bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fulminant aspergillosis of the nose and paranasal sinuses: A new clinical entity
Authors: Mcgill Trevor J. , Simpson George , Healy Gerald B. 
Published: October 2006

AbstractFulminant aspergillosis of the nose and paranasal sinuses represents a new clinical entity occurring in individuals with depressed immunological responses. It is marked by a rapid malignant course, requiring early recognition, aggressive surgery and chemotherapy. Clinical manifestations include a rapidly progressive gangrenous mucoperiostitis advancing relentlessly to destruction of the nasal cavity and the paranasal sinuses within a few days. The recent emergence of this form of aspergillosis appears to be directly related to the increased intensity of chemotherpay and immunosuppression in the treatment of previously fatal neoplastic diseases. Control of this disease process requires aggressive therapy. This may include radical sinus ablation, debridement of nasal structures, chemotherapy and possible correction of immunological deficits, i.e., bone marrow transplantation. Four cases are discussed in detail to present the clinical spectrum of this new disease entity.
Giant cell tumors of the maxilla in children
Authors: Quick Cedric A. , Anderson Roger , Stool Sylvan 
Published: October 2006

AbstractThree types of giant cell lesions occur in the facial skeleton; namely, giant cell reparative granuloma, Brown tumor of hyperparathyroidism, and true giant cell tumor — osteo‐clastoma preferably called giant cell neoplasm. An appraisal of the clinical course biochemical laboratory data, radiographic appearance, and histological features are all necessary to distinguish between these varieties. Differentiation is a prerequisite to treatment because the management differs in each lesion. Three case reports illustrate these features. The important considerations of facial growth following surgery to the facial skeleton of a child are discussed. Long‐term observation is imperative.
Diagnostic use of ultrasound in diseases of the head and neck
Authors: Chodosh Paul L. , Silbey Robert , Oen K. T. 
Published: October 2006

AbstractUltrasound has been utilized for diagnostic purposes for the past ten years. It was originally utilized mainly in ophthalmology and obstetrics and gynecology, although recently it has proven invaluable in diagnosis of cardiac and abdominal diseases. While there have been some reports on its use in thyroid and parotid diseases, there are few reports on its general use in the diagnosis of head and neck diseases. This technique is non‐invasive and is cost effective when compared to CAT scanning. Ultrasound is capable of differentiating not only cystic from solid lesions but also can be helpful in the diagnosis of malignant vs. benign masses. Its value in delineating the presence of multiple lymph nodes as well as following the course of resolution of infectious diseases is presented, and its use in the diagnosis of those conditions involving the parotid gland itself as well as the parapharyngeal space is presented. It would appear to be a valuable adjunct in our management of head and neck diseases.
Neonatal nasotracheal intubation: An evaluation
Authors: Stewart A. R. , Finer N. N. , Moriartey R. R. , Ulan O. A. 
Published: October 2006

AbstractA retrospective review of 100 surviving infants, all requiring nasotracheal intubation in the neonatal period for greater than 24 hr. was performed to assess the morbidity of this form of airway management. Seventy infants needed only one intubation, 22 were intubated twice and 8 infants required 3 intubations. No infant had evidence of laryngeal or tracheal sequelae, either in the immediate newborn period or on follow‐up. Nasotracheal intubation by an experienced practitioner with appropriate tube fixation and toilet coupled with the use of low pressure ventilation and a consistent extubation routine will result in very low long‐term tracheal morbidity in the neonate.
The diagnosis of CSF rhinorrhea by metrizamide ct scanning
Authors: Schaefer Steven D. , Diehl Jan T. , Briggs William H. 
Published: October 2006

AbstractA case of cerebrospinal fluid rhinorrhea is presented in which routine diagnostic evaluation failed to disclose the site of leakage. Computerized tomography (CT) scanning with metrizamide, a nonionic contrast medium, provided not only documentation of the leak but also demonstrated the actual sinus involved.Metrizamide cisternography with CT scanning is a valuable technique in the evaluation of CSF rhinorrhea. It may only be used when an active leak is present. The patient described in this report lost several drops of CSF from the nose per minute in the face‐down position.Neurotoxicity may be avoided by routine pre‐examination medication with valium or phenobarbital. Mixing of the contrast agent with CSF. is diminished by injecting in the subarachnoid space at C1‐C2.The methods used in this examination and their indications are described, and the literature concerning metrizamide toxicity and pharmacologic properties reviewed.
Management of intratemporal vascular tumors.
Authors: Mangham Charles A. , Carberry Joseph N. , Brackmann Derald E. 
Published: October 2006

