bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glomus tympanicum — excision by radical mastoidectomy exposure with autograft reconstruction
Authors: Smith Mansfield F. W. , Shinn John B. 
Published: September 2006

AbstractWide surgical exposure, total tumor removal and anatomic and functional reconstruction are the goals of tumor management. These goals are met by radical mastoidectomy exposure for the removal of glomus tympanicum tumors and reconstruction by autograft replacement of the posterior osseous canal, and if the tympanic membrane, malleus and incus are removed for tumor exposure, autograft replacement may also be accomplished. The history, physical findings, X‐rays and details of surgical management of two patients with glomus tympanicum are reviewed. Wide removal of the posterior osseous canal, just lateral to the VIIth nerve with total replacement of this segment gives excellent exposure of the middle ear space and affords total reconstruction of the posterior osseous canal.
Stapedectomy: Gelfoam compared with tissue grafts
Authors: Sheehy James L. , Perkins John H. 
Published: September 2006

AbstractThe commonest causes of failure with the prefabricated wire loop‐gel‐foam pad technique are inferior displacement of the loop in the window, high membrane formation and window fibrosis. As a result of these problems some members of the Otologic Medical Group have abandoned the use of gelfoam in favor of tissue grafts.A comparison of the results with gelfoam, fat grafts, and fascia grafts in 573 primary cases is made. Tissue grafts yielded a lower incidence of postoperative vertigo, of temporary and permanent sensori‐neural hearing impairment, of fistulas and of long‐term hearing regression. The conclusion is that a tissue graft is preferable to gelfoam as an oval window covering in stapedectomy.
Temporal bone histopathology in experimental hypovitaminosis a
Authors: Chole Richard A. , Quick Cedric A. 
Published: September 2006

AbstractTwenty‐five years ago hearing loss was observed in some subjects during a comprehensive study of the effects of hypovitaminosis A on human volunteers. Experimental studies documenting histopathological changes in the temporal bone due to hypovitaminosis A are conflicting. Even the recent textbooks of otolaryngology and physiology make no mention of a role of vitamin A in the ear. To explore the role of vitamin A in the ear adult and. weanling rats maintained on a diet totally lacking vitamin A were sacrificed at intervals. Their temporal bones were examined with the light microscope.After six weeks on a vitamin A free diet weanling rats showed hypertrophy of the periostial portions of the otic capsule. At 16 weeks a narrowing of the internal auditory canal due to bony exostoses was present. The neuroepithelia of the cochlea and the vestibular apparatus were histologically normal even in the longest surviving animals.Although we have demonstrated marked abnormalities of the otic capsule in hypovitaminosis A, our results do not support those of some earlier investigators who reported that atrophy of the cochlear and vestibular neuroepithelium occurred in the absence of dietary vitamin A.
Basis and some diagnostic implications of electrocochleography
Authors: Naunton R. F. , Zerlin S. 
Published: September 2006

AbstractElectrocochleography (ECoG) involves the recording of electrical responses to sound from the vicinity of the cochlea. The technique, as we practice it, utilizes a trans‐tympanic recording needle situated on the promontory of the middle ear. Filtered clicks in the frequency range between 500 and 8,000 Hz are presented to the ear under test at a rate of 10/sec. Repetitive clicks of a given frequency are first presented at high intensity and the responses summed (averaged) in a computer. The click is systematically lowered in intensity, and an average is collected at each level until the normal dynamic range of hearing has been explored.Two major electrical indices are present in the recording: these are 1. the whole‐nerve action potential (AP) derived from the first‐order auditory neurons, and 2. the cochlear microphonic (CM) derived from the hair cells.Inspection of the whole nerve AP as intensity is lowered allows the estimation of the response threshold, which correlates well with behavioral threshold.Inspection of the relation between the CM and the AP allows qualitative differentiation to be made between pathology arising in the hair cell (sensory) and in the nerve (neural).
Functional hearing loss
Authors: Nilo Ernest R. , Saunders William H. 
Published: September 2006

