bluuebunny/crossref_metadata_2025_split huggingface dataset:
A clinical prospective study of peritonsillar abscess in children
Authors: Brodsky Linda , Sobie Stephen R. , Korwin Debbie , Stanievich John F. 
Published: October 2006

AbstractDistinguishing peritonsillar abscess from cellulitis is an important clinical problem, particularly in children, who may require a general anesthetic for drainage of these abscesses. In order to identify those clinical factors most significant for peritonsillar abscess, we did a prospective study of 21 patients who presented with sore throat, fever, trismus, and tonsillar bulge; all symptoms that are consistent with the diagnosis of peritonsillar abscess. On admission, the following parameters were recorded: patient age, duration of sore throat, fever, white blood cell count, drooling, the degree of trismus (measured exactly as incisor‐incisor distance), the degree of pharyngotonsillar bulge, and change in voice. After 24 to 48 hours of parenteral antibiotics, 12 patients (57%) had improved sufficiently and were continued on antibiotics until resolution (cellulitis group). Nine patients (43%) had no improvement and underwent surgery for drainage of the peritonsillar abscess (abscess group).At the end of the 18‐month study period, the cellulitis and abscess groups were compared. On admission, no significant difference was found in age, duration of sore throat, fever, or white blood cell count. The pharyngotonsillar bulge was mild in 58% and moderate in 42% of the cellulitis group, while in the abscess group, the pharyngotonsillar bulge was mild in only 33% and moderate in 67%. After 24 to 48 hours of parenteral antibiotics, all patients in the cellulitis group had improvement of at least one symptom; whereas, all patients in the abscess group had no change or worsening of at least one symptom, including trismus, dysphagia, voice change, drooling, or pharyngotonsillar bulge. On admission, the precise measurement of trismus was not significantly different in the two groups (24.7 mm in cellulitis group vs. 22.5 mm in abscess group). However, after 24 hours of antibiotics, trismus averaged 7 mm more in the abscess group versus the cellulitis group (p<0.05).The above data strongly correlate the precise clinical evaluation of disease progression following a trial of parenteral antibiotic therapy with the correct diagnosis of peritonsillar abscess in children.
Wound prophylaxis with metronidazole in head and neck surgical oncology
Authors: Robbins K. T. , Byers R. M. , Fainstein V. , Schantz S. P. , Wolf P. , Cole R. , Guillamondegui O. M. , Weber R. S. , Goepfert H. 
Published: October 2006

AbstractAnaerobic organisms are thought to be an important source of wound infection in head and neck oncologic surgery. Antibiotic prophylaxis consisting of agents specific for anaerobes combined with broad‐spectrum agents that provide coverage for other well‐recognized pathogens should be an effective combination regimen for this group of patients.We conducted a prospective, randomized study comparing the efficacy of prophylaxis using combination of metronidazole and cefazolin—designated group A, to prophylaxis using cefazolin alone—group B, for patients undergoing oncologic procedures of the head and neck.The rate of wound infection in the cefazolin‐metronidazole group (158 patients) was 9.5%, compared with 18.6% in the cefazolin group (172 patients) (p=0.03). Patients undergoing clean procedures had a 4.9% infection rate overall, compared with 17.9% for clean‐contaminated procedures, and 33.3% for contaminated procedures. The average length of hospitalization was 20.7 days for patients who developed infections, compared with 8.9 days for patients without infection. Anaerobic organisms were cultured in 12 of 26 patients, ten of whom did not receive metronidazole.The lower rate of wound infection among patients who received metronidazole suggests that anaerobic organisms are an important source of wound infection in head and neck oncologic surgery. Chemoprophylaxis for these patients should, therefore, include specific anaerobic coverage in addition to the broad‐spectrum agents that cover the more familiar aerobic organisms.
Presentation and management of neck abscess: A retrospective analysis
Authors: Tom Michael B. , Rice Dale H. 
Published: October 2006