AbstractVascular tumors (vascular malformations and hemangiomas) of the temporal bone are uncommon, and guidelines for their management have not been published. In an effort to develop an approach to their management, the present study examined the pathological, clinical, and surgical experience with ten of these lesions treated at the Otologic Medical Group, Inc., and St. Vincent Medical Center in Los Angeles from 1960 to 1980.Intratemporal vascular tumors occurred most frequently at two sites, the internal auditory canal and the geniculate ganglion. Histological features and clinical behavior did not correlate. Both vascular malformations and hemangiomata invaded the facial nerve. Surgical excision in these cases required severence and repair of the involved facial nerve. Complete surgical excision is the treatment of choice of vascular lesions of the temporal bone.
Pericranial flap for the closure of defects of craniofacial resections.
Authors: Johns Michael E. , Winn H. Richard , McLean W. Copley , Cantrell Robert W. 
Published: October 2006

AbstractMalignant neoplasms involving the ethmoid sinuses mandate en bloc resection via the craniofacial approach. This technique leaves a direct communication between the nasal chamber and the extradural space to be closed. The elevation of dura from the anterior cranial fossa and cribriform area may result in small dural tears, CSF leak and/or CNS infections. We have utilized an inferiorly based pericranial flap and a laterally based osteoplastic bone flap to successfully close this space and dural defects. The laterally based bone flap allows insetting the pericranial flap without compromising the vascularized inferior base and gives generous exposure of the area to be resected.This approach has been used successfully in four patients in the last year. Three patients had esthesioneuroblastomas and the fourth had a squamous cell carcinoma of the maxilloethmoid complex. This communication describes the technique and lists advantages of the inferiorly based pericranial flap.
Familial non‐chromaffinic paragangliomas (glomus tumors) : Clinical aspects.
Authors: Baars Frank Van , Brobk Paul Van Den , Cremers Cor , Veldman Jan 
Published: October 2006

AbstractThe clinical aspects of a study of a large family suffering from glomus tumors are presented. A great deal of fragmentary information is obtained from the literature, but never before has so much information been obtained from one single family.The aim of this study was to screen the individual members of this family by careful history, with special interest taken in symptoms which could be indicative of glomus tumors, and by a physical examination. Because these tumors may be without symptoms or signs, the screening was extended with dynamic angioscintigraphy.
The contralateral ear in acoustic tumors and hearing conservation
Authors: Clemis Jack D. , Mastricola Patricia G. , Schuler‐Vogler Maria 
Published: October 2006

AbstractHearing conservation in acoustic tumor surgery is an admirable goal and a logical extension of micro neurotologic surgery, but ideal candidates for conservation are few, and attempts to preserve hearing in those few fail in about half of all cases. Conserved hearing most often falls far beyond a range that will provide binaural function and is, therefore, of questionable use. The problem of hearing conservation in acoustic tumor surgery is rationally approached based upon the implications of the total presurgical overview, particularly with reference to age, general health, tumor size, and especially hearing in the tumor ear, the contralateral ear, and interaural relationships. Technical considerations, the morbidity and mortality, and, finally, probability factors are reviewed from the literature. The patient's consideration regarding potentials for hearing conservation, his need for conservation, and alternative options are discussed.Rehabilitative options for unilateral hearing impairment are discussed. A review of the amplification requirements of 45 acoustic tumor patients — S or more years postoperative — indicated that three‐quarters had normal hearing in the contralateral ear, 24% of whom required CROS amplification; 67% of the remaining quarter had mild to moderate hearing losses and were effectively wearing BiCROS aids. None were rehabilitated with monaural aids; 20% of the entire group studied had demonstrated some degree of additional hearing loss in the non‐tumor ear since surgery.
Central auditory battery testing in brain stem disease
Authors: Hendershot E. L. , Wood James W. , Karnuta M. A. 
Published: October 2006

