bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sternocleidomastoid muscle transfer and superficial musculoaponeurotic system plication in the prevention of Frey's syndrome
Authors: Casler John D. , Conley John 
Published: October 2006

AbstractParotidectomy may be associated with a significant depression in the retromandibular region and a significant incidence of gustatory sweating (Frey's syndrome). Superiorly and inferiorly based sternocleidomastoid flaps and posterior plication of the superficial musculoaponeurotic system were evaluated for their ability to ameliorate both consequences. Sixteen patients with sternocleidomastoid flaps and 16 patients with superficial musculoaponeurotic system plication were compared to a control group of 104 patients. The incidence of Frey's syndrome was 47.1% in the control group, 12.5% (P = 0.025) in the sternocleidomastoid flap group, and 0% (P = 0.005) in the superficial musculoaponeurotic system plication group. The surgical techniques are described. The prevalence of Frey's syndrome is discussed with respect to age, sex, radiation therapy, and the type of parotidectomy performed. The indications and contraindications of the three surgical techniques are described.
Allergic fungal sinusitis: Problems in diagnosis and treatment
Authors: Allphin Allan L. , Strauss Melvin , Abdul‐Karim Fadi W. 
Published: October 2006

AbstractAlthough first described in 1983, allergic Aspergillus sinusitis (AAS) has yet to gain wide recognition among otolaryngologists and pathologists. We have treated three patients with a history of asthma, nasal polyposis, and recurrent pansinusitis who fit the description of allergic Aspergillus sinusititis. Histopathologically, mucinous material with abundant eosinophils and Charcot‐Leyden crystals (“allergic mucin”) is interspersed with fungal hyphae. Immunologic characteristics include serum total immunoglobulin E (IgE) elevation, increased RAST classes, and cutaneous reactivity to molds.A retrospective analysis of the histopathology of 82 patients with chronic sinusitis was also undertaken. Eleven additional patients with classic allergic mucin were identified, but were found to be without evidence of fungal elements. The clinical features of all 14 patients are reviewed revealing the spectrum of disease. The difficulties of diagnosis and a therapeutic protocol which includes wide local debridement and postoperative use of systemic steroids are discussed.
Ciprofloxacin: Drug of choice in the treatment of malignant external otitis (MEO)
Authors: Levenson Mark J. , Parisier Simon C. , Dolitsky Jay , Bindra Gurpaul 
Published: October 2006

AbstractCiprofloxacin, a fluorinated quinolone with high efficacy against Pseudomonas aeruginosa, was used in the treatment of 10 consecutive patients with malignant external otitis. All patients had skull base osteomyelitis documented by nuclear and computed tomography (CT) scans. Dosages of 1.5 g of ciprofloxacin daily were used for a mean average of 10 weeks. All patients were considered cured with a minimum follow‐up of 18 months after completion of therapy. A new classification of malignant external otitis (MEO) is presented.
A new approach to serial monitoring of ultra—high frequency hearing
Authors: Feghali Joseph G. , Bernstein Richard S. 
Published: October 2006

AbstractEarly detection of drug‐induced hearing loss is best accomplished by monitoring hearing at the ultra‐high frequencies. Unfortunately, at these frequencies, sound pressure at the tympanic membrane (TM) critically depends on the placement of the sound source and on the size and shape of each individual external ear. Thus, presentation of the same sound may yield substantially different sound pressures in different ears. Moreover, only a slight change in the position of an earphone may yield large changes in sound pressure at the tympanic membrane. As a consequence of these characteristics, the reliability of ultra–high‐frequency audiometry is poorer than at conventional audiometric frequencies. However, for the early detection of ototoxicity, it is necessary only to monitor for increases in thresholds. Accordingly, a sound‐delivery system was developed which fixes the relative position of the sound source and the ear. This system ensures that sounds at the same level may be presented during different test sessions. To assess the stability of ultra–high‐frequency thresholds, normal hearing subjects were tested in sessions separated by several weeks. Thresholds were obtained between 1 and 16 kHz and were found to be reliable. It is concluded that this type of system can be used for monitoring the ototoxic effects of drug therapy.
Otoplasty: Critical review of clinical results
Authors: Adamson Peter A. , Mcgraw Becky L. , Tropper Guy J. 
Published: October 2006

