bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrical promontory testing in differential diagnosis of sensori‐neural hearing impairment
Authors: House William F. , Brackmann Derald E. 
Published: September 2006

AbstractThe possibility of rehabilitation of sensory deafness by a peripherally implantable prosthesis makes it very important to differentiate sensory from neural hearing impairment. We do this by a technique which we call electrical promontory testing, which includes measuring the electrical potentials generated in the auditory system and stimulating the inner ear electrically.Types of Sensori‐Neural Hearing Impairment.There are four or more types of sensori‐neural hearing impairment which in the past have collectively been termed sensori‐neural. They are: 1. sensory loss — deficiency in the hair cells; 2. neural loss — auditory nerve deficit; 3. brain stem loss — nuclear deficiency; and 4. central loss — auditory cortex defect.Method of Testing.Recording of the potentials evoked in the auditory system by the techniques of electrocochleography, brain stem audiometry and cortical evoked response audiometry is an important objective means of study of the auditory system. Characteristics of the potentials obtained such as wave form, latency, and amplitude help greatly in classifying types of partial hearing loss.In severe hearing loss no potentials are obtained from the auditory system. In these cases, a low‐voltage, low‐frequency electrical current is applied to the promontory.If the patient perceives an auditory sensation as a result of this stimulation, we believe that this demonstrates the presence of auditory neurons and the loss is classified as sensory. If an auditory sensation is not evoked, the deafness is classified as a neural or more central loss.
The conservative management of the negro nose
Authors: Kamer Frank M. , Parkes Morey L. 
Published: September 2006

AbstractThe difficulties in obtaining an adequate result in the Negroid nose have been elucidated by other authors. Paucity of lobular cartilage; the flat dorsum; short columella; wide flaring nares; and skin that tends to keloid formation have led many surgeons to attempt radical surgical techniques to obtain rather limited results.To circumvent the complications in the more radical procedures, a more conservative concept of an entirely intranasal operation without external skin incisions is outlined. This technique consists of tip rotation and lobular cartilage trimming; the use of a non‐absorbable basal bunching suture, and the placement of a dorsal implant without performing osteotomies.A comparison with other techniques is made, as well as surgical aims, limitations and a discussion of results. Pertinent illustrations and photographs are presented.
Laryngeal microcirculation and pathways of cancer spread
Authors: Pearson Bruce W. 
Published: September 2006

AbstractThe microcirculation of the human larynx was studied in cleared anatomic specimens. The distribution of the endolaryngeal blood supply was constant enough to permit naming of the subdivisions of the superior and inferior laryngeal arteries. There was a remarkable correlation between arteriolar and capillary distribution and the laryngeal routes of cancer spread within the larynx. Compartmentalization of the larynx was not apparent. The paraglottic space was filled with blood vessels.
Use of thermography to evaluate the optimum time for surgery after preoperative radiation
Authors: Scruggs Hugh J. , EL‐Mahdi Anas M. , Teates Charles D. , Fitz‐Hugh G. S. Laughter , Constable William C. 
Published: September 2006

AbstractAt the University of Virginia Hospital, patients undergoing preoperative irradiation for carcinoma in the head and neck region are usually scheduled for surgery four to six weeks after completion of therapy. Since preoperative irradiation produces no significant difference in the operative difficulty or postoperative morbidity, it is assumed that the vascularity of the area has returned to the pre‐treatment level. Thermography is being used to quantitatively gauge the amount of vascularity and thus, help predict the optimum time for surgery.Thermography is obtained at two‐week intervals after a pre‐treatment baseline and is carried out for eight weeks after completion of therapy. During therapy the vascularity as determined by thermography is noted to increase to a maximum at approximately three to four weeks or 3 to 4,000 rads. Following completion of treatment, the vascularity subsides gradually and returns to the pre‐treatment level at four to six weeks after completion of therapy.
The bifid uvula in ear, nose and throat practice
Authors: Saad Ezzat F. 
Published: September 2006

