bluuebunny/crossref_metadata_2025_split huggingface dataset:
Croup and epiglottitis: A radiologic study
Authors: Stankiewicz James A. , Bowes Anita King 
Published: October 2006

AbstractBecause of the controversy regarding the benefits of the lateral neck and chest radiographs in the evaluation of croup and epiglottitis, a two‐part retrospective study was initiated. Part I consisted of a retrospective chart review of 44 patients with a final diagnosis of croup and epiglottitis. Part II consisted of the 42 Interal neck and chest x‐rays from patients in part I presented to six radiologists who knew only the patients age and the history of respiratory distress. Two hundred forty‐six responses were obtained.The results of the part I study showed that 64% of patients with documented epiglottitis had a positive radiologic diagnosis. Only 33% of patients with croup had a positive radiologic diagnosis and importantly 27% had a diagnosis of possible epiglottitis.The results of part II showed 38% of the documented epiglottitis patients had a positive lateral neck radiograph. The croup patients had a lateral neck and/or chest x‐ray positive in 38%. Of interest, 24% had readings consistent with possible epiglottitis.Based on this two‐part study, it is our conclusion that the lateral neck and chest x‐ray may be unreliable and inaccurate in the diagnosis of croup and epiglottitis. Caution and good clinical judgement should be utilized when interpreting these x‐rays.
Neurotropic melanoma of the head and neck
Authors: Gentile Richard D. , Donovan Donald T. 
Published: October 2006

AbstractNeurotropic melanoma is a lesion which simulates a cutaneous fibrous tumor whose clinical course is characterized by local infiltration, multiple recurrences, and commonly by metastasis. Like adenoid‐cystic tumors of the head and neck, the neurotropic melanoma has a predilection for perineural invasion and extension along peripheral nerves. Its microscopic picture is characterized by atypical “neuroma‐like” patterns of Schwann cells and spindle cells, by poorly defined margins, and by neurotropism. Lentigo malignant melanoma (LMM) is a precursory lesion. The neurotropic melanoma is of particular interest to the head and neck surgeon because in the less than 50 reported cases of this rare tumor the preponderant sites were head, neck, and lip.We report two cases of neurotropic melanoma of the head and neck which demonstrate the characteristic perineural invasion of cranial nerves and extension along cranial nerves to the central nervous system. The clinical and pathologic features of the neurotropic melanoma are reviewed and the key diagnostic and therapeutic considerations in these patients are discussed.
Dilemmas in the management of chronic nasal and sinus inflammatory diseases of unknown etiology
Authors: Duncavage James A. , Durkin Gretchen E. , Lehman Roger H. , Toohill Robert J. 
Published: October 2006

AbstractThe diagnostic criteria and therapeutic regimens for upper airway necrotizing diseases such as Wegener's granulomatosis, polymorphic reticulosis, and the recently described idiopathic midlinc destructive disease have been better defined and clarified in the past decodes. Despite an improved understanding of the various disease processes, there continues to be difficulty in establishing an early diagnosis before proceeding with prompt treatment to minimize loss of function and cosmetic deformity. To achieve these goals, we have expanded the indications for the use of the cytotoxic drug, cyclophosphamide, in those patients whose clinical and histologic presentations are suggestive of Wegener's granulomalosis, but in whom a specific diagnosis has not been confirmed by biopsy specimen. We have seen ten patients with upper airway lesions of a chronic inflammatory nature over the past six years at the Medical College of Wisconsin affiliated hospitals. Only three of these have had a definitive histopathologic diagnosis of Wegener's granulomatosis made prior to the initiation of cytotoxic therapy. Six have undergone treatment under our expanded criteria without a prior definitive diagnosis. Five of these have had arrest of the disease process, and one has had no response to therapy. One patient was not treated. There have been no serious side‐effects from cyclophosphamide therapy in these patients.
Sudden hearing loss and cerebellopontine angle tumors
Authors: Pensak Myles L. , Glasscock Michael E. , Josey Anne Forest , Jackson C. Gary , Gulya Aina Julianna 
Published: October 2006