AbstractA retrospective analysis of deep neck abscesses managed at the Los Angeles County‐USC Medical Center was performed. Fifty‐one patients met the criteria and were reviewed as to presentation, etiology, location, and microbiology. Hemolytic streptococci and anaerobic species, especially Bacteroides and peptostreptococci, were the most common organisms isolated. Intravenous drug abuse was the most common etiology, and was an important source of primary carotid space infection. This group was most commonly infected with Streptococcus species (50%).
Intraoperative electrophysiologic monitoring of laryngeal muscle during thyroid surgery
Authors: Lipton Richard J. , McCaffrey Thomas V. , Litchy William J. 
Published: October 2006

AbstractA technique is described for intraoperative electrophysiologic monitoring of laryngeal muscles. This technique has been used to identify the laryngeal nerves during surgery for recurrent tumors of the thyroid gland, when direct visualization of the nerves is difficult or impossible.Laryngeal muscle electrical activity is monitored with endoscopically placed wire‐hook electrodes inserted into the vocal folds bilaterally. Neurotonic discharges are detected when the recurrent laryngeal nerves are manipulated during surgical dissection. Precise localization of the recurrent nerves is possible using a hand‐held bipolar stimulator.
Trigeminal trophic syndrome
Authors: Arasi Richard , Kay Marilynne Mc , Grist William J. 
Published: October 2006

AbstractTrigeminal trophic syndrome is an unusual condition also known as trigeminal neurotrophic ulceration or trigeminal neuropathy with nasal ulceration. The diagnosis is suggested when ulceration of the face, especially of the ala nasi, occurs in a dermatome of the trigeminal nerve that has been rendered anesthetic by a surgical or other process involving the trigeminal nerve or its central sensory connections. A history of paresthesias and self‐induced trauma to the area further support the diagnosis.Neurological deficits causing trigeminal trophic syndrome may result from surgical trigeminal ablation, vascular disorders and infarction of the brainstem, acoustic neuroma, postencephalitic parkinsonism, and syringobulbia. The following etiologies of nasal ulceration should be excluded: postsurgical herpetic reactivation and ulceration, syphilis, leishmaniasis, leprous trigeminal neuritis, yaws, blastomycosis, paracoccidioidomycosis, lethal midline granuloma, pyoderma gangrenosum, Wegener's granulomatosis, and basal cell carcinoma.In the case reported here, the diagnosis of TTS was made primarily as a result of previous experience with the syndrome, underscoring the importance of physician recognition of this unusual disorder.
Small fenestra stapedotomies with and without ktp laser: A comparison
Authors: Silverstein Herbert , Rosenberg Seth , Jones Raleigh 
Published: October 2006

AbstractThe results of 33 small fenestra stapedotomies performed using conventional techniques were compared with the results of 33 stapedotomies performed using the argon or KTP laser. The ossicular chain was reconstructed using a Teflon® wire piston of 0.6 mm diameter, and follow‐up was at least 1 year. Over‐closure of the air‐bone gap or closure to within 10 dB was accomplished in 91% of the laser‐treated group versus 72% of the conventionally treated group (p<0.10). The hearing results were statistically better in the laser group (p<0.05). Transient delayed vestibular symptoms, lasting from 1 to 3 weeks, were present in 39% of the laser‐treated group and in 12% of the patients treated by conventional techniques (p<0.05).The KTP laser stapedotomy, using a micromanipulator mounted on the microscope, is a safe, efficient technique that reduces some of the technical difficulties associated with conventional stapes surgery. The main advantage of the laser is that it enables the surgeon to make an atraumatic, bloodless opening in a fixed or mobile stapes footplate without mechanical manipulation of the stapes. Using a lower wattage to vaporize the footplate and waiting several seconds between laser bursts may decrease the incidence of postoperative vestibular symptoms.The use of the KTP laser in stapes surgery represents a major advance in surgery for otosclerosis.
Evaluation of prostaglandin E1 therapy for sudden deafness
Authors: Nakashima Tsutomu , Kuno Kayao , Yanagita Noriyuki 
Published: October 2006

AbstractProstaglandin E1, a vasodilator and potent inhibitor of platelet aggregation, was administered by intravenous drip infusion to 51 patients who had sudden deafness. The results were compared with results from 362 patients who received no prostaglandin E1 therapy. There was no significant difference in outcome between patients who received prostaglandin E1 therapy and those who did not receive prostaglandin E1 therapy.
The effects of peritonsillar infiltration on the reduction of intraoperative blood loss and post‐tonsillectomy pain in children
Authors: Broadman Lynn M. , Patel Ramesh I. , Feldman Bruce A. , Sellman Gloria L. , Milmoe Gregory , Camilon Felizardo 
Published: October 2006

