bluuebunny/crossref_metadata_2025_split huggingface dataset:
Saddle nose deformity: Etiology, prevention, and treatment; augmentation rhinoplasty with polyamide
Authors: Beekhuis G. Jan 
Published: September 2006

AbstractSaddle nose deformity is characterized by an abnormally concave dorsum with an apparent upward tilting of the nasal tip; the osseous or the cartilaginous vault or both regions may be affected. Over the years, the etiology has changed: formerly syphilis was a major cause of destruction of the nasal supporting structures; today, mechanical and surgical trauma to the nose, fractures, septal hematoma, and racial features are the primary causes of saddle nose deformity; the incidence is increasing as fractures from high‐speed automobile accidents increase, and as Orientals and Negroes seek elective nasal plastic procedures. Prevention involves early treatment of nasal injuries in childhood, which affects the growth centers in the nose; treatment of hematoma that may follow injury at any age; avoidance of excessive hump removal during rhinoplastic operations. Treatment of saddle nose deformity, either for physiologic and/or for cosmetic reasons, is augmentation rhinoplasty. Filler materials range from human living or cadaveric tissue — autografts or homografts of bone or cartilage —, heterografts — animal cartilage or processed bone; and inorganic implant materials — metals, synthetic alloplastics. A brief review of the materials and their use during the years gives evidence that the “ideal” material is still to be found. The author's experience with the alloplastic, polyamide mesh, in 30 patients within the last two years has led to initial satisfactory results in 27 patients and subsequently satisfactory results in two patients; one patient awaits a reimplantation. In the three patients who had initial failures there was underlying infection. In all 30 patients the polyamide mesh was well tolerated by the human host; there were no foreign body reactions, no rejections. It was found that the host tissues actually invaded the implant, giving it stability and incorporating it into the host tissues. No implant became displaced. The polyamide mesh has approximately the same flexibility as the host tissues, and the naturally semimobile part of the nose can be readily moved around, providing a repair that approaches the normal nose. The cosmetic effects are entirely satisfactory, and the author believes that polyamide mesh is a valuable adjunct to augmentation rhinoplasty and expects to continue to use it for correction of saddle nose deformity and also to document the results over a long postoperative period. All augmentation materials have advantages and disadvantages; these are summarized in Table I.
Impairment of function of the intrinsic laryngeal muscles after regeneration of the recurrent laryngeal nerve
Authors: Satoh Isei , Harvey Joseph E. , Ogura Joseph H. 
Published: September 2006

AbstractComplete return of laryngeal function, as evidenced by normal excursion of the vocal folds during respiration and phonation, seldom follows division and repair of the laryngeal nerves. In order to investigate this phenomenon further the recurrent laryngeal nerve was sectioned and repaired in five dogs. Some functions of the intrinsic laryngeal muscles in these dogs were observed at intervals following repair of the nerve and compared to other dogs in which the nerve had been crushed or subjected to sustained pressure.Results obtained utilizing a high speed movie camera, electromyographic, and evoked electromyographic techniques, suggest that the reinnervated intrinsic laryngeal muscles showed impaired function when compared with normal muscles. The mechanisms possibly active in causing this reduction of function are discussed.
Surgical treatment of squamous cell carcinoma of the tonsil
Authors: Whicker James H. , Desanto Lawrence W. , Devine Kenneth D. 
Published: September 2006

AbstractFrom 1960 through 1968, we examined 117 patients with carcinoma of the tonsil. Of these 117 patients a choice of the primary treatment modality existed for 96 patients, and 68 percent had surgery as their initial treatment. The absolute five‐year survival for all patients undergoing surgical procedures designed to cure was 48 percent. Tonsillar cancers are neither anaplastic nor markedly radiosensitive. The incidence of local recurrence in seven published series in which the primary tonsillar cancer was treated with radiation averaged 49 percent. We believe that the local recurrence rate of 19 percent in our surgical series reflects our dependence on frozen tissue examination and suggests that surgery offers a good chance of eradicating operable tonsillar carcinoma.
Nasal mastocytosis
Authors: Mckenna E. L. 
Published: September 2006

