bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tongue reconstruction: Concepts and practice
Authors: Haughey Bruce H. 
Published: October 2006

AbstractTotal or subtotal tongue resection results in the potential for severe speech and swallowing disruption and life‐threatening aspiration. This report documents the development of a new design for latissimus dorsi flaps used in tongue reconstruction. In order to create a contractile muscle sling which will raise the neotongue toward the palate for speech and swallowing, the flap is harvested with muscle fibers oriented transverse to its long, skin component axis. The flap is then transferred to the oral and oropharyngeal defect and sutured at the level of the mandibular angle to the remaining muscles of mastication. Conventional microvascular anastomosis for free flaps is followed by end‐to‐end reanastomosis of the hypoglossal nerve stump to the nerve to latissimus dorsi. The skin component is set into the floor of mouth with a curved wedge resected anteriorly, raising a mound to assist with articulation.Fourteen such reconstructions have been performed on patients undergoing glossectomy for cancer. If not invaded by cancer, the glottic larynx was preserved, and the decannulation rate was 80% at a median postoperative interval of 3.2 weeks. Seventy percent of patients achieved oral intake with pureed food or better, and upward motion of the flap was documented by video swallowing studies. Articulation was particularly good.This innervated latissimus dorsi flap design therefore is a viable method for rehabilitation after total or subtotal glossectomy.
The vertebrate larynx: Adaptations and aberrations
Authors: Kirchner John A. 
Published: October 2006

AbstractThe complex anatomy of the vertebrate larynx shows a steady progression from the simple slit on the floor of the lungfish's pharynx to the fine‐tuned mechanism of the human vocal apparatus. The frog's larynx acts as a check valve to prevent collapse of the lungs during a dive, since the animal has no rib cage. The crocodile's laryngeal framework has acquired an epiglottic analogue which fits snugly into the nasopharynx and protects the lower respiratory tract from inundation while the animal drowns its prey. The snake's larynx lies intraorally and can be extended beyond the lower teeth while the reptile leisurely swallows its prey intact. The mammal has acquired a cricothyroid joint, allowing its membranous vocal folds to be stretched during phonation. In Homo sapiens, vocal performance has reached its highest degree of versatility, with a vocal fold capable of adjustment in length, tension and shape. In the course of organic evolution, man appears to have chosen the ability to speak and sing over the security that an intranarial epiglottis would have given him.“In Wisdom hast Thou made them all”—Inscription on John Hunter's tomb, Westminster Abbey
MRI evaluation of the sphenoid sinus after transsphenoidal approach to the pituitary
Authors: Stickney Kathleen O'Leary , Weymuller Ernest A. , Mayberg Marc 
Published: October 2006

AbstractThe transsphenoidal approach to the pituitary (TSA) is currently the most common approach used to treat pituitary tumors. The surgical technique necessitates an incomplete stripping of sphenoid sinus mucosa. Long‐term postoperative magnetic resonance imaging (MRI) evaluation of the sphenoid sinus has not been reported. A retrospective review of patients undergoing a TSA at the University of Washington Hospitals was performed. Preoperative scans were compared with postoperative scans done during three time intervals. Group 1 had scans at 1 to 12 weeks postoperatively; 10 of 10 patients had sinus effusions. Group 2 had scans at 6 to 18 months postoperatively; 22 of 31 had mucosal abnormalities. Group 3 had scans at 2 to 3 years; 7 of 9 were abnormal. MRI evaluation indicates that a majority of patients have both acute and chronic sphenoid sinus abnormalities after TSA.
Endoscopic treatment of supraglottis and hypopharynx cancer
Authors: Zeitels Steven M. , Koufman James A. , Kim davis R. , Vaughan Charles W. 
Published: October 2006

