bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hearing results in tympanoplasty
Authors: Wehrs Roger E. 
Published: October 2006

AbstractRecent reports from Scandinavian authors have put forth the concept that hearing improvement following tympanoplasty is seldom satisfactory and difficult to obtain. This view is contradictory to the experience of most American authors. A study, therefore, was undertaken to evaluate the hearing results obtained by this author through the use of homograft material in middle ear and mastoid reconstruction.These hearing results are categorized according to time periods, types of reconstruction, and materials used. The hearing statistics are all taken from audiograms obtained one year or more postoperatively. These correspond with the type of reconstruction employed such as an intact ossicular chain, absence of the malleus, absence of the superstructure of the stapes, or both. Other categories include tympanoplasty with mastoidectomy or reconstruction of the posterior canal wall with homograft knee cartilage.The surgical techniques are not discussed in this article because they have been detailed in previous publications.
Predictive value of laryngeal electromyography in patients with vocal cord paralysis of neurogenic origin
Authors: Parnes Steven M. , Satya‐Murti Saty 
Published: October 2006

AbstractLaryngeal electromyography can provide prognostic information when evaluating patients with vocal cord dysfunction. Twentyfour patients were studied to determine the predictive capacity of this test. Six patients had bilateral vocal cord paralysis, constituting a total of 30 vocal cords examined.Sixteen of these cords had decreased or absent motor unit potentials, fibrillations, or positive waves. None of these patients recovered function. Fourteen cords demonstrated either normal motor unit or polyphasic potentials. Return of mobility was evident in 11 of these cords. The combined total was 27 of 30 cords correctly predicted, demonstrating a 90% accuracy rate.
Cricopharyngeal myotomy: A review of surgical results in patients with cricopharyngeal achalasia of neurogenic origin
Authors: Berg Howard M. , Persky Mark S. , Jacobs Joseph B. , Cohen Noel L. 
Published: October 2006

AbstractCricopharyngeal myotomy is an effective procedure for the treatment of swallowing disorders due to dysfunction of the upper esophageal sphincter and pharyngeal musculature. Eight patients with documented pharyngeal and sphincteric dysfunction have undergone myotomies with significant improvement in swallowing associated with restoration of oral feeding without aspiration in 5, while 3 patients have not improved. The preoperative work‐up and evaluation is discussed as well as criteria that may identify those patients most likely to benefit from this treatment.
Facial paralysis in lyme disease
Authors: Clark Jane R. , Carlson Roy D. , Pachner Andrew R. , Sasaki Clarence T. , Steere Allen C. 
Published: October 2006

AbstractLyme disease is a multisystemic illness caused by a tick‐borne spirochete. Once considered unique to the Connecticut coastline, thousands of cases are now documented throughout the United States, northern Europe, and Australia.Unilateral and bilateral facial paralysis may occur in up to 11% of patients with Lyme disease. This paper reviews the clinical course, distinguishing features, and outcome of 124 such palsies in 101 patients seen between 1975 and 1984. The 99.2% spontaneous recovery rate demonstrates the unequivocally excellent prognosis of this palsy and confirms that operative intervention is not indicated.The otolaryngologist should consider this etiology in all otherwise idiopathic facial paralyses, especially when presenting in summer months in endemic areas, or when bilateral. Positive Lyme disease spirochete titers are helpful in the diagnosis. We believe antibiotics should be given to patients with this facial palsy in order to treat any other concurrent manifestations of the illness and to prevent subsequent complications.
True vocal cord paralysis following intubation
Authors: Cavo John W. 
Published: October 2006

