bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical treatment of juvenile nasopharyngeal angiofibroma
Authors: Jafek Bruce W. , Nahum Alan M. , Butler R. Melvin , Ward Paul H. 
Published: September 2006

AbstractTwenty‐five cases of juvenile nasopharyngeal angiofibroma are reviewed. Surgical removal via a transpalatal approach accompanied by a gingivobuccal incision and exploration of the pterygomaxillary space to remove lateral extension is advocated. This procedure is almost uniformly successful in eradicating tumors without intracranial extension. Pre‐operative estrogen therapy and temporary ligation of the ipsilateral carotid artery in selected cases appears to decrease blood loss at surgery. Pre‐operative angiography delineates the nasopharyngeal mass, shows any pterygomaxillary space extension, and demonstrates any middle cranial fossa extension. A fairly accurate estimate of the percentages of vascular contribution is also obtained, allowing the surgeon to plan possible vascular control by ligation. Intracranial fossa extension generally greatly increases the operative blood loss and risk, because of probable subtotal resection but is not an absolute contraindication to surgery.
Tympanic membrane grafting with fascia: Overlay vs. undersurface technique
Authors: Glasscock Michael E. 
Published: September 2006

AbstractEarly attempts to repair tympanic membrane perforations were not uniformly successful. At first, full thickness and later split thickness skin was used as an overlay graft. The many problems associated with this material soon led most surgeons to seek a substitute. Over the years canal skin and connective tissue (particularly fascia) became popular, and two grafting techniques developed. The use of connective tissue made it possible to place the graft under the drum remnant as well as over.There are some difficulties associated with both procedures. When fascia is placed over the drum remnant several problems such as anterior sulcus blunting, graft lateralization, epithelial pearls and delayed healing may occur. The undersurface procedure is technically more difficult, and error in graft placement accounts for many of the failures that occur with this method.This paper discusses both classic techniques in general terms, stressing the advantages and disadvantages of both. By combining some features of each technique and by employing the postauricular approach, a method of undersurface grafting in presented that has consistently produced good tympanic membranes. Results (take rate and quality of drum head) are described in 237 cases in which both techniques of grafting were used.
Long term results of perilymph fistula repair
Authors: Althaus Sean R. , House Howard P. 
Published: September 2006

AbstractThis paper presents the long term results of post‐stapedectomy perilymph fistula repair in a group of patients followed over several years. These results indicate that, in general, the outlook for preservation of hearing and relief of vertigo is promising in most cases. In 73 percent of cases hearing was maintained or improved, and in 75 percent of patients having vertigo significant improvement occurred.Hearing loss following fistula repair occurs more often when the original stapes prosthesis was a wire loop. Patients with vertigo as a symptom have an increased possibility of further hearing loss after repair of a perilymph fistula.
Hypometabolism in allergy: A review for otolaryngologists
Authors: Withers Ben T. 
Published: September 2006

AbstractTreatment failure in hyposensitization therapy for allergy is frequently associated with lack of utilizable thyroid hormone in the periphery at the cell level. Basic biochemical principles and endocrinological aspects of the problem relate to the enzymatic mechanism of allergy and atopy (Godlowski). Enzymatic protein synthesis and breakdown in the mitochondria within the cells requires energy supplied by the APT/ADP cycle. In turn, energy from metabolically active thyroid hormone (T3) is necessary as a driving force for the preceding. If T3 is lacking in the process, faulty, inefficient, toxic enzymes result, which cannot completely break down ragweed or other entering antigens to symptomless metabolites. Toxic allergy symptoms result in the patient.Diagnosis and application of corrective measures in clinical allergy cases as well as treatment precautions will be detailed in representative case reports.
Overt responses of listeners to alaryngeal speech
Authors: Hartman David E. , Scott Davis A. 
Published: September 2006

AbstractThe investigators observed and analyzed the nonverbal and verbal reactions of 30 service station attendants who were exposed to alaryngeal speech produced with an electronic larynx and the reactions of another 30 attendants who heard normal speech. Although there was a significant difference between the patterns of response of the two groups of subjects, the difference was attributable primarily to responses on only three of the 16 behavior categories studied. Subjects who heard alaryngeal speech tended to stare more or speak louder or slower. The authors concluded that listener reactions should not be cited as an argument against the use of an artificial larynx; potential adverse reactions will be minimal, can be coped with easily, and will not interfere with effective communication.
Ceruminous gland tumors: Report of three cases
Authors: Anagnostou G. D. , Papademetriou D. G. , Segditsas TH. D. 
Published: September 2006

