bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proximal intratemporal facial nerve in bell's palsy surgery. A study correlating anatomical and surgical findings
Authors: Goin Donald W. 
Published: October 2006

AbstractThis paper deals with the surgical approaches to that part of the intratemporal facial nerve lying proximal to the cochleariform process and focuses on two issues: the advisability of disarticulating the ossicular chain to reach this area and the accessibility of the labyrinthine segment via the transmastoid, extralabyrinthine, subtemporal route.Relevant anatomical features, which are based on 39 gross temporal bones, 47 histologic sections, and 10 cadaveric specimens are first considered. In the head specimens, it was possible to attempt exploration of the entire nerve with the transmastoid, extralabyrinthine, subtemporal operation and then remove the labyrinth to gauge the adequacy of this approach as an avenue to the labyrinthine segment.These anatomical findings, their bearing on the questions at hand, and the author's clinical experience are incorporated into descriptions of the operations currently in vogue for exploring the proximal nerve in patients with Bell's palsy.
Electrophysiologic analysis of auditory, vestibular and brain stem function in chronic renal failure
Authors: Hutchinson James C. , Klodd David A. 
Published: October 2006

AbstractUtilizing audiometry, acoustic reflex threshold and reflex decay testing, electronystagmography and the brain stem auditory evoked response, cochlear‐vestibular and brain stem function in chronic renal failure has been investigated. After elimination of the etiologic factors known to affect — or possibly affect — such function, a clinically significant abnormality of auditory, vestibular and brain stem function was not noted.
Auditory brain stem response and central auditory test findings for patients with brain stem lesions: A preliminary report
Authors: Musiek Frank E. , Geurkink Nathan A. 
Published: October 2006

AbstractBasic audiologic data, as well as five selected measures of the auditory brain stem response, and results from seven central auditory tests were obtained from ten adult subjects with a variety of brain stem lesions. The ABSR measures included latency, waveform morphology, amplitude ratio, presentation rate and intensity function. The central tests administered were competing sentences, rapidly alternating speech, binaural fusion, staggered spondaic words, dichotic digits, frequency patterns and low pass filtered speech. Both procedures (ABSR and C.A.T. battery) were highly sensitive to brain stem lesions in the study group as a whole, but showed some limitations for individual subjects. The data also indicated the value of employing a test battery and multiple electrophysiologic measures as opposed to single indices of auditory performance. Findings on individual central tests and ABSR measures are reported, as well as data on laterality effects.
Comparison of SMAS plication with smas imbrication in face lifting
Authors: Webster Richard C. , Smith Richard C. , Papsidero Michael J. , Karolow Wayne W. , Smith Karen F. 
Published: October 2006

AbstractUndermining and imbricating the superficial musculoaponeurotic system (SMAS) have been advocated by many recent authors to enhance the results of face lifting procedures. Because all undermining has dangers, we compared in 5 fresh cadavers and 15 patients the immediate operative effects on the labial commissures, buccolabial grooves, submental areas, and cervicomental regions of undermining and imbrication with those of plication without any undermining. Closures were made on both sides and with each technique with the layers pulled to their limit of stretch. We found no significant difference between the two methods in the effects on the areas mentioned.Disproven by this study is the theory that undermining and imbricating of the SMAS by itself will permit, at the time of surgery, greater displacement of esthetically important landmarks than will mere SMAS plication without undermining.
Five years experience using the intact canal wall tympanoplasty with mastoidectomy for cholesteatoma: Preliminary report.
Authors: Kinney Sam E. 
Published: October 2006