AbstractFunctional hearing loss is a rather common entity, although it probably is overlooked more often than not. In most instances, the services of an experienced audiologist are necessary if one is to detect these cases.First, one must consider carefully the patient's behavior before and during the otologic and audiologic examination, and note the referral source, if any, since patients with certain backgrounds are more apt to exhibit functional hearing loss than others. Second, careful attention is given to certain aspects of the initial basic audiometric examination. Discrepancies here often stand out and point clearly toward functional loss.A so‐called “modified approach” to conventional audiometry has enabled us to detect almost all cases of functional hearing loss without resort to the special audiometric tests designed for that purpose.
The management of sickle cell patients undergoing surgery
Authors: Spooner Thomas R. , Dark Alison W. 
Published: September 2006

AbstractBetween 10 and 15 percent of blacks have sickle cell disease or sickle cell trait. Either is capable of a sickle cell crisis which could occur during a surgical procedure. Because of this, we as otolaryngologists should be aware of how to diagnose sickle cell disease and what specific measures should be followed in order to avoid a sickle cell crisis. This paper deals with specific diagnostic tests available, their interpretation, and our protocol for management of these patients when they are in the hospital for a surgical procedure.
The osteo‐mucoperiosteal flap in repair of cerebrospinal fluid rhinorrhea
Authors: Mccabe Brian F. 
Published: September 2006

AbstractRepair of fistulas producing cerebrospinal fluid rhinorrhea, as with any reconstructive operations, should take into account the basic principles of reconstructive surgery for best results: 1. tissue needing replacement should be replaced by like tissue; and 2. a flap is always superior to a graft. In the case of this disease, the tissue sealing the fistula should be a flap containing not only mucosa or mucoperiosteum, but also pedicled bone. Two kinds of regional flaps are described which successfully closed the fistula in each of three patients. Follow‐up is long term.
Nasal obstruction after rhinoplasty: Etiology, and techniques for correction
Authors: Beekhuis G. Jan 
Published: September 2006

AbstractOf 1,000 consecutive patients who underwent rhinoplasty, about 10 percent had some nasal obstruction postoperatively. The majority of patients in whom the author performed the primary rhinoplasty had an obstructive, vasomotor type of rhinitis that ensued, and which usually could be cured by the injection of corticosteroids into the turbinates. Fifty patients had undergone rhinoplasty by other surgeons, and most of those patients requested surgical correction to relieve the nasal obstruction and/or to improve the external nasal appearance. In those patients the causes of nasal obstruction were; pre‐existent, undetected, or diagnosed but uncorrected, septal deviations; caudal septal dislocation; or turbinate hypertrophy; intranasal adhesions; scar tissue web formation in the nasal vault; inadequate nasal tip support, and alar collapse. The author's technique of surgical repair for each of these conditions is outlined.
Tuberculosis of the larynx
Authors: Travis Lawrence W. , Hybels Roger L. , Newman M. Haskell 
Published: September 2006

AbstractTuberculosis of the larynx, once a common disease, has become quite rare with the advent of anti‐tuberculous chemotherapy. In the pre‐antibiotic era two modes of laryngeal infection were recognized; bronchogenic and hematogenous. The literature is briefly reviewed. Thirteen patients in the past 15 years in whom tuberculous laryngitis was diagnosed upon indirect laryngoscopy by members of the University of Michigan Department of Otorhinolaryngology are presented. Bronchogenic infection was present in 11, and in two patients the disease was consistent with hematogenous spread. Tissue biopsy from a case of bronchogenic contamination demonstrated epithelioid tubercles, while numerous subepithelial acid‐fast bacilli without typical tuberculous histological change were present in a case of hematogenous laryngeal infection. A case of cicatricial laryngeal stenosis was successfully treated surgically by laryngofissure, excision of fibrosis with arytenoidectomy, and free mucous membrane grafting. Finally, the initial subtle presentation of many of our patients emphasizes the importance of a consideration of tuberculosis in the differential diagnosis of chronic laryngitis.
Difficult direct laryngoscopy
Authors: Lewy Robert B. , Brusca Peter A. 
Published: September 2006

