bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstruction of large fronto‐orbital defects with dacron® polyurethane custom prosthesis and autogenous bone
Authors: Stanley Robert B. , Shih Tyson 
Published: October 2006

AbstractReconstruction of large defects of the frontal bone and bony orbit may be required following trauma or ablative tumor surgery. Autogenous bone or alloplastic implants used alone may prove inadequate due to difficulties obtaining symmetric contours with bone and lack of strength and resistance to infection with alloplastic materials. These problems can be overcome with the combined use of a prefabricated Dacron® polyurethane mesh prosthesis (Osteo‐Mesh, Xomed, Inc.) to establish contour of the forehead and superciliary ridges, and underlying split‐rib grafts to protect the brain and isolate the paranasal sinuses. This technique is not indicated for small frontal defects, but it should be considered for use by the head and neck surgeon who is faced with the challenge of reconstructing a major fronto‐orbital defect.
Microsurgical application of freeze‐dried arterial allografts
Authors: Pratt Michael F. , Schneider James , Galey Frank R. 
Published: October 2006

AbstractArterial allografts of 1.0 mm diameter and 1.0 cm length were freeze‐dried and placed into the femoral arteries of 15 Sprague‐Dawley albino male rats in order to study patency and tissue reactions of the host. Patency in the first three postoperative days was determined by monitoring viability of the epigastric island flap. All grafts were patent during this early postoperative period. Fourteen of the subjects were surgically explored after 2 months of observation. At that time, 13 (93%) remained patent. Histopathological studies, and transmission and scanning electron microscopy were used to analyze the specimens. These data demonstrated that freeze‐dried arteries are remodeled by the host, but do not induce a cellular immune reaction. Dependable freeze‐dried microarterial allografts have potential future application in clinical microvascular surgery.
Post‐tympanostomy otorrhea
Authors: Gates George A. , Avery Christine , Prihoda Thomas J. , Richard Holt G. 
Published: October 2006

AbstractOtorrhea is the most common complication of surgical drainage of the tympanum for the treatment of chronic secretory otitis media. Otorrhea present at the first postoperative visit may be due to the operative procedure, the underlying disease process, or both. After analyzing data from 525 operations on 1045 ears of 396 children with chronic secretory otitis media, and finding an over‐all incidence of immediate postoperative otorrhea of 3.4%, we conclude that preparation of the ear canal with povidone iodine and the postoperative prophylactic use of an antimicrobial‐corticosteroid topical preparation provides optimal control of postoperative wound infection. Sporadic increases in the incidence of postoperative otorrhea may be due to extrinsic factors such as outbreaks of upper respiratory infection.
Temporal bone showing polyarteritis nodosa, otosclerosis, and occult neuroma
Authors: Adkins Warren Y. , Ward Paul H. 
Published: October 2006

AbstractThe clinical and general histopathologic manifestations of systemic vasculitis of the polyarteritis nodosa type are well known. Although hearing loss associated with polyarteritis nodosa has been reported, only two temporal bone studies are available. The findings in a 60‐year‐old man with well‐documented hearing loss who had rheumatoid arthritis, polyarteritis nodosa, and otosclerosis are presented. Polyarteritis nodosa extensively involved the subarcuate arteries and arteries of the facial canal. There were decreased nerve fibers to and sensory cells in the crista of the semicircular canals and macula of the utricle and saccule. Focal and diffuse atrophy of the stria vascularis and decreased cellularity in the spiral prominence and ligament were present. There was a loss of outer hair cells. Otosclerosis involved the left and right oval window niches (bilateral stapedectomy had been performed). There was a small Antoni type A neuroma of the superior division of the vestibular nerve on the left.
Primary cutaneous lymphoma of the head and neck
Authors: Fisher Samuel R. , Burton Gary V. , Murray John C. , Borowitz Michael , Crocker Ian R. 
Published: October 2006