AbstractThree patients with ceruminomata were treated by radiation therapy, surgery or a combination of both of them.One patient was treated by surgery followed by radiation treatment and then, after recurrence of the tumor, by radical surgery, and another patient treated by surgery only, are free from disease six and five years respectively. One patient treated by incomplete radiation therapy only, has had recurrence of the tumor three months later, but after a full treatment by Cobalt teletherapy is free from recurrence four months later.Surgery is considered the treatment of choice; however, radiation therapy may be indicated when the tumor, either primary or recurrent, has extended beyond limits of surgical resection, or because of distant metastases, due to the patient's general condition precluded surgery, or finally, when surgery is refused.
Pilomatrixoma masquerading as a parotid mass
Authors: Krausen Anthony S. , Ansel David G. , Mays Ben R. 
Published: September 2006

AbstractA case report of pilomatrixoma masquerading as a parotid, tumor is presented. Although well known to dermatologists and knowledgeable pathologists, this is, to our knowledge, the first time this entity has been presented in the otolaryngologic literature. Radiographic, sialographic, and histopathologic features of this tumor are presented with differential diagnoses. Because this is strictly a benign lesion, treated by local excision, the importance of correct histopathologic diagnosis is emphasized. The ultimate intent of this report is to make otolaryngologists aware of this entity so that they might include it in the differential diagnosis of calcified masses presenting in the parotid region.
Submaxillary gland tumors
Authors: Lowe James T. , Farmer Joseph C. 
Published: September 2006

AbstractTumors arise much less frequently in the submaxillary gland than in the parotid gland; however, the incidence of malignancy is higher in submaxillary neoplasms. The records of 50 patients with submaxillary gland tumors were reviewed and the findings compared with those of other recent series. Malignant tumors of the submaxillary gland were found to behave aggressively, and poor results were obtained in treating these lesions, especially when recurrences were present. It is felt that a planned approach consisting of adequate initial resection would lead to improved results.
Vestibular pathology in otosclerosis temporal bone histopathological report
Authors: Sando Isamu , Hemenway William G. , Miller Daniel R. , Black Franklin O. 
Published: September 2006

AbstractA histopathologic study of four temporal bones from two patients with vestibular pathology concurrent with otosclerosis is presented. The findings are as follows: 1. In each of the temporal bones, the otosclerotic focus was seen in apposition to the superior vestibular nerve with invasion of the cribriform area of the nerve in one of these ears; 2. there was vestibular nerve degeneration distal to these foci in all cases, worse in those nerve fibers close to the otosclerotic focus. In one case there was retrograde degeneration up to the area of Scarpa's ganglion; 3. three of the four temporal bones showed a marked degeneration of the sensory epithelium of the cristae of the lateral semicircular canals as well as loss of the subepithelial cells and neural elements; and 4. in all four temporal bones a basophilic deposit was found in the ampulated end of the posterior semicircular canal which may represent cupulolithiasis.We feel that the findings in these temporal bones are important histological confirmations of vestibular pathology in otosclerosis which have not been previously reported. This pathology may be the explanation for various clinical vestibular disorders seen in patients with otosclerosis, but, heretofore, very poorly understood.
Quantitative determination of alkaline phosphatase and inorganic phosphate in fetal and neonatal otic capsules of rats
Authors: Marovitz William F. , Black Martin J. 
Published: September 2006

AbstractA quantitative assay technique for alkaline phosphatase in pooled fetal ears has been developed. The data obtained by this microchemical assay agrees well with previous histochemical techniques. Starch gel electrophoresis was unable to differentiate different alkaline phosphatases in the extract. These data should prove useful for examination of experimental pathology of the embryonic capsule.
Epiglottitis — Individualized management with steroids
Authors: Strome Marshall , Jaffe Burton 
Published: September 2006

AbstractThree therapeutic modalities are available for the management of acute epiglottitis — medical, intubation, and tracheotomy. Helping the otolaryngologist discern the regimen of choice for a given situation is the format for this paper. The incidence of diagnosed epiglottitis is definitely increasing in our institution and in others; therefore, a rational individualized approach based on recent information is essential. Twelve cases formed the basis for the concepts presented.Our current management protocol for supraglottic infection is as follows: first, medical management for selected cases is given a two‐hour trial. Should this prove unsuccessful, intubation is effected. Tracheotomy will no longer be performed unless the internal lumen of the tube placed is so small that crusting becomes a problem; the patient cannot be extubated in 48‐72 hours; or in the very rare contingency that the patient could not be intubated.In this series, medical management alone sufficed in eight cases. Two cases received a tracheotomy. These were performed prior to the initiation of our current protocol. Two patients were intubated.The 12 cases were analyzed with regard to the parameters which might depict those cases that would not respond to medical management. The initial respiratory rate, pulse rate, and temperature elevation were not indicative. Rather, the potential and direction of change of the aforementioned recorded over a two‐hour period was very significant. A significant medical response as manifested by a decreased respiratory rate was seen in four cases in less than one hour and within two hours in the remaining four cases. It is of significance that in one of the eight cases steroids were withheld for the first two hours with a significant deterioration in the patient's condition. Steroids were then given, and within two hours there was a definite clinical improvement. It should be noted that the steroid response could not be correlated with the length of symptoms prior to admission; also, those patients whose initial difficulty was primarily dysphagia seemed to have a more benign general course. Medical management was therapeutic in all of these cases. Information from our later cases supports this contention as well.An analysis of the four initial cases requiring airway intervention revealed a syndrome of cyanosis, exhaustion, and severe sternal retraction to indicate an initially poor medical response. Patients with this triad should be intubated as soon as possible and given appropriate antibiotics and steroids.
Prevention of complications of composite resection after high dose preoperative radiotherapy
Authors: Tucker Harvey M. , Rabuzzi Daniel D. , Sagerman Robert H. , Reed George F. 
Published: September 2006

