bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of the internal carotid artery in surgery of the skull base
Authors: Andrews James C. , Valavanis Anton , Fisch Ugo 
Published: October 2006

AbstractManagement of the internal carotid artery in skull‐base surgery can be a difficult problem when disease involves this vessel or resection is anatomically limited by it. The recent radiologic development of the detachable balloon catheter has permitted occlusion of the internal carotid artery in a controlled setting prior to any surgical procedure. An obvious prerequisite to using this technique is the demonstration of adequate collateral blood flow to the brain. Patients are evaluated with arteriography and temporary arterial balloon occlusion while monitoring physical signs and electroencephalography (EEG). Although usually performed preoperatively, internal carotid artery occlusion is needed intraoperatively on occasion. This essential adjuvant technique for the skull‐base surgeon will be detailed along with its indications and limitations in 24 patients.
Melanomas of the mucous membrane of the head and neck
Authors: Conley John J. 
Published: October 2006

AbstractMelanoma of the mucous membrane is a rare condition and the most serious of all head and neck melanomas. Its highest incidence is in the oral cavity, followed by the nasal and pharyngeal cavities. It usually occurs during the fifth decade of life. In its early stages it is asymptomatic and often located in areas difficult to see upon visual examination and technically inaccessible. These facts lead to a delay in diagnosis, which reduces curability to 8%. In spite of these negative factors, there has been a significant improvement in the extension and quality of life for patients with melanoma of the mucous membrane. The biological characteristics of this disease are analyzed and a philosophy of management is offered.
Multiple synchronous and metachronous cancers of the upper aerodigestive tract: A nine‐year study
Authors: Panosetti Eugene , Luboinski Bernard , Mamelle Gerard , Richard Jean‐Marie 
Published: October 2006

AbstractThree hundred fifty (42.1%) of these multiple cancers were considered synchronous, while 480 (57.9%) were classified as metachronous.Fifty percent of the metachronous cancers occurred within 31 months after the first primary; the mean time between the first primary and the second primary was 45 months. Approximately 22% of second primaries were found more than 5 years after the initial tumor.Five‐year survival rates were higher in metachronous cancers (55%) than in synchronous cancers (18%). Survival rates varied according to the treatment. In 49.4% of synchronous tumors the treatment had to be modified because of the presence of two cancers. In these patients, 5‐year survival rates were as low as 8%.In synchronous cancers that required no modification of the treatment, the prognosis was better and the survival rate was 28%. The preferential anatomical location of the second synchronous and metachronous cancers is discussed for first primaries situated in the oral cavity (103 cases), the oropharynx (120 cases), the hypopharynx (92 cases), and the larynx (87 cases).Second primaries in the esophagus were mostly synchronous cancers while, in the lung, second cancers were more frequently metachronous tumors.
Nasal polyps: Epithelium and goblet cell density
Authors: Larsen Per L. , Tos Mirko 
Published: October 2006

AbstractThe density of goblet cells was determined in 14 anterior and 15 posterior nasal polyps using the whole‐mount method. The specimens were then serial cut and the type of epithelium was determined in nine localities in each polyp. The goblet cell density was correlated to the epithelial type. Pseudostratified, cylindrical epithelium was the prevailing type, occurring in 62% of anterior localities and 78% of posterior localities. Transitional types of epithelium were found in 33% of the anterior and 19% of the posterior localities. Stratified squamous epithelium occurred in 5% and 3%, respectively. The goblet cell density was highest in hyperplastic pseudostratified epithelium, whereas it was four times lower in transitional epithelium and even lower in squamous epithelium. Marked differences in the distribution of epithelium and goblet cell density were found between anterior and posterior polyps, illustrating that the epithelium constantly changes under the influence of air current, contact with other polyps, infection, growth, and age of the polyp as well as other unknown factors.
Effect of ultrasonic nebulization of miraclid® on the proteolytic activity in tracheobronchial secretions of rats
Authors: Kosugi Tadayoshi , Nakamura Mariko , Noguchi Shuji , Wu Huang Guang 
Published: October 2006