AbstractThe treatment of obstructed nose due to removable lesions such as adenoidal hypertrophy, nasal polyps, tumors or deviation of the septum is surgical. In the non‐surgical obstructed nose the establishment of the proper diagnosis in order to institute proper therapy is obvious. The allergic nose is treatable in most instances with antihistamines, decongestants, and, appropriately, by desensitization. There is a considerable body of patients with non‐allergic perennial rhinitis who have no surgical obstruction, and who have been treated, usually for years, with the usual modes appropriate for the allergic nose. The results universally are poor.Nasal biopsies have been used to show a marked difference of infiltration of the mast cell in the submucosa of patients with perennial rhinitis who have neither obstruction due to surgically treatable conditions or due to allergic rhinitis. It is postulated that the mast cells infiltrate the nasal mucosa in response to factors yet to be determined. The mast cell contains chemical mediators which when released into the nasal tissue cause the symptoms of perennial rhinitis. The diagnosis cannot be made by direct visualization or even by nasal mucus smears but only made by biopsy. Surgery and allergy management usually fail in these patients, and usually they respond only to an honest explanation of the condition and short term steroid therapy.
Carcinoma of maxillary antrum: The role of pre‐operative irradiation
Authors: Pearlman Alexander W. , Abadir Rushdy 
Published: September 2006

Abstract
Nineteen patients with carcinoma of the maxillary antrum were treated sequentially with pre‐operative irradiation and radical surgery.
Seven of 19 patients (37 percent) were free of disease for longer than three and one half years (one patient for two years).
Infrastructure tumors were more favorable than those involving the entire antrum. The control rate for infrastructure tumors was five of 11 patients (45 percent).
The most important cause of failure is the inability to destroy the tumor locally or early local recurrence.
Pre‐operative irradiation at a dose level of 6,000 rads in five weeks or its equivalent is an important addition to the treatment of advanced antral cancer.
Cryosurgery of respiratory structures. II. Cryonecrosis of the lung
Authors: Neel H. Bryan , Farrell Kenneth H. , Payne W. Spencer , Desanto Lawrence W. 
Published: September 2006

AbstractThis study was undertaken in dogs and monkeys to assess the sequelae of cryosurgery of the lung. In seven animals, a cryoprobe was repeatedly applied to the entire right middle lobe. In no instance was the probe inserted through the pleura into pulmonary parenchyma, but the pulmonary parenchyma was firmly compressed beneath the probe tip during freezing. This permitted through‐and‐through freezing of the entire right middle lobe and ensured complete cryonecrosis of the entire lobe. In three animals, a portion of the right lower lobe was also frozen by repeatedly applying the probe tip to the midportion of that lobe.All animals survived the procedures, and all resumed normal activity within 24 hours of operation. There were no pleural space complications except for the production of pleural adhesions. All lesions had the features of an acute hemorrhagic infarct, characterized by intense local hemorrhage and complete coagulation necrosis, typical of cryolesions. Subsequently, there was total collapse and fibrosis of underlying pulmonary tissue with areas of hemorrhagic necrosis, hemosiderin in macrocytes, focal calcification, and hyalinization. Serum lactic dehydrogenase values and leukocyte counts promptly increased after cryosurgery; however, all values returned to normal within 14 days, and no significant changes were noted thereafter. Thoracic roentgenograms showed changes consistent with consolidation of the right middle lobe, and by seven weeks, the only roentgeno‐graphic evidence of the cryotreated middle lobe was a small density in the hilus. Histologically, this was a small mass of scarified tissue that sealed the bronchial stump and major vessels at the hilus and consisted of organized fibrosis.
Management of undescended lingual and subhyoid thyroid glands
Authors: Wertz Max L. 
Published: September 2006

AbstractThere are approximately 400 reported cases of undescended thyroid glands. Ninety percent of these are located in the base of the tongue, and 10 percent in the anterior neck superficial to the hyoid bone. The presumptive diagnosis is usually made by scintiphotography. These glands are probably quantitatively deficient and function at marginal levels. Apparently, TSH stimulation causes hypertrophy, usually at an early age, producing undesirable symptoms or local cosmetic change.The treatment varies, depending upon the problems that arise: observation, suppressive doses of thyroid, isotope suppression, surgical excision, and autotransplantation are methods used in attempting to benefit these patients.This communication deals with guidelines for therapy and attempts to evaluate allotransplantation based on the available data. To date, some degree of success has been obtained by autotransplantation; however, a more vigorous effort by the medical community is needed to obtain and report clinical and laboratory data to evaluate autotransplantation fully.
Prevention of post‐rhinoplasty edema
Authors: Stucker Fred J. 
Published: September 2006

AbstractPostoperative edema was investigated in 50 consecutive rhinoplasty patients utilizing essentially the same technique. All patients were operated upon by the author. Thirty‐five patients were positioned so that the head was elevated 90† postoperatively, and 15 patients were placed in the more commonly utilized position of 30† elevation. Photographs were obtained at 24 hours following surgery. The periorbital edema was then graded on a scale 0 to 3 by four rhinoplastic surgeons who were unaware of any change in postoperative care. Using the chi‐square test there was a statistically significant difference between the two groups. This study allows one to expect less postoperative edema if the patient's head is maximally elevated.
Sinography and the radiolucent foreign body: A case report
Authors: Smith Curran J. , Black Franklin O. , Smith Raymond O. 
Published: September 2006