AbstractOne hundred three patients with Stage I and II extranodal primary lymphomas of the head and neck were reviewed. Six patients (5%) presented with cutaneous lesions, five with single site and one with multiple sites of involvement. Histopathology was malignant lymphoma (ML) large cell (3), ML small cleaved cell (1), ML small lymphocytic (1), and ML mixed large and small cell (1). Five of six patients relapsed following initial treatment. Four patients were treated with primary radiation therapy, three of which had relapses outside the treatment area. One patient was treated with intralesional steroid injection and also recurred outside the treated area. One patient was treated with radiation and chemotherapy and recurred outside the treatment area. Three patients are alive without disease, two died of disseminated disease, and one died of unrelated causes.Isolated cutaneous presentation of head and neck lymphoma is uncommon. Radiation therapy appears to have been curative in one patient with localized disease. Four patients recurred outside the radiation portals despite careful staging, suggesting that systemic therapy may be necessary for disease control.
Laryngotracheal trauma: a protocol approach to a rare injury
Authors: Gussack Gerald S. , Jurkovich Gregory J. , Luterman Arnold 
Published: October 2006

AbstractLaryngotracheal trauma is rare and complications are frequent. Twelve major series totalling 392 cases have been published over the past decade, with complication rates as high as 40%. We have treated over 30,000 trauma victims at our Level I Trauma Center over the past 5 years, of which 109 had neck injuries, but only 12 suffered cervical laryngotracheal trauma. The mechanism of injury was penetrating in eight and blunt trauma in four. The time to tracheostomy decannulation varied from 7 to 60 days. Airway patency was assured without stenosis or significant granulation tissue in 10 of the 12 patients. Three patients suffered permanent voice changes. Based on review of the 392 previously reported cases and a critical analysis of our 12 cases, a detailed management algorithm is proposed.
Primary adenocarcinoma of the temporal bone with posterior fossa extension: case report
Authors: Gulya Alna Julianna , Glasscock Michael E. , Pensak Myles L. 
Published: October 2006

AbstractPrimary adenomatous tumors of the middle ear and mastoid are rare. We recently cared for a man with a far‐advanced primary adenocarcinoma of the middle ear and mastoid. Complete tumor removal was accomplished by a modified infratemporal fossa approach and was supplemented with postoperative radiation therapy. The postoperative complications of aspiration pneumonia and cerebrospinal fluid (CSF) leakage through the wound stimulated subsequent incorporation of temporary gastrostomy and CSF shunting into our surgical procedure. Now, 23 months after surgery, the patient is without evidence of recurrent disease. His case illustrates our approach to the management of such extensive temporal bone lesions as well as some of the potential problems which may be encountered.
A rare manifestation of metastatic adenocarcinoma
Authors: Yeatman Timothy J. , Seagle Michael B. , Cassisi Nicholas J. 
Published: October 2006

AbstractWe report a very rare case of adenocarcinoma metastatic to the epiglottis and cervical lymph nodes that presented clinically with symptoms of dysphagia. The method of diagnosis, including recent advances in the evaluation of head and neck metastases, is discussed.
Severity of sleep apnea as a predictor of successful treatment by palatopharyngoplasty
Authors: Caldarelli David D. , Cartwright Rosalind , Lilie Jamie K. 
Published: October 2006

AbstractAs awareness and understanding of obstructive sleep apnea has increased so has the number of treatments for this disorder. Options include surgical procedures: tracheostomy, palatopharyngoplasty(PPP), and mandibular advancement. Other treatments are medication, nasal CPAP, Tongue Retaining Device, and a position alarm. With these numerous choices available, it is important that reliable indicators be developed to guide treatment choice. And although PPP surgery is a one‐time intervention with possibility of permanent correction, reports of percentages of successful treatment have varied widely from 85% to 0%. This has led us to investigate predictors of successful treatment.Twenty‐two patients treated with PPP following their diagnosis by standard clinical polysomnography were restudied an average of 8 weeks later. When 11 successful cases were compared to 11 unsuccessful cases, successes were found to be initially more severely apneic (X AI=90.55 versus 49.45).Palatopharyngoplasty appears to be most appropriate for the sleep apnea patient whose apnea index is 70 or above and less effective for milder cases.
Cochlear implants for deaf children
Authors: Miyamoto Richard T. , Myres Wendy A. , Pope Molly L. , Carotta Catherine C. 
Published: October 2006