AbstractImproved hemostasia and reduction of postoperative pain are desired goals when performing tonsillectomy. This is especially true in children, who may be reluctant to receive intramuscular injections for pain relief and who may lose a higher percentage of total blood volume during surgery than adults. This study evaluated the effects of peritonsillar infiltration upon operative blood loss and postoperative pain in 42 children. For the purpose of infiltration, patients were randomly assigned to one of four groups. Children in groups I, II, and III had their peritonsillar infiltrations performed with the contents of a coded vial which contained bupivacaine 0.25% with epinephrine (1:200,000), normal saline with epinephrine (1:200,000), and normal saline, respectively. Group IV children (controls) received no infiltration. All solutions were prepared in the hospital pharmacy to assure blinding of the operator and observer. All infiltrations were performed following the induction of general anesthesia and 5 minutes prior to the onset of surgery. Anesthetic agents, end‐tidal carbon dioxide levels, and the administration of intravenous fluids were carefully regulated. Surgery was performed by one of two attending otolaryngologists or a senior otolaryngology fellow using the same dissection and snare technique. Hemostasia was managed by suction‐electrocautery and packs.Patients in group IV, the control group, lost twice as much blood as did those who had infiltrations performed with normal saline, group III (p<0.001). However, patients in group III lost 1.5 times more blood than did those children in either of the two groups whose infiltrations were performed with an epinephrine solution, groups I and II (p<0.01). No postoperative bleeding was noted in any patient. Infiltration of the peritonsillar space with epinephrine (1:200,000) was shown to be more effective in reducing blood loss than infiltration with normal saline.Because of the small sample size we were unable to evaluate the beneficial effects of peritonsillar infiltration performed with bupivacaine upon the reduction of the severity of pain and the requirement for narcotic analgesics following tonsillectomy. Therefore, until further studies demonstrate such efficacy, all peritonsillar infiltrations should be performed solely for the purpose of reducing operative blood loss. As such, infiltrations should be performed with either normal saline containing epinephrine (1:200,000) or lidocaine containing epinephrine (1:200,000).
Surfer's ear in Japan
Authors: Umeda Yoshio , Nakajima Mikiko , Yoshioka Hirohide 
Published: October 2006

AbstractFifty‐one Japanese professional surfers were examined in order to analyze surfer's ear. Forty‐one cases (80%), 71 ears, were diagnosed as surfer's ear. In 19 cases (37%), 30 ears, the external auditory canals had stenosed by more than 50%. In general, surfer's ear begins to appear after 5 years and is further aggravated by continued surfing. The age at which surfing is taken up has no influence on the appearance of surfer's ear. Surfers who surf on northern (colder) coasts have severer surfer's ear than those who frequent the southern (warmer) coasts.
Complications in endoscopic intranasal ethmoidectomy: An update
Authors: Stankiewicz James A. 
Published: October 2006

AbstractA previous publication by this author discussing complications of endoscopic intranasal ethmoidectomy indicated an overall complication rate of 29% in 90 patients (17% in 150 ethmoidectomies). Compared to published complications rates for traditional intranasal ethmoidectomy (2.7% to 3.7%), 17% is alarming and of concern.The complication results in 300 ethmoidectomies performed on 180 patients are presented. The overall complication rate was 9.3%. Only two further complications have occurred since the first reported series: a cerebrospinal fluid leak and one case of subcutaneous emphysema.Methods and techniques that have led to the reduction of complications are briefly discussed. Endoscopic ethmoidectomy is a valid, safe procedure in experienced hands.
Comparative analysis of the safety of endotracheal tubes with the KTP laser
Authors: Fried Marvin P. , Mallampati S. Rao , Caminear David S. 
Published: October 2006