AbstractOut of 2,000 consecutive ear, nose and throat patients, 44 were found with bifid uvulas. Five of the cleft uvulas were associated with submucous cleft palate, and eight were associated with short palates; however, dyslalia was evident in only one case. Compensation for the wide palato‐pharyngeal space can occur by hyperplasia of the nasopharyngeal tonsil and hypertrophy and increased mobility of the pharyngeal constrictors and Passavant's ridge.On the other hand, otologic manifestations were complained of in 13 cases. The asymptomatic cases were examined under magnification and audiometrically and a further three cases were, then, diagnosed as secretory otitis media. Hypoplasia of the tensor palati is the probable explanation of otologic manifestations in bifid uvula
Laser excision of carcinoma of the larynx
Authors: Strong M. Stuart 
Published: September 2006

AbstractThe CO2 surgical laser and microscope assembly have been used to excise carefully selected T1 carcinomas of the membranous portions of the cord. Healing has been prompt and return of function satisfactory.General anesthesia and suspension laryngoscopy have provided excellent definitions of the lesions; the laser has provided a precise method of dissection.Initial results have been excellent and long term results will depend on the accuracy with which the margins of the tumor are defined and the presence or absence of the tendency of the larynx to produce multicentric disease.
Blue light endoscopy
Authors: Höurzeler Dietrich 
Published: September 2006

AbstractThe introduction of high intensity proximal light sources has greatly improved the already high standard in technique of endoscopy. They enable us to illuminate the periphery of the bronchi. The advantage of better illumination must, nevertheless, be paid for with a levelling of contrast, as the bright light outshines the fine differences (e.g., tubercles in the mucous membrane).In order to heighten the contrast, first theoretical, then practical tests were carried out with different colored lights. Filters (red, green, yellow and light blue) were placed in front of the light source and the subjective perceptible changes in contrast examined. These tests showed that the light blue filter gave a heightened contrast between light and dark red as well as between yellow and red. Intra‐ and submucosal nodules, scars, metaplasias, hyper‐ and parakeratoses as well as precancerous conditions are more clearly visible in the mucous membrane. Circumscribed lesions are better seen and specimens for histological verification are more accurately located for biopsy. Foreign bodies are more easily grasped. The remaining filters heighten the contrast in special cases (such as mycosis and colored foreign bodies).Individual filters or multifilter discs placed between the light source and the glass fiber light carrier are easy to manipulate, so that colored light can be employed in routine bronchoscopy in order to improve diagnosis.
Special considerations in epiglottitis in children
Authors: Scheidemandel Heinz H. E. , Page Russel S. 
Published: September 2006

AbstractThe often perplexing clinical findings in acute epiglottitis are produced by the relative absence of cyanosis and hypercapnia in the face of severe hypoxemia, since expiration and CO2 elimination are not impaired. A serious situation arises when intubation is unsuccessful. Six hundred otolaryngologists were polled to determine whether life‐saving tracheotomy in such a situation could be performed within the time limits.
Intratracheal thyroid
Authors: Myers Eugene N. , Pantangco Irineo P. 
Published: September 2006

AbstractEctopic thyroid tissue within the trachea (intratracheal or endotracheal tissue) is a rare cause of upper airway obstruction. The symptoms may be classical or, as in most cases in which the voice is not affected, the first sign may be a wheeze. This may result in the symptoms being mistaken for asthma. The presence of a submucosal upper tracheal mass is quite unusual. If one is familiar with the fact that thyroid tissue may occur in this location, then this diagnosis should be considered in patients with such symptoms, and the appropriate diagnostic studies and surgical management should be instituted. The present case report entailed a 56‐year‐dld female who was admitted to the hospital after having been treated for a year in an outlying area. She had increasing shortness of breath and wheezing and had been treated several times for asthma. Indirect laryngoscopy revealed an upper tracheal submucosal mass which was confirmed by direct laryngoscopy and by tomography. Biopsies were taken confirming nodular ectopic thyroid tissue.The patient was operated on through a cervical incision and a tracheal flap was elevated in order to carry out a submucosal dissection of this mass. The patient has done well for more than a year following surgery, and histologically this lesion was benign in the thyroid tissue.
Localization of laryngeal motor neurons in the kitten
Authors: Gacek Richard R. 
Published: September 2006

