bluuebunny/crossref_metadata_2025_split huggingface dataset:
Respiratory distress after recurrent laryngeal nerve sectioning for adductor spastic dysphonia
Authors: Salassa John R. , Desanto Lawrence W. , Aronson Arnold E. 
Published: October 2006

AbstractAdductor spastic dysphonia is a voice sign associated with various neurologic and psychologic disorders. Treatment of spastic dysphonin in selected patients is unilateral recurrent laryngeal nerve sectioning. Except for voice change or, in some patients, return of phonatory spasticity, there have been no long‐term sequelae or complications of this treatment. We describe three patients with adductor spastic dysphonia who underwent recurrent laryngeal nerve sectioning and who, 3 to 38 months later, suffered respiratory distress that required tracheostomy. The respiratory distress in all three patients was due to episodic jerky vocal cord hyperadductions that caused stridor during inspiration and expiration. These repetitive laryngospasms during respiration and phonation were progressive. Two patients needed an arytenoidectomy to achieve a useful voice, and all three required a permanent tracheostomy to alleviate in‐spiratory laryngeal obstruction.
Synchronous video recording of the pharyngeal airway and polysomnograph in patients with obstructive sleep apnea
Authors: Rojewski Thomas E. , Schuller David E. , Schmidt Helmut S. , Clark Robert W. , Potts Robert E. 
Published: October 2006

AbstractA system of synchronous, simultaneous video recording of the laryngopharyngeal airway in patients with sleep disorders is described. Observations made during the study of 12 patients are reported. Repeated obstruction of the laryngeal inlet by collapse of the hypopharyngeal musculature is thought to be the primary pathological event in patients suffering with obstructive sleep apnea.
Panel discussion: Pathogenesis of otitis media. Bacteriology and immunology
Authors: Lim David J. , Demaria Thomas F. 
Published: October 2006

AbstractThree features of otitis media with effusion (OME) are important in understanding its pathogenesis: 1. it is most common among children, when the eustachian tube is poorly developed; 2. it is most common during the winter months, when the common cold is prevalent; and 3. bacteria are found in a large number of middle ear effusions from OME patients. Although middle ear effusions are conventionally thought to be sterile, numerous recent investigations favor a bacterial pathogenesis of OME. Four possibilities can be considered: 1. bacteria are modified by antibiotics or antibodies, causing a lingering inflammation; 2. early antibiotic treatment may interfere with the development of local immunity; 3. bacterial antigen trapped in the middle ear causes immune injury leading to OME; and 4. bacterial endotoxin and inflammatory mediators cause middle ear effusions.
Panel discussion: Pathogenesis of otitis media. Current treatment of otitis media based on pathogenesis studies
Authors: Paparella Michael M. 
Published: October 2006

AbstractStudies of pathogenesis of otitis media indicate clear cut categories including POM (acute purulent otitis media), SOM (serous otitis media), MOM (mucoid or secretory otitis media), COM (chronic suppurative otitis media) and sequellae with frequent overlap of types. One type of otitis media can lead to another type along a continuum. In this paper our concepts of treatment based on laboratory studies and clinical observation, both medical and surgical, are documented.
Scanning and transmission electron microscopic aspects of the nasal acilia syndrome
Authors: Dudley James P. , Welch Michael J. , Carney Jean M. , Stiehm E. Richard , Soderberg‐Warner Margaret 
Published: October 2006

AbstractA 3‐month‐old boy was admitted with failure to thrive and persistent fevers. During a 4 month hospitalization for treatment of suspected sepsis, persistent purulent nasal discharge developed. Biopsies of his nasal mucosa on 3 separate occasions disclosed thinned respiratory epithelium and a complete absence of cilia when examined by electron microscopy (EM). Despite an initial granulocytopenia and a wide range in T‐cell numbers, he did not show any evidence of lower respiratory tract infection. A tracheal biopsy processed for EM demonstrated normal ciliated epithelium. This patient appears to have an unrecognized syndrome of normal tracheal cilia but absent nasal cilia.
Use of estrogen in treatment of familial hemorrhagic telangiectasia
Authors: Harrison D. F. N. 
Published: October 2006