AbstractAlthough it is generally believed that otoplasty provides uniformly gratifying results, thorough patient follow‐up reviews are quite rare. Otoplasty surgery performed on 119 ears was retrospectively reviewed to assess the results of our cartilage‐sparing technique. This method of otoplasty relies on a conchal set‐back and suture transfixion technique to improve the antihelical contour.Yuricular medialization averaged 10.3 mm. Overcorrection is required, particularly in the superior pole, as loss of correction with healing was approximately 40% of the initial medialization. Revision surgery due to loss of correction was necessary for 6.6% of the ears initially operated on by the senior author. Patients who presented following cartilagecutting procedures tended to have a higher rate of revision and persistent postoperative stigmata. Complications in general were few; however, mersilene suture extrusion occurred in 8% of ears. Only one of these required revision surgery for associated loss of correction. Despite these drawbacks, over 95% of patients achieved satisfactory results using cartilage‐sparing otoplasty techniques.
The lymphocyte transformation test with type II collagen as a diagnostic tool of autoimmune sensorineural hearing loss
Authors: Berger Peter , Hillman Matthias , Tabak Mehmet , Vollrath Michael 
Published: October 2006

AbstractImmunological disorders of the cellular type can be diagnosed by the lymphocyte transformation test (LTT). An autoimmune mechanism of certain cases of sensorineural hearing loss (SNHL) can be evaluated by using human inner ear tissue as an antigen. Recent studies have shown that type II collagen plays an important role, not only in some autoimmune mediated rheumatoid diseases, but also as an antigenic substrate of inner ear tissue in autoimmune sensorineural hearing loss. This paper deals with results of the lymphocyte transformation test using type II collagen as antigen in 68 patients with progressive sensorineural hearing loss (PSNHL) and 68 healthy volunteers. Thirty‐four patients showed a strong stimulation in the lymphocyte transformation test, in contrast to only four volunteers in the control group, two of whom had a history of rheumatoid arthritis.
P300 response to tones and speech sounds after cochlear implant: A case report
Authors: Kaga Kimitaka , Kodera Kazuoki , Hirota Eiko , Tsuzuku Toshihiro 
Published: October 2006

AbstractP300 potentials evoked by tones and spoken words were recorded from a 20‐year‐old man with a House‐3M® single‐channel cochlear implant. Three months after cochlear implantation, there was a slight appearance of P300 response to both pure‐tone stimuli and spoken‐word stimuli; 6 months later, clearly identifiable P300 response to both pure‐tone stimuli and spoken‐word stimuli were obtained. These results are consistent with an encoding improvement for re‐establishment of information processing after auditory rehabilitation.
The intraoperative management of the thyroid gland during laryngectomy
Authors: Brennan Joseph A. , Meyers Arlen D. , Jafek Bruce W. 
Published: October 2006

AbstractThe standard of care of laryngeal cancer surgery is wide field excision of the larynx combined with ipsilateral thyroid lobectomy. A retrospective review of 247 laryngectomies performed between 1979 and 1989 was undertaken to determine specific intraoperative indications for thyroid gland removal. The incidence of thyroid disease in our patients with laryngeal cancer was compared to the normal population. Eight percent of thyroid specimens removed during laryngeal cancer surgery demonstrated invasion by squamous cell carcinoma. All patients having thyroid invasion had T3 or T4 laryngeal lesions that were stage IV at the time of surgery. All these lesions were found to have transglottic growth and laryngeal cartilage invasion by the pathologist. All of these patients also had abnormal thyroid glands intra‐operatively and laryngeal cartilage destruction that was evident intraoperatively. Total thyroidectomy with bilateral paratracheal and pretracheal lymph node dissection is indicated when squamous cell carcinoma of the larynx involves the thyroid gland. Prophylactic ipsilateral thyroid lobectomy and isth‐musectomy is warranted for large laryngeal cancers (T3, T4) that involve the anterior commissure, the subglottic area, or extend transglottically. Routine thyroid gland removal is not indicated for the majority of laryngeal cancers that do not meet the aforementioned criteria. Finally, abnormal thyroid histopathology was diagnosed in 37% of the surgical thyroid gland specimens removed during laryngectomy.
Functional evaluation following microvascular oromandibular reconstruction of the oral cancer patient: A comparative study of reconstructed and nonreconstructed patients
Authors: Urken Mark L. , Buchbinder Daniel , Weinberg Hubert , Vickery Carlin , Sheiner Alan , Parker Robin , Schaefer Jacqueline , Som Peter , Shapiro Arnold , Lawson William , Biller Hugh F. 
Published: October 2006

