bluuebunny/crossref_metadata_2025_split huggingface dataset:
Canine model of subglottic stenosis secondary to prolonged endotracheal intubation
Authors: Marshak Gabriel , Doyle William John , Bluestone Charles D. 
Published: October 2006

AbstractAcquired subglottic stenosis is usually a consequence of prolonged endotracheal intubation. The present study describes a canine model of subglottic stenosis which is congruent with the known and suspected pathogenesis of the disease in man. Eighteen young pups (Canis familiaris) were used. A modified cuffed endotracheal tube was placed within the subglottis and secured by inflating the cuff. The capillary tube supplying the cuff was sealed and cut so as to lie below the epiglottis. Three animals died of tracheal rupture or collapse prior to or on the thirteenth day following intubation. In the remaining animals, the cuffed tube was removed and the subglottis was examined. All exhibited ulcerations and exuberant polyploid granulations at the level of the subglottis and trachea. A 4 mm uncuffed endotracheal tube was introduced and secured within the subglottis and trachea of a number of the pups to provide an airway. After a 3‐week period, the tube was removed and the dogs were sacrificed. Examination of the specimens showed various degrees of “hard” cicatricial stenosis of the subglottis and trachea. Histologic studies showed destruction of the cartilage with replacement by scar tissue and partial epithelialization. This model may be useful to investigations of the prevention and treatment of the disease.
Effect of sound deprivation on central hearing
Authors: Welsh Louis W. , Welsh John J. , Healy Michael P. 
Published: October 2006

AbstractThe authors have investigated the thesis that intermittent hearing impairment due to middle ear disease in the early years of life results in a central auditory disturbance which may persist in adulthood. The concept that, during the speech development years, auditory disturbances interfere with the normal maturation of central auditory processing appear to be clearly established.Thirty‐five children, free of active ear disease and normally hearing by standard peripheral audiometry, are the basis for the study. The monotic tests employing temporal and frequency distortion and the dichotic challenges of competing stimuli and central integration provide the test data.Approximately 75% of the study group fail at least 1 segment of the battery, beyond 2 standard deviations from the normal data. A decreasing percentage of the study group exceed the normative values in 2 or more of the test components.In view of these data on aggressive program of auditory conservation is suggested during the early years of life.
Ultrastructure of human nasal mucosa
Authors: Jafek Bruce W. 
Published: October 2006

AbstractThis thesis describes the ultrastructure of human nasal mucosa, based upon surgical biopsy specimens. The intent of the study is to characterize the normal ultrastructure of human nasal mucosa with emphasis upon the difference between olfactory and respiratory epithelia. Other nasal epithelia (anterior, sinus, and posterior) are reviewed briefly for comparison only. Several pathological examples of the olfactory and respiratory epithelia are also briefly presented for contrast.
Pulmonary sequelae of intraparenchymal bismuth subgallate
Authors: Cozzi Laura M. , Megerian Cliff A. , Dugue Carlos , Barcello Mark , Abdul‐Karim Fadi W. , Arnold James E. , Maniglia Anthony J. 
Published: October 2006

AbstractBismuth subgallate (BSG) is a heavy metal compound which is effective in lowering the incidence of hemorrhage after adenotonsillectomy and has been demonstrated to activate Factor XII. In a minority of children, the paste has been suctioned from the cuffless oral endotracheal tube after adenotonsillectomy. No pulmonary sequelae have been noted in these patients. To assess the effect of BSG aspiration, 75 rats were divided into groups receiving either intratracheal BSG or saline. Early and late parenchymal effects were documented at 5 and 30 days following administration. Although there were no differences in the general well‐being, activity level, or weight in these rats, acute pneumonia followed by a histiocytic, foreign‐body response was noted in a significant number of rats in the BSG group. Although no clinical pulmonary sequelae of BSG use have been noted in our patients, this information should alert clinicians to the risks of BSG use in the pulmonary‐compromised patient, and encourage them to either employ all methods of preventing aspiration in such patients when using BSG, or to use another hemostatic modality for the utmost safety.
The suprahyoid approach for squamous cell carcinoma of the base of the tongue
Authors: Weber Peter C. , Johnson Jonas T. , Myers Eugene N. 
Published: October 2006

