bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symposium: Cochlear implant, 1978—fact or supposition. Bilateral cochlear implants: Histological findings in a pair of temporal bones
Authors: Johnsson Lars‐Göuran , House William F. , Linthicum Fred H. 
Published: October 2006

AbstractThe specimens were obtained from a 63‐year‐old white male with acquired lues. The patient experienced sudden profound deafness on the left side 15 years prior to death, and a similar loss on the right side 3 years later. By the time of death he had carried a single induction coil in the right ear for 3 years and multiple (5) hardwire electrodes in the left ear for 8 years.A complete micro‐dissection or “mini‐autopsy” of the specimens was performed, and the modiolus was sectioned. Photomicrographs of the dissections will be shown.In the right ear supporting elements and numerous nerve fibers were present in the apical turn. The electrode on this side was apparently tolerated well; scala tympani was normal in shape and appearance.On the left side no nerve fibers were found in the osseous spiral lamina and there was extensive new bone formation in scala tympani. It is difficult to determine if or to what extent the implants were responsible for the severe sensorineural degeneration observed in both specimens.There was severe scarring and ossification of the posterior ampulla in both ears, in all likelihood resulting from the surgery.Some aspects of surgical techniques will be discussed in view of the histopathological findings.
Hemophilus influenzae type b soft tissue infections of the head and neck
Authors: Simpson George T. , McGill Trevor I. J. , Healy Gerald B. 
Published: October 2006

AbstractHemophilus influenzae soft tissue infections produce a variety of specific and dangerous pathologic manifestations in the head and neck. Problems include periorbital cellulitis and abscess, sinusitis, supraglottitis and otitis media. Complications include meningitis, airway obstruction and death. Pediatric patients are especially susceptible to these infections and complications. Effective management includes correct diagnosis, prevention of complications, and high doses of appropriate antibiotics. Increasing ampicillin resistance necessitates alternative antibiotic regimens. Specific physical findings, diagnostic studies and appropriate current treatments are discussed with illustrative cases from Children's Hospital Medical Center, Boston, and reference to pertinent recent litrature.
Heterotopic salivary tissue and branchial cleft sinus
Authors: Goodman Roy S. , Daly John F. , Valensi Quentin 
Published: October 2006

AbstractBilateral lesions which appeared clinically to be branchial cleft sinuses were removed from a patient's neck. One was indeed a branchial cleft sinus, with elements of salivary tissue, but the other proved to be pure salivary tissue with a duct characteristic of a salivary gland. The embryology and clinical characteristics of heterotopic salivary glands are discussed. The occurrence of a heterotopic gland together with a branchial cleft sinus supports the contention that the heterotopic glands arise through errors of development in the branchial apparatus.
High resolution computed tomography in the staging of carcinoma of the larynx
Authors: Sagel Stuart S. , Aufderheide John F. , Aronberg Dixie J. , Stanley Robert J. , Archer Carol R. 
Published: October 2006

AbstractThe normal anatomy of the larynx as displayed on computed tomography is illustrated. Pathological alterations in patients with carcinoma of the larynx are depicted and discussed.Computed tomography (CT) is recommended as the initial radiological procedure when additional diagnostic information is required to supplement the findings of laryngoscopy. CT provides information regarding deep penetration of tumor, including cartilaginous invasion, and about the inferior extension of neoplasm, including the subglottic area. This knowledge helps to determine whether conservation surgery as opposed to total laryn‐gectomy is possible.
Aerobic and anaerobic bacteriology of adenoids in children: A comparison between patients with chronic adenotonsillitis and adenoid hypertrophy
Authors: Brook Itzhak 
Published: October 2006