AbstractThe KTP laser has been used increasingly to treat various disorders of the upper aerodigestive tract. To establish the relative safety of the endotracheal tubes that are currently available, we performed laboratory testing of these tubes by exposing them to the KTP laser in an oxygen‐rich environment. Based on our observations, tubes that were all metal or metal‐wrapped endotracheal tubes were determined to be the safest. The advantage of using the all‐metal tube was that it did not need wrapping. This tube also has a second distal cuff, which would allow for continued ventilation if the proximal cuff becomes disrupted. However, under these circumstances, insertion of a new non‐disrupted tube is advised.
Aided auditory thresholds in children with postmeningitic deafness
Authors: Brookhouser Patrick E. , Auslander Martha C. 
Published: October 2006

AbstractPostmeningitic hearing loss is often bilateral, profound, and rapid in onset. Children with postmeningitic hearing loss may be identified as potential candidates for cochlear implantation. The length of time required for a definitive trial with conventional amplification, which must precede a final decision regarding cochlear implant surgery, has been the subject of debate. Twenty‐five children with bilateral severe‐to‐profound postmeningitic sensorineural hearing loss were fitted with appropriate amplification and results of serial‐aided tests were analyzed to determine the degree of benefit and changes in aided thresholds over time. Twelve children gave aided responses that clearly indicated the presence of residual hearing and good aided benefit. Ten youngsters have responded consistently in the vibrotactile range when aided, thus receiving limited benefit from conventional amplification. Of particular interest are three children who initially exhibited limited or no auditory responses but who, after a period of 16 to 25 months, showed excellent benefit with binaural hearing aids. These children are all in total communication programs and have received good auditory training. Caution should be exercised when concluding that such a child does not benefit from amplification.
Glomus tympanicum tumors: Comtemporary concepts in conservation surgery
Authors: Jackson C. Gary , Welling D. Bradley , Chironis Phillip , Glasscock Michael E. , Woods Charles I. 
Published: October 2006

AbstractThe management of glomus tympanicum tumors is not a new subject. A review of the contemporary management concept is, however, needed for two reasons: 1. the recent literature has suggested radiation therapy as a treatment option in this surgical disease, and 2. patients who are referred to us for management of these tumors continue to exhibit errors in diagnosis and surgical approaches that are unnecessarily radical.The purpose of this paper is to review the diagnosis of these lesions and to prospectively differentiate them from the more extensive jugulare tumors. When type and extent of the tumor are properly determined, a surgical procedure can be planned that conserves as much normal ear anatomy and function as possible.Between May 1970 and July 1988, 60 patients with glomus tympanicum tumors were treated at the Otology Group, P.C, in Nashville, Tennessee. In 47 patients (78%), the tumors were removed using an extended facial recess approach. The external auditory canal wall was removed in seven patients (12%), and six patients underwent a transcanal approach. Total tumor removal was obtained in 90% of patients. Surgical management remains the mainstay of treatment for glomus tympanicum tumors.
Endoscopic sinus surgery for mucoceles: A viable alternative
Authors: Kennedy David W. , Josephson Jordan S. , Mattox Douglas E. , Goldsmith Manning M. , Zinreich S. James 
Published: October 2006

AbstractFunctional endoscopic surgery affords the potential for dramatically reducing operative morbidity of surgery for paranasal sinus mucoceles by offering a minimally invasive approach under local anesthesia. Following surgery, direct endoscopic visualization of the area enables accurate follow‐up. Unlike sinus obliteration, the ability to accurately image the sinus by CT is also preserved. This paper presents our preliminary experience with 18 mucoceles in which endoscopic sinus surgery was attempted. Five patients had preoperative proptosis and diplopia, three had Pott's puffy tumor and five had erosion of the posterior table of the frontal sinus. Fifteen patients were satisfactorily treated endoscopically, two lesions could not be satisfactorily approached and required external surgery, and one patient had persistent disease, No disease recurrence has been noted to date with endoscopic follow‐up of up to 42 months.
Computed tomography of laryngeal cancer with histopathological correlation
Authors: Archer Carol R. , Yeager Vernon L. 
Published: October 2006

AbstractThe results of a correlative study between computed tomography (CT) and transaxial histopathologic sections from cancerous larynges are presented. CT has proved highly reliable in accurately delineating the extent of tumor, but there remain problems of which the interpreter must be aware. This paper is designed to illustrate application of CT examination to the problem of cancer of the larynx.
Renal clear cell carcinoma metastatic to the nose and paranasal sinuses
Authors: Matsumoto Yasushi , Yanagihara Naoaki 
Published: October 2006