AbstractThis article reviews some of the problems involved in direct laryngoscopy. It suggests adequate preparation and evaluation of the patient to avoid complications. An evaluation of laryngospasm is given. Solutions of the problems are suggested using gear power assistance and adequate drugs for relaxation. The importance of correct positioning of the patient is emphasized and illustrated.This summarizes clinical judgment and successful evaluation of the difficult mechanical problems in the exposure of the vocal cords.
Congenital subglottic fibroma in the newborn
Authors: Tsui H. N. , Loréa John M. 
Published: September 2006

AbstractCongenital subglottic fibroma is a rare clinical entity. A review of references did not disclose any previous report. A case of congenital subglottic fibroma is presented. Embryology, etiology, symptomatology and pathology of congenital anomalies of the larynx are reviewed and management discussed.
Glossopharyngeal neuralgia: Surgical treatment and electron microscopic findings
Authors: Ishii Tetsuo 
Published: September 2006

AbstractSeven cases of idiopathic glossopharyngeal neuralgia were treated with surgical resection via pharyngeal approach. Two of these cases showed a recurrence of neuralgia and subsequently, one of the recurring cases underwent a IXth nerve section through a cervical approach. The resected nerves were examined with the light and electron microscope. In five of seven cases, degeneration of myelinated fibers was observed. Under electron microscope, disarrangement and disorganization of the myelin sheath were found, while axonal degeneration was relatively rare. The author recommends an initial resection by the pharyngeal approach. In cases of recurrence, a subsequent attempt to resect the nerve should be made by the cervical approach.
Sensori‐Neural hearing loss following radiotherapy to the nasopharynx
Authors: Moretti Joseph A. 
Published: September 2006

AbstractA retrospective study was done to ascertain the risks of cochlear damage from radiotherapy of the nasopharynx. Audiometric evaluation, pre and post‐radiotherapy, revealed that 7 out of 13 patients had sustained sensori‐neural deafness. Contrary to what is generally believed of the resistance of the cochlea to radiotherapeutic damage, eventual loss of hearing can occasionally be expected in patients undergoing radiation therapy for head and neck tumors.
The otological aspects of palatal myoclonus
Authors: Lyons George D. , Melancon Bradford B. , Kearby Norma L. , Zimny Marilyn 
Published: September 2006

AbstractPalatal myoclonus with its concomittant objective tinnitus is often a missed diagnosis and poses a problem to the clinician in separating it from other middle ear anomalies. The etiology and symptomatology is outlined, but as suggested by our case presentations are not always diagnostic.The anatomical pathways of palatal myoclonus are traced, and its etiological complexities are realized when any locus or pathology along these tracks may create the characteristic chronic rhythmic contractions. We have experienced excellent results in determining a differential diagnosis of palatal myoclonus from other middle ear problems by the correlations of impedance audiometry with our clinical findings. Although the etiology is not defined the target structures can be separated from this test method and, therefore, enable more specific therapy.
Laryngeal problems following infant esophageal surgery
Authors: Robertson James R. , Birck Herbert G. 
Published: September 2006

AbstractThis paper focuses on vocal cord paralysis in children after operation for tracheoesophageal fistula and/or esophageal atresia. We reviewed the charts of 65 children who were operated upon for congenital esophageal atresia and/or tracheoesophageal fistula during a period from 1964 to 1974. Ten of these children manifested laryngeal symptoms. Five had laryngeal paralysis. Two were untreated. One was treated with cordectomy and stent. Two were treated successfully with the Thornell arytenoidectomy, one of these being done without a tracheotomy in place. Mention is made of a third case of bilateral vocal cord paralysis due to hydrocephalus treated successfully by the Thornell procedure.Follow‐up laryngoscopy was done on 21 children without laryngeal symptoms which revealed two previously unsuspected vocal cord paralyses and one vocal cord paresis which cleared.
A new functional approach to the surgical management of pierre robin syndrome: Experimental and clinical report
Authors: Lapidot Abraham , Rezvani Firooz , Terrefe Dessalegn , Ben‐Hur Nahum 
Published: September 2006

