bluuebunny/crossref_metadata_2025_split huggingface dataset:
Complications of endoscopic intranasal ethmoidectomy
Authors: Stankiewicz James A. 
Published: October 2006

AbstractA consecutive series of 90 patients undergoing endoscopic intranasal ethmoidectomy was reviewed. There were 26 complications (29%) in 19 patients in this group. Eight complications (8%) including CSF leak, temporary blindness, and hemorrhage were considered major with the latter occurring most commonly. Synechiae were the most commonly occurring minor complications.Endoscopic nasal sinus surgery performed by inexperienced operators carries with it the same risks and complications as traditional intranasal sinus surgery. Any surgeon who does not routinely perform traditional intranasal ethmoidectomy should accrue endoscopic experience through appropriate didactic training and multiple cadaver dissections (akin to otologic training).
Improvement of olfaction in laeyngectomized patients with the larynx bypass
Authors: Schwartz David N. , Mozell Maxwell M. , Youngentob Steven L. , Leopold Donald L. , Sheehe Paul R. 
Published: October 2006

AbstractHyposmia following laryngectomy is an often recognized phenomenon. A larynx bypass device was used to determine whether this olfactory deficit could be reversed simply by restoring nasal airflow. Odorant detection thresholds and confusion matrix identification tests were administered to laryngectomy and normal comparison groups. Data on nasal airflow characteristics with and without the bypass were also analyzed.The results suggested that restoration of nasal airflow completely reversed the hyposmia for trigeminal nerve stimuli. However, the reversal of hyposmia was not complete for those odorants which primarily, if not exclusively, stimulate the olfactory nerve. This suggested that other factors may contribute to laryngectomy‐induced hyposmia for olfactory nerve stimuli.Additionally, nasal airflow analysis revealed that confusion matrix identification scores were dependent upon inspiratory sniff flow rates with and without the larynx bypass.It is argued that rehabilitation for the laryngectomee should include efforts to restore and maintain preoperative olfactory acuity.
Preservation of hearing in surgical removal of acoustic neuromas of the internal auditory canal and cerebellar pontine angle
Authors: Nadol Joseph B. , Levine Robert , Ojemann Robert G. , Martuza Robert L. , Montgomery William W. , De Sandoval Patricia Klevens 
Published: October 2006

AbstractThe surgical results in 69 patients with unilateral tumors of the cerebellopontine angle or internal auditory canal in whom total tumor removal was accomplished, and in whom an attempt was made to preserve hearing, are presented. The success rate of preservation of hearing and facial nerve function was correlated with the size of the tumor. Useful hearing, as defined by speech reception threshold no poorer than 70 dB and a discrimination score of at least 15%, was preserved in 73% of cases in which the tumor extension to the posterior fossa was no greater than 0.5 cm. In contrast, useful hearing was preserved in 22% of cases in which posterior fossa extension was greater than 2.5 cm. No significant correlation was found between preoperative evoked responses and success in preservation of hearing. The techniques and value of intraoperative monitoring of electrocochleogram (ECoG) and brain stem evoked response are discussed. A theory of pathogenesis of intraoperative hearing loss, based on correlation of changes in evoked responses and simultaneous surgical events, is presented.
Tuberculous otitis media: A clinical record
Authors: Yaniv Eitan 
Published: October 2006

AbstractThe clinical picture of tuberculous otitis media has changed since previously documented. In our series of 31 patients, it was found that severe conductive hearing loss, abundant pale granulations, and denuded malleus handle are constant findings and, in our opinion, are significant clinical features of the pathology. The disease can also manifest itself as an acute mastoiditis.As regards to investigations, bacteriology is considered as being unreliable. This is attributed to secondary organisms interfering with the growth of the tubercle bacillus, as well as the fastidious nature of the bacillus itself. We regard histology as the most reliable means of attaining a definitive diagnosis.Treatment was with a four drug antituberculous regime administered over 6 months. Streptomycin was excluded in all but one case due to its ototoxicity. We believe TB otitis media to be secondary to an established chronic otitis media in the majority of cases.
Venture jet ventilation for microlaryngoscopy: Technique, complications, pitfalls
Authors: Crockett Dennis M. , Scamman Franklin L. , Mccabe Brian F. , Lusk Rodney P. , Gray Steven D. 
Published: October 2006