AbstractA case of an evasive radiolucent foreign body of the infratemporal fossa is reported in which the simple technique of sinography permitted localization and successful excision. The technique is recommended for the evaluation of chronically draining wounds to determine the extent and course of the sinus tract and to aid in the detection of radiolucent foreign bodies.
Vidian neurectomy — Some technical remarks
Authors: Nomura Yasuya 
Published: September 2006

AbstractThis paper describes a new surgical technique of vidian neurectomy. Although the vidian canal is approached transantrally, it differs from the conventional technique in that this procedure does not require dissection of the pterygopalatine fossa.The maxillary sinus is opened, using Caldwell‐Luc's procedure; a U‐shaped mucosal incision is made and lifted up, exposing the posterior bony wall as well as a posterior part of the medial bony wall of the antrum. After removing the bony wall, the periosteum covering the pterygopalatine fossa and the nasal mucosa (underside) are revealed. There is a crevice between these soft tissues. The maxillary surface of the sphenoid can be easily touched by a small periosteal elevator inserted into the crevis. The medial corner of the pterygopalatine fossa is pushed aside laterally with the covering periosteum. This exposes a part of the bony surface of the maxillary surface of the sphenoid. Go upward, touching on the maxillary surface until the elevator goes into the funnel‐like opening of the vidian canal. The content of the vidian canal is electrocauterized and sectioned. It is important to expose the whole circumference of the bony opening of the vidian canal. This guarantees the complete section of the vidian nerve. The canal is plugged with a piece of gelatine sponge and bone wax. The mucosal flap is returned back.This surgical procedure may be properly termed as “Transantral Subperiosteal Vidian Neurectomy.”
The origin and functions of nasal mucus
Authors: Taylor Miles 
Published: September 2006

AbstractUsing histochemical techniques the source and nature of nasal mucus and secretions has been investigated.The secretions from the serous and mucous glands in the stroma consist of acid mucopolysaccharides and mucoprotein. The mucins from the goblet glands are similar but sulfated. The large ducts have a secretory function also.The capillary net lies in the epithelium, allowing rapid transudation to take place. The basement membrane is PAS negative during early life and is permeable. It becomes progressively more PAS positive with age because of this.A comparative study of the uses of mucus has shown that its physio‐chemical characteristics are the most prominent. Mucus may act as a retainer for substances, exhibit surface electrical activity, have permeability and act as a mesh. It is an adhesive, protects the mucosa and transports particulate matter. It allows heat transfer and has water holding properties.It is suggested that mucus has been utilized throughout evolution because of its protean physiochemical properties.
Tumor surgery of the temporal bone
Authors: Arena Sebastian 
Published: September 2006

AbstractAdequate tumor surgery of the temporal bone continues to be difficult and hazardous. This is because of its relationship to vital vascular and neural structures.A classification of tumors of the temporal bone and a system of surgery for these tumors is presented, based on 30 malignancies of the external canal and middle ear, and on four tumors involving the jugular foramen, infratemporal fossa, and posterior fossa.Tumors involving only the external canal require that the excision involves the parotid as well as the external canal. It is not always possible to preserve the facial nerve.Tumors which extend to the middle ear are more complex and require en bloc temporal bone resection. Tumors which involve the petromastoid and tympano‐tubal areas are also in this more complex group.The complications of en bloc resection are severe but can be successfully resolved in most instances. All patients who had recurrence of disease demonstrated evidence of recurrence within six months. Ominous signs are positive neck nodes or infiltration of tumor into the surrounding soft tissues (parotid).Large tumors of the jugular foramen, infratemporal fossa and posterior fossa have been considered inoperable in the past.Techniques have been developed in temporal bone resection that have made many of these tumors surgically accessible. This involves the incorporation of microsurgical and neurosurgical techniques.Large glomus tumors and meningiomas can be resected through the cooperative efforts of the otolaryngologist and neurosurgeon.
Synovial sarcoma of the cervical area
Authors: Liebman Emil P. , Harwick Robert D. , Ronis Max Lee , Gaynor Edward B. 
Published: September 2006