AbstractA functional and simple surgical method for treating the respiratory distress of the neonate affected by Pierre Robin syndrome is described. The base of the tongue is placed in an anterior position via a buried wire suture tied around the body of the hyoid. The method proposed in this paper fulfills the following:
It is physiologic since the infant is able to suckle and maintain its nutrition by preserving the function of the mobile portion of the tongue for deglutition.
Maintenance of the “pushing” action of the tongue stimulates growth of the mandible.
The anchoring wire is not exposed in the oral cavity and the risk of tissue breakdown and infection is eliminated.
This technique utilizes the stronger fibrous portion of the mid‐tongue rather than muscle which “gives” more readily under pressure.
The shortest distance from the base of the tongue to the mid‐hyoid provides the best mechanical advantage.
The suture, if need be, may be tightened at subsequent periods of time.
Under Ketamin (Ketalan) anesthesia the tip of the tongue was held in the forward position. An 18 gauge stainless steel wire was inserted via a large curved needle through the midline of the posterior‐most portion at the base of the tongue. The needle was directed anteriorly and inferiorly to emerge below the mid point of the inferior border of the hyoid bone. The opposite end of the wire was then tunneled submucosally to the anterior portion of the base of the tongue at foramen caecum, and directed inferiorly to emerge above the superior border of the mid‐portion of the hyoid bone. Through a small skin incision opposite the body of the hyoid bone, both free ends of the wire were tied under tension around the body of the hyoid while pulling the base of the tongue forward. The skin incision was closed with a single nylon suture. A prosthetic obturator was used to close the cleft palate. The outcome was satisfactory with no morbidity.
Microscopic characteristics of the acoustic tumor in relationship of its nerve of origin
Authors: Neely J. Gail , Britton B. Hill , Greenberg S. Donald 
Published: September 2006

AbstractThe microscopic characteristics of a 0.9 cm vestibular schwannoma en bloc resected with its nerve of origin which occurred in a 54‐year‐old white woman presenting with a two‐year history of a unilateral progressive sensori‐neural hearing loss is described. The tumor originated in the inferior vestibular portion of the vestibular division of the VIIIth cranial nerve just medial to the internal auditory canal meatus at approximately the level of the glial‐non‐glial junction. The tumor demonstrated two distinctly different, yet simultaneous, modes of involvement with its nerve of origin: 1. inseparable cellular continuity; and 2. peripheral compression of the remainder of the nerve within the tumor capsule. Despite only slight microscopic continuity of the nerve histologically, electronystagmography showed no unilateral weakness on bithermal caloric testing, and pure tone and speech audiometry was only moderately depressed.
Tonsillectomy and infectious mononucleosis — a possible relationship
Authors: Goode Richard L. , Coursey Donald L. 
Published: September 2006

AbstractA review of 1,192 student medical records shows a prior history of tonsillectomy in 41 percent of a control group and 22 percent of an infectious mononucleosis group — a significant difference (p <0.01). Nine hundred eighty‐nine Stanford University students (421 females, 568 males) who visited Cowell Student Health Center between April and September, 1973, comprise the control group. Two hundred three students with positive monospot tests and clinical mononucleosis diagnosed between June, 1968, and May, 1973, comprise the experimental group.The lower incidence of tonsillectomy in the infectious mononucleosis group implies that the tonsillar lymphoid tissue serves as a reservoir and possible replicating milieu for the Epstein‐Barr virus. Prior tonsillectomy may reduce the possibility of contracting infectious mononucleosis.
Sjögren's syndrome and serous otitis media
Authors: Michel Randall G. , Hughes Lynn A. , Hudson William R. 
Published: September 2006

AbstractExtrasalivary lymphoid abnormalities in Sjögren's syndrome are well described. Patients have been found to have lymphoid infiltration of many organ systems. The nature of the lymphoid abnormalities constitutes a spectrum ranging from benign to malignant disease. A case of an elderly patient with long standing Sjögren's syndrome is presented because of the unusual manifestation of a benign lymphoid mass in the nasopharynx producing unilateral eustachian tube obstruction and serous otitis media. Serous otitis media associated with Sjögren's syndrome is recognized, but to our knowledge in previous cases an extrasalivary lymphoid abnormality has not been implicated as the underlying pathology.
The importance of panographic and dental evaluation for lesions of the antrum
Authors: Eisenbud Leon , Kameros Jonathan , Blum Bertram , Glass Walter 
Published: September 2006

