bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical electroneurography: Statistical analysis of controlled measurements in twenty‐two normal subjects
Authors: Hughes Gordon B. , Josey Anne Forrest , Glasscock Michael E. , Jackson C. Gary , Ray Wayne A. , Sismanis Aristides 
Published: October 2006

AbstractElectroneurography, an objective electrophysiologic measurement of a muscle compound action potential, is used to assess the integrity of a peripheral motor nerve. This paper describes how to perform electroneurography with particular attention to control of patient and instrumentation variables. Twenty‐two normal adult subjects were tested in a balanced, designed experiment. The resultant average difference between the right and left halves of the face was not significant. The standard deviation of this difference was divided into three components: test‐retest, daily, and intersubject. The data suggest that the most significant source of error in electroneurography is test‐retest variability (p < 0.05) and that repeated and averaged measures on a given patient will increase the precision of the test. As further understanding and experience are gained, electroneurography measurements should be interpreted in light of clinical findings and more traditional tests.
The eleventh nerve in radical neck surgery
Authors: Brandenburg James H. , Lee Carlton Y. S. 
Published: October 2006

AbstractThe greatest morbidity associated with the radical neck dissection has been the “shoulder syndrome” due to the sacrifice of the spinal accessory nerve. Despite the fact that the XIth nerve can be spared by a careful dissection of the postcervical triangle, to do so remains a controversial issue.The 125 radical neck dissections performed at the University of Wisconsin Clinical Science Center from 1970 through 1975 were carefully evaluated to determine the incidence of recurrent tumor in the operated‐on neck. In 60 cases the spinal accessory nerve was resected with the neck specimen, and in 65 cases the nerve was preserved. A second study was then undertaken involving 245 neck dissections performed from 1975‐1978 in the Wisconsin Head and Neck Cancer Control Network Hospitals. In 69 instances the spinal accessory nerve was spared.The total number of neck dissections (370 cases) from both studies were analyzed. The overall rate for recurrent tumor in the neck with the classical neck dissection was 12%. When the spinal accessory nerve was spared, the recurrent rate was 6%.On the basis of these observations we propose that the classical neck dissection can be modified to preserve the spinal accessory nerve without jeopardizing the chances for a cure in elective neck dissections and selected therapeutic neck dissections.
Identification of the motor laryngeal nerves — a new electrical stimulation technique
Authors: Spahn James G. , Bizal John , Ferguson Steve , Lingeman Raleigh E. 
Published: October 2006

AbstractHead and neck surgeons are familiar with the technique of identifying motor nerves in the head and neck region by using electrical stimulation especially in the identification of the facial and the spinal accessory nerves. The identification of the motor laryngeal nerves by electrical stimulation intra‐operatively has been described; but, the difficulty of visualization of intrinsic laryngeal muscle movement has prevented the wide spread use of this technique. This paper will introduce a simple, safe and reliable method to allow the surgeon to recognize true vocal cord movement while stimulating the recurrent laryngeal nerve. The movement of a two inch 27 gauge needle placed through the cricothyroid membrane into the ipsilateral true vocal cord permits identification of intrinsic laryngeal muscle movement during electrical stimulation of the recurrent laryngeal nerve. This method has been successfully used in confirming conductivity of the laryngeal nerve during thyroid surgery, Zenker's diverticulum surgery, cricotracheal trauma and recurrent nerve neurectomy for spasmodic dysphonia.
Stylohamular dissection: A new method for en bloc resection of malignancies of the infratemporal fossa
Authors: Friedman William H. , Katsantonis George P. , Cooper Margaret H. , Lee Jong M. , Strelzow Victor V. 
Published: October 2006