AbstractExperimental studies of acute inflammation of the tracheobronchial lumen of rats suggest that protease inhibitor increases in tracheobronchial secretions in order to control inflammation. Recent studies have shown that the polyvalent protease inhibitor, Miraclid®, derived from human urine, is useful for treating DIC and acute pancreatitis. In view of this information, local administration of Miraclid was expected to diminish acute inflammation of the respiratory tract by creating a favorable balance in the protease‐antiprotease system. Before the chemotherapeutic use of locally administered Miraclid, the inhibitory activity of Miraclid on various proteases was first estimated in vitro. Administration of Miraclid by means of ultrasonic nebulization was then investigated in rats. The results can be, summarized as follows. 1. During ultrasonic nebulization, the inhibitory activity of Miraclid on protease was decreased by means of mechanical stimulation in comparison to the activity before nebulization. 2. Compared to administration of physiological saline into the tracheobronchial lumen, administration of Miraclid by means of ultrasonic nebulization decreased the fibrinolytic activity in tracheobronchial secretions.
The clinical behavior of inverting papilloma of the nose and paranasal sinuses: Report of 112 cases and review of the literature
Authors: Phillips P. Perry , Gustafson Ray O. , Facer George W. 
Published: October 2006

AbstractBetween 1944 and 1987, 112 patients with inverting papilloma of the nasal cavity were treated. The average duration of follow‐up for this population was 6.2 years. The most common symptoms were nasal obstruction and history of previous surgery for nasal “polyps.” Recurrence rates were lower when treatment consisted of lateral rhinotomy with medial maxillectomy (14%) vs. transnasal operation with a sinus procedure (35%) or transnasal operation alone (58%). Recurrence rates between men and women were not significantly different when treatment methods were analyzed; however, a higher‐than‐expected association with tobacco usage was noted. Eight (7%) of the 112 patients had associated nasal carcinoma. Current treatment is lateral rhinotomy with medial maxillectomy to prevent troublesome and potentially malignant recurrent disease.
Hearing after retrolabyrinthine vestibular neurectomy
Authors: Wazen Jack , Markowitz Arlene , Donatelle Christine , Post Kalmon 
Published: October 2006

AbstractThirty‐four patients underwent vestibular neurectomies between September 1984 and January 1989. The first 15 patients operated on through January 1987 (and followed for a minimum of 2 years) were evaluated separately for long‐term hearing preservation and freedom from vertigo spells. Audiograms taken at 1 postoperative month revealed no change in the pure tone averages of 25 patients and showed improved hearing of 20 to 30 dB in 5 patients. Two patients sustained losses of 18.5 dB and 21 dB, respectively. The speech discrimination scores remained the same in 17 patients, improved in 9, and were reduced in 6. Audiograms performed 12 to 40 months postoperatively showed preservation of the pure tone averages and speech discrimination scores when compared with the earlier 1‐month postoperative audiograms in 73% of the patients. The speech discrimination scores, however, tended to fluctuate with the symptomatic course of each disease. Two patients developed major vertigo spells 1½ years following surgery. Postoperative ice‐caloric testing revealed no responses in 25 patients and markedly reduced responses in 6. There were no major complications or facial paralysis.The retrolabyrinthine vestibular neurectomy is an effective way to control vertigo with preservation of hearing and an acceptably low incidence of complications and side effects.
Management of inverted papilloma
Authors: Myers Eugene N. , Fernau James L. , Johnson Jonas T. , Tabet Jean Claude , Barnes E. Leon 
Published: October 2006

AbstractThis paper updates a 1981 report on the management of inverted papilloma. In that report, routine lateral rhinot‐omy with en bloc resection of the lateral nasal wall, including the entire schneiderian membrane, was recommended. This report emphasizes the use of computed tomography scanning in management planning.Of 33 patients with inverted papilloma treated between 1969 and 1987, 7 had associated squamous cell carcinoma. Twenty‐two patients with IP alone were treated with medial maxillectomy; however, 3 patients have been successfully treated with either a Caldwell‐Luc/ethmoidectomy or an external ethmoidectomy for localized disease. The use of computed tomography capable of higher resolution allowed preoperative determination of the extent of disease, enabling the surgeon to plan the surgery more precisely.Patients were followed for an average of 9.6 years. Recurrent disease occurred in one patient (4%) following a lateral rhinotomy/medial maxillectomy approach.The principles set forth in this series of patients remain the same as those previously described due to the unique characteristics of this tumor: its ability to destroy bone, its tendency to recur, and its association with malignancy. The technique of lateral rhinotomy and en bloc excision of the lateral nasal wall, followed by meticulous removal of all mucosa in the ipsilateral paranasal sinuses, remains the standard therapy.
Tonsillectomy and adenoidectomy: An inpatient or outpatient procedure?
Authors: Guida Robert A. , Mattucci Kenneth F. 
Published: October 2006