AbstractAdenoids were obtained from 18 children with chronic adenotonsillitis (Group A) and from 12 others with adenoid hypertrohy (Group B). Patients' ages ranged from 20 months to 15 years (means 6 years) 18 were males and 12 females. The adenoids were sectioned in half after heat searing of the surface, and the core material was cultured for aerobic and anaerobic microorganisms.Mixed aerobic and anaerobic flora were obtained from all patients, yielding an average of 7.8 isolates (4.6 anaerobes and 3.2 aerobes) per speciman. There were 97 anaerobes isolated. The predominant isolates in both groups were: Bacteroides sp. (including B. melaninogenicus and B. oralis), Fusobacterium sp., gram‐positive anaerobic cocci, and Veillonella sp. There were 138 aerobic isolates. The predominant isolates in both groups were: alha and gamma hemolytic streptococci, beta hemolytic streptococci (Group A, B, C, and F), S. aureus, S. pneumoniae, and Hemophilus sp. Hemophilus infulenzae type B, and S. aureus were more frequently isolated in Group A. B. fragilis was only recovered in Group A. Beta lactamase production was noted in 27 isolates obtained from 18 patients. Fifteen of these patients belonged to Group A (83% of Group A), while 3 were members of Group B (25% of Group B). These bacteria were all isolates of S. aureus (11) and B. fragilis (2), 8 of 22 B, melaninogenicus group, 4 of 11 B. oralis, and two of 8 H. infulenzae type B.Our findings indicate the polymicrobial nature of deep adenoid flora and demonstrate the presence of many beta lactamase‐producing organisms in children with recurrent adenotonsillitis.
Laryngoscopy in neonates and infants: Experience with the flexible fiberoptic bronchoscope
Authors: Fan Lbland L. , Flynn Joseph W. 
Published: October 2006

AbstractA small flexible fiberoptic bronchoscope was used for laryngeal examination in a series of neonates and infants; 104 laryngoscopies were performed in 59 patients. A high yield of diagnostic information was obtained in both postextubation patients and patients presenting with upper airway obstruction. No major complications were observed. This technique is useful in the evaluation of neonates and infants with potential upper airway problems.
The singer‐blom speech rehabilitation procedure.
Authors: Wetmore Stephen J. , Krueger Kathleen , Wesson Kathleen 
Published: October 2006

AbstractSinger and Blom have recently reported a new surgical method for speech rehabilitation of the alaryngeal patient. The method consists of a tracheoesophageal puncture (TEP) followed 2 to 3 days later by insertion of a silicone “duckbill” prosthesis which acts as a one‐way valve allowing pulmonary air to enter and vibrate the esophagus but preventing aspiration.Along with more rapid acquisition of speech, the advantage of tracheoesophageal speech over esophageal speech is the greater volume of air flow through the vibrating segment of the esophagus, which allows smoother and more prolonged speech.Thirteen of our 18 patients (72%) who have undergone TEP are currently using tracheoesophageal speech. The complications associated with this procedure include the TEP tract closing, tracheal mucositis, stenosis of the tracheostoma, aspiration of the prosthesis, esophageal tear, and aspiration from the esophagus.Although we have encountered several problems, we enthusiastically endorse this procedure since it provides oral communication which is comparable to, and in many cases better than, that of the majority of esophageal speakers.
The Effect of nasal packing on sleep‐disordered breathing and nocturnal oxygen desaturation.
Authors: Taasan Vicente , Wynne James W. , Cassisi Nicholas , Block A. Jay 
Published: October 2006

AbstractNasal obstruction is known to cause abnormal ventilation during sleep in infants, but its effects on breathing and oxygenation during sleep in adults are unknown. However, in adults, obstruction of the nose by nasal packing has been shown to cause hypoxia, and on occasion, hypercarbia and sudden death. We have investigated the pattern of ventilation and the level of oxygenation during sleep in seven patients who had nasal packs after nasal polypectomy or septoplasty. Using standard polysomnographic techniques, we monitored chest wall motion, nasal and oral airflow, and arterial oxygen saturation and sleep stages. Nasal packing either caused or worsened sleep‐disordered breathing in all patients and significantly increased the number, duration, and frequency of episodes for the group as a whole. Several patients also had a greatly increased number and severity of episodes of nocturnal oxygen desaturation. This study shows that obstruction of the nose by packing causes marked alterations in breathing during sleep in adults.
Symposium on low frequency harmonic acceleration, the rotary chair.: Rotary chair results in comparison to eng findings
Authors: Pappas Dennis G. 
Published: October 2006