AbstractThis study is a description of the “stylohamular” dissection, a technique for the en bloc resection of the infratemporal fossa. The medial plane of this dissection extends from the styloid process to the hamulus of the pterygoid just lateral to the foramen lacerum, allowing the surgeon to spare the internal carotid artery. The foramen ovale and foramen spinosum are routinely exposed during this procedure. Medially, the pterygoid musculature serves as the margin of the cancer block. Posteriorly, the mastoid tip may be included in this resection. Anteriorly, the lateral pterygoid plate is resected making it the anterior vertical plane of the dissection. Laterally, skin and mandible are the block margins. In the last three years, this approach has been utilized in eight patients with advanced malignancies involving the infratemporal fossa. The results are encouraging. Five patients have remained well and free of disease for a maximum of three years postoperatively. Two patients have had recurrence of their tumor from six months to one year postoperatively. Palliation in all patients was excellent. The literature on various infratemporal dissections and their results is reviewed.
Frontal sinus ablation for frontal osteomyelitis
Authors: Mohr Rose M. , Nelson Louis R. 
Published: October 2006

AbstractFrontal sinusitis with frontal osteomyelitis is a potentially life threatening disease. Diagnostic and therapeutic errors occur frequently because of antibiotic masking of already silent frontal lobe complications or lack of suspicion on the part of the otolaryngologist or the neurosurgeon. Frontal sinus infection and/or trauma frequently require otoneuro cooperation for care. Four cases of complications of frontal sinus infection with osteomyelitis are discussed. Three had epidural empyemas and one had a subdural emypema with an anterior 1/3, superior sagittal sinus thrombosis and multiple brain abscesses.Each patient was approached through a frontal craniotomy and the frontal sinus posterior plate examined from behind. Each had posterior dehiscences. Follow‐up of osteomyelitis requires multiple tests including computerized tomography, polytomography and possibly bone or gallium scans. Twenty year or more follow‐up is essential.
Laryngeal reinnervation
Authors: Rice Dale H. 
Published: October 2006

AbstractIn the past, numerous experiments have been performed to attempt reinnervation of the paralyzed larynx. None have been consistently successful. Two experiments were performed in this study, one to restore abduction of a paralyzed vocal cord and one to restore adduction. To paralyze the vocal cord, the recurrent laryngeal nerve was sectioned in all dogs in both experiments.The first experiment was to restore abduction and was performed as follows. An intralaryngeal dissection was performed to separately identify the abductor and adductor branches of the recurrent laryngeal nerve. The adductor branch was sectioned and ligated. Next the phrenic nerve was identified and sectioned. In the dog, the phrenic nerve will not reach the abductor branch of the recurrent laryngeal nerve, so it was sutured to the main trunk of the recurrent laryngeal nerve. Since the adductor branch was severed, regenerating fibers from the phrenic nerve could only grow into the abductor branch and thus to the posterior cricoarytenoid muscle. This experiment produced excellent return of abduction synchronous with inspiration.The second experiment was to restore adduction and was performed as follows. Intralaryngeal dissection was again done to identify the abductor and adductor branches of the recurrent laryngeal nerve. In addition, the motor branch of the superior laryngeal nerve was identified and transected as it entered the cricothyroid muscle. This branch was then anastomosed to the adductor branch of the recurrent laryngeal nerve. The results of this experiment led to chronic adduction of the vocal cord throughout the respiratory cycle.Suggestions for future research include anastomosis of the ansa cervicalis to the abductor branch of the recurrent laryngeal nerve and anastomosis of the main trunk of the vagus nerve to either the abductor or adductor branches of the recurrent laryngeal nerve.
Malleus teflon piston prosthesis.
Authors: Shea John J. 
Published: October 2006

AbstractThe malleus Teflon piston prosthesis is very useful to reconstruct the sound conducting mechanism of the middle ear in absent or inadequate incus, congenital malformation of the middle ear, and epitympanic fixation of the incus and/or malleus. It has a thin‐walled loop at its upper end to lessen the tendency for ulceration of the overlying drum with an inside diameter of 1 mm to fit around the mid portion of the handle of the malleus at an angle of 30° to the shaft of the prosthesis. There is a cut in the distal part of the loop through which it is snapped onto the handle of the malleus after it is separated from the drum. Examples of the various situations in which this prosthesis has been used will be shown together with the results regarding hearing gain, complications, and other problems. Those situations in which the prosthesis was used in 1972 will be reviewed to give a 10‐year follow‐up, plus some notable examples of other uses of the prosthesis from other times.
Relationships of labyrinthine fluid pressures and blood flow.
Authors: Carlborg Björn , Farmer Joseph C. 
Published: October 2006