AbstractWithin a 25 year period, 118 patients with a definitive diagnosis of familial hemorrhagic telangiectasia were treated for recurrent epistaxis. Twenty‐eight patients had dermoplasty but 67 patients received large dose estrogen therapy using ethinyl estradiol. The latter regime proved successful in every patient and the side effects and possible disadvantages of this treatment are considered in detail.
Surgery on patients with hemostatic disorders
Authors: Lekas Mary D. , Dibenedetto Joseph , Smith Peter S. , Kantesaria Kirtikant P. 
Published: October 2006

AbstractPatients with hemostatic disorders about to undergo surgery present a special challenge for the otolaryngologist. The most common coagulation disorders constituting more than 90% of all patients seen with severe inherited bleeding defects are hemophilia and von Willebrand's disease (pseudohemophilia). Neither of these is an absolute contraindication for surgery. Hemophilia, a sex‐linked disorder, can be divided into two distinct classes: hemophilia A (classic hemophilia), a deficiency of factor VIII production, and hemophilia B (Christmas disease), a deficiency of factor IX production. Von Willebrand's disease is an autosomal dominant disorder consisting of a decrease in factor VIII activity plus a prolonged bleeding time and abnormal platelet aggregation with ristocetin.Careful preoperative evaluation and early hospitalization are important for these patients. The close cooperation of a hematologist, monitoring availability and proper replacement of these factors, is essential. Careful postoperative attention should be directed at the maintenance of sufficient therapeutic levels of replacement therapy for a minimum of 7–10 days. We shall present cases of patients with inherited bleeding diatheses who underwent successful surgery at our institution. The use of Amicar® and Avitene® will also be presented.
Temporal bone encephalocele —diagnosis and treatment
Authors: Kamerer Donald B. , Caparosa Ralph J. 
Published: October 2006

AbstractEncephaloceles of the temporal bone are encountered infrequently by the otolaryngologist and, therefore, may be misdiagnosed. Serious sequelae and central nervous system infections may result with inadequate management. A series of 15 recent cases are presented and discussed in relationship to etiology and surgical management. Transmastoid and middle cranial fossa approaches will be delineated along with the rationale and techniques for each. The use of pedicle and free tissue flaps, as well as autogenous bone and synthetics will be outlined.
Auditory function in acute severe head injury
Authors: Hall James W. , Huang‐Fu Musan , Gennarelli Thomas A. 
Published: October 2006

AbstractThere are few clinical neuro‐otologic investigations of acute head injury. We obtained impedance and auditory brain stem response measures for 25 acute head‐injured patients, usually within 76 hours following injury. All patients were comatose at the time of assessment. Impedance abnormalities were found for over three‐fourths of the patients. Generally, they were associated with transient, reversible dysfunction, such as high negative middle ear pressure. The acoustic stapedius reflex, however, was seldom observed, even in patients with apparently normal middle ear function.Auditory brain stem response measures showed evidence of CNS dysfunction in 80% of the patients. Abnormalities ranged from prolonged latency and reduced amplitude of the wave V auditory brain stem response component to total absence of brain stem auditory activity. There was a relationship between auditory brain stem response findings and neurologic outcome at 1 month post assessment. Electrophysiologic auditory measures are clinically valuable in neuro‐otologic diagnosis and neurologic prognosis of acute, severe head injury.
Choanal atresia: A new embryologic theory and its influence on surgical management
Authors: Hengerer Arthur S. , Strome Marshall 
Published: October 2006

AbstractChoanal atresia was first described in 1755 by Johann Roederer and continues to occur without a proven embryologic basis. Most authors have attributed the defect to persistence of the nasobuccal membrane, which leaves many unanswered questions. This paper proposes the embryologic cause to be a misdirection of the mesodermal elements originating in the neural crest cells. Recognizing this as the probable cause, 37 cases of choanal atresia are analyzed for a variety of factors, including their surgical approach and postoperative results. The clinical findings suggest the transpalatal approach offers a greater degree of success at all ages. This may be explained by the anatomic changes created by this congenital anomaly.
Experiments in laryngeal reinnervation
Authors: Crumley Roger L. 
Published: October 2006