AbstractTrue vocal cord paralysis may follow endotracheal intubation and be the result of peripheral nerve damage. This damage can occur as the result of compressing the nerve between an inflated endotracheal tube cuff and the overlying thyroid cartilage.A series of anatomic dissections defined the likely site of injury to be at the junction of the vocal process of the arytenoid cartilage and the membranous true vocal cord approximately 6 to 10 mm below the level of the cord.Cuff pressures were monitored during anesthetics. Analysis of the results indicated that nitrous oxide diffuses into endotracheal tube cuffs causing a substantial increase in the intracuff pressure.We have concluded that true vocal cord paralysis which follows endotracheal intubation is usually temporary. The solution to the problem lies in its prevention and several methods are described whereby it may be avoided.
The use of osteosynthesis in immediate and delayed mandibular reconstruction
Authors: Komisar Arnold , Shapiro Barry M. , Szporn Monroe , Danziger Eliot , Cobelli Neil 
Published: October 2006

AbstractPrinciples of osteosynthesis utilizing dynamic compression plating have been used in immediate and delayed mandibular reconstruction in five patients. Intermaxillary fixation was not used. Follow‐up ranged from eight to 14 months. Four of five patients have viable bone grafts at the present time. One bone graft has been lost due to infection. We feel mandibular reconstruction based on principles of osteosynthesis helps to rapidly restore cosmesis and function with minimal morbidity.
Computerized database of drug interactions: A paradigm for resolving a communication gap in otolaryngology
Authors: Lucente Frank E. 
Published: October 2006

AbstractThe tremendous increase in the number of prescription and non‐prescription drugs available to physicians and patients increases the likelihood for adverse drug interactions. This study addresses the feasibility of using contemporary computer technology to provide the physician with the most up‐to‐date information in order to prevent such adverse reactions. The study involved three stages: 1. determination of physician attitudes regarding the use of the database; 2. creation of a database applicable to otolaryngology; and 3. testing of the database in office practice. The study demonstrated that many physicians were unsatisfied with their ability to remain conversant with the literature regarding drug interactions and that they were receptive to the notion of using computers for this purpose. It further demonstrated that a database could be constructed by an otolaryngologist for use in office practice and that the database contained other clinically useful information.
PLATE FIXATION FOR OPEN MANDIBULAR FRACTURES
Authors: Klotch Douglas W. , Bilger Joan R. 
Published: October 2006

AbstractEighty‐one patients with mandibular fractures were treated between November 1978 and November 1983. Twenty‐six of these patients had 47 comminuted open fractures treated with rigid internal fixation utilizing AO compression plating.No infected nonunion, osteomyelitis, or plate extrusion occurred. Occlusal relationships of remaining dentition were maintained with normal mandibular function in all patients.Rigid internal fixation is an excellent method for stabilizing and repairing comminuted open mandibular fractures. The technique provides immediate return of mandibular function which may be critical in the management of the polytraumatized patient.
The giant cholesterol cyst of the petrous apex: A distinct clinical entity
Authors: Graham Malcolm D. , Kemink John L. , Latack Joseph T. , Kartush Jack M. 
Published: October 2006

AbstractThe giant cholesterol cyst (GCC) of the petrous apex may now be considered a distinct clinical entity and should be considered in the differential diagnosis of lesions of the midcranial skull base.This benign cystic lesion of the petrous apex gradually enlarges and may produce progressive bone erosion and serial neurologic deficits of the cranial nerves within the temporal bone and jugular foramen.We report here five instances of this lesion (3 patients with unilateral and 1 patient with bilateral petrous apex lesions) and describe the natural history, diagnostic evaluation, pathology, and surgical management.
The tailored CT evaluation of persistent facial nerve paralysis
Authors: Harnsberger H. Ric , Davis R. Kim , Parkin James L. , Osborn Anne G. , Smoker Wendy 
Published: October 2006

AbstractThe clinical, radiographic, and pathologic records of 39 patients with peripheral facial nerve dysfunction seen from October 1981 through July 1984 are reviewed. The extent of preradiologic clinical localization of suspected lesions and their subsequent pathologic confirmation is correlated to the number, sequence, and type of radiographic evaluations performed.Based on this review, an imaging protocol for patients with clinically occult lesions of the peripheral facial nerve is presented.
Spontaneous enophthalmos from chronic maxillary sinusitis
Authors: Wesley Ralph E. , Johnson John J. , Cate Ronald C. 
Published: October 2006