AbstractFifteen profoundly deaf patients under the age of 18 years have received a 3M/House cochlear implant. The surgical procedure employed is essentially the same as that used in adults with a few modifications to accommodate for the smaller dimensions of the mastoid process and the thinness of the scalp and temporal squama. Pediatric subjects.receive timing and intensity information at similar thresholds as adults implanted with this device which contributes to improvement in speech production to various degrees. All subject groups demonstrated significant language delays as a result of their profound hearing losses. Postimplantation, more growth was seen in receptive than in expressive language skills. However, the growth observed did not exceed that expected in profoundly deaf children as reported in the literature. Language growth as a result of the cochlear implant aloneis yet to be documented in our patients.
Endoscopic sizing: An attempt at uniformity
Authors: Stankiewicz James A. , Holinger Lauren D. 
Published: October 2006

AbstractThe inside and outside diameters of all endoscopes and tracheotomy tubes in the endoscopy suite were systematically measured. These measurements were correlated with the manufacturer's stated size and comparisons noted. A lack of uniformity was noted often among and between all product lines. In addition, endoscopes and tracheotomy tubes were not uniformly labeled with inside and outside diameters. As a result, the proper choice of a tracheotomy tube or endoscope for a patient's size and age may be confusing. A chart was developed and included in order to allow quick and accurate recognition of tracheotomy tube and endoscope sizes across product lines to aid in the proper selection of tracheotomy tubes and endoscopic equipment.
Tracheoesophageal speech failure in the laryngectomee: The role of constrictor myotomy
Authors: Henley Julian , Souliere Charles 
Published: October 2006

AbstractDrs. Singer and Blom pioneered the development of a valved voice prosthesis and controlled fistula between the tracheal and esophagcal wall to generate fluent esophageal speech in laryngectomy patients. Since then numerous voice prostheses with different performance capacities have entered the marketplace. In spite of optimal choices and fitting of devices, there remains a population of patients refractory to this type of rehabilitation. It is our experience that a number of patients ultimately benefit from middle and inferior constrictor myotomy with marked improvement in their speech. Patient selection, evaluation, and operative techniques are discussed.Five patients who were unable to speak even after introduction of various commercially available devices showed marked improvement after middle and inferior constrictor surgical myotomy. Minimal complications were encountered even in irradiated patients. These patients were preoperatively injected with Xylocaine to produce a partial blockade. Their speech improved dramatically for the duration of Xylocaine blockade. Esophageal video fluoroscopy of attempted speech with the voice prosthesis in place confirmed constrictor spasm that opposed air flow to the oropharynx.Inferior and middle constrictor myotomy appears to be very beneficial in rehabilitation of failed alaryngeal speakers who demonstrate pharyngeal constrictor spasm.
Temporalis muscle flap: An alternative in oropharyngeal reconstruction
Authors: HÜttenbrink Karl‐Bernd 
Published: October 2006

AbstractAfter resection of the ascending ramus of the mandible, the temporalis muscle is rendered functionless. It represents a viable and versatile bulk of tissue covered by stout fascia, which can be used in oral and oropharyngeal reconstruction after extensive excisional surgery. The surgical effort is reasonable, owing to the vicinity of the defect.The fascia, which resists the saliva, is left uncovered; epithelization is completed after 2 to 3 weeks. The cosmetic result is acceptable. Skin incisions are invisible because they are covered by hair; the flattening of the temporal fossa will be smoothed out by scarring after several months. The postoperative course was uneventful in 11 patients but for minor problems. The flap remained viable in all subjects. The temporalis muscle flap seems to be a valuable alternative among the techniques of oral and oropharyngeal reconstruction.
Pulsatile tinnitus
Authors: Levine Steven B. , Snow James B. 
Published: October 2006

AbstractTinnitus is a frequent presenting symptom. Tinnitus that is rhythmic and synchronous with the patient's heartbeat is rare. Pulsatile tinnitus may be the only symptom of life‐threatening and treatable diseases. The presence of hearing loss or vertigo focuses the diagnostic evaluation. The cause of pulsatile tinnitus may be found on otoscopic examination. Audiologic assessment and enhanced computed tomography often contribute to the diagnosis. Increased intracranial pressure should be excluded with a fundoscopic examination. Arteriography is required to diagnose life‐threatening and treatable lesions in the presence of normal otoscopy, audiologic assessment, and enhanced computed tomography.
Distinctive immunohistochemical labeling of epithelial and mesenchymal elements in laryngeal pseudosarcoma
Authors: Ophir Dov , Marshak Gabriel , Czernobilsky Bernard 
Published: October 2006