AbstractLaryngeal reinnervation surgical procedures were performed in 26 dogs. Nineteen animals comprise the data reported in this thesis.Two different operative procedures were investigated, the ansa hypoglossi neuromuscular pedicle in 5 dogs, and the split phrenic nerve graft in 14 dogs. The studies were designed to evaluate whether either procedure resulted in inspiratory abduction of the vocal cord; and, if so, the mechanism by which abduction was produced.Five dogs in Experiment 1 demonstrated similar results from the ansa hypoglossi neuromuscular pedicle procedure. Apparent vocal cord abduction was seen during hyperpnea from airway obstruction, but was abolished by superior laryngeal nerve transection, or detachment of the sternothyroid muscle. None of the nerves in the neuromuscular pedicles was electrically excitable.Fourteen dogs in Experiment 2 underwent the split phrenic nerve graft operation. Vocal cord abduction, synchronized with inspiration, was noted in 5 animals. Two dogs had inspiratory abduction in quiet respiration. Electromyography, nerve action potentials, endoscopic motion pictures, and histologic study confirmed that posterior cricoarytenoid muscle reinnervation had occurred via the nerve graft from the phrenic nerve. Vocal cord abduction and electromyographic activity in the posterior cricoarytenoid muscle were abolished by transection of the nerve graft or the phrenic nerve.Conclusions of the study include the following: 1. the neuromuscular pedicle procedure does not result in reinnervation of the posterior cricoarytenoid muscle the pedicle's nerve and muscle block. 2. The phrenic nerve procedure may result in reinnervation of the posterior cricoarytenoid via the nerve graft, and inspiratory abduction of the paralyzed vocal cord. Failure of the phrenic procedure to produce reinnervation appeared to be due toa.recurrent laryngeal nerve regeneration, or b. avulsion of the nerve graft due to swallowing and other laryngeal movements.
Management of bilateral acoustic tumors.
Authors: Hughes Gordon B. , Sismanis Aristides , Hays James W. , Glasscock Michael E. , Jackson C. Gary 
Published: October 2006

AbstractBilateral acoustic tumors, often felt to represent a central form of von Recklinghausen's disease, pose a particularly challenging problem to the otologist. This retrospective study reviews the evaluation and surgical results in 15 patients with bilateral acoustic tumors from whom 23 tumors were removed. Early diagnosis can be achieved by clinical awareness of the disease, thorough radiologic evaluation, and appropriate family screening. Total tumor removal with preservation of hearing is usually possible if the lesion is not larger than 1.0 cm. Total removal with hearing preservation is usually not possible if the lesion is larger than 2.0 cm. Hydrocephalus and additional tumors can complicate the overall clinical picture. Guidelines for appropriate management of bilateral acoustic tumors are based on tumor size, hearing sensitivity, and associated intracranial pathology.
Cisplatin vestibular ototoxicity: Preliminary report.
Authors: Black F. Owen , Myers Eugene N. , Schramm Victor L. , Johnson Jonas , Sigler Barbara , Thearle Patricia B. , Burns Denise Shamrock 
Published: October 2006

AbstractSixteen patients were monitored for vestibular ototoxicity while receiving cisplatin in dosages of 180 mg/M2. The incidence of preexisting vestibular functional abnormalities (31%) was higher than the incidence of ototoxicity (18%). Although the number of patients was not large enough for meaningful statistical comparison, the incidence of vestibular ototoxicity from cisplatin was low for the dosage levels employed.Based upon the results of this study, the following recommendations are made for monitoring cisplatin vestibular ototoxicity.1. All patients should receive vestibular tests prior to cisplatin administration. 2. Subjects, who have reduced (or asymmetric) vestibular function upon pretherapy testing, should be monitored at least weekly for any change in function while receiving cisplatin. 3. Subjects who are normal prior to therapy need to be tested only when cumulative doses exceed 400 mg.The severe nausea and vomiting associated with cisplatin chemotherapy is not related to vestibular ototoxicity.
Bell's palsy: A 5 year review of 174 consecutive cases: An attempted double blind study.
Authors: Brown James S. 
Published: October 2006