AbstractThe suprahyoid pharyngotomy is a well‐recognized surgical approach to the base of the tongue. However, its use has been widely criticized for squamous cell carcinomas. Some surgeons believe this approach offers limited exposure and that violating the preepiglottic space increases the risk of recurrence.A retrospective study of squamous cell carcinoma of the base of tongue was carried out to address these surgical concerns. Nineteen patients presented with T1 or T2 lesions, 13 of whom underwent suprahyoid pharyngotomy with neck dissection. Those with nodal disease underwent adjunctive irradiation therapy and those with extracapsular spread also received subsequent adjuvant chemotherapy. At present, all patients are disease free. The suprahyoid pharyngotomy is an ideal surgical approach in the management of T1 or T2 squamous cell carcinoma of the base of tongue.
Intracranial complications of mucormycosis: An experimental model and clinical review
Authors: Anand Vinod K. , Alemar Gilberto , Griswold John A. 
Published: October 2006

AbstractThe clinical course of patients with mucormycosis of the paranasal sinuses can be unpredictable and is often determined by intrinsic host factors. The degree to and mechanism(s) by which these factors influence a patient's ability to survive the disease are poorly understood. Extensions to orbital and intracranial structures occur in some patients with paranasal sinus mucormycosis despite aggressive treatment. Controversies persist over adequate anti‐fungal regimen, the precise role of hyperbaric oxygenation, and the appropriate extent of surgical debridement. We have developed an alloxan‐induced immunocompromised murine model of mucormycosis in mice. Deferoxamine iron chelation produced rhinocerebral mucormycosis in these animals when challenged intraethmoidally with Rhizopus spores. The implications of our experimental studies in the context of our clinical experience in managing patients with intracranial extensions of paranasal sinus mucormycosis are discussed.
Hearing prognosis and intraoperative guidance of brainstem auditory evoked potential in microvascular decompression
Authors: Sindou Marc , Fobé Jean‐Luc , Ciriano Daniel , Fischer Catherine 
Published: October 2006

AbstractIntraoperative monitoring of brainstem auditory evoked potential (BAEP) was done in 34 patients submitted to microvascular decompression (MVD). Seventeen of these patients had trigeminal neuralgia, and 17 had hemifacial spasm. Transitory postoperative hearing loss was observed in 6 (18%) of the patients, and permanent hearing loss was observed in 2 (6%) of the patients. Wave I‐V interpeak latency (IPL) was calculated during each step of the MVD procedure in order to identify the dangerous steps of the surgery. Wave I‐V IPL abnormalities occurred more frequently during cerebellar retraction.Of the 6 patients who had total loss of BAEP lasting throughout the surgery, 1 (17%) had definitive deafness. Ten of the 34 patients had an absence or partial diminution of BAEP without total normalization before the end of surgery. Among these 10 patients, 2 had transitory hearing loss and 1 had permanent hearing loss.
Predictive value of objective esophageal insufflation testing for acquisition of tracheoesophageal speech
Authors: Callaway Elizabeth , Truelson John M. , Wolf Gregory T. , Thomas‐Kincaid Lauren , Cannon Steve 
Published: October 2006

AbstractThis prospective study was undertaken to assess the predictive value of esophageal insufflation on the acquisition of tracheoesophageal (TE) speech. Fourteen total laryngectomy patients were evaluated prior to tracheoesophageal puncture (TEP) using objective esophageal pressure measurements. These patients then were followed prospectively for 6 to 13 months. Speech was assessed at the time of prosthesis fitting, at 1 month, at less than 6 months, and at greater than 6 months post‐TEP. No patient underwent pharyngeal myotomy. Pre‐TEP esophageal insufflation pressure was associated (P = .065) with successful TE speech at the time of prosthesis fitting, but was not associated with successful TE speech acquisition after 6 months. This study's results suggest that patients with poor pre‐TEP esophageal insufflation test results will usually obtain successful TE speech given adequate time and training, even without pharyngeal myotomy.
Facial electroneurography: Analysis of techniques and correlation with degenerating motoneurons
Authors: Coker Newton J. 
Published: October 2006