AbstractOur experience with Venturi jet ventilation as the method of anesthesia in 872 cases of microlaryngeal surgery is presented. Our indications and exact technique are presented, as well as a review of our complications. Possible pitfalls and their avoidance are discussed. With attention to detail and good clinical judgement on the part of anesthesiologist and surgeon, Venturi jet ventilation can be safe and efficient with minimal complications.
Anatomic reconstruction and functional rehabilitation of oromandibular defects with rigid internal fixation
Authors: Wenig Barry L. , Shikowitz Mark J. , Stern Jamie R. , Keller Alex J. , Casino Anthony J. , Pollack Jed M. , Pipman Yacov 
Published: October 2006

AbstractFifteen consecutive patients undergoing extensive surgery for head and neck cancer involving the oral cavity and oropharynx were reconstructed using the technique of rigid internal fixation combined with various vascularized flaps. The follow‐up ranged from 6 to 18 months.Modifications in various myocutaneous or vascularized free flaps combined with an analysis of the radiation physics necessary to make this procedure a viable alternative for immediate and delayed mandibular reconstruction will be discussed. Consistently satisfactory functional and cosmetic results have been achieved.
Carotid artery resection and bypass for neck carcinoma
Authors: Biller Hugh F. , Urken Mark , Lawson William , Haimov Moshe 
Published: October 2006

AbstractTwenty‐six patients were treated by carotid artery resection and vascular replacement for recurrent cancer of the neck. The incidence of postoperative neurologic sequelae was 7%. The absolute 12‐month disease‐free survival for metatastic squamous cell carcinoma was 25%. It is concluded that in selected patients, this aggressive surgical therapy is indicated.
Congenital subglottic hemangiomas: A treatment update
Authors: Wenig Barry L. , Abramson Allan L. 
Published: October 2006

AbstractCongenital subglottic hemangiomas are rare lesions associated with a significant degree of morbidity and mortality. Although various methods of treatment have been proposed, no one single modality has yet been shown to be uniformly effective in treating this life‐threatening condition. Amongst the myriad of suggested treatments, the carbon dioxide laser, as originally proposed by Healy, et al.,1 appears to have the highest degree of success with the lowest incidence of complications. The purpose of this paper is to review a large experience at a single institution with the use of the carbon dioxide laser for treatment of congenital subglottic hemangiomas.
Localized injections of botulinum toxin for the treatment of focal laryngeal dystonia (spastic dysphonia)
Authors: Blitzer Andrew , Brin Mitchell F. , Fahn Stanley , Lovelace Robert E. 
Published: October 2006

AbstractSpastic dysphonia is a condition producing a strain‐strangle phonation. We have previously classified most of these patients as having focal laryngeal dystonia, a disorder of central motor processing.The initial success of recurrent nerve section in many of these patients has been followed by recurrence of symptoms in months to years. Bilateral involvement of the vocal cords with hyperfunction of the nonparalyzed vocal cord could explain these failures.Injection of botulinum toxin (BOTOX) has been effective treatment for many focal dystonias. We have treated more than 100 patients with dystonia including five with laryngeal dystonia. All of the patients laryngeal had dramatic improvement after 48 to 72 hours; benefit lasted 3 to 9 months for each injection period. BOTOX injection can be performed on awake, ambulatory patients. Bilateral treatment and titration of dose can achieve the desired degree of weakness.
Dynamic compression plating in treatment of the fractured, edentulous mandible
Authors: Krebs Festus J. 
Published: October 2006

AbstractThe repair of a mandibular fracture in the edentulous patient can be a difficult surgical problem. A recent report of a large series of such cases by the University of Michigan disclosed a 20% rate of nonunion. Dynamic compression plating is particularly suited to the repair of fractures of the edentulous mandible as intermaxillary fixation is unnecessary, normal speech and diet are resumed immediately, and bone grafts can be used when necessary. This series of 36 plates used in the management of mandibular fractures in 24 edentulous patients is the largest series of its type reported thus far. No nonunion or other major complication occurred in this series.Because nonunion, delayed union, and the problems associated with intermaxillary fixation were avoided in this series, it is suggested that compression plating is a highly effective method for repair of fractured edentulous mandibles.
The versatile midface degloving approach
Authors: Price John C. , Holliday Michael J. , Johns Michael E. , Kennedy David W. , Richtsmeier William J. , Mattox Douglas E. 
Published: October 2006