AbstractConcern over the rising cost of health care has created a trend toward outpatient surgery. Because adenotonsillec‐tomy is such a frequently performed procedure, there is pressure on many otolaryngologists to do this operation on an ambulatory basis. A prospective study was undertaken to evaluate the incidence and severity of postoperative hemorrhage, protracted emesis, and fever at specified times within the first 24 hours after surgery.Over a 1‐year period, 1000 tonsillectomy and/or adenoidectomy patients were studied. There was a 2.1% incidence of serious complications within the first 6 postoperative hours. The incidence of serious hemorrhage, fever, and protracted emesis was 0.7% each. The incidence of significant complications between the 6th and 24th postoperative hours was 1.7%. Hemorrhage occurred in 0.4% of the patients, fever in 0.7%, and protracted emesis in 0.6%. The total incidence of hemorrhage during this time period was 1.1%. There were no deaths.The greatest percentage of complications occurred within the first 6 postoperative hours. Based on this study, outpatient tonsil and adenoid surgery should be followed by at least 6 hours of postoperative observation before discharge. The choice to perform ambulatory tonsil and adenoid surgery depends on the professional judgment of the operating physician based on this and other recent studies, the sophistication of the physician's ambulatory surgery center, and the medical and social background of the patient.
Vocal cord paralysis resulting from neck injections in the intravenous drug use population
Authors: Hillstrom Robert P. , Cohn Arnold M. , Mccarroll Kathleen A. 
Published: October 2006

AbstractIntravenous drug use patients present to the head and neck surgeon when injections are directed “in the pocket,” or more appropriately, toward the internal jugular vein in the neck. The more common complications of this practice include the development of cellulitis, abscess, and venous thrombophlebitis and, potentially, pulmonary embolism and pseudoaneurysm of the carotid and subclavian arteries. Vocal cord paralysis as a result of neck injection in the intravenous drug‐using population is rarely described, and a review of the literature has yielded only two reports addressing this uncommon phenomenon.During a 7½‐ year period between October 1981 and June 1989, nine patients presented to Detroit Medical Center with hoarseness, upper‐airway obstruction, or both following the injection of heroin or related substances into the neck. Otolaryngologic evaluation demonstrated unilateral or bilateral vocal cord paralysis coincident with recent neck injections. The clinical signs and symptoms, location of the injections, acute management, and subsequent complications are catalogued. Acute management of these patients consisted of airway assurance via tracheotomies when indicated and observation for the development of cellulitis, abscess, or more life‐threatening neurovascular complications. Follow‐up laryngeal examinations ranged from 4 months to 4½ years and found no demonstrable return of vocal cord function in any of the nine patients.
Randomized comparison of two chemotherapy, radiotherapy schemes for stage iii and iv unresectable squamous cell carcinoma of the head and neck
Authors: Merlano Marco , Rosso Riccardo , Sertoli Mario Roberto , Benasso Marco , Bacigalupo Almalina , Ardizzoni Andrea , Mereu Paola , Margarino Giovanni , Scala Marco , Vitale Vito , Corvog Renzo , Santi Leonardo , Grimaldi Andrea , Pallestrini Eugenio , Barbieri Marco , Accomando Emilio , Scasso Felice , Novella Vittorio , Moratti Maurizio , Sampietro Maurizio , Fracchia Paolo , Brema Fulvio 
Published: October 2006