AbstractSpontaneous enophthalmos has been reported to occur after demineralization of the orbital floor from chronic maxillary sinusitis. We report a 24‐year‐old female who developed spontaneous enophthalmos without demineralization of the orbital floor. A contracture from the maxillary sinus apparently pulled the orbital floor downward. Release of the fibrous tissue through a combined orbital and sinus approach produced satisfactory correction of the enophthalmos without the use of alloplastic implants. This case suggests that fibrotic contraction in the maxillary sinus pulling the floor of the orbit downward can produce spontaneous enophthalmos without boney destruction.
Myocutaneous fenestration in sleep apnea patients
Authors: O'Leary Michael J. , Farrell George 
Published: October 2006

AbstractWe present a patient with severe obstructive sleep apnea syndrome (OSAS), including O2 desaturations to 11%, who was successfully managed with myocutancous fenestration tracheostomy.The myocutaneous fenestration technique employs bilateral horizontal skin‐platysma advancement flaps sutured directly to a trachecal fenestra created between rings two to four. It conforms ideally to the unique physical and psychological demands of the sleep apnea patient. Rapid healing time and minimal granulation tissue, combined with a permanently functional, yet reversible and minimally disfigurative stoma, highlight the advantages of the technique over standard tracheostomy. The myocutaneous fenestration tracheostomy is uniquely applicable to the surgical treatment of patients with moderate to severe obstructive sleep apnea.
Management of facial palsy caused by birth trauma
Authors: Bergman Ira , May Mark , Wessel Henry B. , Stool Sylvan E. 
Published: October 2006

AbstractWe present a newborn with a unilateral complete facial palsy caused by birth trauma, and discuss the differential diagnosis, pathophysiology, and management of this common, usually benign, condition. This child made a rapid, complete, spontaneous recovery despite a severe initial injury. Surgical exploration of the facial nerve should be considered only for infants with complete paralysis, clinically and electrophysiologically, who demonstrate no improvement by 5 weeks of age.
A finite element model of skin deformation. I. Biomechanics of skin and soft tissue: A review
Authors: Larrabee Wayne F. 
Published: October 2006

AbstractSkin flap design has traditionally been based on geometric models which ignore the elastic properties of skin and its subcutaneous attachments. This study reviews the theoretical and experimental mechanics of skin and soft tissues (I) and proposes a mathematical model of skin deformation based on the finite element method (III). Finite element technique facilitates the modeling of complex structures by analyzing them as an aggregate of smaller elements.This paper gives the results of an animal model developed to study the deformation and mechanical properties of skin, including its viscoelastic properties (hysteresis, creep, and stress relaxation). A new skin extensometer, constructed with digital stepper motors and controlled with a microcomputer, is described to measure these properties for both skin and its subcutaneous attachments. Deformation grids quantitated from photographs with a digitalizing tablet are presented, and computer software is introduced to standardize and analyze them (II). The mathematical model is used to simulate wound closures such as the ellipse and rectangular advancement flap. In addition, a series of mathematical experiments performed to simulate deformation of a strip of skin are described; the relationships between the various elastic constants are investigated; and a comparison of these simulations with actual deformation is presented. Limitations of the model and areas for future investigation are discussed (III).
Changes in caloric nystagmus induced by vasodilating drugs
Authors: Baldwin R. L. , Formby C. 
Published: October 2006

AbstractSystemic blood flow, blood flow to the peripheral skin, middle ear, and temporal bone, and that to the inner ear of normal volunteers was manipulated selectively through the use of vasodilator drugs. The effect of selective vasodilation was monitored via changes in the temporal course of the slow‐phase velocity of nystagmus evoked by bithermal caloric irrigation. Drug influenced eye velocities were compared with control values measured before drug administration. Eye velocities measured after niacin (a peripheral vasodilator) administration generally were greater than control values, whereas eye velocities measured after papaverine (a central vasodilator) and histamine (a systemic vasodilator) administration typically were less than control values. These findings, with the exception of the cool caloric/niacin condition, are consistent with a model of vestibular dynamics and measurements of cochlear blood flow in animal models.
Multiple primary neoplasms in patients with salivary gland or thyroid gland tumors
Authors: Johns Michael E. , Shikhani Alain H. , Kashima Haskins K. , Matanoski Genevieve M. 
Published: October 2006