AbstractTransoral excision of supraglottic and hypopharynx cancer as a single modality is effective when lesions are selected for small size and endoscopic accessibility. Excisional biopsy with clear margins of larger supraglottic tumors in combination with postoperative radiotherapy provides an excellent treatment alternative for selected lesions in patients who are not candidates for open surgery. In this preliminary report, 45 cases using this minimally invasive approach are reviewed outlining oncologic rationale and functional advantages.A large bore tubed laryngoscope or the adjustable bivalve supraglottiscope was used along with a carbon dioxide laser in all cases. In 22 of the 45 patients (mostly TI), local en bloc excision of the primary cancer was performed as sole treatment on selected lesions of the supraglottis and hypopharynx. There were no local recurrences, however, 1 patient developed a neck recurrence and was salvaged by neck dissection.Twenty‐three of the 45 patients had more extensive primaries (mostly T2, T3) and N0 necks. Transoral excisional biopsy was followed by full‐course radiation therapy to the primary site and both necks. All 23 were followed a minimum of 2 years, and the median follow‐up period was 58 months. Clear margins were obtained in 16 of 23, and there were no recurrences in the larynx. Two of 16 did fail in the neck and died despite neck dissection. Seven of 23 patients had positive margins and, despite full‐course radiotherapy to the primary site and both necks, 5 of 7 failed locally or regionally. Two of the 7 died of their disease despite open salvage surgery. Therefore, 4 of 23 patients who underwent transoral excision of larger lesions followed by full‐course radiotherapy died of recurrent cancer.
Eustachian tube compliance in cleft palate a preliminary study
Authors: Takahashi Haruo , Honjo Iwao , Fujita Akihiko 
Published: October 2006

AbstractWith the use of the tubal compliance test and the forced response test (FRT), the compliance and ventilatory functions of the eustachian tube (ET) were examined in 19 children with otitis media with effusion (OME) and cleft palate, in 31 children with OME but without cleft palate, and in 19 individuals with traumatic perforation of the eardrum without history of other otological disease (controls). The tubal compliance results in the group with both cleft palate and OME were significantly higher than the results obtained with the controls, but did not differ significantly from the results obtained with the patients with OME but without cleft palate; this indicated that the ETs of those patients with OME and cleft palate, and the ETs of those patients with OME but without cleft palate, appeared to be more collapsible than the ETs of normal subjects. It was speculated that such an aerodynamic property of the ET observed in the group with OME and cleft palate and in the group with OME but without cleft palate may be due mainly to possible inflammatory condition of the tubal mucosa rather than to abnormal anatomy or to an abnormal physical property of the framework (such as cartilage) of the ET.
Tracheal reconstruction using an epithelial equivalent
Authors: Duff Brian E. , Wenig Barry L. , Applebaum Edward L. , Yeates Donovan B. , Wenig Bruce M. , Holinger Lauren D. 
Published: October 2006

AbstractThe application of a rapidly vascularized epithelial equivalent that inhibits wound contraction would have great potential in the prevention and repair of tracheal stenosis. An animal model was developed to simulate the effects of circumferential tracheal injury and an autologous epithelial equivalent was created from a fibroblast‐collagen matrix and subsequently implanted in the traumatized site in an attempt to prevent stenosis. Postinjury physiologic and histologic evaluation revealed near‐normal mucosal flow analysis in the treated sites and an area of less than 20% stenosis versus 95 + % in controls. This study's findings indicate that tracheal stenosis can be limited by the use of an epithelial equivalent.
Preliminary report: Endoscopic versus external surgery in the management of inverting papilloma
Authors: McCary W. Scott , Gross Charles W. , Reibel James F. , Cantrell Robert W. 
Published: October 2006

AbstractSince January 1977, twenty‐four patients with inverting papilloma of the nose and paranasal sinuses have been treated at the University of Virginia. Two patients had bilateral disease, for a total of 26 surgically treated sides. Patients were aged from 10 to 83 years, and 71% were male. Most tumors originated on the lateral nasal wall, with 62% involving the adjacent sinuses. Nineteen sides were treated by external approach and 7 were treated intranasally. There was a total of 5 recurrences in 4 patients and no associated squamous cell carcinomas. Seven patients were treated with endoscopic excision (4 primary tumors and 3 recurrences). There have been no recurrences since endoscopic treatment. These preliminary data give further evidence that endoscopic excision is a viable surgical option for many inverting papillomas.
Three‐dimensional models for head and neck tumor treatment planning
Authors: Eisele David W. , Richtsmeier William J. , Graybeal John C. , Koch Wayne M. , Zinreich S. James 
Published: October 2006