AbstractBetween August 1983 and December 1986, 116 previously untreated patients with squamous cell carcinoma of the head and neck were randomized to receive induction chemotherapy followed by radiotherapy given in conventional fractions (55 patients, arm A) or an alternating chemotherapy and radiotherapy (3 courses of 20 Gy, 10 daily fractions each; 61 patients, arm B). The same chemotherapy was used in both arms: 6 mg/m2 vinblastine sulfate, hour 0; 30 mg bleomycin, hour 6; 200 mg methotrexate, hours 24 to 26; 45 mg leucovorin, hour 48. Forty‐five patients had stage III disease and 71 had stage IV disease. All patients were evaluated for survival, 112 for toxicity, and 105 for analyses of response and time from the start of treatment until progression of disease. At the end of the combined treatment, we observed an overall response rate of 52% in arm A and an overall response rate of 64.9% in arm B. The incidence of mucositis was more relevant in arm B compared to arm A (P >.00004). The difference in complete response, progression‐free survival, and survival was statistically significant, with an advantage for arm B (P >.03, P >.02, and P >.03, respectively). The analysis at a median follow‐up of 36 months (range = 19 to 59) demonstrates a higher effectiveness for the alternating program.
Vocal changes in patients undergoing radiation therapy for glottic carcinoma
Authors: Miller Susan , Solomon Beth , Sessions Roy B. , Harrison Louis B. 
Published: October 2006

AbstractA prospective evaluation of vocal changes in patients receiving radiation therapy for T1 and T2 (AJC) glottic carcinoma was undertaken in January 1987. Vocal analysis was performed prior to radiotherapy and at specific intervals throughout the radiation treatment program. The voicing ratio was extrapolated from a sustained vowel /a / phona‐tion using the Visipitch interfaced with the IBM‐PC. Preliminary observations suggested three distinct patterns of vocal behavior: 1. reduced voicing ratio with precipitous improvement within the course of treatment, 2. high initial voicing ratio with reduction secondary to radiation induced edema, with rapid improvement in the voicing component after the edema subsided, and 3. fluctuating voicing ratio during and following treatment. Enrollment of new patients and a 2‐year follow‐up of current patients was undertaken.
Controlled laryngoplasty for vocal cord medialization: A technique using tissue expansion
Authors: Kuriloff Daniel B. , Blaugrund Stanley M. , Krespi Yosef P. , Goldsher Moshe 
Published: October 2006

AbstractLaryngeal framework surgery has become an increasingly popular alternative to Teflon® injection for vocal rehabilitation. Vocal cord medialization requires custom tailoring of the implant's size and shape to optimize individual vocal quality, whether it be via the interposition of Silastic® implants between the thyroid ala and the inner thyroid perichondrium or through a cartilage window.A new technique is described for vocal cord medialization using an implanted miniature tissue expander. Intra‐operative and postoperative vocal cord medialization was achieved in a canine model by controlled percutaneous filling of a remote injection valve. The implants were well tolerated and allowed continued control of vocal cord position for several weeks.Using this technique, vocal quality can be fine‐tuned with a degree of precision not previously possible. The advantages, limitations, and technical aspects of expansion laryngoplasty are discussed.
HPV DNA Typing of adult‐onset respiratory papillomatosis
Authors: Duggan Maire A. , Lim Megan , Inoue Masafumi , Gill M. John 
Published: October 2006

AbstractRespiratory papillomatosis is a recalcitrant, human pap‐illomavirus‐induced disorder of the upper airways. Using in situ hybridization and biotinylated deoxyribonucleic acid (DNA) probes, the type of human papillomavirus (HPV) in nine adults was determined both at presentation and during subsequent recurrences. Fifty‐three biopsies obtained from seven men and two women over a 10‐year period were examined for HPV 6, 11, 16 and 18. All patients had either type 6 or 11. One dual infection was found. Despite intensive therapy with lasers with or without alpha interferon, no elimination or change in viral type occurred. Despite identical histologies, the amount of HPV DNA present in a given patient's papillomata varied markedly. The results suggest that adult‐onset respiratory papillomatosis is due to HPV 6 and/or HPV 11, and that its recurrent nature, despite therapy, is due to persistence of a viral reservoir.
Cervicofacial mycobacterial adenitis in children: Endemic to san diego?
Authors: Pransky Seth M. , Kearns Donald B. , Seid Allan B. , Collins David L. , Krous Henry F. , Reisman Bruce K. 
Published: October 2006