AbstractThe exposure obtained using the degloving approach is superb and the absence of resultant facial scar or deformity provides a dramatic new addition to the otolaryngologist's surgical repertoire. The advantages of the degloving technique in exposure of the midface, nasal cavities, paranasal sinuses, nasopharynx, skull base, and clivus have led to its increasing importance in the otolaryngology literature. Within 2 years of the technique's introduction in our department, it had been used 48 times for a wide variety of problems, including inverting papilloma, juvenile angiofibroma, chordoma and selected cases of fungal disease of the sinuses.This article describes the procedure, reports the results from a panel of 48 patients, and discusses potential complications.The authors' experience with this procedure indicates that it should become a procedure of choice for management of inverting papilloma and juvenile angiofibroma, as well as a major alternative method in many other circumstances.
The role of adenoids in the development of normal speech following palate repair
Authors: Gereau Sezelle A. , Shprintzen Robert J. 
Published: October 2006

AbstractThe controversy surrounding the various approaches to palate repair continues unabated. Issues which have been studied relative to the development of normal speech following palate repair have included surgical technique and the timing of surgery. However, regardless of the various refinements in surgery, a percentage of children require secondary surgery to resolve velopharyngeal insufficiency. To date, other factors which might be responsible for the development of normal speech have been ignored. The purpose of this report is to discuss the importance of the relative size of the adenoids in relation to the success or failure of primary palatoplasty. Velopharyngeal valving in noncleft (normal) children was also observed. Eight hundred fifty children with nonsyndromic clefts and 138 children with syndromic clefts were analyzed for speech results postpalatoplasty relative to adenoid size. One hundred normal children were also studied. The data suggest a strongly positive correlation between the incidence of hypernasal resonance postpalatoplasty and relative adenoid size in the cleft children. Velar‐adenoidal closure was consistently observed in both the cleft and normal children.
Hemilaryngectomy rescue surgery for radiation failure in early glottic carcinoma
Authors: Strauss Melvin 
Published: October 2006

AbstractRadiotherapy for early glottic carcinoma has produced excellent results and low complication rates. Therefore, hemilaryngectomy and other forms of vertical partial laryngectomy have been used mainly for rescue therapy following radiation failure. Over a 9‐year period selective application of this approach was used in eight patients out of 122 laryngeal cancer surgeries performed. Five patients were T1N0 and three were T2N0 at the time of initial diagnosis and at the time of recurrence.Three patients had healing problems postoperatively. Tracheal decannulation time was increased compared to patients who had hemilaryngectomy without previous radiotherapy. To date there has been no recurrence of carcinoma at any site with a mean follow‐up of 58 months in surviving patients.This experience confirms reports which indicate that with careful selection, radiation failures for early glottic carcinoma can be rescued by hemilaryngectomy achieving excellent tumor control and moderately good preservation of laryngeal function.
Vocal cord abduction rehabilitation by nervous selective anastomosis
Authors: Attali J. P. , Henry C. , Urtassun A. , Traissac L. , Gioux M. , Vital C. 
Published: October 2006

AbstractLaryngeal reinnervation procedures were performed on 15 dogs. An anastomosis was performed between a selected motor branch of the ansa hypoglossi and the posterior cricoarytenoid nerve. The results were analyzed endoscopically, electromyographically, and histologically. Results were satisfactory in 12 cases. The methods and results have been compared with those obtained using other reinnervation techniques.
Laryngeal/voice findings in patients with velopharyngeal dysfunction
Authors: D'Antonio Linda L. , Muntz Harlan R. , Province Michael A. , Marsh Jeffrey L. 
Published: October 2006