AbstractA laryngeal squamous cell carcinoma in situ with an underlying spindle cell nodule (pseudosarcoma) was immunohistochemically labeled with antibodies to tissue‐specific intermediate filament proteins, including desmin, vimentin, and cytokeratin. Two distinct populations of cells were found within the lesion: cytokeratin‐positive cells, corresponding to the carcinomatous component of the tumor, and vimentin‐positive spindle cells in the subepithelial nodule. In view of the strict specificity of antivimentin and anticytokeratin for cells of mesenchymal and epithelial origin, respectively, it is proposed that the two components of the pseudosarcoma in our case are not morphologic variants of the same tumor, and that the subepithelial nodule represents a mesenchymal lesion. These results can, however, not be extrapolated to other cases since in some the spindle cell component may represent metaplastic epithelial cells. In view of the difficulties encountered in reaching a correct diagnosis in these lesions, it is recommended to use intermediate filament typing to elucidate the nature of the spindle cells in this controversial tumor.
Endoscopic middle meatal antrostomy: Theory, technique, and patency
Authors: Kenned David W. , Zinreich S. James , Kuhn Frederick , Shaalan Hisham , Naclerio Robert , Loch Eric 
Published: October 2006

AbstractOstial obstruction is a major factor in the pathogenesis of sinusitis. Detailed diagnostic evaluation in patients with maxillary sinusitis demonstrates the prominence of disease in the ethmoidal infundibulum and in adjacent ethmoid cells. Surgical procedures performed to improve maxillary sinusitis by inferior meatal antrostomy leave residual disease in the ostiomeatal area and may result in persistent mucociliary obstruction.Historically, the possibility of closure following ostial manipulation and the importance of dependent drainage of the maxillary sinus have been cited as arguments against the middle meatal approach. In this study of middle meatal antrostomies the patency rate was 98% between 4 and 32 months. The postoperative endoscopic findings and symptomatic improvement suggest that mucociliary clearance occurs through the surgically widened ostium. We conclude that endoscopic middle meatal antrostomy does not lead to ostial stenosis.
Obliteration Of Mastoid And Middle Ear For Severe Trauma To The Temporal Bone
Authors: Kveton John F. 
Published: October 2006

AbstractA review of four cases of severe trauma to the temporal bone involving fracture of the external auditory canal indicates that adipose obliteration of the mastoid and middle‐ear cleft with closure of the external auditory canal is the optimal method of repair. In two of four patients, one‐stage repair was successful using this technique, and in the other two patients, obliteration was required as a revision operation after cholesteatoma developed from previous procedures.
Neodymium‐yag laser intranasal photocoagulation in hereditary hemorrhagic telangiectasia: An update report
Authors: Kluger Paul B. , Shapshay Stanley M. , Hybels Roger L. , Kirk Bohigian R. 
Published: October 2006

AbstractHereditary hemorrhagic telangiectasia is a challenging problem for the otolaryngologist since frequent, often severe epistaxis is the major symptom. Options for therapy in the past have included nasal packing, electrocautery, systemic estrogens, septal dermatoplasty, arterial embolization, and arterial ligation. Although successful treatment has been achieved with some of these methods, particularly septal dermatoplasty, other forms of therapy are needed prompting the use of laser photocoagulation.The neodymium yttrium‐aluminum‐garnet (Nd‐YAG) laser was used to treat a group of 19 patients with hereditary hemorrhagic telangiectasia over a 4‐year period without complications. Endonasal laser photocoagulation was effective in decreasing epistaxis in patients not requiring frequent transfusions prior to laser therapy. Three patients with the most severe epistaxis received minimal or no benefit from Nd‐YAG laser photocoagulation. In most patients Nd‐YAG photocoagulation is successful in treating epistaxis associated with hereditary hemorrhagic telangiectasia and should be a therapeutic option for this chronic disease having no available cure.
Condylomatous lesions of the upper aerodigestive tract
Authors: Nash Michael , Lucente Frank E. , Gould Wilbur J. , Srinivasan Krishna 
Published: October 2006