AbstractLesions of the cerebellopontine angle may cause a sudden hearing loss. To illustrate and reaffirm the importance of a thorough neurotologic evaluation we performed a retrospective review of the audiologic and clinical data available on 506 patients with proven lesions of the cerebellopontine angle. Seventy‐seven patients (15.2%) were found to have a history commensurate with sudden hearing loss. We reviewed the relevant audiologic data as well as the clinical circumstances of this select patient population.
Caustic ingestion in adult patients
Authors: Schild Joyce A. 
Published: October 2006

AbstractSixteen adult patients who ingested caustic substances were seen from 1977 through 1984. All patients underwent endoscopy to determine the site and severity of burns; mild hyperemia to severe, penetrating necrosis was detected in each patient. Ten ingestions were intentional, 4 accidental, and 2 questionably accidental. Morbidity and mortality were high, especially in patients who ingested caustic materials intentionally. A protocol for treatment with steroids and antibiotics was followed in half the patients studied. Those patients who completed this regime tended to have moderately severe burns. Caustic ingestion in adults must be viewed as a problem different from that of accidental ingestion in children. Since most adult caustic ingestions are intentional, the injuries are worse, more deaths result, and more severe scars causing permanent disability are a frequent outcome.
A study of endotracheal tube injury to the subglottis
Authors: Whited Robert E. 
Published: October 2006

AbstractAn endotrachal tube presses against distinct pressure points within the airway. These areas are the shaft of the tube against the arytenoids and posterior cricoid and the cuff‐tube tip in the trachea. An ulcerative injury occurs at these interfacing points from motion occurring between tube and tissue. Minimizing this inherent movement is possible by tube modification and, in the presented animal model, prevents injury.
Efficacy of bronchoscopic carbon dioxide laser surgery for benign strictures of the trachea
Authors: Ossoff Robert H. , Tucker Gabriel F. , Duncavage James A. , Toohill Robert J. 
Published: October 2006

AbstractThere have been conflicting reports in our literature concerning the efficacy of bronchoscopic carbon dioxide laser surgery for the treatment of benign strictures of the trachea. We have examined our experience in the management of this disease over a 2 1/2‐year period; in all cases, our initial management was performed utilizing the rigid, ventilating bronchoscope with the universal endoscopic coupler and carbon dioxide laser.Eight of 14 patients were successfully managed in this study; retrospective analysis of our results revealed that the presence of one or more of the following four factors was extremely important in predicting an unfavorable prognosis of patients with tracheal stenosis managed endoscopically with the carbon dioxide laser: 1. loss of cartilaginous support; 2. stenosis length greater than 1 cm; 3. circumferential scarring; and 1. carinal involvement.
Long‐term adaptive changes of the vestibulo‐ocular reflex in patients following acoustic neuroma surgery
Authors: Jenkins Herman A. 
Published: October 2006

AbstractA series of 26 patients undergoing translabyrinthine acoustic neuroma surgery was evaluated pre‐ and postoperatively using rotatory vestibular testing. Patients were tested immediately prior to surgery and followed long‐term at frequent intervals for periods of one week to two years, depending on availability and length of time postoperative. Rotatory testing was performed at multiple frequencies of 0.0125, 0.05, and 0.2 Hz, and the vestibulo‐ocular reflex was measured using electro‐oculographic techniques. Dependent variables of the slow component of the vestibulo‐ocular reflex were derived by computer analysis, including gain, phase, DC bias, ampullopetal and ampullofugal responses of the remaining labyrinth, and asymmetry. These variables changed in a predictable fashion as related to the reciprocal of time. Results of this data are fitted with a linear statistical model, validating the changes.
Functional versus organic vocal cord paralysis: Rapid diagnosis and decannulation
Authors: Myears Donald W. , Martin Richard J. , Eckert R. Christa , Sweeney Maurine K. 
Published: October 2006

AbstractFunctional versus organic vocal cord paralysis can be difficult to differentiate at times. If a tracheostomy has already been performed, the distinction can be made by the use of intratracheal pressure monitoring while the patient is being sedated. If the problem is functional then rapid decannulation can be accomplished as described in this report.
Thyroid cartilage flap reconstruction of the larynx following vertical partial laryngectomy: A preliminary report in two patients
Authors: Burgess Lawrence P. A. , Quilligan Jay J. , Yim Donald W. S. 
Published: October 2006