AbstractA large dentigerous cyst which displaced the antrum and partly eroded its bony walls was interpreted as a malignant neoplasm in routine sinus films. The true nature of the process was readily apparent in a panographic view which showed an unerupted third molar lying horizontally above the apices of the first and second molars. This case is an excellent demonstration of the important role of panographic views in the differential diagnosis of maxillary sinus lesions.
Paget's disease and sensori‐neural deafness: Temporal bone histopathology of paget's disease
Authors: Lindsay John R. , Suga Fumiro 
Published: September 2006

AbstractFour cases with Paget's disease of the temporal bone are presented to illustrate the pathogenesis of the associated deafness.One case illustrates the combination of severe deafness due to bilateral otosclerosis with probably asymptomatic bilateral Paget's disease.One case with advanced Paget's disease presents features to explain early stages of sensori‐neural deafness before actual cellular invasion of the inner ear.One case of profound deafness due to Paget's disease presents a different stage of cellular invasion of the inner ear by the disease on each side.One case illustrates invasion of the internal auditory meatus by Paget's disease with infiltration of the acoustic division of the nerve and profound deafness.
Otitis media with effusion: Specific antibody activities against exotoxins in middle ear effusions
Authors: Mogi Goro , Maeda Shoichi , Yoshida Toyoharu , Watanabe Noritake 
Published: September 2006

AbstractFindings of recent immunologic studies on otitis media with effusion indicate that antibodies in middle ear effusions can either originate from serum and/or from local production in the middle ear cavity and Eustachian tube. Determination of specific antibody activity of different immunoglobulin classes in effusions and sera against certain bacterial antigens may aid in a better understanding of the pathogenesis of otitis media with effusion. A radioimmunosorbent assay was employed in the present study to determine specific antibody activity against streptolysin or staphylolysin. Although these antibody activities were mainly limited to IgG and IgA class antibodies in effusion as well as in serum, it was also found that SIgA of various types of the effusion possesses the antibody activity against these exotoxins. Findings of this study suggest that a local immunity functions in the middle ear cavity of patients with otitis media with effusions and that bacterial infection may contribute to the development of middle ear effusion in certain cases.
Investigation of acoustic trauma from the airbag
Authors: Richter Harry J. 
Published: September 2006

AbstractSince the automobile‐airbag passive restraint system may be in general use in early 1976, and, in fact, is now an option on some automobiles, its potential biomedical hazards need to be examined.The objective of this study was to investigate the effects of local slap pressure of airbag deployment against the external ear and tympanic membrane and to measure its effects on subsequent hearing acuity. Adult and infant squirrel monkeys were used as experimental subjects. To create an adequate simulation of the airbag trauma, a small airbag was fabricated and mounted on a pneumatic impact facility. This device was designed to produce a specific velocity to determine the behavior of objects under impact conditions simulating accident kinematics.Cochlear nerve action potentials were measured in both ears of 10 subjects prior to blast, immediately post‐blast, and several weeks post‐blast. High‐speed photography recorded the events of the blast as well as the technique of recording the electrical potential from the cochlea. No permanent hearing damage, eardrum perforation, disruption of ossicles, or loss of hair cells occurred at airbag velocities up to 100 mph and a sound intensity level of 150 db.
Epitympanic malleus fixation: Correction without disrupting the ossicular chain
Authors: Armstrong B. W. 
Published: September 2006

AbstractThe preoperative diagnosis of malleus fixation can be made consistently with a pneumatic otoscope. Nontympanosclerotic epitympanic malleus fixation, for the most part, has been corrected by disrupting the ossicular chain and then reconstructing the sound‐conducting mechanism. Once the diagnosis of malleus fixation is established, the surgical approach should be modified to cope with the fixed malleus.A wide, inferiorly based tympanotomy flap affords ample access to the epitympanum and permits definitive resolution of the associated conductive hearing loss. Atticotomy and discreet osteotomy can free the fixed malleus and preserve continuity of the ossicular chain in over 90 percent of the patients with this syndrome.Experience for 46 patients having bony epitympanic malleus fixation, both congenital and acquired, was examined in concluding that the anatomical continuity of the ossicular chain can and should be maintained in most patients. The residual air‐bone gap is less with an intact, though modified, ossicular chain than it is with a chain that has been reconstructed.