AbstractThe CAT scan and the BERA have revolutionized the practice of otology. There is a tendency to accept a negative scan report as indicating a lack of pathology. The authors have found cases where central battery testing has indicated progressing brain stem disease in the presence of a normal CAT scan. In one case, the abnormal test preceded a hemiplegia by two weeks. This raises the possibility of delaying or aborting an infarct if the correct diagnosis is made early.
Polytomography and congenital external and middle ear anomalies
Authors: Wright J. William 
Published: October 2006

AbstractThe preciseness of the detail which can be demonstrated by multidirectional tomography makes it a useful and almost essential method of examination of congenital anomalies of the external and middle ear. Multiple examples are described which are of inestimable value to the surgeon in the diagnosis and surgical correction of anomalies of the temporal bone. Variations of the external canal, temporomandibular joint, pneumatization of the temporal bone, tegmen, tympanic cavity, ossicles, oval and round windows, jugular bulb and carotid artery and facial nerve as seen by polytomography are described.
Results following cochlear implantation and rehabilitation
Authors: Engelmann Larry Robert , Hough J. V. D. , Waterfall M. Kathleen 
Published: October 2006

AbstractNine post‐lingually deafened adults received single‐electrode cochlear implants and afterwards participated in a rehabilitation program. For these nine patients the average threshold sensitivity in soundfield was significantly better with use of the cochlear prosthesis than with hearing aid amplification in the same ear prior to implantation. Significant changes also occurred in discrimination of environmental sounds, recognition of words and stress patterns, and in speechreading skill. Certain aspects of phonation (harshness, control of intensity, and habitual pitch) and some articulation problems improved, while inflection abnormalities were not altered. Data concerning daily hours of implant activation, an indicator of patient acceptance, reveal that seven of the nine use their cochlear prosthesis for at least eight hours per day. These results suggest that the single electrode cochlear implant is a clinically useful tool in the rehabilitation of selected profoundly deaf individuals.
Suturing techniques in endolaryngeal surgery
Authors: Kirchner Fernando R. 
Published: October 2006

AbstractIn the past 15 years surgery of the endolarynx has been greatly expanded. This development has been the product of three main factors: technological advancements such as the microcautery, improved knowledge about the healing properties of the endolarynx, and new surgical techniques. These types of approaches are being increasingly used in the treatment of complex reconstructive procedures of the larynx. An integral part of these new procedures are special suturing techniques.At present suturing techniques are being used to fulfill a number of requirements, including approximation and lateralization of anatomical structures for operative or exposure purposes, intraoperative retraction of endotracheal tubes, closure of wounds and securement and fixation of skin grafts, intralaryngeal molds, and interfacing Silastic® sheeting materials.With amazing simplicity the above requirements can be met if a few basic steps are comprehended and followed.
Immunologic mechanisms in the production of food sensitivities
Authors: Trevino Richard J. 
Published: October 2006

AbstractFifty‐five test patients and ten control patients were selected for provocation of symptoms using the oral challenge test. The provoking food was selected with the use of the leukocyte cytotoxic test. The test patients developed adverse symptomatology clinically while the control patients did not. During the phase of symptomatology it was shown that IgE did not change in the blood and, therefore, the Type I, anaphylactic type of reaction, which is IgE dependent, did not participate in symptom production. It was shown that 2 components of the classical pathway of complement C3 and C4 were utilized in the test group and not in the control group. Complement is 1 of the 2 components of the humoral system of the human immune system. C4 is one of the components that is triggered by the classic complement pathway, whose stimulus is IgG and IgM, and not by the other complement pathways. It can therefore be hypothesized that all the components of the circulatory humoral system are participating in this reaction and that Type II, the cytotoxic, and Type III, the immune‐complex type of immunologic reaction, are the major contributors in the production of symptoms.
Primary hyperparathyroidism and laryngeal carcinoma: A cause of associated hypercalcemia
Authors: Haar J. G. , Boulos Ekram John 
Published: October 2006