AbstractReconstruction of the larynx following vertical partial laryngectomy may be undertaken with many techniques. Methods using soft tissue employ readily accessible structures within the operative field with straight forward reconstructive designs. However, decannulation is often delayed, and variable degrees of atrophy must be planned for. Methods using cartilage may lead to early decannulation without long‐term atrophy as a problem. However, grafts or flaps are less accessible, and reconstructive designs are often complex. In addition, chondritis may be a significant problem, especially in radiated patients.A supraglottic thyroid cartilage flap is described that is readily accessible and maintains its blood supply from external and internal perichondrium, as well as internal mucosa. Its use is reserved for unilateral glottic lesions without supraglottic spread. Experience with this technique is described in two patients.
Diagnosis and treatment of iatrogenic cerebrospinal fluid leak and brain herniation during or following mastoidectomy
Authors: Neely J. Gail , Kuhn John R. 
Published: October 2006

AbstractIatrogenic brain herniation, with meninges (meningoencephalocele) or without meninges (encephalocele), following mastoidectomy is rare. However, the seriousness of the complication and the potential for its prevention necessitate periodic review and emphasis.In this study, 6 patients with small iatrogenic dural injury during mastoidectomy, 1 patient with postoperative large encephalocele, and 2 patients with three spontaneous meningoencephaloceles are reviewed.These cases, and the literature, support the following: 1. A dural injury is necessary for herniation. 2. If the arachnoid remains intact, a meningoencephalocele results with the potential for cerebrospinal fluid leak into the middle ear and recurrent meningitis. 3. If the arachnoid is not intact, an encephalocele results which presents predominantly as a mass without a cerebrospinal fluid leak. 4. The dura and arachnoid may be torn during mastoidectomy, resulting in an immediate cerebrospinal fluid leak that can go easily unrecognized. Taking time to carefully inspect any area of dural exposure obviates this oversight. 5. A satisfactory technique of tegmen and duralarachnoid repair in these ten cases is described.
Vocal cord polyps: Biochemical and histologic evaluation
Authors: Steinberg Bettie M. , Abramson Allan L. , Hirschfield Larry , Kahn Leonard B. , Freiberger Ida 
Published: October 2006

AbstractThe stratified squamous epithelium covering vocal cord polyps can vary from normal to hyperplastic and keratinized. We have analyzed the histology and cytokeratins of 11 of these polyps. Cytokeratins were separated on one‐dimensional SDS‐acrylamide gels to determine molecular weights. There was significant heterogeneity in the cytokeratins present in the different polyps. Comparison of histologic findings and cytokeratin content showed a correlation between extent of keratinization and presence of high molecular weight cytokeratins. We conclude that the epithelium of vocal cord polyps exhibit patterns of cytokeratins characteristic of both hyperproliferation and abnormal states of differentiation, which are mirrored by histologic variations, and that vocal cord polyps are a heterogenous group of benign lesions.
Counseling before laryngectomy
Authors: Berkowitz Jessica Fuchs , Lucente Frank E. 
Published: October 2006

AbstractCounseling of laryngectomy patients was studied by a questionnaire survey among 294 fellows of the American Society for Head and Neck Surgery and otolaryngology house officers (77% attendings and 23% residents). Seventy‐nine percent of respondents spent less than one hour counseling patients. Subjects emphasized during preoperative counseling included: extent of surgery, loss of speech, alternatives to surgery, immediate postoperative disfigurement, possible effects of surgery on life expectancy, and possibility of recurrence. At least 24% of physicians were unwilling to discuss the psychosocial effects laryngectomy.Ninety‐five percent of respondents often or always included family members in preoperative counseling sessions. The speech pathologist was utilized by at least 80% of the respondents to help with preoperative counseling. Differences in counseling practices between attendings and residents are discussed.
Laryngopyocele as a cause of airway obstruction
Authors: Weissler Mark C. , Fried Marvin P. , Kelly James H. 
Published: October 2006