AbstractMany advances have occurred in the treatment of acute suppurative inflammation of the middle ear; however, the problem of chronic otitis media with cholesteatoma still persists today. This paper deals with the author's experience over 5 years using the intact canal wall tympanoplasty with mastoidectomy treatment in chronic otitis media with particular emphasis on the treatment of cholesteatoma both in adults and children.From May 1, 1976 to May 1, 1981, 204 ears were operated on for chronic otitis media with the tympanoplasty with mastoidectomy technique. Of this group, 104 ears were operated on using the intact canal wall technique when there was cholesteatoma present. The major emphasis of this paper will be to evaluate those ears with cholesteatoma.The technique of the procedure used and modifications that have been made are outlined with particular reference as to why modifications were made as problems arose while observing this group of patients.The results of this study suggest that there is a greater incidence of recurrence of cholesteatoma using the intact canal wall technique in children than in adults. It is believed that this higher rate is due to ongoing eustachian tube difficulties present in children. It is also felt that the intact canal wall technique does provide a better chance of auditory functional rehabilitation than an open cavity ear procedure. The problem of residual cholesteatoma still exists using the intact canal wall procedure; however, the problem seems to be well taken care of using a planned two‐stage procedure. This is particularly necessary because two‐thirds of all residual cholesteatoma was found to be in the middle ear.The conclusions of the study suggest that a planned two‐stage intact canal wall tympanoplasty with mastoidectomy can accomplish the goals of cholesteatoma surgery, i.e., control of the disease and improved functional results. It is felt that, if cholesteatoma recurs in a child, the revision operation should be converted to a properly performed open cavity procedure. It was felt that the anatomic removal of the posterior bony canal wall in an open cavity procedure does not render an ear safe from further problems.
Fine‐Needle aspiration biopsy revisited.
Authors: Frable Mary Ann Smith , Frable William Jackson 
Published: October 2006

AbstractBetween November 1972 and December 1981, 1303 fine needle aspiration biopsies were performed on pntients with head and neck masses at the Medical College of Virginia, Virginia Commonwealth University. The results of 649 lymph node, 227 salivary gland, 286 thyroid, and 41 miscellaneous aspiration biopsies are reviewed. No radical treatment resulted from false positive diagnoses and no patient delay in treatment occurred because of false negative reports.Techniques for performing the procedure are briefly reviewed. Cost containment is stressed, particularly the savings that occur when the diagnosis is not neoplastic.Future developments and uses of the procedure are discussed.
Adductor spastic dysphonia: Three years after recurrent laryngeal nerve resection
Authors: Aronson Arnold E. , De Santo Lawrence W. 
Published: October 2006

AbstractThe voices of 33 patients, ages 44 to 79 years, were assessed otter recurrent laryngeal nerve resection for adductor spastic dysphonia. Voice improvement was noted in all patients 24 hours after surgery: in 97% at 1 month, 97% at 6 months, 82% at 1 year, 70% at 1 1/2 years, 58% at 2 years, 52% at 2 1/2 years, and 36% at 3 years. Of the 64% with failed voices by 3 years, 48% were worse than before surgery. Of the 36% whose voices remained improved, 58% were worse than at any previous period and 42% were better. Failures among women (77%) were considerably higher than among men (36%). Except for one patient, none of the patients with improvement achieved a normal voice. Patients with improvement had varied types and degrees of dysphonia: breathiness, hoarseness, diplophonia, and falsetto pitch breaks. The voices of some patients approached normalcy. A high percent of patients had voice tremor and regular voice arrests on vowel prolongation, signaling that the spastic dysphonia may have been related to essential (voice) tremor and that the spastic dysphonia returned because of increased severity of the neurologic tremor. We conclude that recurrent laryngeal nerve surgery for adductor spastic dysphonia has long‐term limitations and that the differential diagnosis between neurologic and psychogenic types is imperative prior to therapeutic decision making.
Delayed failure of myocutaneous flaps in head and neck reconstruction
Authors: Cho Hyun T. , Mignogna Frank , Garay Kenneth , Blitzer Andrew 
Published: October 2006