AbstractCondyloma acuminatum is one of four types of common human verrucous lesions that are of viral etiology. Also known as “moist wart,” condyloma acuminatum is most often seen on the mucosal surfaces of the anogenital area. However, occurrences in the mucosal lined areas of the head and neck region are quite rare.Since 1901, 30 cases of condylomatous lesions have been reported in the upper aerodigestive tract, occurring mainly in the various regions of the oral cavity. Eighteen of the cases were confirmed by histopathologic documentation, while the remainder were anecdotal.We have recently encountered six new cases of condyloma acuminatum, verified by histologic examination. One occurred on the tongue, another in the tonsillar fossa, one in the hypopharynx and three on the vocal cords. We present these cases and review the previously reported cases. In addition, we will discuss the differential diagnosis of these lesions, and their importance to the practicing otolaryngologist.
Compaeison of polysomnography and sonography for assessing regularity of respiration during sleep in adenotonsillar hypertrophy
Authors: Potsic William P. 
Published: October 2006

AbstractIncreasing awareness of the role of adenotonsillar hypertrophy in the etiology of chronic airway obstruction and disturbed respiration during sleep has created interest in the diagnostic methods available to assess the effects of obstruction. This study evaluates and compares simultaneously‐obtained recordings of polysomnography and sleep sonography in children obstructed by adenotonsillar hypertrophy. Four hundred sixty‐five 4‐minute samples obtained from 18 patients in a clinical studies unit were analyzed and rated as to severity. Agreement between polysomnography and sleep sonography was very high in scoring the respiratory pattern (r=0.79) and detecting apnea (r=0.89). These findings demonstrate that sleep sonography is a reliable method for evaluating patients with upper airway obstruction due to adenotonsillar hypertrophy.
Patency of the internal jugular vein after functional neck dissection
Authors: Fisher Cynthia B. , Mattox Douglas E. , Zinreich James S. 
Published: October 2006

AbstractThe objective of this study was to determine the immediate patency rate for internal jugular veins preserved in functional neck dissections. Thirteen patients had contrast‐enhanced CT scans 2 to 4 weeks postoperatively. Ten veins were patent and had a diameter comparable to that seen on the preoperative scan; one vein was narrowed but patent; two were occluded. Probable factors associated with occlusion include trauma of the vessel and extrinsic compression of the vein by the skin or myocutaneous flaps.
The anatomical basis for post‐tracheotomy innominate artery rupture
Authors: Oshinsky Alan E. , Rubin John S. , Gwozdz Christina S. 
Published: October 2006

AbstractClassical teaching suggests that placement of a tracheostomy tube through the second or third tracheal rings will safeguard the innominate artery in the majority of patients.A tracheotomy was performed on ten fresh, adult cadavers through a vertical incision in the second and third tracheal rings. A series of measurements was made evaluating the relationship of the innominate artery to the tracheostomy tube and to laryngotracheal structures.In every dissection, some part of the tracheostomy tube cuff or tip was found to be adjacent to the innominate artery.We conclude that, contrary to general belief, placement of the tracheotomy incision at the second and third tracheal rings will not in and of itself protect the innominate artery from rupture.
Comparative studies of speech processing strategies for cochlear implants
Authors: Wilson B. S. , Finley C. C. , Weber B. A. , White M. W. , Farmer J. C. , Wolford R. D. , Merzenich M. M. , Lawson D. T. , Kenan P. D. , Schindler R. A. 
Published: October 2006

AbstractA wide variety of speech processing strategies for multichannel auditory prostheses were compared in studies of two patients implanted with the UCSF electrode array. Each strategy was evaluated using tests of vowel and consonant confusions, with and without lipreading. Included among the strategies were the compressed analog processor of the present UCSF/Storz prosthesis and a group of interleaved pulses processors in which the amplitudes of nonsimultaneous pulses code the spectral variations of speech. For these patients, each with indications of poor nerve survival, test scores were significantly higher with the interleaved pulses processors. We believe this superior performance was a result of 1. the substantial release from channel interactions provided by nonsimultaneous stimuli and 2. a fast enough rotation among the channels to support adequate temporal and spectral resolution of perceived speech sounds.