AbstractIt is reported frequently that individuals with palatal clefts have a high occurrence of laryngeal/voice symptoms. It has been speculated that vocal pathology in this population is the result of laryngeal compensation for abnormal velopharyngeal valving.This paper describes the prevalence of laryngeal/voice findings in a group of 85 patients referred for multimethod evaluation of velopharyngeal dysfunction. Forty‐one percent of the patients had auditorily perceived voice symptoms and/or observable laryngeal abnormalities. Twenty‐one percent of the patients had vocal fold nodules or thickened vocal folds. There was no clear relationship between laryngeal/voice findings and nasoendoscopic or aerodynamic assessments of velopharyngeal dysfunction. However, there was a significant relationship between laryngeal/voice findings and estimated subglottal pressure. Patients with laryngeal/voice findings (with or without nodules) had average estimated subglottal pressure values which were outside the normal range more often than patients without laryngeal/voice findings.These results suggest patients referred for assessment of velopharyngeal dysfunction should receive a comprehensive evaluation which includes screening laryngeal structure and function.
The temporal fossa in head and neck reconstruction: Twenty‐two flaps of scalp, fascia, and full‐thickness cranial bone
Authors: Matsuba Howard M. , Hakki Ayman R. , Little John W. , Spear Scott L. 
Published: October 2006

AbstractWe reviewed 22 consecutive flaps based on the blood supply of the temporal fossa. Our purpose was to demonstrate reliability of the vascular supply and to illustrate the versatility of these tissues for reconstruction of specialized structures, including eyelids, eyebrow, ear, lips, oral lining, orbit, and mandible.For these complex problems, all but one patient required multiple‐stage surgery to obtain their final aesthetic and functional results. All flaps proved reliable and versatile. Their advantages include proximity to the reconstructive site, ease of bilateral reconstructions, and well‐camouflaged donor deficit. In particular, the ability to transfer vascularized full‐thickness cranial bone for total or bilateral mandibular reconstructions presents an additional possibility for this difficult problem. We conclude that the reconstructive potential of these flaps is limited only by the surgeon's ingenuity.
Long‐term implantation of a system of electrical stimulation of paralyzed laryngeal muscles in dogs
Authors: Bergmann Klaus , Gerhardt H.‐J. , Warzel H. , Eckhardt H.‐U. , Hopstock U. , Hermann V. 
Published: October 2006

AbstractElectrical stimulation of the posterior cricoarytenoid muscle, synchronized with inspiration, was achieved in dogs utilizing a radio frequency stimulus triggered by a chest wall expansion transducer. This system brings about abduction of the paralyzed vocal cord for the entire duration of inspiration, which allows a normal flow of air through the larynx. The implantable part of that system was tested successfully in chronic experiments (up to 11 months) in dogs with experimental paralysis of the recurrent laryngeal nerve. We feel that the system may be suitable for pacing the paralyzed human larynx.
Vocal fatigue and dysphonia in the professional voice user: Bogart‐bacall syndrome
Authors: Koufman James A. , Blalock P. David 
Published: October 2006

AbstractOver the past 5 years, the authors have treated 67 adult professional voice users with a musculoskeletal tension disorder involving the larynx and supporting structures and leading to vocal dysfunction. Common clinical features in both sexes were muscle tension in the neck, poor control of the breath stream, and an abnormally low‐pitched speaking voice. Most of the men sounded like Humphrey Bogart and the women like Lauren Bacall. These cases represent a discrete clinical vocal fatigue syndrome, the treatment of which is patient education and voice therapy.
Retrolabyrinthine vestibular neurectomy: A reevaluation
Authors: Mcelveen John T. , Shelton Clough , Brackmann Derald E. , Hitselberger William E. 
Published: October 2006

AbstractSelective vestibular neurectomy is considered an effective means of relieving intractable vertigo while preserving hearing. In order to determine the effectiveness of the retrolabyrinthine approach to selective vestibular neurectomy, we evaluated 161 patients who underwent vestibular neurectomy between April 1981 and September 1985. Questionnaire responses indicated that 97% of the Meniere's disease patients and 68% of the non‐Meniere's disease patients experienced a substantial improvement or resolution of their vertiginous symptoms. Hearing was maintained within 10 dB of the preoperative level in the majority of the patients. Neurological complications were limited to 2 cases of meningitis which resolved with medical therapy, 7 cases of cerebral spinal fluid leaks, and 3 cases of complete sensorineural hearing loss. Based on this review, we concluded that retrolabyrinthine vestibular neurectomy continues to be a safe and effective approach to relieve ear‐related vertigo.
Induction of HLA‐DR antigen on human squamous carcinoma by recombinant interferon gamma
Authors: Koch Wayne M. , Richtsmeier William J. , Diaz Luis A. , Dugan Elizabeth 
Published: October 2006