AbstractSince the concept of myocutaneous flap reconstruction of the head and neck region was introduced it has opened a new approach to surgical management in this area. This flap not only reduced the number of operations as compared to “staged procedure,” but also reduced the costs of medical care. We are, however, experiencing significant failures as the applications of this flap are extended. This paper reviews our experience with myocutaneous flaps in 15 partial and total failures.An evaluation of these failures reveals that most occurred 1 1/2 to 3 weeks after reconstruction. The factors predisposing to failure seem related more to technical errors rather than to general factors. Diabetes, peripheral vascular disease, malnutrition and low hemoglobin, and low blood pressure were not major contributors to the failures in our series. Local factors predisposing to failure of myocutaneous flaps can be divided into two large categories — arterial failure and venous failure.In our series of unsuccessful myocutaneous flaps, the major factors appeared to be venous stasis leading to arterial insufficiency. All failures had developed after the initial critical period of flap survival (7–10 days). The following techniques showed an especially high rate of failure: 1. SCM — myocutaneous flap to resurface floor of mouth. 2. Tubed pectoralis myocutaneous flap to reconstruct pharynx and esophagus. 3. Flaps developed with very narrow vascular pedicles. Individual cases representing delayed failure are presented.
The infratemporal fossa approach for nasopharyngeal tumors.
Authors: Fisch Ugo 
Published: October 2006

AbstractThe technique and results of the infratemporal fossa surgical removal of carcinomas and juvenile angiofibromas of the nasopharynx are presented. Effective palliative removal of T4 and radical removal of T1 and T2 nasopharyngeal carcinomas was achieved. A classification of juvenile nasopharyngeal angiofibroma is presented. The infratemporal fossa approach allows radical removal of type III tumors and subtotal removal of type IV tumors. If residual tumor has to be left back in the cavernous sinus, irradiation is used to stop further growth of the tumor. If radiotherapy fails the neurosurgical removal of the intracranial portion of the tumor is indicated.
Symposium: The nose versus the environment
Authors: Ballenger John J. 
Published: October 2006

AbstractRelatively little is known of the effect of the environment on the nose and pathogenesis of nasal disease. Basic to the acquisition of such knowledge is an appreciation of normal nasal physiology and, importantly, the mucociliary transport system (MTS). So, following a short introduction of this physiology, the panel members will discuss some important aspects of the environment and ultrastructure of the cilia on the MCT, and in so doing provide some new insights on the pathogenesis of nasal disease.
Anterior approaches to the cervical spine
Authors: Sherk Henry H. , Pratt Lindsay 
Published: October 2006

AbstractExcellent exposure of the cervical spine from C4 to T1 can be attained with the standard anterior approach which utilizes a longitudinal or transverse incision to gain access to the anterior border of the sternocleidomastoid which, along with the trachea, esophagus, and carotid sheath, is retracted. Blunt dissection anterior to the sheath exposes the prevertebral fascia and the anterior aspect of the spine from C4 to T1. Occasionally surgery in the lower cervical spine necessitates detachment of the sternal head of the sternocleidomastoid. Anterolateral approaches to the upper cervical spine and base of the skull often require partial release of the sternocleidomastoid from the mastoid process and retraction of the carotid sheath and hypoglossal and spinal accessory nerves. If these retropharyngeal approaches do not provide sufficient access to the base of the skull and C1 and C2, a transoral approach, possibly with mandible and tongue splitting, can be useful. Infection is a consideration in transoral surgery, however, and this approach is indicated only in special circumstances.
Complications associated with the surgical treatment of cholesteatoma
Authors: Pratt Lindsay L. 
Published: October 2006

AbstractThe surgical complications associated with a cholesteatoma are predictable preoperatively depending upon the location of a cholesteatoma. If the patient has as attic cholesteatoma the surgeon can anticipate postoperatively a dry ear, minimal chance of persistent or recurrent cholesteatoma, satisfactory hearing restoration, and, although a mastoidectomy is usually necessary, the size of the mastoid cavity in an adult can be extremely small.If a patient has a middle ear cholesteatoma the surgeon can anticipate postoperatively a relatively high incidence of moist ears, persistent or recurrent cholesteatoma, and an unsatisfactory hearing result. However, seldom will the creation of a mastoid cavity be necessary as rarely will mastoidectomy be required.Although most of the children before puberty in the study had middle ear cholesteatomas, all children — regardless of the location of cholesteatoma — had a higher incidence of surgical failure than did the adults.
Tetracycline induced esophageal ulcers. A clinical and experimental study
Authors: Carlborg Björn , Lindqvist Christina , Densert Ove 
Published: October 2006