AbstractControl of labyrinthine blood flow analogous to the autoregulation of cerebral blood flow has been suggested but not experimentally demonstrated.This study concerns the influence of systemic arterial pressure changes on the perilymph and CSP pressures in cats with the cochlear aqueduct (CA) blocked. No direct correlation was found between changes in arterial and CSF pressure. This seemed to be due to the efficient autoregulation of the global cerebral blood flow — a main factor for CSF pressure regulation. The CSF and central venous pressures induced little and much delayed influence on the perilymph pressure when the CA was blocked. However, there was a direct correlation between changes in systemic arterial pressure and the perilymph pressure. This relationship seemed to be mediated via changes in local labyrinthine blood flow. The study indicated a lack of autoregulation of labyrinthine blood flow and a direct correlation between labyrinthine fluid pressure and blood flow when the CA was obstructed.
Endolymphatic subarachnoid shunt operation for idiopathic endolymphatic hydrops.
Authors: Cody D.Thane R. , Mcdonald Thomas J. 
Published: October 2006

AbstractIn 1974 we reported on 92 patients who had endolymphatic subarachnoid shunt surgery for idiopathic endolymphatic hydrops. That group had a follow‐up of at least 5 years, and only 41% had satisfactory control of vertigo. The purpose of this paper is to describe the results after a larger postoperative follow‐up (12 1/2 years, with a range of 68 to 182 months), and to discuss some additional observations regarding endolymphatic sac operations.Two patients have died of unrelated causes, one in the 115th postoperative month and the other in the 124th postoperative month. Eight patients have been lost to follow‐up.Our data show that 35% of the patients have had satisfactory control of their vertigo: 23% have had no vertigo, and 12% have had the vertigo improved by at least 75%. The remaining patients had improvement in vertigo but not to a satisfactory degree, had pronounced improvement in vertigo, but with subsequent recurrence of severe attacks of dizziness, or had no improvement at all. In addition, there has been a steady deterioration in the success rate with increased time of observation.Nineteen percent of the patients showed significant improvement in hearing after surgery, 47% demonstrated no change in hearing, and 34% had a moderate to profound decline in hearing postoperatively.Of 17 patients who had socially adequate hearing in the afflicted ear preoperatively, 12 showed deterioration in hearing to the point that air‐conduction thresholds were below the socially adequate level.Six patients with bilateral endolymphatic hydrops who had almost identical auditory acuity in each ear underwent a unilateral shunt operation. In each of these patients, the unoperated‐on ear had better results from the hearing standpoint.The data show, therefore, that control of vertigo with the endolymphatic subarachnoid shunt operation was not only disappointing initially, but as the patients were followed over a longer time, the percentage of patients with satisfactory vertigo control declined. Additionally, one‐third of the patients experienced further moderate to profound sensorineural deafness, either as a result of surgery or because the operation failed to control the disease process. Last, it is obvious that the endolymphatic subarachnoid shunt operation did not preserve hearing, even when the operation was performed early in the course of the disease.
Adenoma of the middle ear.
Authors: Jahrsdoerfer Robert A. , Fechner Robert E. , Moon Cary N. , Selman John W. , Powell Ii James B. 
Published: October 2006

AbstractBenign adenoma of the middle ear emerged as a distinct entity following a review of 20 cases as reported from the Armed Forces Institute of Pathology in 1976. We report 4 additional cases and note that the pathologic diagnosis is not so clear cut. Benign primary adenoma may be confused with adenocarcinoma, ceruminoma, and glomus tumor. The otologic surgeon must take a hard look at the clinical signs and symptoms to determine if they are compatible with the diagnosis of primary middle ear adenoma. While middle ear adenoma has recently been implicated as a cause of facial paralysis (including a case herein), bone destruction should never be found in concert with this neoplasm.
Early recognition and treatment of postintubation dysphonia
Authors: Feder Robert J. 
Published: October 2006