AbstractOver the past decade, the use of free flap transfers in head and neck surgery has led to remarkable advances in the reliability and the ultimate results of oromandibular reconstruction. Stable and retentive dental restorations have been achieved using enosseous implants placed directly into the vascularized bone flaps. However, the functional assessment of patients who underwent primary mandibular reconstruction with these techniques has not been previously reported. A group of 10 reconstructed and 10 nonreconstructed segmental hemimandibulectomy patients were compared using a battery of tests to assess their overall well‐being, cosmesis, deglutition, oral competence, speech, length of hospitalization, and dental rehabilitation. In addition, objective measures of the masticatory apparatus (interincisal opening, bite force, chewing performance, and chewing stroke) were used to compare these two groups as well as normal healthy subjects and edentulous patients restored with conventional and implant‐borne dentures. The results show a clear advantage for the reconstructed patients in almost all categories. Persistent problems and future directions in oromandibular reconstruction are discussed.
Computerized tomography and magnetic resonance imaging following cranial base surgery
Authors: Carrau Ricardo L. , Weissman Jane L. , Janecka Ivo P. , Snyderman Carl H. , Curtin Hugh D. , Sekhar Laligam , Lee Hyung Seok 
Published: October 2006

AbstractThe computed tomography scans and magnetic resonance imaging films of 57 patients who underwent anterior or anterolateral cranial base surgery from January 1987 to August 1989 were retrospectively reviewed to ascertain the significance of early and late postoperative intracranial imaging changes.Extra‐axial changes (air, blood, cerebrospinal fluid collection) were found in 96% of patients; axial changes (brain edema, contusion) were seen in 30% of patients in the first postoperative period (72 hours). Subsequently, extra‐axial changes began to resolve but axial changes became more prevalent. After 6 months, only axial changes persisted (enceph‐alomalacia).It was encouraging to find a low correlation of imaging abnormalities with clinically significant findings.
Quantifying the spread of botulinum toxin through muscle fascia
Authors: Shaari Christopher M. , George Elaina , Wu Bei‐Lian , Biller Hugh F. , Sanders Ira 
Published: October 2006

AbstractBotulinum toxin was recently approved for treating several head and neck dystonias. Paralysis of neighboring muscles is the major complication of its use. Spread of toxin from the injected muscle has been suggested as an etiology. This study examines how botulinum toxin crosses muscle fascia by a novel method of quantifying muscular paralysis.Botulinum toxin (0.2 to 10 U) was placed onto the fascia of rat tibialis anterior (TA) muscles (n = 6). Toxin was also placed on dose‐matched muscles that had their fascia surgically removed (n = 6). Twenty‐four hours later, the nerve to the tibialis anterior was electrically stimulated to deplete the muscle fibers of glycogen. Toxin‐paralyzed fibers retained their glycogen and appeared purple on periodic acid‐Schiff (PAS) stain.Botulinum toxin easily passed through muscle fascia even at subclinical doses. The presence of fascia reduced the spread of botulinum toxin by 23%. These results suggest that spread of botulinum toxin can be prevented only by delivering small doses to the center of a target muscle.
Otoacoustic emissions in normal and hearing‐impaired children and normal adults
Authors: Spektor Zorik , Leonard Gerald , Kim D. O. , Jung Marjorie D. , Smurzynski Jacek 
Published: October 2006

AbstractAlthough distortion‐product otoacoustic emissions (DPOEs) have been studied in adults recently, there is little information regarding them in young children. DPOEs and click‐evoked otoacoustic emissions (CEOEs) were measured from a same group of normal and hearing‐impaired children (age 4 through 10 years) and normal adults (age 22 through 29 years). Measurements of DPOEs in 13 children's ears with normal hearing showed higher levels of emissions in the 700‐ to 1400‐Hz and 5.7‐kHz regions relative to the data obtained in 10 normal adult ears. The 22 ears of children with sensorineural hearing loss demonstrated agreement between pure‐tone audiograms and “DPOE audiograms.” Measurements of CEOEs revealed that the average level of emission in 15 normal‐hearing children's ears was slightly lower than that previously obtained in newborns, but slightly higher than that of adults. In children, the CEOE spectral components in the 4‐ to 6‐kHz region were lower than in newborns, but higher than in adults. These results support the view that the DPOEs and CEOEs comprise a valuable tool in assessment of cochlear function in subjects of all ages.
The natural history of epistaxis in hereditary hemorrhagic telangiectasia
Authors: Aassar O. Sami , Friedman Craig M. , White Robert I. 
Published: October 2006