AbstractRecent reports have suggested that carcinoma of the tonsil and adjacent structures (tonsillar pillars, adjacent soft palate and lateral pharyngeal wall) can be treated with improved survival rates by combining definitive surgery with planned preoperative radiotherapy. Experience to date does not clearly demonstrate the ideal dose of preoperative radiotherapy; however, in general it appears that survival rates improve in proportion to increasing dosage of preoperative radiation. The use of preoperative radiation in doses approaching or exceeding tumoricidal levels (6,000‐6,500 rads at approximately 1,000 rads/week) has been limited by the unacceptable complication rate to be expected. The rate of major complications reported has ranged from 18 percent to almost 47 percent.For the past three years, all patients seen by the Department of Otolaryngology of the Upstate Medical Center with malignancies involving the tonsil and its adjacent structures have been managed by a combined modality of 5,500 rads preoperative radiotherapy followed by definitive surgical resection, using distant, unirradiated flaps for repair where necessary. There were 33 patients in the group, including three T2, 20 T3 and 10 T4 lesions. Joint evaluation and planning of treatment between radio‐therapy and otolaryngology coupled with meticulous attention to various aspects of surgical management has yielded the results reported in the table. The major complication rate has been limited to 3.03 percent. These results indicate that it is possible to undertake extensive resections for carcinoma of the tonsil and adjacent structures after high‐dose preoperative radiotherapy without incurring any significant increase in morbidity over surgery alone.
Extracranial arteriovenus fistulas
Authors: Stucker Fred J. 
Published: September 2006

AbstractThis paper gives a brief description of the etiology, diagnosis and treatment of extracranial arteriovenous fistulas.These fistulas may be either acquired or congenital in origin. Their natural history is one of progression which can result in severe hemodynamic changes. Extracranial arteriovenous fistulas usually occur between the terminal branches of the external carotid artery and the lateral sinus or jugular venous systems. The most common symptom, pulsatile tinnitus, can often be decreased by common carotid artery compression unless there is a significant contribution from the vertebral arterial system.Selective arteriography utilizing subtraction technique is the most important diagnostic study.The recommended treatment is complete surgical excision of the fistula and ligation of all feeding vessels. The recurrence rate is higher with the other methods of control, such as simple ligation, irradiation, injection of sclerosing agents and embolization.Two patients with congenital arteriovenous fistulas are presented.
Complications of laryngotracheal disruption
Authors: Alonso William A. , Pratt Lindsay L. , Zollinger William K. , Ogura Joseph H. 
Published: September 2006

AbstractOwing to the increased use of automobiles, minibikes, motorcycles and other devices for recreational activities, we are now seeing a growing number of severe head and neck injuries. In this paper we will discuss a rare and often fatal injury of the neck, namely, traumatic laryngotracheal separation. There are isolated reports in the literature of heroic efforts to save the lives of such patients, but little has been said regarding surgical repair of the injury and possible late complications.Seven case reports of laryngotracheal avulsion injuries are presented with emphasis placed on the methods of repair of the acute injury and reconstruction of late complications. The etiology of the injury in all cases was a severe localized blow to the extended neck at the level of the cricoid cartilage. Most patients arrived in the emergency room near death, showing obvious signs of upper airway obstruction. A rapid tracheostomy was responsible for saving their lives. In most cases the avulsed trachea was repaired primarily over an internal stent. Associated laryngeal and cricoid fractures were reduced and immobilized. A thorough exploration of the neck was done in most of these patients, and injury to the recurrent laryngeal nerves was commonly noted. Late sequelae depended on the type and extent of associated injuries, the type of repair performed, and timing of the definitive reconstruction. The most satisfactory results were obtained in patients receiving early reconstruction with the use of an internal stent. Equally as important in determining a favorable result following reconstruction was an accurate preoperative and operative assessmet of the extent of injury. Despite optimal early treatment of the acute injury, some patients will remain disabled either from a compromised airway or a poor voice. Additional surgical intervention is possible in most cases, and the variety of problems encountered taxes the versatility of the surgeon.
Acoustic and vestibular defects in lightning survivors
Authors: Wright J. William , Silk Kenneth L. 
Published: September 2006