AbstractA study was done to compare the effectiveness of electronystagmography (ENG), harmonic acceleration (Rotary Chair testing), and computerized tracking in diagnosing the vertiginous patient. The data from 109 patients with clearly defined symptoms has been carefully analyzed to determine the reliability of each diagnostic procedure. Numerically, a combination of harmonic acceleration testing and computerized tracking (72%) showed more abnormals than ENG (61%).
Symposium on low frequency harmonic acceleration, the rotary chair.: SHA as a modality for monitoring patient progress
Authors: Rubin Wallace 
Published: October 2006

AbstractENG organized and simplified the disorganized conventional vestibular evaluation. The addition of SHA to the vestibular evaluation has improved our capability for identifying subtle abnormalities and even more important its use has enabled us to effectively monitor habituation and compensation (patient progress). This then allows us to monitor patient progress, confirm the patient's history and in some cases even to predict the course of the disease or injury.
Primary malleus fixation: Diagnosis and treatment
Authors: Moon Cary N. , Hahn Milege J. 
Published: October 2006

AbstractPrimary malleus fixation occurs in an otherwise normal middle ear without evidence of congenital deformity and without chronic inflammatory changes. It occurs in the latter decades of life and is frequently associated with sensorineural presbycusis. We believe it is a ligament ankylosis with osteoarthritis related to the aging process.The diagnosis of malleus fixation is facilitated through the use of a modified Siegle pneumatic otoscope in conjunction with the Zeiss binocular microscope. The literature pertaining to this subject as well as the more historical reports are reviewed. Goodhill has written extensively on malleus fixation.The audiologic test results in the fixed malleus cases reviewed for this study often presented a misleading picture, sometimes mimicking stapedial otosclerosis with a characteristic Carhart's notch and sometimes indistinguishable from sensorineural presbycusis. Usually speech discrimination scores fell in the very good to excellent range. Weber tests, whether performed by tuning forks or audiometrically, almost always lateralized to the suspect ear. Impedance frequently failed to conform to the expected fixed malleus pattern of low static compliance and absent acoustic reflexes; there was an equal number of low compliance and normal range compliance tympanograms and 15% of the total number of our cases had abnormally high compliance tympanograms. Stapedial reflexes are normally expected to be absent with lateral ossicular fixation, but this was not a consistent finding with contralateral test stimulation.The decision for surgical treatment is dependent on the audiological findings and the potential hearing gain. The technique described consists of the removal of the incus and the head of the malleus and the reconstruction of a sound conducting pathway from the handle of the malleus to the mobile stapes or from the mobile stapes to the under surface of the tympanic membrane using a prosthesis‐ossicle arrangement.Malleus fixation occurs far more often than it is diagnosed. Surgical correction can result in a worthwhile hearing gain even when the air‐bone gap is narrow or nonexistent. The technique of ossicular reconstruction is dictated by the anatomical findings. Some form of autograft ossicular reconstruction from the malleus handle to the stapes is most frequently utilized.Otosclerosis with stapes fixation sometimes causes a lateral ossicular fixation due to degenerative disease and fibrosis. In this instance a stapedectomy is performed as the primary procedure with subsequent revision as necessary to eliminate the lateral obstruction.
Down's syndrome: A modern otorhinolaryngological perspective
Authors: Strome Marshall 
Published: October 2006