AbstractThe most common complication of prolonged endotracheal intubation is vocal change. This dysphonia is a result of the laryngeal pathology produced by the recurrent frictional irritation of the endotracheal tube with each respiratory exchange.The purpose of this paper is to present three representative cases, stress early recognition, and outline a course of vigorous early treatment which has proved to be successful in alleviating and reducing the prolonged symptoms of this iatrogenic dysphonia.
An evaluation of bera for hearing screening in high‐risk neonates
Authors: Alberti Peter W. , Hyde Martyn L. , Riko Krista , Corbin Hollis , Abramovich Solomon 
Published: October 2006

AbstractBrain stem electric response audiometry (BERA) is evaluated for early detection of hearing loss in high‐risk newborns selected from a general hospital population. They receive screening BERA in the nursery and detailed frequency‐specific BERA in the Audiology clinic, just before discharge. Three months later, testing is repeated and recommendations are made.From 1364 assessments, 321 at‐risk babies were identified; 234 received predischarge tests, and 200 had follow‐up tests. Screening BERA with 40 dB nHL clicks is appropriate in the nursery. Screening sensitivity is good, and only 8% of babies failed. Several of these had mild hearing loss, resolving in the first trimester. Follow‐up BERA confirmed hearing loss in 8 babies.Parental compliance is high, and the program is well‐accepted. In conjunction with the high‐risk register, BERA is useful both for screening and for quantitative audiometry in the infant.
Reconstruction of the mandible
Authors: Maisel Robert H. , Hilger Peter A. , Adams George L. , Giordano Anthony M. 
Published: October 2006

AbstractForty‐five patients were evaluated for reconstruction of the mandible. Thirty‐four patients had a particulate cancellous bone and marrow (PCM) crib graft placed. Thirty of 34 were successful at the primary operation producing a success rate of 88%. By using secondary procedures all 33 patients repaired to date have been rehabilitated. A dynamic bendable defect bridging plate with cancellous cortical graft (DBDB plate with CCG) was used in 7 patients, 4 of whom had tumor surgery and 3 of whom were operated on after trauma to the anterior mandible. All 7 cases were successfully rehabilitated in achieving a stable, functioning mandibular arch.An osteomyocutaneous flap was planned to reconstruct the anterior mandible in 4 cases; 1 in this group was not reconstructed. The PCM graft has been our first line approach to the mandibular non‐union but with experience we are beginning to rely on the DBDB plate with CCG for large bony defects after both trauma and secondarily after tumor surgery. When indicated, the osteomyocutaneous flap has been eminently successful in restoring function and form in the tumor patient.
Solving ossicular problems in tympanoplasty
Authors: Schuring Arnold G. , Lippy William H. 
Published: October 2006

AbstractFour troublesome problems encountered in ossicular reconstruction are: low profile stapes, lateral tympanic membrane, remaining stapes crura, and absent stapes capitulum. The design advantages and modifications of the semibiological ossicle cup and ossicle columella prostheses ore given to solve these problems. The hearing results are completely satisfactory.
Congenital bilateral recurrent nerve paralysis and ptosis: A new syndrome?
Authors: Tucker Harvey M. 
Published: October 2006

AbstractBilateral vocal cord paralysis is a rare, but not unheard of, occurrence in the perinatal period. It is often incompatible with life unless the problem is recognized promptly, the child intubated, and — following this — a tracheotomy performed. Bilateral congenital ptosis is a very rare occurrence and is almost always associated with either significant central nervous system deficit or with other oculomotor problems. The combination of congenital bilateral recurrent nerve paralysis and congenital ptosis has not been previously reported in the English language literature. The author has had the opportunity to manage two patients, a father and his daughter, both of whom manifested this unusual combination of symptoms. Detailed case histories are presented. Both of the patients were successfully managed by temporary tracheotomy followed by reinnervation of the larynx, with eventual extubation and satisfactory day‐to‐day airway. Although only two cases represent an inadequate number to determine a new syndrome, these striking findings in a father and his only offspring suggest the possibility that this may, indeed, represent a new symptom complex of congenital origin.
Acquired immune deficiency syndrome presenting as oral pharyngeal and cutaneous kaposi's sarcoma
Authors: Napier Bradford L. , Mctighe Arthur H. , Snow Jon F. , Czako Robert G. , Leavitt Richard D. , Blanchard Cyrus L. 
Published: October 2006