AbstractMedication with oral drugs has not been considered as a cause of esophageal lesions in the general literature of esophageal disease. This study demonstrates 40 patients with complaints of sudden onset of intense retrosternal pains and odynophagia during treatment with oral tetracyclines. All patients had distinct circumferential ulcers in the esophagus. Medical history, barium swallows, esophagoscopy, biopsies and esophageal manometry revealed no other apparent etiology but a local corrosive effect of the tetracyclines. Experimental tests on the esophagus of the cat verified a severe local corrosive effect of the tetracyclines. Another tetracycline, lymecycline, not reported previously to induce esophageal lesions in man, was significantly less ulcerogenic than doxycycline and oxytetracycline.Drug induced esophageal ulcerations are likely to be more numerous than previously suspected. The experimental model used appears to be sound for investigating ulcerogenic potentials of orally administered drugs.
Malignant fibrous histiocytoma in the maxillary sinus. Xanthoma‐like change of the tumor after radiotherapy
Authors: Sasaki Ryoji , Sakai Shun‐Ichi , Itoh Mahito , Murata Masami , Honda Mitsuya , Aozasa Katsuyuki 
Published: October 2006

AbstractA case of malignant fibrous histiocytoma (MFH) in the right maxillary sinus is reported. Patient was a 30‐year‐old male, and was diagnosed as pleomorphic type of MFH by biopsy before therapy. The tumor shrunk and changed into xanthoma‐like tumor after radiotherapy. A case like the present case has not been reported previously in the literature.
Tracheostome construction during laryngectomy —a method to prevent stenosis
Authors: Lam K. H. , Wei W. I. , Wong J. , Ong G. B. 
Published: October 2006

AbstractA new technique for construction of the tracheostome at the time of total laryngectomy is described. It involves making an X‐shaped incision on the lower skin flap and four slits on the divided trachea. The result is a serrated suture line at the tracheocutaneous junction. The incidence of stenosis in 116 patients who did not have this method of construction was 31%. Sex difference and previous irradiation was not found to be related to the occurrence of stenosis. Of 25 patients who had the new method of tracheostome construction, only one patient had to wear a tube until she died at 7 months. The rest, followed up for at least 9 months, did not have stenosis. It is concluded that this new method of tracheostome construction will reduce the incidence of stenosis.
Complications in surgery for stomal recurrences
Authors: Myers Ernest M. 
Published: October 2006

AbstractStomal recurrences are diffuse epidermoid carcinomas of the tracheostoma. There is a 8.3% incidence associated with patients having a total laryngectomy. Most can be prevented by several prophylactic measures; however, surgery may be required. The procedure advocated is mediastinal dissection and its surgical technique is outlined. Recently the use of the pectoralis myocutaneous flap has greatly diminished morbidity and mortality associated with this procedure. The complications that may be encountered with mediastinal dissection have been categorized and analyzed. The dynamic interplay of these complications is stressed.Separately, each complication is formidible, but collectively, they may be overwhelming. This entire web of complications is synergistic and at times fatal. In essence, the motto of the surgeon when operating on a patient with a stomal recurrence should be eternal vigilance.
Facial nerve decompression complications
Authors: May Mark , Klein Susan R. 
Published: October 2006

