study of human laryngeal epithelium and its susceptibility to cancer induction and prevention.
The enigma of post‐radiation edema and recurrent or residual carcinoma of the larynx
Authors: Ward Paul H. , Calcaterra Thomas C. , Kagan A. R. 
Published: September 2006

AbstractPersistence of significant edema of the larynx beyond six months after completion of radiotherapy presents the lavyngologist with a diagnostic dilemma. Review of the results of 43 cases demonstrated a high incidence of residual or recurrent carcinoma. Based upon this experience earlier and frequent laryngeal biopsies are recommended for these cases.
Indirect laryngoscopy
Authors: Goldman Joseph L. , Roffman Jeffrey D. 
Published: September 2006

AbstractIndirect laryngoscopy is one of the procedural methods used for achieving a histopathologic diagnosis of cancer of the larynx.A chronologic historical summary of the development of mirror laryngoscopy is presented. The details of the procedure employed for obtaining a biopsy with the aid of topical anesthesia is discussed.
Ossiculotympanic transplantation
Authors: L. Smyth G. D. , Kerr A. G. , Pahor A. , Law K. 
Published: September 2006

AbstractContinued investigations into current tympanoplasty problems have been carried out in the Eye and Ear Clinic, Royal Victoria Hospital, Belfast. Retrospective studies have been helpful in identifying some of the main problems responsible for many of our unsatisfactory results, both in the irradication of disease and the restoration of aural function. Prospective studies into the behavior of grafting materials for tympanic reconstruction in the experimental animal have led us to an overwhelming preference for natural materials as opposed to plastics or stainless steel. Both homologous and autologous bone and cartilage appear to offer good prospects in ossicular replacement techniques. The most satisfactory material we have used for repair of tympanic membrane defects continues to be either autologous or homologous temporalis fascia. The long‐term success of these materials in functional restoration is utterly dependent on continued aeration of the tubotympanic cleft.
Traumatic ophthalmoplegia: A complication of fractures of the zygomaticomaxillary complex. Review of etiology with report of an unusual case
Authors: Yee King F. , Cravens James , Kotler Robert 
Published: September 2006

AbstractOcular muscle imbalance is a common complication in fractures of the zygomaticomaxillary complex. Involvement can be direct; caused by entrapment of either the muscle or tendon in the fracture; or indirect, produced by central or peripheral damage to the cranial nerves supplying the muscles, massive orbital edema or hemorrhage. A case of complete paralysis of the extraocular muscles caused by a critical reduction of the size of the orbit as a result of fracture of the zygomaticomaxillary complex is described.
Voice following radiotherapy
Authors: Stoicheff Margaret L. 
Published: September 2006

AbstractThis study was undertaken to provide information on the voice of patients following radiotherapy for glottic cancer. Part I presents findings from questionnaires returned by 227 of 235 patients successfully irradiated for glottic cancer from 1960 through 1971. Part II presents preliminary findings on the speaking fundamental frequencies of 22 irradiated patients.Normal to near‐normal voice was reported by 83 percent of the 227 patients; however, 80 percent did indicate persisting vocal difficulties such as fatiguing of voice with much usage, inability to sing, reduced loudness, hoarse voice quality and inability to shout. Amount of talking during treatments appeared to affect length of time for voice to recover following treatments in those cases where it took from nine to 26 weeks; also, with increasing years since treatment, patients rated their voices more favorably. Smoking habits following treatments improved significantly with only 27 percent smoking heavily as compared with 65 percent prior to radiation therapy. No correlation was found between smoking (during or after treatments) and vocal ratings or between smoking and length of time for voice to recover. There was no relationship found between reported vocal ratings and stage of the disease.Data on mean speaking fundamental frequency seem to indicate a trend toward lower frequencies in irradiated patients as compared with normals. A trend was also noted in both irradiated and control groups for lower speaking fundamental frequencies in heavy smokers compared with non‐smokers or previous smokers. These trends would indicate some vocal cord thickening or edema in irradiated patients and in heavy smokers.It is suggested that the study of irradiated patients' voices before, during and following treatments by means of audio, aerodynamic and acoustic instrumentation would yield additional information of diagnostic value on recovery of laryngeal function. It is also suggested that the voice pathologist could assist in evaluating and guiding patients in vocal usages during and following treatments.
Functional evaluation after partial resection in patients with carcinoma of the larynx
Authors: Padovan I. F. , Orešković M. 
Published: September 2006