AbstractThe incidence of Down's syndrome is estimated at 1.5 per 1000 births, or 7,000 newborns annually in this country. Mounting financial considerations in the delivery of medical care, as well as humanitarian considerations, fostered this in‐depth prospective, multidisciplinary study. One hundred and seven patients comprised the initial group, and 83 met the criteria established for documentation of otorhinolaryngological parameters. All patients were home based and given scheduled, routine pediatric care. Otolaryngology care, when indicated, was by consultation. The uniqueness of this study exists in the fact that children were followed from the first year of life, in what must be considered an enhanced environmental setting for Down's syndrome patients.Otologic, rhinologic and laryngologic parameters were explored in‐depth with the following resultant data. Patients with stenotic ear canals had a markedly increased incidence of associated middle ear effusion. In addition, patients with an increased frequency of upper respiratory tract infections in association with stenotic canals had an even greater incidence of effusion. When stenotic canals were present, the diagnosis of fluid proved difficult for the primary care physician. The total incidence of conductive middle ear pathology was shown to be significantly lower than in most reported studies. Equally important was the fact that at the time of data computation, none of the children had active, chronic middle ear pathology and cholesteatoma had not been identified.Adenoidectomy was shown clinically to have little apparent effect on the course of otologic pathology, nasal respiration or rhinorrhea in Down's syndrome. Previously unreported surgical correlates of the nasopharyngeal anatomy were related to upper respiratory obstructive symptoms manifest by many of these children. Apparent, spontaneous resolution of the latter, in most instances with age, correlated well with anticipated changes in the growth of the involved structures. Low dose antibiotic therapy was shown to be of benefit in controlling early rhinorrhea.Isolated congenital abnormalities of the lower respiratory tract were discussed with the findings that symptoms related to the respiratory tract must not be assumed to be inherent to the syndrome until other potential etiologies have been thoroughly considered.Factors relating to intelligence in Down's syndrome were explored with the conclusion that a direct and favorable comparison could be made in this study between improved hearing and improved intellect.
An holistic approach to Meniere's disease. Medical and surgical management
Authors: Wiet Richard J. , Kazan Robert , Shambaugh George E. 
Published: October 2006

AbstractA review of the medical and surgical management of 195 patients with Meniere's disease is presented. In order to avoid a piecemeal approach to the problem of Meniere's disease, the “whole” patient must be treated. Psychological counseling, medical management, and when indicated selective surgical management is advocated. The diagnosis of Meniere's must be confirmed through careful history, physical, neurotological evaluation and selective testing.The majority of patients can be controlled medically; however, in this study 52 (26%) patients underwent surgical therapy. Twenty‐eight patients underwent some type of saccus surgery for Meniere's disease with overall relief of 71%; however, better relief of vertigo was seen with labyrinthectomy and nerve section. The most common indication for surgery was disabling vertigo. However, fluctuating progressive sensorineural loss, may be an important reason to advise surgery.Surgical techniques for Meniere's disease continue to evolve. A graduated approach is preferred, starting with endolymphatic‐mastoid shunt, proceeding to middle fossa vestibular nerve section when medical status and hearing are adequate. When hearing is socially inadequate, labyrinthectomy with or without yestibular nerve section is preferred. A good working relationship with a neurosurgeon is advised for otolaryngologists performing middle fossa surgery.
Recovery nystagmus in ménière's disease
Authors: Mcclure Joseph A. , Copp John C. , Lycett Paul 
Published: October 2006

AbstractSpontaneous nystagmus occurs during a Ménière's attack although the literature indicates that the direction can be variable. Previous observations made during the acute and recovery stages of a Ménière's attack suggested that the direction of the spontaneous nystagmus was consistent with the primary‐secondary sequence of nystagmus that occurs with relatively prolonged stimulation of the normal vestibulo‐oculomotor system. To evaluate this nystagmus pattern further, spontaneous nystagmus was monitored in eight patients using DC electronystagmography during an acute Ménière's attack. All showed an initial contralateral nystagmus during the acute phase of the attack with reversal to an ipsilateral (or recovery) nystagmus, as the acute symptoms subsided. Such a pattern of nystagmus occurring over a few hours is a helpful diagnostic aid, and when surgery is being considered, it provides objective evidence of the ear with active disease.
Stapedectomy: Incus bypass procedures. A report of 203 operations
Authors: Sheehy James L. 
Published: October 2006

AbstractThe records of 203 stapedectomy operations in which we used a prosthesis from the malleus handle or a columella from the tympanic membrane were reviewed; 63 operations were primary stapedectomies, and 85% had a postoperative conductive deficit of 15 dB or less. The most common single indication for an incus bypass procedure was idiopathic malleus head fixation.Sixty‐six operations were revision stapedectomies; 65% had a postoperative deficit of 15 dB or less. In 50% the bypass indication was necrosis of the incus.There were 74 stapedectomies in a previously fenestrated ear; 60% had a postoperative deficit of 15 dB or less.Incus bypass procedures in stapedectomy, when indicated, yield satisfactory hearing results. Otolaryngologists who perform stapedectomy must be familiar with these procedures.
Panel discussion: Pathogenesis of otitis media. Studies on middle ear effusions
Authors: Juhn S. K. 
Published: October 2006