AbstractThe purpose of this retrospective study is to document the natural history of epistaxis in patients with hereditary hemorrhagic telangiectasia. A telephone questionnaire was administered to 73 patients who had been previously screened for pulmonary arteriovenous malformations (PAVMs). The incidence of epistaxis in this population was 93%, with a mean onset age of epistaxis of 12 years, a mean frequency of bleeding of 18 episodes per month, and a mean duration of bleeding of 7.5 minutes. More than 90% of patients experienced the onset of epistaxis before the age of 21 and symptoms were progressive with age. There were no differences in the age of onset, frequency of epistaxis, or duration of epistaxis between patients with PAVMs versus those without PAVMs. Although the natural history of epistaxis does not predict the presence or absence of pulmonary arteriovenous malformations, epistaxis is an early marker of the disease, hereditary hemorrhagic telangiectasia, and might guide screening for pulmonary and cerebral arteriovenous malformations in children of affected parents.
Cis‐platinum ototoxicity in children
Authors: Pasic Thomas R. , Dobie Robert A. 
Published: October 2006

AbstractCis‐platinum is an ototoxic antineoplastic drug. Evaluation of auditory thresholds in 33 children receiving cis‐platinum shows that a threshold shift at 6 and 8 kHz is first measurable after a cumulative dose of 201 to 300 mg/m2. A 35‐ to 40‐dB high‐frequency threshold shift is evident after a cumulative cis‐platinum dose of 301 to 400 mg/m2. Increasing cumulative doses of cis‐platinum are associated with a greater degree of hearing loss. Receiver‐operator characteristic curves were used to find a criterion value that effectively identified threshold shifts that were due to cis‐platinum ototoxicity. A 15‐dB or greater shift in the 6‐ and 8‐kHz threshold average identifies a high true‐positive (50%) and low false‐positive (0%) rate of cis‐platinum‐induced hearing loss. Using this criterion, cis‐platinum ototoxicity affected 77% of children who received cis‐platinum (median cumulative dose 360 mg/m2).
Anatomical correlates of functional recovery in the avian inner ear following aminoglycoside ototoxicity
Authors: Girod Douglas A. , Tucci Debara L. , Rubel Edwin W. 
Published: October 2006

AbstractTucci and Rubel have demonstrated functional recovery of the chick cochlea following aminoglycoside ototoxicity. The cochleae of these same animals were examined by scanning electron microscopy (SEM) in order to further understand this recovery process.Hatchling chicks were given daily doses of gentamicin for 10 days. Auditory‐evoked potential measurements and examination of the cochlea by scanning electron microscopy were performed after survival periods of 5 days to 20 weeks.After 5 days of gentamicin exposure, there was near complete basal hair cell loss associated with a high‐frequency hearing loss. Apical progression of damage with a broad‐band hearing loss occurred over 4 weeks. At 20‐weeks, hair cell counts were normal with a small high‐frequency hearing loss. Hair cell regeneration played a major role in the functional recovery of the cochlea.
Surgical pathology of cancer of the oral cavity and oropharynx
Authors: Brennan Clare T. , Sessions Donald G. , Spitznagel Edward L. , Harvey Joseph E. 
Published: October 2006

AbstractA study was designed to determine the influence of certain surgical pathologic findings on tumor spread and survival in patients with cancer of the oral cavity and oropharynx. All patients with the histopathological diagnosis of carcinoma of the oral cavity or oropharynx from 1955 to 1983 were included in the study. Using the Head and Neck Tumor Registry of the department of otolaryngology of the Washington University School of Medicine, information was obtained regarding preoperative evaluation, staging, classification, diagnosis, treatment, surgical pathology parameters, and outcome results. The patient populations consisted of 545 patients with oral cavity cancer and 224 patients with oropharynx cancer, all of whom were eligible for 3‐year follow‐up.Information from a retrospective analysis of the pretreatment examination records regarding site and size of the primary tumor and neck dissection, and specific treatment, and from surgical pathology reports regarding site, size, tumor spread and resection margins, was correlated with treatment outcome. The database file was analyzed using dbase III and its companion program Framework, and SAS PC (Statistical Analysis Systems for personal computers).
The rhinologic evaluation of alzheimer's disease
Authors: Feldman Jeffrey I. , Murphy Claire , Davidson Terence M. , Jalowayski Alfredo A. , De Jaime Gabriella Galindo 
Published: October 2006