AbstractSymptomatic laryngoceles are unusual lesions. Laryngopyoceles are even more unusual, with a total of 32 cases reported in the world literature. Two cases of laryngopyocele presenting as airway obstruction are described along with a review of the anatomy, etiology, clinical course, and management of this lesion. An argument is made supporting the resection of the symptomatic laryngocele to prevent the rapid respiratory obstruction that may occur in the presence of a laryngopyocele.
Operative complications of tracheoesophageal puncture
Authors: Silver Frederick M. , Gluckman Jack L. , Donegan J. Oliver 
Published: October 2006

AbstractTracheoesophageal puncture is not a complex procedure; nevertheless, significant complications are possible. In the last four years we have performed this procedure in 47 patients. Seven of them (15%) sustained significant complications related to the procedure. These included three cases of mediastinitis and sepsis, although surgical drainage was not required. Three other patients developed cellulitis of the trachea and root of the neck, centered around the tract through the party wall; one patient suffered a fracture of the cervical spine. Eight lesser complications also occured.Tracheoesophageal puncture's simplicity and effectiveness surpass those of any other surgical procedure for voice restoration. However, our experience demonstrates that, as with any operation, the technique may be associated with significant operative complications.
Staging parameters for cancers of the head and neck: A multi‐factorial analysis
Authors: Jacobs John R. , Spitznagel Edward L. , Sessions Donald G. 
Published: October 2006

AbstractUtilizing a multi‐variate computer based analysis technique, the 1,400 case head and neck tumor registry of Washington University was examined for possible staging variables as an alternative to the current TNM system. Site, age, characteristics of surgical margins, and absence of neck node metastasis were identified as being predictive of nonrecurrence of cancer. A computer model utilizing the variables was compared to the current TNM system and found to be somewhat better (71.2% vs. 65.2%) in accuracy of prediction of nonrecurrence of cancer. Further analysis suggests that future improvements in predictive ability of the model will have to await the identification of new variables such as those that might arise from the current work in areas of flow cytometry or human stem cell cultures.
Otogenic complications with an intact tympanic membrane
Authors: Samuel Julian , Fernandes Carlos M. C. 
Published: October 2006

AbstractA review of 21 cases of complications of acute otitis media with a hyperemic, dull, bulging but intact tympanic membrane is presented. All cases had a retroauricular swelling.In 10 cases, a subperiosteal abscess was found, 1 of them complicated with a posterior fossa abscess, 2 had meningitis, 3 had Bezhold's abscess, 2 had thrombosis of the lateral sinus, 1 had a cerebellar abscess, 1 had cerebellitis, and 2 presented with facial nerve palsy. Ninety percent of the patients were below the age of 13.An incomplete course of antibiotic treatment was found to have been given in seven cases (30%) prior to admission. Surgical therapy consisted of a cortical mastoidectomy and a wide myringotomy. Ventilating tubes were inserted in three patients. The mastoid radiography demonstrated cloudiness, and CT scan was performed in six patients with suspected intracranial complications.The present study stresses that an intact tympanic membrane with minimal changes may be regarded by the medical profession with a low index of suspicion and can lead to severe otogenic complications. The disease can be masked by an improper antibiotic therapy.
Natural killer cell activity in patients with carcinoma of the larynx and hypopharynx
Authors: Wustrow Thomas P. U. , Zenner Hans‐Peter 
Published: October 2006

AbstractNatural killer (NK) cells have recently gained much attention as potential effector cells in antitumor and antiviral immune defense mechanisms. The role of NK cells in patients with squamous cell carcinoma has not yet been described. In our study of larynx and hypopharynx cancer patients, no correlation was found with the extent of the disease expressed by the TNM classification or the TNM staging. Furthermore, no change of the spontaneous natural killer cell mediated K562 lysis was shown in advanced malignant disease or in the postoperative period up to 24 months following surgery. When the NK cell activity was compared with two control groups of healthy volunteers, aged 20 to 30 or 55 to 65 years, both with high alcohol and tobacco consumption, no alterations of the killing capacity for K562 targets were observed during aging, with or without a tumor.NK cell cytotoxicity was significantly lower in tumor draining lymph nodes of the neck than the values found in peripheral blood. In cancer patients as well as in healthy donors, the spontaneous killer cell activity was significantly enhanced by incubation with β‐interferon. The differences, however, between natural killing in peripheral blood and lymph nodes were increased in the head and neck cancer population mainly by an overall reduced NK cell cytolysis in the tumor draining lymph nodes. Although none of the lymph nodes used was infiltrated by malignant cells as seen under microscopic examinations, the diminished NK cell activity in laryngeal and hypopharyngeal cancer patients seems to be caused by factors or the presence of locoregional suppressor cells capable of reducing natural cell mediated immunity.
Oculopharyngeal muscular dystrophy: Recent ultrastructural evidence for mitochondrial abnormalities
Authors: Pratt Michael F. , Meyers Peter K. 
Published: October 2006