AbstractA 25‐year‐old black male homosexual with AIDS presented with Kaposi's sarcoma of the tongue, palate and skin.The definition, epidemiology, diagnosis, treatment and prognosis of AIDS are discussed. The role of the otolaryngologist‐head and neck surgeon in diagnosing this disease is outlined.
Incidence of hypothyroidism following multimodality treatment for advanced squamous cell cancer of the head and neck
Authors: Posner Marshall R. , Ervin Thomas J. , Fabian Richard L. , Weichselbaum Ralph R. , Miller Daniel , Norris Charles M. , Rose Christopher 
Published: October 2006

AbstractThe incidence of chemical hypothyroidism, as manifested by elevated thyroid stimulating hormone (TSH) levels, has been estimated to be as high as 25% after radiation therapy and 45% after radiation therapy and surgery to the neck for treatment of nodal metastases from squamous carcinoma of the head and neck. We prospectively evaluated 43 previously untreated patients seen in the Dana Farber Cancer Institute Interdisciplinary Head and Neck Service who were treated with aggressive combination chemotherapy in addition to standard surgery and/or radiotherapy. All patients were serially monitored for serum TSH, serum T4, and clincial evidence of hypothyroidism. Following cis‐platinum, bleomycin, and methotrexate chemotherapy and subsequent surgery and/or radiotherapy, decreased thyroid reserve appeared in 37% of patients at a median follow‐up of 9 months. Thirty percent of patients receiving radiotherapy alone and 43% of patients receiving surgery and radiotherapy developed elevated TSH levels. Only one patient developed clinical symptoms. Other patients were asymptomatic despite persistently elevated TSH levels. Abnormalities appeared within the first 4 months after completion of all therapy and were slowly progressive. The addition of combination chemotherapy does not appear to increase the incidence or severity of thyroid dysfunction following radiation therapy and surgery to the neck. In view of the extended survival seen in patients treated with interdisciplinary regimens, we recommend that all patients receiving irradiation to the neck – particularly those patients having neck dissections or total laryngectomies – have routine thyroid function studies performed following the cessation of treatment.
Excisional biopsy in the selective management of T1glottic cancer: A three‐year follow‐up study
Authors: Blakeslee Don , Vaughan Charles W. , Simpson George T. , Shapshay Stanley M. , Strong M. Stuart 
Published: October 2006

AbstractTransoral excisional biopsy has been used in the evaluation and management of 103 Tl glottic cancers. A 3‐year follow‐up on these patients indicates that excisional biopsy unequivocally established the diagnosis and stage of the disease and that it is adequate treatment for micro and mini squamous cell cancers of the glottis in which the margins of excision are clear.Excisional biopsy with positive margins and larger Tl tumors establishes the absolute need for radiotherapy. Excisional biopsy is ideal for the diagnosis and management of verrucous carcinoma and spindle cell carcinoma. Recurrent/residual squamous cell carcinoma after radiotherapy should be explored by excisional biopsy which may be curative or will establish the need for partial or total laryngectomy.The appropriate use of excisional biopsy in the selective management of early T1 glottic cancers requires attention to detail by the surgeon and the pathologist and sound clinical judgment.
Tonsillectomy — Some like it hot
Authors: Mann Douglas G. , St. George C. , Scheiner E. , Granoff D. , Imber P. , Mlynarczyk F. A. 
Published: October 2006

AbstractMethods of tonsillectomy using electrocautery for dissection and hemostasis are gaining popularity. A prospective, controlled, randomized, single blind study was designed to compare this method to tonsillectomy performed by scissor dissection with suture hemostasis.In general, tonsillectomy by electrocoagulation was found to reduce operative time and blood loss, and to increase postoperative pain and prolong healing. Overall morbidity in the study was low, and no significant differences in complications, e.g., bleeding, were noted.