AbstractTwo cases of laryngeal carcinoma are presented which, upon initial evaluation, were noted to have asymptomatic hypercalcemia with no evidence of bone metastases. Exploration of the parathyroid glands at the time of definitive surgery revealed parathyroid pathology in both cases. Calcium levels returned to normal postoperatively in both cases.We conclude that in patients with head and neck cancer with hypercalcemia and no evidence of bone metastases, parathyroid pathology should be considered. Exploration of the parathyroid glands at the time of definitive surgery or as a separate procedure may prove rewarding.
Aerodigestive tract papillomatosis: Bacille calmette‐guérin (BCG) immunotherapy
Authors: Strauss Melvin , Conner George H. , Harvey Harold A. , White Deborah S. 
Published: October 2006

AbstractAerodigestive tract papillomatosis (ADTP) remains a distinct challenge for the otolaryngologist. None of the myriads of therapies utilized to date offers a distinctly improved prognosis with less frequent clinical recurrences or absolute cure rates. Significant complications are avoided by withholding tracheotomy whenever possible and avoiding overly aggressive papilloma removal. Laser technology seems to offer a distinct benefit as regards the latter. Despite much activity in this area, little new knowledge has actually influenced the outcome of patients afflicted with papillomatosis. The disorder remains one of long‐term morbidity in those acquiring it early in life and one with a significant rate of mortality for those with involvement of the lower airway.A review and selected discussion of our experience at The Milton S. Hershey Medical Center of The Pennsylvania State University with ADTP from 1974 to 1981 is presented. Nineteen patients ranging in age at the time of presentation from 1.5 to 68 years old have been diagnosed and treated. For the most part, therapy consisted of repeated microendoscopies with forceps removal of papillomas until recurrences ceased. However, in four adult patients with either rapidly recurring laryngeal and/or tracheobronchial papillomas, bacille Calmette‐Guérin (BCG) immunotherapy has been administered. Two of these patients are evaluable for greater than 12 months. The rationale and efficacy of the treatment of a high risk group in this fashion are discussed.
Carotid rupture and tissue coverage
Authors: Hillerman Braxton L. , Kennedy Thomas L. 
Published: October 2006

AbstractCarotid rupture following the treatment of head and neck malignancy is the most dreaded complication faced by the head and neck surgeon. Tissue coverage of the carotid artery has been advocated as the method of protection likely to prevent carotid rupture. A retrospective study was carried out to assess the benefit of carotid coverage and whether such protection plays a role in decreasing mortality and morbidity. A brief history of carotid protection is presented. A series of 194 head and neck cancer patients who underwent resection of their mucosal primary in continuity with radical neck dissection over a ten‐year period was reviewed. No coverage was used in 120 cases, while 72 cases received carotid coverage. There was a 13% fistula rate and a 15% rate of wound complication without fistula. Six patients without recurrence who had carotid rupture or ligation for imminent rupture were identified. This group was scrutinized with regard to several parameters. Three received tissue coverage of the carotid system, while the other three were left unprotected.There was a 50% mortality rate and 25% rate of neurologic sequelae amongst the survivors. This review tends not to support the premise that tissue coverage is a major factor in the prevention of carotid rupture.
Intranasal antrostomy — causes of failure
Authors: Sogg Alan J. 
Published: October 2006

AbstractA brief historical review of the intranasal antrostomy is followed by a list of possible causes of failure of the procedure. Definitions of various terms employed are given and a full description of the author's technique of making the antral window. Long‐term follow‐up of between 6 and 12 years has been possible in 87 patients. The various causes of recurrent problems in this group of patients are reported. Emphasis is placed on the desirability of informing the patient of the reasons for the antrostomy and explaining what can and cannot be expected from the procedure.
Management of mandibular fractures using biphasic pins and mandibular splints
Authors: Cooper Jeffrey , Rojer Charles L. , Rosenfeld Philip A. 
Published: October 2006