AbstractThe exact risk of multiple primary neoplasms in patients with salivary gland or thyroid gland malignancies is difficult to ascertain from the data available in the literature. This study examines, retrospectively, 198 patients with a first malignancy of the salivary gland and 186 patients with a first malignancy of the thyroid gland, treated over a 10‐year period. Fourteen cases of second tumors were found in the first group and 29 cases in the latter. Patients whose second neoplasm was a skin cancer or who had a previous neoplasm at a site other than those selected for study were excluded. The risk of a second tumor was compared to the expected number of second cancers from the Combined National Cancer Institute Registry Data, and the results indicated an increased risk in males with a first malignancy of the salivary gland and in both men and women with a first thyroid malignancy. The salivary glands, larynx, and colon were the most common sites of second tumors after a first salivary cancer. The adrenals, brain, lymphatic system, and breast were the most common site after a first thyroid cancer. The previously reported association of cancers of the thyroid and the breast in females is confirmed here in men and women. The excess of brain tumors and lymphomas has not been reported previously.
Compression plates in the treatment of advanced anterior floor of mouth carcinoma
Authors: Papel Ira D. , Price John C. , Kashima Haskins K. , Johns Michael E. 
Published: October 2006

AbstractAdvanced anterior floor of mouth squamous cell carcinoma has been traditionally treated with wide excision in conjunction with mandibulectomy and radical neck dissection. This has resulted in significant mandibulofacial defects with functional and cosmetic significance. Efforts at primary reconstruction in the past using bone grafts, osteomyocutaneous flaps, and other methods have yielded unsatisfactory results. A history of prior irradiation has made this problem even more refractory.We present a series of 11 patients who underwent composite resection for advanced anterior floor of mouth carcinoma (T2‐T4), with primary reconstruction using a dynamic compression plating system in conjunction with local and regional tissue flaps. The clinical courses, complications, and surgical techniques are discussed.The issues of reconstruction at primary treatment, irradiation with a metal plate in the field, and the early restoration of oral function are addressed. Experience in this series shows that compression plates can be an effective method of primary reconstruction for advanced anterior floor of mouth lesions.
Laryngoplasty for vocal cord medialization: An Alternative To Teflon®
Authors: Koufman James A. 
Published: October 2006

AbstractLaryngeal framework surgery, using a Silastic®implant placed between the thyroid cartilage and inner thyroid perichondrium for vocal cord medialization, offers an exciting new surgical option to intracordal Teflon®injection for the relief of symptomatic unilateral vocal cord paralysis. A series of 11 patients who have undergone medialization laryngoplasty is presented. The advantages, technical details, and results of surgery are discussed.
Mediastinitis occurring as a complication of odontogenic infections
Authors: Levine Toni M. , Wurster Carl F. , Krespi Yosef P. 
Published: October 2006

AbstractMediastinitis occurring from a descending odontogenic infection occurs rarely. The diagnosis is sometimes difficult to make and is often delayed until the patient is in extremis. The physical examination is often nondiagnostic, but may include brawny edema of the neck and chest. CT scanning provides the most accurate diagnostic information. The treatment is always surgical, in combination with appropriate antibiotics. Five patients with mediastinitis secondary to odontogenic infections are presented, and the technique of transcervical drainage of the anterior and posterior mediastinum is reviewed.
Light dosimetry in animal models: Application to photodynamic therapy in otolaryngology
Authors: Werkhaven Jay , Harris David M. , Krol Glenn , Hill James H. 
Published: October 2006