AbstractOculopharyngeal muscular dystrophy is a rare, autosomal dominant disorder which has been traced through 11 generations of a French Canadian family. The classic presenting complaints are palpebral ptosis and oropharyngeal dysphagia. The dysphagia is usually progressive and leads to repetitive regurgitation, increased alimentation time, and weight loss. Immunologic studies generally reveal elevated levels of IgA and IgG, while manometry demonstrates poor pharyngeal contraction. The dysphagia is frequently relieved by cricopharyngeal myotomy. We present two case reports and also a new ultrastructural finding of abnormal metallic mitochondrial inclusions. This finding has not been previously described in this disorder.
Nasal polypectomy and sinus surgery in patients with asthma and aspirin idiosyncrasy
Authors: English G. M. 
Published: October 2006

AbstractThis study attempted to determine whether or not nasal and sinus surgery had a beneficial or deleterious effect upon the asthma of patients with nasal polyps and aspirin idiosyncrasy. There were 205 patients in this study. A classification system was devised to provide a means of determining the severity of asthma before and after surgery. The data indicate that surgery does improve the patient's asthma for relatively long periods of time.
Hearing aids poststapedectomy: Incidence and timing
Authors: Smyth G. D. L. , Hassard T. H. 
Published: October 2006

AbstractNinety‐four percent of 508 patients operated on between 1960 and 1975 have been followed‐up at yearly intervals. Their status as of 1977 was assessed in order to determine their mean duration of socially adequate hearing levels and to relate the type of surgical procedure to the interval between operation and hearing aid requirement. Postoperative hearing losses due to conduction and sensorineural deficits resulted in preoperative bone/postoperative air gaps greater than 10 dB in up to 40% of large fenestra operations and in 15% of small fenestra operations at 5 years. On average, a large fenestra ear would require amplification at 13 years and a small fenestra ear at 21 years postoperatively.
Melanoma of the larynx
Authors: Reuter Victor E. , Woodruff James M. 
Published: October 2006

AbstractPrimary laryngeal melanomas (LM) are rare. In a review of all mucosal melanomas of the head and neck (MMHN) at Memorial Hospital from 1949 to 1983 we identified only three such cases. Review of the literature shows that LM usually involve the supraglottic larynx of elderly males. Although survival is as poor as for other MMHN, local recurrence is less frequent, even when primary therapy consists of more conservative surgical procedures than total laryngectomy.
Inverting papilloma of the nose and paranasal sinuses
Authors: Segal Karl , Atar Eli , Mor Cilia , Har‐El Gadi , Sidi Jack 
Published: October 2006

AbstractA series of 30 patients with inverted papillomas of the nose and/or the paranasal sinuses is presented. The inverted papilloma is a rare tumor with an overall incidence varying from 0.5% to 4% of all primary nasal tumors. The incidence of inverted papilloma is much more common in the fifth to seventh decades.An association between inverted papilloma and carcinoma is well established. In the large series of patients, the incidence of malignancy associated with inverted papilloma ranges from 1% to 13%, and in our series 10%.Treatment of inverted papilloma is always surgical. The incidence of recurrence is directly related to the method of surgical treatment. Among our 20 patients who were treated by limited surgery, there was recurrence in 14 cases (70%). By contrast, medial maxillectomy and ethmoidectomy via lateral rhinotomy reduced the recurrence rate dramatically. In our opinion this approach is the surgery of choice in the treatment of inverted papilloma.