AbstractThe authors have evaluated two types of practical maxillofacial model systems useful to the head and neck surgeon: 1. plastic mandibular model generated by three‐dimensional computerized tomography (CT) reconstruction, and 2. dental impression model of the maxilla. The first model is expensive and technology intensive; the second is simple but limited. Both three‐dimensional models offer several advantages: 1. they provide segmental mandibular relationships that are not known because of oncologic restrictions or previous surgery; 2. they allow preoperative reconstructive planning including prosthesis fabrication and visualization of tumor extent not obvious by two dimensional imaging; and 3. they provide a permanent record for future needs or reconstructions. The disadvantages include cost, time, and possible inaccuracies secondary to image artifacts. We find both models to be of significant practical value in selected head and neck tumor patients.
Arytenoid motion evoked by regional electrical stimulation of the canine posterior cricoarytenoid muscle
Authors: Sanders Ira , Rao Frank , Biller Hugh F. 
Published: October 2006

AbstractAnatomical studies have demonstrated that the posterior cricoarytenoid muscle in the dog is composed of three bellies. These bellies are termed vertical, oblique, and horizontal on the basis of their orientation. The purpose of this study was to show whether each of these bellies can move the vocal fold in different ways. Ten anesthetized dogs underwent laryngectomies while paralyzed with curare. The posterior cricoarytenoid muscles were then exposed by dissecting the overlying esophageal mucosa. Electrical stimulation was applied to each belly, and the motion of the arytenoid cartilage was measured. Because the oblique belly overlies the vertical belly, they were usually stimulated together. It was found that the vertical and oblique bellies rock the arytenoid backwards while sliding it laterally, thus causing a maximal dilation of the airway. The horizontal belly caused a swiveling motion of the arytenoid. It is proposed that the vertical and oblique bellies normally cause vocal fold abduction during respiration, while the horizontal belly primarily is used to adjust finely the position of the vocal process during phonation. Because the human posterior cricoarytenoid is also composed of separate bellies it, too, may have distinct functions.
Rapid tumor cell proliferation after induction chemotherapy in oropharyngeal cancer
Authors: Bourhis J. , Wilson G. , Wibault P. , Janot F. , Bosq J. , Armand J. P. , Luboinski B. , Malaise E. P. , Eschwege F. 
Published: October 2006

AbstractTumor cell kinetics were studied in vivo in a series of 97 patients with oropharyngeal cancer. The duration of S phase (tS), the labeling index (LI), and the potential doubling time (Tpot) were obtained by flow cytometry measurements of a tumor biopsy obtained after intravenous injection of 200 mg 5‐bromodeoxyuridine to the patient. The mean LI was 9.7% (standard deviation [SD], 5.4), the mean tS was 10.1 hours (SD, 3.6), and the mean Tpot was 4.6 days (SD, 3.5). No significant relationship was found between the Tpot or LI and the size of the tumor, nodal status, histological grade, or the site of the primary within the oropharynx. Conversely, aneuploid tumors had longer tS (P<.001), higher LI (P<.001), and shorter Tpot (P<.05) than the diploid tumors. The mean LI and Tpot of the tumors obtained after induction chemotherapy were significantly higher and shorter, respectively, than those measured before any treatment. The data strongly suggest that rapid tumor cell proliferation frequently occurs in oropharyngeal cancer which had responded poorly to chemotherapy.
Odontogenic keratocysts: A study of 50 patients
Authors: Anand Vinod K. , Arrowood John P. , Krolls Sigurds O. 
Published: October 2006

AbstractThe odontogenic keratocyst (OKC) is a locally aggressive neoplasm with rates of recurrence reported as high as 60%. Correlation between histopathology and the likelihood of recurrence remains a subject of controversy. In this review of the authors' experience in treating 50 patients with OKC between 1977 and 1993, 58 specimens were studied to correlate the likelihood of recurrence with the presence of the following histologic features—parakeratosis, orthokeratosis, satellite cysts, epithelial rests, or epithelial proliferation. Orthokeratinized cysts were associated with a higher recurrence rate than in previously reported studies. Disruption of the epithelial lining in the resected specimen was found to be a primary determinant of recurrence.
Fate of liposuctioned and purified autologous fat injections in the canine vocal fold
Authors: Mikus Joseph L. , Koufman James A. , Kilpatrick Scott E. 
Published: October 2006