AbstractEvery structure contained within the temporal bone in close proximity to the facial nerve is at risk during intratemporal bone surgery on the facial nerve. We present a review of the causes of injuries to these structures and of ways to prevent such injuries. This review includes information drawn from pertinent literature, from the author's experience managing 139 patients undergoing temporal bone surgery for a variety of facial nerve disorders between 1974 and 1981, from an analysis of 43 of our patients whose hearing was evaluated before transmastoid facial nerve surgery and again 6 months after surgery, and from the experiences of colleagues.We found that the most frequent complication of intratemporal facial nerve surgery is auditory involvement. An air‐bone gap of 15 dB or greater was noted in 14% of the 43 patients studied and a sensorineural loss, primarily at the 4000 and 8000 cycles, occurred in 51% of these patients. A decrease in discrimination of 15% or greater was noted in 7% of patients, and a shift in speech reception threshold of 15 dB or greater was noted in 16% of the patients. Twelve percent of the patients had tinnitus following surgery and 5% required a hearing aid as a result of a combined sensorineural and conductive hearing loss which occurred in their better hearing ear as a result of surgery. Structures less commonly injured during transmastoid decompression of the facial nerve included the facial nerve itself, the chorda tympani nerve, the balance function of the labyrinth, the cochlea, the ossicles, the sigmoid sinus and superior petrosal vein, the middle meningeal artery and the stylomastoid artery, the dura, and the brain. We review all of these complications, as well as discuss the incidence of cerebrospinal fluid leak and infection which also may result from this type of surgery.
Complications of conservation surgery of the laryngopharynx
Authors: Yonkers Anthony J. 
Published: October 2006

AbstractConservation surgery of the larynx describes various surgical techniques which are generally used in the management of neoplastic conditions involving the larynx or the laryngopharynx. By utilizing these partial resections of the larynx, the phonotary and protective functions of the organ are preserved, as well as an adequate laryngeal lumen for breathing without compromising the patient's overall survival rate.In the majority of instances, conservation surgery of the larynx is carried out with only a low incidence of complications. When proper surgical technique is followed, the metabolic condition of the patient is acceptable, and the blood supply to the tissues subjected to surgery remains good, the incidence of complications is low. Alternatively, if surgery is undertaken when conditions are not totally correct or are marginal, the complication rate rises accordingly.This paper will summarize the complications which occur more commonly when undertaking this type of surgery and will describe some of the circumstances in which a higher incidence of complications can be expected to occur.
Identification and functional recording of the recurrent nerve by electrical stimulation during neck surgery
Authors: Hvidegaard Torkil , Vase Poul , JØSrgensen Karsten , Blichert‐Toft Mogens 
Published: October 2006

AbstractA method for identification and functional recording of the recurrent nerve during neck operations is described. The basic principle implicates electrical stimulation of the recurrent nerve causing adduction of the vocal cord registered by means of a balloon placed between the vocal cords. Three different recording methods have been tested in animal experiments and during 26 neck operations on patients. The most simple method employed is recommended as a routine procedure, likely to reduce surgical damage to the recurrent nerve.
Lingual tonsillectomy: A treatment for inflammatory lesions of the lingual tonsil
Authors: Joseph Michael , Reardon Edward , Goodman Max 
Published: October 2006

AbstractLingual tonsillectomy is a surgical treatment that is seldom performed because lingual tonsillitis is infrequently diagnosed. We have reviewed a group of patients with lingual tonsillitis or lingual tonsil hyperplasia who were treated with lingual tonsillectomy. Lingual tonsil lesions, the anatomy and histology of the lingual tonsil, and surgical approaches to lingual tonsillectomy are discussed.
Caldwell‐Luc operation in the treatment of childhood bronchial asthma
Authors: Juntunen Kaisu , Tarkkanen Jorma , Mäkinen Judith 
Published: October 2006

AbstractA follow‐up study was carried out in 15 children with severe bronchial asthma. Chronic infection of the paranasal sinuses was connected with the unfavorable course of their bronchial asthma. As adenoidectomy and intranasal antrostomy had failed to cure the sinusitis, the Caldwell‐Luc operation was performed at the age of 6–16 years. The follow‐up examination was done 3–12 years after the radical operation of the maxillary sinuses. The majority of the patients had normal working capacity, and the need of medical treatment was reasonable. It is concluded that the Caldwell‐Luc operation is indicated in children with severe bronchial asthma, when repeated respiratory infections are associated with asthmatic attacks and adenoidectomy and intranasal antrostomy have proved ineffective.