AbstractOften the otolaryngologist is asked to manage the patient with facial trauma. Mandibular fractures make up 20 to 39% of all facial trauma cases, and thus necessitate a diversified and complete set of management tools. We have selected two seldom discussed modes of therapy for the complicated jaw fracture to present in this paper: 1. external fixation or Joe‐Morrison Hall biphasic pins, and 2. mandibular dental appliances — splints. The advantage of the biphasic pin apparatus is that the fracture can be repaired and stabilized at a point remote from the infected fracture site. The high risk patient, endentulous patient, and patients with fractures from gunshot wounds all prove to be more easily managed by using the external appliances.The splint technique eliminates medial or lingual tip rotation and resultant postoperative malocclusion. Endentulous patients, pediatric patients, and those with multple facial trauma also benefit from this procedure.
Toxic shock syndrome: Otolaryngologic presentations
Authors: Tag Arnold R. , Mitchell Foy B. , Harell Moshe , Morrison Winsor V. 
Published: October 2006

AbstractToxic shock syndrome is a recently discovered and widely publicized disease found to occur in young menstruating women and thought to be associated with the use of vaginal tampons. To this date, there has been no known report of a similar disease being caused by nasal or sinus packing.The following is a discussion of the toxic shock syndrome (TSS) and a presentation of two cases that demonstrated a striking similarity to that disease.
Ossicular chain reconstruction: The torp and porp in chronic ear disease.
Authors: Jackson C. Gary , GlasscockIii Michael E. , Schwaber Mitchell K. , Nissen Alan J. , Christiansen Sidney G. , Smith Peter G. 
Published: October 2006

AbstractThe traditional objectives of tympanoplasty are infection control, closure of the ear by grafting techniques, and hearing rehabilitation via ossicular reconstruction. The multiplicity of contemporary prostheses and surgical options available would seem to underscore the magnitude of the ossicular reconstruction problem in the difficult chronic ear relative to all else. The success of stapedectomy has led to great expectations for all problems of ossicular reconstruction. The circumstances of the chronic ear is a milieu hostile in comparison and precludes any such comparison.Multiple sites of ossicular pathology, variations in mucosa health, inconsistent middle ear aeration and the overall complexity of the chronic ear present the otologist with a physiodynamic problem the solution of which is far from simplistic. The TORP and PORP have been enthusiastically endorsed in this regard, as a very suitable answer. Such enthusiasm, however, has been largely derived from data accumulated in the short term, often in less than a year's follow‐up.This report reviews the authors' results in 141 patients in whom 86 TORPs and 55 PORPs were employed. For comparison, hearing data in 276 ears in which the fitted incus prosthesis, the authors' preferred reconstruction format, was used. Success for TORP reconstruction was assessed as air‐bone gap closure to within 30 dB and for PORP, to within 20 dB. This was accomplished in 85% and 49% respectively. Extrusion rate, overall, was 10%.Relative advantages and disadvantages of the TORP and PORP are discussed and serve as a basis for the decision to continue to use this method of ossicular reconstruction. This data is put into perspective in acknowledging that the TORP and PORP are not the ultimate solution to this problem. When employed in combination with newer techniques in cartilage tympanoplasty, further improvement is expectant.
Intracranial complications of acute and chronic infectious ear disease: A problem still with us.
Authors: Gower David , McGuirt W. Frederick 
Published: October 2006

AbstractAmong 334,884 admissions to the North Carolina Baptist Hospital from 1963 through 1982, 100 patients had central nervous system (CNS) complications of middle ear disease. The complications occurred predominantly in young patients, 85 of the 100 being less than 20 years of age. Meningitis occurred in 76 patients; the acute form was more prevalent (63 cases). The less common nonmeningitic complications included brain abscess (n=6), effusion (n=5), lateral sinus thrombosis (n=5), otitic hydrocephalus (n=5), and empyema (n=3). Overall mortality was 10%. One patient with brain abscess died; 9 of the 76 patients with meningitis died (12%), with 4 of those deaths occurring among the 13 patients with chronic meningitis (31%). Because these complications have declined markedly since the advent of antibiotics, many contemporary otolaryngologists have been unexposed to these complications. However, as this series shows, they do still occur, their natural history remains the same, and the resulting mortality is still alarmingly high. A plea is made for otolaryngologists to maintain an awareness of these complications and to work with pediatricians and neurosurgeons for the best team care of patients with CNS complications of middle ear disease.