AbstractIn a series of 12 newborn kittens, horseradish peroxidase (HRP) was used to trace retrograde axoplasmic flow in the motor neurons to laryngeal muscles. The animals were sacrificed 24 hours after injection of HRP into a specific laryngeal muscle, and the brain stems were stained for peroxidase. This clear‐cut colorimetric method permitted the localization of the motor neurons in two nuclei of the ipsilateral brain stem. These are the nucleus ambiguus and the retrofacial nucleus.The primary source of laryngeal motor supply is the nucleus ambiguus. All the laryngeal muscles were represented here in two divisions. Adductor neurons were located in the dorsal division and were more loosely arranged in the lateral reticular formation. The abductor neurons of the posterior cricoarytenoid muscle formed the compact ventral division of the nucleus ambiguus and were fewer in number than adductor neurons by a factor of four to one.Since the expiratory and inspiratory centers are also located dorsally and ventrally in the brain stem reticular formation, the motor cells of the nucleus ambiguus are conveniently arranged to receive their afferent input. This arrangement is probably the result of phylogenetic development of abductor laryngeal function and pulmonary function in lower forms.A second source of laryngeal innervation is the retrofacial nucleus. This small nucleus is situated rostral to the nucleus ambiguus and is made up of small and medium‐sized neurons of at least two types. Only the cricothyroid (CT) and posterior cricoarytenoid (PCA) muscles were shown to have significant innervation from this nucleus. The CT neurons were located peripherally while the PCA cells occupied the central portion of the nucleus. The functional significance of this nucleus is unknown, but it is suggested that it may have something to do with the various types of muscle units that have been demonstrated physiologically in the CT and PCA muscles.
Etiologic factors in non‐suppurative otitis media
Authors: Brookler Kenneth H. 
Published: September 2006

AbstractTwo observations in non‐suppurative otitis media, namely the serous fluid and the tympanic membrane retraction, may have separate explanations as to the etiologic factors. The first is the obstruction of the collecting lymphatic tubules of the middle ear and eustachian tube as they drain to the retropharyngeal lymphatics. This leads to a transudation of fluid in the middle ear or serous fluid. The second observation, retraction of the tympanic membrane, may be due to an absence or significant reduction of the surface tension lowering substance (Surface Active Membrane) of the eustachian tube, preventing the transmission of air to the middle ear from the nasopharynx.
Granular cell myoblastomas
Authors: Frable Mary Ann , Fischer Ronald A. 
Published: September 2006

AbstractGranular cell myoblastoma is an uncommon benign tumor. The diagnosis is rarely suspected preoperatively, and the clinician is frequently baffled or frightened by an unfamiliar diagnosis.Twenty‐eight patients with the diagnosis of granular cell myoblastoma presented for treatment at Richmond Eye and Ear Hospital and the Medical College of Virginia Hospitals between January 1, 1952, and December 31, 1974. The authors believe that this is one of the largest series of cases reported in the world literature. The tumor presents most often in the fourth decade of life and about equally in the sexes. Of interest is the nearly 5:1 predominance in the Negro race compared to the Caucasian race.
Symposium: Contraindications to tympanoplasty: II. An exercise in clinical judgment
Authors: Glasscock Michael E. 
Published: September 2006

AbstractThe two primary symptoms of chronic ear disease are otorrhea and hearing loss. The goal of any tympanoplasty is to eradicate disease and improve hearing. These are the primary indications for this procedure. The success or failure of the surgery is influenced by many factors such as the age and general health of the patient, the extent and type of disease present, and whether the upper airway is functioning properly. Contraindications to tympanoplasty will vary from one surgeon to another depending upon his training, philosophy, experience, and surgical skill.It is helpful to think of these contraindications as being either absolute or relative. Absolute contraindications consist of: 1. uncontrolled cholesteatoma; 2. malignant tumors; 3. unusual infections and/or extenuating circumstances; and 4. complications of chronic ear disease, such as meningitis, brain abscess, or lateral sinus thrombosis. Relative contraindications are less well defined: 1. eustachian tube insufficiency or non‐function; 2. the uncooperative patient; 3. the dead ear; 4. the better hearing or only hearing ear; 5. the elderly patient; 6. the young child; and 7. the repeated failure case.The otologic surgeon must exercise good clinical judgment in selecting patients for tympanoplasty. This paper deals with some of the more common problems in decision making.
Familial laryngomalacia: A case report
Authors: Shulman Joel B. , Hollister David W. , Thibeault Donald W. , Krugman Mark E. 
Published: September 2006