AbstractAn analysis of our series of seven patients who have survived lightning strokes and a review of such cases mentioned in the world literature since 1960 reveals that the most common audiovestibular lesion in lightning survivors is tympanic membrane rupture. Of the various injury‐producing properties of lightning, the one most likely implicated in the pathogenesis of these lesions is the cylindrical shock wave which expands from the axis of the lighting bolt. The tympanic membrane in close proximity to the lightning bolt is suddenly stressed with enough force to cause its rupture.Lightning victims may also manifest various forms of neurosensory deafness and dizziness of central or vestibular origin. Possible explanations for these lesions are described but are primarily conjectural.Otologic management of these cases varies with the lesion sustained. Cochlear, retrocochlear and vestibular lesions are usually treated expectantly and medically as symptoms indicate. Surgical treatment is reserved for incapacitating vestibular problems unresponsive to conservative treatment and to reconstructive approaches to the tympanic membrane and middle ear when indicated.
Osteitis fibrosa (brown tumor) of the maxilla
Authors: Beard Charles H. , Nichols Richard D. 
Published: September 2006

AbstractPatients who present to the regional specialist with localized manifestations of systemic disease provide especially interesting diagnostic problems. We present a patient who was seen initially for facial swelling, thought to be caused by carcinoma of the antrum; however, tissue for biopsy was compatible with osteitis fibrosa, giant cell reparative granuloma, or giant cell tumor of bone, lesions which have identical histopathologic features.There were no other radiographic abnormalities, but the diagnosis of hyperparathyroidism was suggested by persistent hypercalcemia without other clinical states to explain the abnormality and was confirmed by parathyroid exploration which revealed a large adenoma. Prior to operation, causes of hypercalcemia, such as malignant disease, the milk‐alkali syndrome, hypervitaminosis D, and others were ruled out by clinical evaluation.When the Brown tumor of the maxilla failed to regress following treatment of the primary disease it was necessary to remove the mass surgically to relieve nasal obstruction and achieve a more acceptable facial appearance.Brown tumors are seen occasionally in the skull and facial bones, but occurrence in the maxilla appears to be quite rare. Only six cases of isolated presentation of this abnormality in the maxilla have been cited. In each case this was an oral rather than a superior maxillary manifestation of the disease, the mass presenting from the superior alveolus or the hard palate.
Juvenile angiofibroma: A more rational therapeutic approach based upon clinical and experimental evidence
Authors: Ward Paul H. , Thompson Ronald , Calcaterra Thomas , Kadin Michael R. 
Published: September 2006

AbstractA new and more rational therapeutic approach to the diagnosis and management of juvenile angiofibromas was formulated based upon the experiences in 35 cases.Preoperative angiography is essential in delineating the mass, and demonstrating extension into surrounding areas, and for delineation of the sources of blood supply to the tumor. Arteriography has shown 20 percent of the cases to have middle fossa extension, and that the size of the tumor in the nasopharynx does not necessarily represent the size and extent of the tumor and may be only the “tip of the iceberg.”The death of a patient with intracranial extension. The cessation of bleeding, and shrinkage of the tumor was demonstrated by pre and post therapy arteriography and scanning. Because of the success of the transpalatal surgical approach and the hesitancy of administering irradiation too, surgical excision is the treatment of choice in all cases that do not have intracranial extension.
Early diagnostic signs and symptoms of laryngeal disease
Authors: Brewer David W. 
Published: September 2006

AbstractA compilation of late and early symptoms of patients who ultimately were found to have laryngeal disease was carried out. Notation of even minor changes in the indirect laryngoscopic appearance of the same patients was made routinely. Correlation of symptoms with signs has made possible a better understanding of the natural history of certain laryngeal lesions such as contact ulcer, polyps, nodes, dysphonia plica ventricularis as well as some of the pareses, paralyses and fixations. Identical early symptoms and numerous signs have apparently been ignored in subsequently proven cases of cancer of the larynx.The expanded list of symptoms (33 in number) and the detailed list of signs (54 in number) may now assist the Otolaryngologist in earlier diagnosis. Although the reported findings are not specifically diagnostic of cancer of the larynx, they should draw earlier attention to the larynx as the etiological site of such symptoms. Earlier recognition of minor laryngeal changes, as detailed in the text, should lead to earlier biopsy and tissue diagnosis, earlier and more enlightened public awareness, and earlier and, therefore, more effective utilization of present day modalities in the management of carcinoma of the larynx.