AbstractNontuberculous mycobacteria (NTM) are an important cause of cervicofacial lymphadenitis in children. A dramatic increase has been seen in confirmed cases of NTM lymphadenitis in San Diego in the past few years. This report encompasses a span of 2 years 9 months, during which 22 children had confirmed NTM infection and another 14 had necrotizing granulomatous lymphadenitis in whom the specific diagnosis of NTM could not be made. This apparent increase in the prevalence of NTM as compared to previous reports in the literature suggests a possible endemic risk for NTM in the San Diego area. These cases are reviewed and our diagnostic and surgical approach to possible NTM infection is described. We also discuss possible explanations for the increasing occurrence of NTM in the San Diego area.
Spontaneous cervical and mediastinal emphysema
Authors: Parker Gregg S. , Mosborg David A. , Foley Richard W. , Stiernberg Charles M. 
Published: October 2006

AbstractSubcutaneous cervical emphysema often appears as a result of surgery or trauma. However, when it occurs spontaneously, the patient may present with clinically impressive and dramatic features. The etiology is related to the rupture of terminal alveoli and dissection of air along the pulmonary vasculature. Exercise may contribute to the process by increases in intrathoracic pressure. Six cases of spontaneous cervical emphysema, all related to SCUBA diving training at a Naval facility, were recently seen at our institution. Proper management entails having a high index of suspicion for diagnosis, and then being able to identify potentially life‐threatening complications.
Middle fossa decompression of the internal auditory canal in acoustic neuroma surgery: A therapeutic alternative
Authors: Gadre Arun K. , Brackmann Derald E. , Kwartler Jed A. , House William E. , Hitselberger William E. 
Published: October 2006

AbstractUnilateral acoustic neuromas in only‐hearing ears and bilateral acoustic neuromas (NF‐2) are separate entities, but both pose a common problem because surgical removal has the potential to leave the patient totally deafened.A middle fossa decompression of the internal auditory canal (IAC) was performed in 8 patients (5 with NF‐2 tumors and 3 with neuromas in an only‐hearing ear). In 5 of the 8, the speech discrimination scores at the 6‐month follow‐up were better than preoperative scores. After 6 months, however, hearing regressed at variable rates. Although not a definitive therapeutic treatment, decompression of the IAC appears to improve and perhaps prolong useful hearing, which gains valuable time for rehabilitation. Rigid follow‐up by computed tomography scans or magnetic resonance imaging is essential.
Early complications of airway management in head‐injured patients
Authors: Lanza Donald C. , Parnes Steven M. , Koltai Peter J. , Fortune John B. 
Published: October 2006

AbstractHead‐injured patients are frequently young, healthy individuals whose excellent medical condition is suddenly altered by trauma. The purpose of this study is to evaluate the early complications of airway management which occur in head‐injured patients and to determine if these are different from what has been reported in patients with chronic illnesses (i.e., diabetes, atherosclerosis, or immunosuppres‐sion).Chart review of 52 head‐injured patients reveals an early complication rate of 61% for endotracheal intubation and 20% for tracheotomy. Discriminant analysis shows that increasing duration of intubation is the most significant factor in predicting airway management complications (P<0.008). The incidence of complications seen in head‐injured patients is similar to that of the chronically ill. Complications of endotracheal intubation are judged to be more severe than those of tracheotomy. Data from this study supports the early tracheotomy of severely head‐injured patients who are likely to require prolonged airway management.
Squamous cell carcinoma of the oropharynx: An analysis of 213 consecutive patients scheduled for primary radiotherapy
Authors: Johansen Lars Vendelbo , Overgaard Jens , Overgaard Marie , Birkler Niels , Fisker Anders 
Published: October 2006

AbstractRadiotherapy was administered to 213 consecutively treated patients with oropharyngeal squamous cell carcinoma. The classification (Union Internationale Contre le Cancer, 1982) showed primary tumors (Tl, 13%; T2,51%; T3, 34%; T4, 2%) and regional lymph nodes (NO, 38%; Nl, 38%; N2, 4%; N3, 20%). The 10‐year actuarial value for local control was 48%; for regional control, it was 66%. Distant failure occurred in 20 patients. The 10‐year actuarially corrected survival rate was 40% (stage I, 57%; stage II, 51%; stage III, 43%; stage VI, 21%).Locoregional tumor control was significantly influenced by irradiation parameters (total dose and treatment time), tumor volume, sex, and hemoglobin value. It is concluded that local control of the tumor while still in the T position is the parameter most crucial to success. This end point is currently being aimed at evaluating primary surgery and testing a radiation technique with larger total doses and shrinking fields and a new radiosensitizer, while at the same time investigating the influence of hemoglobin concentration.