AbstractThis report describes the hereditary occurrence of severe laryngomalacia in three of five siblings of a Mexican‐American family. The mother, who experienced respiratory difficulties in the first year of life, may also have been affected. All three affected children required neonatal tracheostomy, and two died of pulmonary complications. Histological studies of tracheal cartilage revealed distinct hypercellularity and histochemical staining abnormalities of the cartilaginous matrix without defects in skeletal cartilage.Although laryngomalacia is not uncommon, this disorder previously has not been documented to occur as a familial trait, nor have distinct abnormalities of cartilage been associated with laryngomalacia. This report suggests that etiologic and pathophysiologic heterogeniety exists for the clinical syndrome of laryngomalacia.
Symposium: Methods of reconstruction in tympanoplasty: IV. Conchal perichondrium as a tympanic graft with maintenance of drum conization
Authors: Wright William K. 
Published: September 2006

AbstractTympanoplasty reconstruction of the eardrum approached normal anatomy and function with the use of connective tissue to replace the substantia media. Perichondrium taken from the concha is preferred because it lies flat and is easy to manipulate. Grafts placed on the outer surface of the remnant tend to lateralize with loss of drum conization. Grafts placed on the undersurface of the remnant do not have this disadvantage.
Symposium: Congenital anomalies of the middle ear: I. Epitympanic fixation of incus and malleus
Authors: Shea John J. , Tabb Harold G. 
Published: September 2006

AbstractEpitympanic fixation of the incus and malleus may be surgically corrected by transcanal atticotomy and removal of the fixed incudomalleolar mass.Restoration of serviceable hearing has resulted in five of six cases by repositioning the natural incus or using a homograft incus.
Symposium: Congenital anomalies of the middle ear: II. Vascular anomalies of the middle ear
Authors: Storrs Lloyd A. 
Published: September 2006

AbstractOf all the abnormal situations that one encounters in performing a tympanotomy, probably the last one to be thought of is vascular anomalies, and yet, potentially, this is one of the most hazardous of anomalous problems with which we have to deal.Most of the anomalies which have been reported concern the persistent stapedial artery. This artery arises from the stump of the second aortic arch (stapedio‐hyoid artery), it traverses the developing stapes bone, leaving behind a monument to its existence — the obturator foramen of the stapes. The artery exits from the middle ear along the horizontal portion of the facial nerve, traversing this area for a variable distance and then usually divides into an intra‐cranial branch and a sphenoidal branch. The stapedial artery in its development before its regression, gives rise to the anlage of many important cranial arteries. These vessels are usually anastomosed with and distributed by the branches of the internal maxillary artery and the ophthalmic artery. The hyoid artery is represented in the adult by the carotico tympanic artery.Anomalies involving the internal carotid artery are much more rare. The anomalies that have thus far been reported are:

Absence of the internal carotids.
Aneurysms.
Unusual courses.

Venous anomalies are generally uncommon and are usually represented by an abnormally placed jugular bulb which can simulate a glomus jugulari tumor.
Traumatic esophagopericardial fistula
Authors: Edison Bruce D. 
Published: September 2006

AbstractThe pathological state of esophagopericardial fistula is a rare phenomenon. Its etiology may be either traumatic or disease induced. In either event, it is a most serious condition with a frequently fatal outcome. This case report concerns itself with an iatrogenic induced esophagopericardial fistula which was successfully treated by a thoracotomy and pericardotomy.
Lymphangiomatous macroglossia
Authors: Dinerman William S. , Myers Eugene N. 
Published: September 2006