AbstractOlfactory dysfunction is currently not listed among the NINCDS‐ADRDA clinical criteria for the diagnosis of Alzheimer's disease. There is a large amount of psychophysical and neuropathologic evidence to suggest that patients with Alzheimer's type dementia have olfactory system abnormalities. The rhinologic status of this group has not been characterized. The authors examined 21 Alzheimer's patients and 21 age‐matched controls to determine whether 1. the Alzheimer's group, in fact, had a diminished sense of smell, and whether 2. rhinologic factors were responsible for this nasal dysfunction. The findings support a neurologically mediated phenomenon as the cause for significant impairment in olfactory function in patients with probable Alzheimer's disease.
A comparison of risk factors in juvenile‐onset and adult‐onset recurrent respiratory papillomatosis
Authors: Kashima Haskins K. , Shah Farida , Lyles Alan , Glackin Robert , Muhammad Nadayah , Turner Laurie , Van Zandt Shirley , Whitt Sheila , Shah Keerti 
Published: October 2006

AbstractThe clinical triad of a firstborn delivered vaginally to a young (teenage) mother has been previously noted among juvenile onset recurrent respiratory papillomatosis (JO‐RRP) patients. This study was based on a questionnaire survey of JO‐RRP patients, adult onset recurrent respiratory papillomatosis (AO‐RRP) patients, and juvenile and adult controls. The survey results revealed that the complete or partial triad was observed in 72% of JO‐RRP patients, 36% of AO‐RRP patients, 29% of juvenile controls, and 38% of adult controls. As compared with juvenile controls, JO‐RRP patients were more often firstborn (P <.05), delivered vaginally (P <.05), and born to a teenage mother (P <.01). Among adult participants, AO‐RRP patients reported more lifetime sex partners (P <.01) and a higher frequency of oral sex (P <.05) than reported by adult controls.AO‐RRP and JO‐RRP appear to have distinguishable epidemiologic features indicating that the mode of human papillomavirus (HPV) transmission is different in these two disorders.
Metastatic head and neck malignancy treated using MRI guided interstitial laser phototherapy: An initial case report
Authors: Castro Dan J. , Lufkin Robert B. , Saxton Romaine E. , Nyerges Anthony , Soudant Jacques , Layfield Lester J. , Jabour Bradley A. , Ward Paul H. , Kangarloo Hooshang 
Published: October 2006

AbstractInterstitial laser phototherapy (ILP) guided by magnetic resonance imaging (MRI) may become an attractive adjunctive modality for the treatment of deep and surgically inaccessible tumors of the head and neck when accurate methods of laser dosimetry and “real‐time” monitoring techniques with the MRI are introduced. We recently demonstrated in ex vivo and in vivo models, a linear relationship between levels of laser energies, thermal profiles, MR signal intensity changes, and histopathological tissue damage. Results of treatment in a patient with an unresectable large right jugulodigastric metastatic squamous carcinoma using new approach of MRI guided ILP are now reported. The patient complained of significant right‐sided neck pain and headaches secondary to a rapidly growing metastatic lymphadenopathy which recurred after previous surgery, radiation, and chemotherapy. Two treatment sessions were used at an interval of 2 weeks. Each treatment was performed in the MRI suite under heavy sedation. Using a 600‐μm bare fiber of the Nd:YAG laser implanted interstitially under MR guidance, the metastatic node was treated at three sites. T1‐ and T2‐weighted images were performed prior to, immediately after, 24 and 48 hours, and 4, 5, 7, 9, 16, and 25 days post‐treatment. Successful relief of pain and growth arrest of this node was observed after the second treatment and at the 3‐month follow‐up. These results demonstrate that this technique of ILP guided by MRI may be feasible in humans, and will become clinically practical when appropriate methods of dosimetry and instrumentation are developed.