AbstractFacial electroneurography is the one electrophysiologic test that quantifies the degree of nerve degeneration. This two‐part study establishes electroneurography (ENoG) as a reliable and valid system of measurement. Part I examines three different ENoG techniques in normal subjects and in patients with advanced paralysis. Myogenic compound action potential (CAP) absolute amplitudes differ according to methodology, site, and gender. Analyses of side‐to‐side and test‐retest GAP differences demonstrate optimized and standardized recording lead techniques to be comparable and consistent when CAPs are recorded in the midface. The most significant variable is time, i.e., the inconsistency of test‐retest results. The coefficient of reliability increases when averaging results of test sessions repeated at a similar point in time. Part II, an animal model, supports the correlation between ENoG predictions following facial nerve injury and the level of motoneuron degeneration, as assessed by retrograde transport of horseradish peroxidase to the somata of the facial motor nucleus and by peripheral axon counts.
Facial nerve regeneration through semipermeable chambers in the rabbit
Authors: Spector J. Gershon , Lee Patty , Derby Albert , Frierdich G. , Burke J. J. , Vogler George P. , Roufa D. G. 
Published: October 2006

AbstractPeripheral neural regeneration, over a 10‐mm transectional gap, was determined in 70 rabbit buccal divisions of the facial nerve using two entubational systems (semipermeable and impermeable silicone chambers) prefilled with three natural occurring media (serum, blood, and saline) during a 5‐week period. The number of myelinated axonal regenerates at the midchamber and at 2 mm in the distal transected neural stump were counted in each group and compared to pooled myelinated axonal counts in 9 normal rabbit buccal divisions of the facial nerve. Semipermeable porous chambers had an overall greater regeneration success rate (75% vs. 42.8%) and regained, on the average, a higher number of myelinated axons (51.4% vs. 26.1%) than silicone chamber regenerates. Semipermeable chambers prefilled with serum or blood had significantly higher regeneration success rates, myelinated axonal counts, and percentages of neural innervation of the distal transected neural stump. Both entubational systems produced similar axonal counts with intraluminal saline. The highest overall success rate (93.7%) and average number of myelinated axons per chamber (3072) were achieved in semipermeable chambers prefilled with serum. The greatest variability in myelinated axonal counts (0 to 3266 axons) and percentage of distal stump innervation (5.5% to 98.1%) was seen in silicone chambers filled with saline. The percentage of myelinated axons from the midchamber that innervated the distal stump was greater in semipermeable chambers with blood (73%) and serum (54%) than in silicone saline chambers (43%). On the average, the distal stumps from semipermeable chambers filled with serum (47%) and blood (33.5%) regained a higher percentage of normal myelinated axonal counts than silicone‐saline chambers (12.5%). These results suggest that both the construction of entubational chamber and the intraluminal medium can have significant influence on neurite regeneration. Semipermeable chambers prefilled with serum have a strong neurite‐promoting potential in peripheral neural regeneration of rabbit facial nerves.
Granular cell tumors of the trachea
Authors: Burton Deborah Mitchell , Heffner Dennis K. , Patow Carl A. 
Published: October 2006

AbstractIn contrast to the relative frequency of granular cell tumors (GCT) in the larynx and bronchi, the occurrence of these tumors in the trachea is rare. A 50‐year review of the English‐language literature disclosed only 24 described cases of tracheal GCT. This report reviews the clinicopathologic data from those 24 cases, along with the data from 2 cases obtained via a personal communication and the data from 4 previously unpublished cases obtained from a 30‐year review of the Armed Forces Institute of Pathology archives. Tracheal resection was the predominant mode of therapy and often was performed as a salvage procedure for failed endoscopic excisions. Recommendations for a more uniform approach to surgical management are provided.
Promontory electrical stimulation in postoperative acoustic tumor patients
Authors: Lambert Paul R. , Ruth Roger A. , Thomas Jean E 
Published: October 2006

AbstractComplete deafness can follow acoustic tumor surgery and results from labyrinthine injury, auditory nerve trauma, and/or vascular compromise. A central auditory prosthesis is one potential rehabilitative strategy in such patients. Anatomical studies suggest that some spiral ganglion cells may survive after vascular occlusion, and we have demonstrated responses to electrical stimulation in patients after labyrinthectomy. It was thus hypothesized that patients deafened after a hearing conservation attempt, but maintaining an intact auditory nerve, could utilize an intracochlear implant. To investigate this possibility, promontory electrical stimulation was performed on three patients who had tumors less than 2 cm and who had serviceable preoperative hearing, but no responses postoperatively. Behavioral responses and electrically evoked auditory brainstem and middle latency responses were obtained from two patients, one of whom was 6 years postsurgery. These data indicate that a cochlear implant may be possible after acoustic tumor surgery.
Thin malignant melanomas of the head and neck
Authors: Fisher Samuel R. , Langford F. P. Johns , Molter David W. , Seigler Hilliard F. 
Published: October 2006