AbstractThe etiology of Bell's palsy is unknown and present treatment is empirical and, at best, controversial.Between 1973 and 1976, 174 consecutive cases were seen and clinically divided into a group with incomplete facial palsy and a group with complete facial palsy. The incomplete group consisted of 82 patients who were matched and treated alternatively with steroids or supportive treatment only. The return of function in each patient was tabulated and results in the two groups compared. Patients in this group have an excellent prognosis regardless of treatment. The complete facial palsy group consisted of 92 cases, who were matched according to age, sex, race and clinical picture and most importantly to the results of a series of tests designed to test the function of the affected facial nerve and its musculature. In this group 10 patients elected to have supportive treatment only, while 41 cases received cortisone and 41 matching patients underwent well planned decompression of the facial nerve.The patients were assessed at 6 and 12 months by an independent clinician. They will be continued to be assessed for the next 5 years. The results of this study are reported in this paper.
Observations on the pathogenesis of chronic Non‐Specific pharyngitis and laryngitis
Authors: Ward Paul H. , Berci George 
Published: October 2006

AbstractRepeated analysis of cinephotographic and cinefluorographic studies, correlated with clinical observations, have provided insight into the physiopathology of many cases of chronic non‐specific pharyngitis, laryngitis, contact ulcers, granulomas, and pachylaryngitis. Hiatal hernia and gastroesophageal‐pharyngeal reflux appear to be the cause of local irritation. Chronic coughing and habitual harsh throat clearing initiate the contact ulcers and granuloma formation. The successful treatment of this entire family of lesions is dependent upon elimination of vocal abuse and control of the factors that ore responsible for the chronic irritations.
Tinnitus aurium: Fact… or fancy.
Authors: Kauer John S. , Nemitz James W. , Sasaki Clarence T. 
Published: October 2006

AbstractWe have used the 14C 2‐deoxyglucose (2DG) technique to examine changes in metabolic activity in the auditory pathway of 29 guinea pigs after removal of the cochlea, removal of the middle ear ossicles, and after treatment with sodium salicylate. Three experiments were performed.In the first experiment we examined the levels of neuronal activity at 1–2 hours to 42 days after unilateral and bilateral cochlear ablations. In this series of experiments, we observed a spontaneous increase in activity which appeared at 3–14 days in brain stem regions having major connections to the ablated cochlea.In the second series, we performed unilateral and bilateral removal of the middle ear ossicles. These manipulations, in contrast to cochlear removal, caused little or no spontaneous increase on the side connected to the lesion when examined at either 1 day or 21 days. This observation suggested that the increased activity seen several days after cochlear removal was due to the process of deafferentation per se and not to the deafness which was caused by both cochlear and ossicle removals. These findings are consistent with the possibility that the spontaneous increase in metabolic activity seen after cochlear removal may be a reflection of the subjective sensation of tinnitus experienced by human beings after cochlear damage or VIIIth nerve section.In the third experimental series, we administered sodium salicylate orally to animals. All animals had unilateral ossicle removal. This experiment was designed to determine whether high levels of a salicylate, known to produce tinnitus in human beings, could elicit increased activity in those animals which would normally have experienced a conductive hearing loss and, therefore, absent neuronal activity. In the animals examined to date after salicylate administration, an increase in 2DG uptake was observed. These preliminary data are consistent with the findings seen after cochlear ablation and further suggest that increased neuronal activity may reflect a tinnituslike phenomenon in the experimental animal.We believe the findings from these three sets of experiments form the basis for development of an experimental animal model which can be used to study a profound otologic symptom about which there is yet no pathophysiological information. As such, these data represent a very important first step in developing a reasonable and successful therapeutic regimen for afflicted human beings.
“How i do it” — otology and neurotology. A specific issue and its solution. Surgical technique for open mastoid procedures.
Authors: Glasscock Michael E. 
Published: October 2006

AbstractIn mastoid surgery for chronic ear disease (with or without cholesteatoma), the removal of the posterior canal wall does not necessarily insure a “safe” ear. Open procedures are subject to many of the same complications that ore associated with the more controversial closed technique. In addition, if the canal wall down procedure is not performed with great care and under strict guidelines, the postoperative ear can be a continual nuisance to the patient.The author has reached these conclusions based upon 20 years' experience in dealing with “problem cavities” created by himself and others. The purpose of this paper is to define the “problem cavity” and how to prevent it.
Cutaneous carcinoma of the head and neck: Management of massive and previously uncontrolled lesions
Authors: Levine Howard 
Published: October 2006