AbstractInjection of autologous fat obtained by liposuction has been reported as an augmentation technique for vocal fold paralysis. Unfortunately, it is not known whether this technique is associated with long‐term graft survival.The purpose of this study, using a canine model, was to determine the volume of viable injected fat grafts when the tissue was harvested and processed by two different methods: 1. by liposuction alone, and 2. by “purification,” i.e., excision of adipose tissue, followed by tissue homogenization and centrifugation in a buffering solution.The results of this study confirm that injected fat grafts survive long‐term; however, the average volumetric “take” was only about 20%. Surprisingly, significantly more liposuctioned fat survived than grafts prepared by the purification method (P<.05). At 12 weeks, there was relatively little inflammation present in the tissues surrounding the injected fat, suggesting a stable fat graft volume.
Laryngeal function in postpolio patients
Authors: Driscoll Brian P. , Gracco Carol , Tierney Elizabeth , Sasaki Clarence T. , Coelho Carl , Goldstein Jonathan , Oshima Kiyoshi 
Published: October 2006

AbstractOf the 250,000 survivors of the polio epidemics, approximately 25% experience progressive muscle weakness known as postpolio syndrome (PPS). Laryngeal function in postpolio patients previously has not been studied. This paper presents data detailing laryngeal function in a group of postpolio patients who had been evaluated for swallowing complaints. Nine patients underwent comprehensive history and physical exam, acoustical voice analysis, and laryngeal videostroboscopic endoscopy. Three patients underwent laryngeal electromyography (EMG) evaluation. Results indicated some degree of phonatory or laryngeal deficit in all subjects. Subjects with dysphagia also demonstrated vocal fold paralysis. EMG revealed decreased recruitment and increased amplitude, findings consistent with EMG studies in skeletal muscle in postpolio patients. Results suggest that postpolio patients who complain of swallowing difficulties are at risk for laryngeal pathology.
Qualitative and quantitative immunoglobulin production by specific bacteria in chronic tonsillar disease
Authors: Koch R. James , Brodsky Linda 
Published: October 2006

AbstractTonsillar tissue lymphocyte (TTL) function as measured by immunoglobulin production was assessed in vitro in 60 tonsils, 51 diseased and 9 normal controls. The diseased specimens were from children (aged 3 to 10 years) clinically classified as having recurrent tonsillitis (RT), idiopathic tonsillar hyperplasia (ITH), or recurrent tonsillitis with hyperplasia (RT/H). TTLs were challenged with intact, heat‐inactivated bacteria found in the core of diseased tonsils—Streptococcus pyogenes (SP) and Haemophilus influenzae type B (HIB) as well as the dominant bacterium (DB) grown from that particular tonsillar core. The phytomitogen, leukoagglutinin (LA), was used as a nonspecific activator. Qualitative immunoglobulin production was assessed for the immunoglobulin G (IgG), immunoglobulin M (IgM), and immunoglobulin A (IgA) classes. Immunoglobulin‐specific production was quantified at the basal level, and at 2, 4, and 6 days following stimulation.Stimulation with HIB produced the greatest amount of IgG and IgM in TTLs from control tonsils. The DB was a relatively weak stimulator of normal (control) TTLs, yet produced relatively brisk IgG responses in the RT and ITH categories. It did, however, yield only marginal IgM secretion in these groups. IgA was consistently produced after stimulation in diseased TTLs, yet was not elicited from normal TTLs. The aforementioned findings suggest a differential qualitative and quantitative immunoglobulin response for healthy, recurrently infected, and hyperplastic tonsils. Lymphocyte hypofunction along with structural changes associated with hyperplasia may be central to the etiology of chronic tonsillar disease. The tonsillar immunologic response in disease and health is discussed.
Transoral laser resection with staged discontinuous neck dissection for oral cavity and oropharynx squamous cell carcinoma
Authors: Eckel Hans Edmund , Volling Peter , Pototschnig Claus , Zorowka Patrick , Thumfart Walter 
Published: October 2006