AbstractThe analyses of middle ear effusion (MEE) in otitis media may prove important information for better understanding of etiology, evaluation of inflammatory stages of the middle ear cavity, and evaluation of the efficacy of the treatment. Biochemical composition of serous and mucoid effusion has been characterized in terms of enzymes (lactate dehydrogenase, (LDH), lysozyme, alkaline and acid phosphates), and hexosamine content of MEE. In addition to immunoglobulin (IgA, G, and M) content, several new immunochemical parameters (immune complexes, complements, secretory IgA) and histamines have been determined in various types of MEE. Bacteriological findings of MEE, age of patients, viscosity of MEE, and clinical course (fresh or recurrent) have been correlated with the results of biochemical and immunochemical analyses of MEE. Parallel studies of animal models (serous otitis media by eustachian tube obstruction, purulent otitis media by direct innoculation of pneumococcus) showed sequential changes of mucoperiosteum and alteration of enzyme levels (LDH, lysozyme) at various times after the induction of experimental otitis media. It was found that LDH and lysozyme levels were higher in the purulent otitis media group than in the serous otitis media group and that enzyme levels decreased with clearing of the bacteria along with the resorption of inflammatory changes evidenced by histology. Human MEE studies showed that lysozyme levels were higher in the culture positive group than in the negative group, substantiating the animal findings.Strong indications have been shown that biochemical and immunochemical characteristics of MEE can reflect the degree of inflammatory changes in the middle ear cavity. Thus, baseline information necessary to specify the factors responsible for chronicity or the tendency of recurrence of otitis media has been established. Further longitudinal studies are necessary to evaluate the efficacy of presently available treatment on the management of the disease process in otitis media.
Paecilomyces fungus infection of the maxillary sinus
Authors: Rowley Steven D. , Strom C. Gordon 
Published: October 2006

AbstractPaecilomyces is a fungus only recently recognized as a human pathogen. We describe the only known case of sinusitis to date due to such a fungus. The histologic characteristics of paecilomyces are presented, and based on a review of fungal sinusitis and a disease‐free 30 month follow‐up, the treatment of this entity is suggested to be conservative local surgical debridement and aeration.
The cochlear implant — oklahoma group experience to date
Authors: Hough Jack , Mcgee Mike , Dormer K. J. , Richard G. , Guthrey George , Waterfall Kathleen , Engelmann Larry , Shaefer Arlene B. 
Published: October 2006

AbstractThe establishment of a cochlear implant team and the implementation of the Oklahoma City project was for the purpose of monitoring techniques and results reported by other investigators as well as perhaps contributing to the improvement of this method of restoring sound to profoundly deafened individuals. Years of planning and 3 years of actual experience with over 25 patients who have been implanted will be documented. Technical advances in prosthetic attachments and new transformer circuitry as well as better methods of evaluating results will be presented. Our assessment of the value of the cochlear implant and its future will be discussed.
The use of the tidal breathing flow volume loop in laryngotracheal disease of neonates and infants
Authors: Abramson Allan L. , Goldstein Mark N. , Stenzler Alex , Steele Andrew 
Published: October 2006

AbstractFlow volume loops have been valuable in the diagnosis of upper airway obstruction in adults; however, the use of this technique in neonates has been limited because of their inability to perform a forced exhalation. We have used the tidal breathing flow volume loop (TBFV) to evaluate upper airway function in 100 neonates and infants. Eleven of the neonates and infants tested with this method were found to have laryngotracheal abnormalities such as tracheal stenosis, innominate artery compression, subglottic hemangioma, and unilateral vocal cord paralysis.Normal neonates and infants demonstrate a round or oval TBFV loop pattern, while those with upper airway obstruction show a flat inspiratory or expiratory curve.Tidal breathing flow volume loops offer a new, rapid and noninvasive method for evaluating the upper airway function in neonates and infants, and may play an important role in diagnosing upper airway dysfunction and evaluating the need for therapeutic intervention.