AbstractCutaneous basal cell and squamous cell carcinoma is the most common of malignant neoplasms. The etiology and natural history of these cutaneous neoplasms are related to actinic exposure, age, sex, hereditary factors, previous tissue injury, and chemical ingestion and exposure.Identification of cutaneous basal cell and squamous cell carcinoma is important. There are several different histologic subtypes of basal cell carcinoma, and each behaves clinically in a different way.There are several accepted methods of treatment including cryosurgery, electrodesiccation and curettage, radiotherapy, surgical excision and Mohs' histographic surgery. Each of these methods is reviewed.The vast majority of cutaneous basal cell and squamous cell carcinomas are easily cured no matter what the treatment modality. However, about 10% of these tumors (30,000 new cases each year) are not cured. These tumors often become massive and uncontrollable.Sixty patients met the criteria of being massive and/or uncontrollable. These criteria are 1. size 3 cms or greater, 2. involvement deeper than skin and subcutaneous fat, 3. four or more previous treatments without control, or 4. proven metastatic disease.These patients with massive and/or uncontrollable tumors underwent treatment with either Mohs' histographic surgery followed by conventional surgery with total microscopic marginal control or conventional excision with total microscopic marginal control.Of the 60 patients treated in this way, 53 are free of disease; 41 of these patients have been free of disease for more than 24 months.Massive and/or previously uncontrollable tumors appear to be better controlled with total microscopic marginal control while preserving as much normal tissue as possible. This technique appears to allow preservation of important esthetic and functional tissue while excising the complete tumor with the greatest degree of certainty.
Head and neck cancer in women — a changing profile
Authors: Mcguirt W. Frederick 
Published: October 2006

AbstractA progressive trend toward increased occurrence of head and neck cancer in women is reported. Over the most recent 6 year period, 533 newly diagnosed patients were referred for treatment of head and neck cancer; 169 (32%) were women. Review of their cases showed heavy use of tobacco and alcohol by many of these women patients. The acceptance of the use of these mucosal irritants and changing social mores in the tobacco belt society under study predate recent national trends of similar nature. Thus, the increased incidence of head and neck cancer in women reported here probably presages similar increases in that incidence nationwide.
Elusive head and neck carcinomas beneath intact mucosa
Authors: Mancuso Anthony A. , Hanafee William N. 
Published: October 2006

AbstractThis study presents 19 patients who had mucosally inapparent carcinomas of the upper aerodigestive tract demonstrated by computed tomography (CT). This group contains subpopulations that were identified both retrospectively and prospectively. During the same period 40 nasopharyngeal, 20 oropharyngeal‐tongue base, and over 100 laryngeal and hypopharyngeal carcinomas were studied; all had clinically obvious mucosal components. Nine of our 19 patients had strictly submucosal tumors and a variety of clinical presentations; 5 patients had strictly submucosal recurrence of treated carcinomas and 5 had mucosal lesions which were not identified on examinations by more than one practicing head and neck surgeon. Sixteen of the 19 tumors were confirmed histologically; in 3 others confirmation was by a combination of CT and clinical course.CT can demonstrate the deep extent of aerodigestive tract carcinomas more accurately than physical examination and it can show mucosally inapparent disease. CT should be part of the staging work‐up in nearly all upper aerodigestive tract carcinomas and in patients suspected of harboring an unknown primary within this region.
Physiologic maxillary antrostomy — UPDATE
Authors: Sanderson Bruce A. 
Published: October 2006

AbstractPhysiologic antrostomy, as presented in this paper, is a procedure developed by the author using both old and new techniques. Indications and contraindications for the use of the physiologic maxillary antrostomy are listed. The osteoplastic flap (trapdoor) is used to enter the antrum. The nature of the lesions which can be handled through this approach are covered. The methods for removal of the lesions without removing the mucous membrane lining are given. The indications for removing this membrane are also presented. The methods are presented for the placing of the ventilation tube in the natural ostium.A step by step description of the technique used to perform this type of surgery is presented. Using this method, surgery that is done in or through the maxillary sinus is simplified and the severe sequelae of the Caldwell‐Luc type of surgery are largely overcome.