AbstractTransoral laser resection of oral cavity and oropharynx squamous cell carcinoma (OOSCC) is a widely accepted approach in the absence of cervical lymph node metastases. This study investigated the results of transoral laser surgery and discontinuous neck dissection (ND) for OOSCC with clinically obvious or suspected cervical node metastases.One hundred seventeen patients with infiltrating oral carcinoma were treated for cure with transoral resection of the primary and staged ND. Twenty‐nine primaries were classified as T1, 50 as T2, 35 as T3, and 3 as T4. Lymph node metastases were identified in the ND specimen of 36 patients. All patients were followed for a minimum of 3 years unless they died. Estimated tumor‐related survival after 5 years is 81% for stage I and II disease of the oral cavity, 86% for stage I and II disease of the oropharynx, 73% for stage III disease of the oral cavity, 65% for stage III disease of the oropharynx, and 21% for stage IV disease of the oral cavity and the oropharynx. Local and regional control of cancer was achieved in 72 (62%) of the 117 patients. Forty‐five local and regional recurrences were diagnosed during the follow‐up period. Two patients died of distant metastases with no evidence of local or regional recurrence.The combination of transoral laser resection and staged ND for the treatment of OOSCC seems to offer satisfactory cure rates for a selected group of patients. These two minor surgical interventions cause less morbidity than commando‐type surgery and lead to low perioperative mortality and morbidity.
Prognostic significance of prostaglandin E2 production by mononuclear cells and tumor cells in squamous cell carcinomas of the head and neck
Authors: Milanovich Michelle R. , Snyderman Carl H. , Wagner Robin , Johnson Jonas T. 
Published: October 2006

AbstractProstaglandin E2 (PGE2) has been implicated as a cause of immunosuppression in patients with head and neck cancer. To determine the relative contribution of tumor cells and mononuclear cells to PGE2 levels in vivo, tumor cells and tumor‐infiltrating mononuclear cells (TIMC) were isolated from fresh tumor biopsy specimens of 23 patients with squamous cell carcinoma of the head and neck (SCCHN) by using enzymatic digestion and differential gradient centrifugation. Peripheral blood mononuclear cells (PBMC) and lymph node mononuclear cells (LNMC) from metastatic and nonmetastatic lymph nodes were also isolated. Cell fractions were cultured for 24 hours, and PGE2 levels of supernatant were determined by radioimmunoassay. PGE2 production by LNMC was significantly decreased compared to tumor cells, TIMC, and PBMC (P =.0002). LNMC from metastatic lymph nodes produced significantly higher levels of PGE2 (P =.02) compared to nonmetastatic lymph nodes. Although T stage was not correlated with PGE2 production by TIMC or tumor cells, advanced N stage (N1–3) was associated with decreased PGE2 production by TIMC (P =.006). These results suggest that both tumor cells and TIMC are sources of PGE2 in tumor tissues of patients with SCCHN and that decreased PGE2 production by host inflammatory cells may have clinical significance in the development of cervical metastases.
Sinonasal papillomas: A report of 82 cases in copenhagen county, including a longitudinal epidemiological and clinical study
Authors: Buchwald Christian , Franzmann Maria‐Benedicte , Tos Mirko 
Published: October 2006

AbstractThe present epidemiological and clinical study comprises 82 patients with sinonasal papillomas diagnosed from 1975 to 1993. Histology showed 58 cases of inverted papillomas including 5 cases of associated carcinoma, 19 cases of exophytic papilloma, and 5 cases of columnar cell papilloma. The incidence of sinonasal papillomas in Copenhagen County was 0.74 per 100,000 inhabitants per year. The inverted and columnar cell papillomas were typically located in the middle meatus with a varying degree of involvement of the adjacent sinuses. The exophytic papillomas were predominantly located multicentrically on the nasal septum. Good results of treatment, especially with regard to inverted papillomas, were not correlated to the aggressiveness of surgery. A lateral rhinotomy with medial maxillectomy was performed as primary surgery in 28 patients. In 50% of these patients there were recurrences. The preliminary results of endonasal endoscopic surgery revealed a high success rate, i.e., no recurrences in 5 cases so far. The septal papillomas were typically resected by a simple endonasal procedure. There were recurrences in 66% of these cases. The midfacial degloving procedure may be advocated instead of or as a supplement to the lateral rhinotomy if the tumor cannot be visualized sufficiently by endoscopy. Smoking may dispose to sinonasal papillomas.