AbstractPhotodynamic therapy (PDT) for treatment of head and neck cancer uses a photoactive compound that is illuminated with 630 nm (red) light. The effectiveness of PDT depends on the penetration of light into tissue that is both tissue and wavelength dependent. The characterization of the optical properties of an animal oral mucosa and skin has been done to determine the amount of light below these tissues available to be used for photodynamic therapy. The tissue absorbance of visible light from 400 nm to 700 nm has been determined in vitro for hamster cheek pouch mucosa and for athymic mouse skin. The pattern of absorbance is similar for both tissues and demonstrates greater transmission at the longer wavelengths. The diffuse transmittance of light in vivo for these animal models was measured with an interstitial fiberoptic probe. At 630 nm the diffuse transmittance for nude mouse skin averages 10% of the incident light energy, and that for the hamster mucosa almost 50% of the incident light energy.
A systematic approach to the surgical management of acoustic neuroma
Authors: Glasscock Michael E. , Kveton John F. , Jackson C. Gary , Levine Samuel C. , Mckennan Kevin X. 
Published: October 2006

AbstractContemporary otomicrosurgical techniques have made total removal of acoustic tumor with preservation of the seventh and sometimes the eighth cranial nerves possible. The four approaches currently used in acoustic tumor surgery are the middle cranial fossa, the translabyrinthine, the suboccipital, and the combined translabyrinthine‐suboccipital. This review examines the surgical results in the removal of more than 600 acoustic tumors and outlines a rationale for the choice of approach. Tumor size on computed tomographic scan and auditory reserve establish the parameters used in planning the surgical procedure. The translabyrinthine exposure is used most frequently followed by the combined translabyrinthine‐suboccipital. The middle fossa and suboccipital approaches are used when preservation of hearing is attempted. Total removal of tumor was accomplished in more than 99% of patients with a mortality rate of less than 1%. Anatomic preservation of the facial nerve, which is directly related to tumor size, was achieved in more than 80% of patients. Preservation of hearing is unlikely when the tumor is larger than 2 cm; anatomic preservation of the cochlear nerve was successful in 73% of hearing preservation procedures.
Blood transfusions in surgery of the larynx and neck
Authors: Levine Steven B. , Kimmelman Charles P. , Zwillenberg Seth , Silberstein Leslie 
Published: October 2006

AbstractEffective utilization of blood and blood products is an important consideration in elective surgical procedures. A cost‐effective process will maintain availability to the general population while supplying reasonable surgical needs. Removing stored blood from the general pool strains these resources and drastically increases cost.To establish the first clinical model of study and to better predict blood requirements for elective surgery of the larynx and neck, medical records of 137 consecutive patients who underwent laryngeal surgery from January 1, 1981 to June 30, 1984 were reviewed. All patients had one or a combination of one of the following: radical neck dissection, total laryngectomy, hemilaryngectomy, and/or supraglottic laryngectomy. Data analyzed included estimated allowable blood loss, estimated intraoperative blood loss, as well as preoperative and postoperative blood hemoglobin concentrations.Actual blood utilization was adjusted for individual patient need, and recommendations for appropriate blood screen and cross‐match were derived for each of the above surgical procedures. It was concluded that blood availability for the individual patient is best assessed by the surgeon.
Olfactory evoked potentials in the rat
Authors: Inokuchi Akira , Kimmelman Charles P. , Wang Hui‐E , Snow James B. 
Published: October 2006

AbstractRoutine clinical assessment of the integrity of the olfactory pathway using olfactory evoked potentials remains an elusive goal. One important difficulty arises from the uncertainty of the exact origin of the potentials: are they produced by olfactory or trigeminal elements? To resolve this problem, an animal model using the rat was developed. Amylacetate was used as an odorant stimulus, and potentials were measured and computer averaged after elimination of trigeminal and vomeronasal activity. A positive‐negative wave was recorded from the olfactory bulb surface, and a negative wave often followed by a positive wave was recorded from the surface of the cerebral cortex. Measurements from the scalp surface gave comparable results. Lesioning experiments of the olfactory pathway indicate that the evoked potentials recorded at the vertex originate in the ventral forebrain, specifically in the prepyriform cortex, olfactory tubercle, and anterior olfactory nucleus.