AbstractHistorically, Breslow classified thin melanomas as invasive lesions less than 0.76 mm in depth with rare instances of recurrence and mortality. From 1970 to 1990, 87 patients with thin head and neck melanoma were treated at Duke Medical Center. A computer'aided retrospective analysis was performed. Recurrence occurred in 30% of these patients; however, of the 66 patients seen at this institution prior to recurrence, only 8% recurred. Recurrence significantly shortened survival. Compared to an overall 84% 5‐year survival, there was less than a 50% 5‐year survival after recurrence. For thin melanomas, thickness did not affect survival. There was no difference in survival between thin melanomas and those ranging from 0.76 to 1.5 mm. A multivariate analysis was performed. The data suggest that thin melanomas of the head and neck may recur at a higher rate than previously reported and in addition, that they can be lethal.
Results of endoscopic sinus surgery for the treatment of inverted papillomas
Authors: Waitz Gerhard , Wigand Malte Erik 
Published: October 2006

AbstractFifty'one patients suffering from inverted papillomas of the nose and paranasal sinuses were reexamined in a retrospective study. Thirty'five had undergone surgery by an intranasal endoscopic approach and 16 had undergone surgery by an extranasal approach. The recurrence rate following endoscopic interventions was 17% (6/35), as compared to 19% (3/16) after extranasal operations.Endoscopic surgery proved to be successful even in the treatment of large lesions affecting the posterior ethmoidal sinus, the nasofrontal duct, or the sphenoidal sinus. Its indication thus no longer needs to he restricted to limited lesions of the anterior nasal cavity.Patients with inverted papillomas will benefit from this surgical technique which remains minimally invasive and thus retains the paranasal bony framework, preserves unaffected mucosa capable of recovery, and prevents damage to the patients' cosmetic features.
The sensitivity of auditory brainstem response testing in small acoustic neuromas
Authors: Wilson David F. , Hodgson Richard S. , Gustafson Margaret F. , Hogue Susan , Mills Leigh 
Published: October 2006

AbstractAuditory brainstem response (ABR) testing is a reliable and sensitive test for retrocochlear pathology in neurotologic diagnosis. Several investigators have reported the sensitivity of ABR testing as 95% or greater. 3–5 Fifty‐one consecutive patients with surgically confirmed acoustic neuromas were examined. Forty patients had sufficient hearing preoperatively for assessment with ABR. In addition, all had been evaluated with gadolinium‐enhanced magnetic resonance imaging and conventional electronystagmography. Overall, 34 of 40 patients (85%) had abnormal ABRs. One of 25 patients with extracanalicular tumors had a normal ABR for a false‐negative rate of 4%; however, 5 of 15 patients with intracanalicular tumors had normal ABRs for a false‐negative rate of 33%. Tumor size and nerve of origin were important factors affecting the ABR sensitivity. The ABR was less sensitive in detecting intracanalicular tumors than in detecting extracanalicular tumors.
Human papillomavirus in sinonasal papillomas and squamous cell carcinoma
Authors: Kashima Haskins K. , Kessis Theodore , Hruban Ralph H. , Wu T. C. , Zinreich S. James , Shah Keerti V. 
Published: October 2006