AbstractLymphangiomatous macroglossia, or giant tongue, usually presents within the first two years of life. The tongue enlarges to the point of protrusion from the mouth with resultant ulceration and frank necrosis of the tip. There may be associated malocclusion and prognathia produced by the enlargement of the tongue.The pathology and clinical manifestations of lymphangioma of the tongue are discussed in this paper, and a case report is presented.
One‐stage dermal pedicle flap reconstruction of the oropharynx (an experimental and clinical study
Authors: Kohut Robert I. , Small Ralph , Suesberry Wilbur , Bain Leslie , Akazawa Melvin , Bridger William 
Published: September 2006

AbstractA single stage dermal pedicle graft method for reconstruction of oropharyngeal defects is presented. Its successful clinical use is described. The advantages of the method include large surface‐to‐surface anastomosis which appears to minimize breakdown secondary to hypovascularity of an irradiated recipient bed. Other advantages include its single stage feature, persistent blood supply, avoidance of external tubed pedicles and intermediate salivary fistulas. A histologic study in pigs preceded its clinical use in humans. Findings of both aspects of the study are discussed.
Sudden sensori‐neural hearing impairment: A report of 1,220 cases
Authors: Shaia Fred T. , Sheehy James L. 
Published: September 2006

AbstractWe reviewed the findings in 1,220 cases of sudden sensori‐neural hearing impairment encountered over a nine‐year period at the Otologic Medical Group. A thorough neuro‐otologic evaluation is indicated in each case. Ten patients had an acoustic tumor.A vasodilator regimen was prescribed in 380 cases and resulted in hearing improvement in 40 percent. Favorable prognostic findings were a low tone loss and absence of vertigo.
Tympanomastoid reconstruction: An operative procedure for anatomical and functional restoration of the radicalized ear
Authors: Perkins Rodney 
Published: September 2006

AbstractA new operative procedure for the anatomical and functional restoration of both the middle ear and mastoid is described. The technique employs homograft tympanic membrane with ossicles en bloc for the middle ear reconstruction and a homograft dura form and autogenous bone paté is used to recreate the bony posterior ear canal wall. The reconstructed wall becomes hard viable bone in about one year. Results in terms of wall integrity, tympanic membrane survival and hearing are discussed. The mechanism of new bone formation is discussed with presentation of histologic findings.
Thin rubber sheeting in frontal sinus surgery: Animal and clinical studies
Authors: Neel H. Bryan , Whicker James H. , Lake Clifford F. 
Published: September 2006

AbstractClosure of the nasofrontal communication is the most common cause of failure of nonobliterative external frontal sinus operations for chronic sinus disease. To determine whether silicone rubber sheeting or tubing might prevent closure, we designed animal experiments and conducted a clinical study. We enlarged the nasofrontal duct in dogs, inserted silicone rubber tubing or sheeting and assessed ductal patency grossly and microscopically. The tubes prevented epithelization and failed to prevent local osteoblastic reaction, fibroplasia, and scar formation. In contrast, sheeting permitted rapid mucosal regeneration, less osteoblastic activity, and less fibrosis. Our 16 patients with chronic sinus disease underwent a modified Lynch operation, with enlargement of the nasofrontal duct and stenting with rubber tubes or sheeting. The sheeting provided the best long‐term result. In our experience, it raised the success rate of the classic Lynch external operation.
Surgical management of bilateral vocal cord paralysis
Authors: Sessions Donald G. , Ogura Joseph H. , Heeneman Hans 
Published: September 2006

AbstractFifty‐five patients with bilateral abductor paralysis of the vocal cords were managed surgically from 1957 to 1973. Initially, unilateral arytenoidectomy or arytenoidopexy was employed. If this was not satisfactory, a contralateral arytenoidectomy was performed 6 to 12 months later. If the patient's airway was still inadequate, then open unilateral submucous resection of the vocal cord was accomplished.Initial management was successful in 62 percent (34/55) of patients, and 50 of 55 patients (91 percent) were eventually decannulated. Failure of the arytenoidectomy appeared to be related to traumatic etiology of the bilateral paralysis, presence of previous treatment, and technical problems of the procedure itself.