AbstractThe antigen recognition system which plays the major role in immunologic attraction mechanisms, including graft rejection, is the class II major histocompatibility complex containing the HLA‐DR locus. Few types of cells constitutively express this antigen, as it is a potent immunological activating signal usually confined to antigen processing cells, activated lymphocytes, and endothelium. Using indirect immunofluorescence, we have observed induction of the HLA‐ DR glycoprotein in selected head and neck squamous cell carcinoma tissue cultures treated with recombinant interferon gamma. This occurs in concert with growth arrest and morphological changes after rHuIFN‐γ treatment. This report describes the induction of a surface antigen that may have profound prognostic significance. Understanding the kinetics of HLA‐DR induction will aid in the design and assessment of adoptive immunotherapy with rHuIFN‐γ.
Incidence of zenker's diverticulum with hiatus hernia
Authors: Gage‐White Linda 
Published: October 2006

AbstractThe concomitant occurrence of Zenker's diverticulum and hiatus hernia in several patients prompted an investigation to determine whether there is a statistically significant increased incidence of hiatus hernia in patients with Zenker's diverticulum.Radiologic reports contained in 104 charts of patients from the University of Iowa with a diagnosis of Zenker's diverticulum were analyzed retrospectively for the presence of hiatus hernia. Radiologic reports contained in charts of a control group of patients, who had a barium swallow for work‐up of a head and neck malignancy, were also analyzed.The control group had a 16% incidence of hiatus hernia, which was consistent with published data. The Zenker's diverticulum group had a 39% incidence of hiatus hernia, a statistically significant increase over the control group. The pathophysiology linking these conditions and the clinical implications of their relationship are discussed.
Recurrent bell's palsy: Analysis of 140 patients
Authors: Pitts David B. , Adour Kedar K. , Hilsinger Raymond L. 
Published: October 2006

AbstractOf 1,700 patients with facial paralysis seen in a retrospective study from 1969 through 1977 and 280 patients seen prospectively from 1983 through 1986, 7.1% had recurrence of Bell's palsy. In this group, the frequency of ipsilateral recurrence was equal to that for contralateral recurrence. The mean age at onset of Bell's palsy was 33.0 years; Bell's palsy recurred a mean of 9.8 years later. Recurrent facial paralysis did not indicate a worse prognosis for recovery regardless of which side was affected. There was no statistical difference between results for male patients or female patients, nor was there a statistically significant sex predominance, except in the age group 10 to 19 years. In our results, computed tomography (CT) scan in patients with recurrent Bell's palsy detected no facial‐nerve neuroma. Of 77 patients followed a mean of 33 years after the first episode (range, 2.8 to 60 years), none showed progressive facial‐nerve dysfunction or any signs of tumor. We conclude that an ipsilateral recurrence of facial paralysis without documented evidence of a tumor does not warrant a transmastoid decompression of the facial nerve. The results of our analysis were verified prospectively as well as retrospectively. A new classification system is introduced for ease of computer analysis and for simplified discussion of recurrent facial paralysis.
Osteoradionecrosis of the temporal bone: A surgical technique of treatment
Authors: Ma K. H. , Fagan P. A. 
Published: October 2006

AbstractOsteoradionecrosis of the temporal bone is a well‐documented complication of radiotherapy to the ear, with potentially lethal complications. Three cases of advanced disease, treated surgically, are presented. In two of these, subtotal petrosectomy with blind‐sac closure of the external auditory canal was carried out via an anterior approach. The enclosed space was obliterated with pedicled temporalis muscle. Primary healing took place. One case was similarly obliterated using a prolonged posterior incision. The wound broke down, requiring a microvascular free flap for closure.Radiotherapy jeopardizes the viability of skin flaps. An anterior incision bases the flap behind on the occipital and postauricular arteries. When radiotherapy has been used, this incision has theoretical and practical advantages over a standard posterior incision.