AbstractThe diagnostic and prognostic relevance of human papillomavirus (HPV) types 6, 11, 16, and 18 in squamous papilloma, inverted papilloma, and squamous carcinoma of the sinonasal epithelium was examined using the polymerase chain reaction (PCR) technique. Four (15%) of 26 squamous papillomas, 7 (24%) of 29 inverted papillomas, and 1 (4%) of 24 squamous carcinomas were positive for HPV when examined using the PCR amplification technique.Human papillomavirus 6 was present in 5 specimens (3 squamous and 2 inverted papillomas); HPV‐11 was present in 6 specimens (1 squamous and 5 inverted papillomas); and HPV‐18 was present in 1 of 24 squamous carcinomas. HPV‐16 was not identified in any specimen. The proportion of tissue samples showing HPV presence, and the association of HPV types 6 and 11 with benign lesions and HPV‐18 with malignant lesions, are both in accord with findings from prior investigations.Two major questions regarding nasal papilloma are the probability for lesion recurrence after surgical excision and the risk for malignant transformation. There is no unanimity of opinion regarding the prognostic value of histopathologic dysplasia to forecast these outcomes. HPV is etiologically related to a subset of sinonasal papillomas and squamous carcinoma, and those with benign and malignant clinical course are separable on basis of HPV type. Because of the paucity of these nasal lesions, a multi‐institutional prospective collaborative study is the ideal way to address these questions.
Cochleovestibular nerve compression syndrome. I. Clinical features and audiovestibular findings
Authors: Schwaber Mitchell K. , Hall James W. 
Published: October 2006

AbstractCochleovestibular nerve compression syndrome (CNCS) is the term used to describe a group of audiovestibular symptoms thought to be due to a vessel compressing the cochleovestibular nerve. These symptoms include recurrent vertigo, continuous disequilibrium and acquired motion intolerance. Recently, Moller reported that CNCS can be diagnosed based on abnormalities in the auditory brainstem response (ABR).After specifically excluding all other vestibular disorders, 63 patients with symptoms suggestive of CNCS were identified. These patients were systematically evaluated with a standard neurotologic test battery, and the results were reviewed retrospectively. Hearing loss was found in 51 (81%) of 63 cases, including 33 cases of unilateral high‐frequency loss and 14 cases of middle‐frequency loss. ABR data were interpreted with respect to Moller's criteria, and abnormal studies were found in 42 (75%) of 56 cases. Abnormal electronystagmograms were found in 57 (93%) of 61 cases. Thirteen of the patients subsequently underwent a posterior fossa procedure for vertigo and, vessels were found in contact with the cochleovestibular nerve in 11 of 13 cases.The results of this study suggest that the majority of CNCS patients have neurotologic test findings that suggest an abnormality of the cochleovestibular nerve. The results and their implications are discussed.
Hydroxylapatite ossicular replacement prostheses: Results in 157 consecutive cases
Authors: Goldenberg Robert A. 
Published: October 2006

AbstractThe use of hydroxylapatite for ossicular chain reconstruction is increasing. In this study, hearing results and extrusion rate for 157 consecutive patients receiving hydroxylapatite prostheses were evaluated. Results were compared to those of a control group of patients who had received either homograft hone or Plasti‐Pore prostheses.Four (2.6%) cases of extrusion have occurred. Hearing success was defined as a postoperative pure‐tone average air‐bone gap of ≤ 15 dB for incus prostheses and partial ossicular replacement prostheses (PORPs) or ≤ 25 dB for incus‐stapes prostheses and total ossicular reconstruction prostheses (TORPs). Overall success rate in the hydroxylapatite group was 51.4% for the 140 patients with postoperative data (mean follow‐up, 11.5 months) and 46.7% for 90 patients who were followed for more than 6 months (mean follow‐up, 16 months). PORP results were significantly poorer than those of the other prostheses. The success rate for the control group was 58.6% for 58 patients. The difference between hydroxylapatite and control group success rates appears to be due to the poorer results of the hydroxylapatite PORP.
Posttympanostomy otorrhea: The efficacy of canal preparation
Authors: Scott Bruce A. , Strunk Chester L. 
Published: October 2006

AbstractOtorrhea is the most common posttympanostomy complication. This study is designed to determine the efficacy of canal preparation prior to tympanostomy tube placement.One hundred thirty ears were prospectively randomized into prepared (Betadine and alcohol) and nonprepared (control) groups. Cultures obtained before, during, and after preparation were analyzed to determine the external canal flora and effectiveness of sterilization. Prepared ears and nonprepared control ears were examined for relation to otorrhea.Forty percent of the canals were sterile before preparation, and only 8% harbored suspected pathogenic organisms. Canal preparation successfully sterilized only 33% of the ears that contained bacteria. There was no difference in the otorrhea incidence among treatment groups (9.8%). Based on these bacteriologic and clinical findings, it is concluded that canal preparation with Betadine and alcohol does not reduce posttympanostomy otorrhea.