AbstractTwo cases of metastatic renal clear cell carcinoma to the nose and the paranasal sinuses are reported. Case 1 was a 73‐year‐old man with metastases to the bilateral maxillas and left cervical lymph nodes. These metastatic lesions were surgically eliminated together with the primary renal cancer. Case 2 was a 48‐year‐old man with a right maxilloethmoidal metastasis. Because of severe repeated bleeding and profound necrosis, conclusive diagnosis was hard to obtain. In both cases primary renal carcinoma was detected after the nasal tumors were confirmed to be a metastatic clear cell carcinoma. Early diagnosis and surgical removals of both primary and metastatic tumors are important to prolong the patient's life. When persistent epistaxis with intranasal necrotic mass occurs, the possibility of metastatic renal clear cell carcinoma should be considered.
Management of osteomyelitis of the skull base
Authors: Benecke James E. 
Published: October 2006

AbstractOsteomyelitis of the skull base is the most severe form of malignant otitis externa. As a result of having treated 13 patients with skull base osteomyelitis over a 4‐year period, we have developed a method of staging and monitoring this malady using gallium and technetium scanning techniques. Stage I is localized to soft tissues, stage II is limited osteomyelitis, and stage III represents extensive skull base osteomyelitis. All stages are treated with appropriate anti‐pseudomonal antibiotics. The duration of therapy depends upon the clearing of inflammation as shown on the gallium scan. Each case must be looked at independently and not subjected to an arbitrary treatment protocol.
High‐resolution computed tomography: Determination of the cause of pediatric sensorineural hearing loss
Authors: Pappas Dennis G. , Simpson L. Clark , Mckenzie Randolph A. , Royal Stuart 
Published: October 2006

AbstractHigh‐resolution computed tomograms (HRCT) reveal strikingly little variation in the dimensions of inner ear structures among people with normal hearing. However, a subgroup of people exist who have a sensorineural hearing loss (SNHL) and morphologically normal HRCT scans, yet have subtle radiographic aberrations based on measurements of inner ear dimensions. These changes might have resulted from teratogenic influences during the late first to mid second trimester, a time when the inner ear has achieved adult form, yet continues to enlarge to adult size.A retrospective study of HRCTs on three groups of ears was performed to determine inner ear structure dimensions. Group I, the control group, consisted of 50 ears with no SNHL and no discernible abnormalities on HRCT. In group II, there were 70 ears with SNHL and obvious abnormalities on HRCT. Group III, the test group, was composed of 140 ears with SNHL and “normal” HRCTs. Groups II and III were analyzed, applying the normal dimensions derived from group I. When compared to the control group (I), all of the ears in group II were abnormal. Moreover, 75% of the ears in group III had subtle differences not apparent unless measurements were made. Two or more abnormal dimensions were found in 32%. Findings and implications are thoroughly discussed.
Detection of human papillomavirus dna in laryngeal squamous cell carcinomas by polymerase chain reaction
Authors: Hoshikawa Tomohide , Nakajima Takashi , Uhara Hisashi , Gotoh Masahiro , Shimosato Yukio , Tsutsumi Kouichiro , Ono Isamu , Ebihara Satoshi 
Published: October 2006

AbstractThe presence of human papillomavirus genomes‐16 and ‐6b in metastatic cervical lymph nodes was examined in 34 cases of laryngeal carcinomas by means of polymerase chain reaction, which had been fixed in formalin and embedded in paraffin. Human papillomavirus DNAs extracted from paraffin‐embedded tumor tissues were used for polymerase chain reaction with amplification of the E6 region of human papillomavirus genome‐16 and the El region of human papillomavirus genome‐6b. Human papillomavirus genome‐16 sequences were positively amplified in six (17.6%) metastatic tumors; ‐6b sequence was positively amplified in one (2.9%) metastatic tumor. Laryngeal carcinomas of glottic origin showed high human papillomavirus genome‐16 DNA‐positive rates (4 of 9 cases, 44.4%) compared to those of other sites. These results suggest that human papillomavirus genome‐16 infection might be closely associated with the development of some laryngeal squamous cell carcinomas of glottic origin similar to uterine cervical carcino‐genesis.