AbstractThis paper presents the results of conservative operations on patients with laryngeal carcinoma in the ENT Department of the University Hospital “Dr. Mladen Stojanovic,” Zagreb, Yugoslavia, during the last 20 years. The authors have evaluated the functional results after partial vertical and horizontal surgical interventions on the larynx and after the reconstruction of the larynx following these operations. Functional analysis of the voice was performed by stroboscopic, indirect microlaryngostroboscopic and sonagraphic examinations of the laryngeal function, as well as by the spirometric analysis of the respiratory potential of these patients, especially the degree of obstruction of the upper respiratory tract and changes on the cardiovascular system. Attention has been given likewise to the examination of the act of swallowing, especially after horizontal partial resections of the larynx. Radiography and radiocinematography was used for these examinations. Based on this research the authors have formulated new conceptions and opinions about the voice generator.
Fiber‐optic video study of the post‐laryngectomized voice
Authors: Brewer David W. , Gould Leo V. , Casper Janina 
Published: September 2006

AbstractSimultaneous video‐fluoroscopy and fiber‐optic video laryngoscopy was carried out on a series of eight laryngectomees. Previous concepts supported by an earlier report1 indicated that the folds of the rebuilt cricopharyngeal sphincter were seen to represent the primary source of sound vibration for voice production. Fold vibration was envisioned as an essential for sound production. Present findings present a challenge to the older concept.The fluoroscopic studies showed a considerable variation in the vertical thickness of the sphincteric area — from several millimeters to as many as 10 centimeters. Mucus bubbles in rapid motion were easily visible immediately above the narrowest portion of the reconstructed cervical esophagus. Ingestion of barium only enhanced the visualization of this bubbling. Vibration of a long vertical area of the thin anterior and thicker posterior esophageal walls well above and well below this point was regularly noted.Fiber‐optic visualization failed to show actual fold vibration at any time. Momentary opening of the food tract during air injection or intake, immediately prior to the onset of phonation, was seen on many occasions. During phonation, routinely, the anticipated pseudoglottic opening was obscured by bubbles of mucus or barium. These findings suggest that the air, when accumulated below the narrowest spot in the hypopharyngeal‐esophageal tract and when forced upward through a narrow opening, sets the accumulated mucus, not the mucous membrane, into vibration; further, that this vibration is of sufficient amplitude to transmit itself to both the anterior wall and the posterior wall of an extensive vertical portion of the neck.
Allergic secretory otitis media: An approach to management
Authors: Viscomi George J. 
Published: September 2006

AbstractAn allergic etiology should always be suspected in those children having recurrent secretory otitis media. These children often have a seasonal recurrence of middle ear effusion, a history of allergic disease in infancy or early childhood, and a family history of allergy. An approach to allergic management is presented. Inhalants are tested by the serial dilution titration technique and treated at optimum dose levels. Several food tests are used to detect offending foods. They are used in progressive fashion which utilized each technique to best advantage. Fifty allergic children with recurrent secretory otitis media, despite conventional surgical therapy, were treated for inhalant and food allergy for one year. There was a significant reduction in the recurrence of secretory otitis media and need for myringotomy.
Alcoholism in cancer of the head and neck
Authors: Lowry W. Sidney 
Published: September 2006

AbstractOne hundred patients with a diagnosis of head and neck cancer were investigated carefully for a history of alcoholism.A majority of cases had a severe drinking problem; in fact, alcoholism was twice as common as initially anticipated. Patients were frequently able to hide the problem from their physician. Often the true diagnosis was obtained only by closely questioning relatives and friends.Most patients with cancer of the tongue, tonsil and oro‐pharynx were alcoholic. About one‐half of the patients with supraglottic carcinoma were alcoholic. In the nasopharynx and true vocal cords, there was no association with heavy drinking.The study is of epidemiological interest but also has implications in the management of the malignancy, depending upon the anatomic site involved.
Treatment of carcinoma of the base of the tongue and the larynx
Authors: Novack Alvin J. 
Published: September 2006

AbstractCancer of the base of the tongue and the larynx is usually treated primarily with irradiation to 6,000 rads. Persistence of tumor after irradiation is common and requires a logical, thoughtful approach designed to augment all tissues removed. Careful preoperative planning and the use of the lateral approach to the base of the tongue, in conjunction with pharyngostome and laryngostome formation allows wide resection of the cancer.Preservation of the function of speech and swallowing, and preservation of the mandibular contour are important, and correlate closely with carotid artery protection.Five different methods of approach to the problem are analyzed and presented.