AbstractSynovial sarcoma is a malignant tumor which usually arises from the extremities. Involvement of the cervical area has been quite rare and to date only 12 cases have been reported. Two additional cases are reported in this paper and their management discussed. Case 1 is a 32‐year‐old white female with a submucosal mass of the right retromolar area displacing the tonsillar fossa and soft palate anteriorly. Surgical exploration revealed a well encapsulated mass separate from the parotid gland. Surgical excision was carried out on August 30, 1972. Pathological report was a synovial sarcoma. There has been no recurrence to date. Case 2 is a 34‐year‐old male with a 4 to 5 centimeter submandibular mass. Sialography and carotid arteriography were non‐contributory. Biopsy showed synovial sarcoma. On May 12, 1973, surgical excision of the mass was carried out with the ipsilateral attached greater corneal of the hyoid bone and right hypoglossal nerve which ran into the tumor. Postoperative X‐ray therapy was given. There is no recurrence to date. Discussion: Synovial sarcoma represents a type of mesenchymal tumor whose differention can mimic non‐neoplastic synovial membrane. Histologically the tumor contains two neoplastic cell types. These are described as the fibrosarcomatous element and the synovial element. The tumor usually has no true capsule and grows by expansion with adherance to surrounding structures. The rate of growth is slow but the long term prognosis is poor. Metastasis usually occurs via blood stream most commonly to the lungs. Regional lymph node metastasis occurs in areas outside of the head and neck but has not been recorded in synovial sarcoma of the head and neck to date. Surgical excision is agreed to be the mode of treatment. The value of X‐ray therapy is uncertain but Pack and Ariel were able to show their best results with a combination of surgical resection followed by postoperative X‐ray therapy. It has been suggested that synovial sarcoma of the head and neck may behave in a more benign manner than synovial sarcoma elsewhere. Long term follow‐up is not available in enough of the cervical sarcoma cases to determine if this is true. Until a more benign behavior is proven the tumor should be treated as an aggressive malignancy. Wide surgical excision is the treatment of choice. Postoperative X‐ray therapy should be considered.
Cardiac complications of microsurgery of the larynx: Etiology, incidence and prevention
Authors: Strong M. Stuart , Vaughan Charles W. , Mahler Donald L. , Jaffe Donald R. , Sullivan R. Craig 
Published: September 2006

AbstractIn no surgical arena is the cooperation and mutual understanding of the anesthesiologist and surgeon more important than in endolaryngeal surgery; here in the narrowest part of the airway, they compete for a share of the limited space available! The anesthesiologist must understand the requirements for optimal operating conditions but more importantly, the surgeon must understand the requirements for safe general anesthesia if unnecessary complications are to be avoided.Cardiac infarction, myocardial ischemia and arrhythmias, may occur during or after microsurgery of the larynx; they are most likely to be precipitated by pressure stimulation of the deep receptors of the larynx during suspension of the laryngoscope. The reflex pathway that produces the arrhythmia includes the superior laryngeal nerve and the cardio‐in‐hibitory fibers of the vagus. It appears that the complications are most often induced by the surgical manipulation and potentiated by abnormal blood gases.A small bore cuffed endotracheal tube appears to be an eminently satisfactory way of providing control of the airway and good operating conditions.The incidence of cardiac complications was studied in 540 patients and found to be 6.8 percent in the high risk group and 1.9 percent in the group without a preoperative history of cardiac disease.These figures are somewhat higher than those reported by Tarhan, et al., in their study of the incidence of myocardial infarction following surgery of various types under general anesthesia.To keep these complications to a minimum, constant vigilance must be maintained by the surgeon and anesthesiologist, especially on the cardiac monitor and airway. If arrhythmias appear, steps must be taken immediately to remove the cause, otherwise myocardial ischemia and infarction are very likely to follow.
The management of subglottic laryngeal stenosis by resection and direct anastomosis
Authors: Gerwat John , Bryce Douglas P. 
Published: September 2006

AbstractThe causes and relative incidence of stenosis in the trachea and subglottis are described. The special difficulties encountered in the subglottic region are discussed and references made to various treatments described in the past.An operation designed to produce a one‐stage cure with preservation of vocal cord function is described in detail. This consists of exposure of the laryngo‐tracheal complex and examination of the lesions directly. If suitable for excision, the upper line of resection is made at the lower border of the thyroid cartilage anteriorly and through the posterior cricoid lamina below the crico‐thyroid joints posteriorly. This is carried out only after identifying the recurrent laryngeal nerves on each side and tracing them up to the crico‐thyroid joints. Anastomosis of upper trachea to the remaining larynx is performed after mobilizing the two ends. At the upper end, this is achieved by the laryngeal drop procedure previously described by Bryce (1972). A stent may be inserted if the anastomosis requires support. A check suture preventing neck extension is not considered necessary.Postoperatively, a tracheostomy is maintained until the danger of aspiration has passed or until a stent is removed three weeks later. Naso‐gastric feeding is required for the first few days.Four case histories are presented.Pre‐operative radiographic assessment has been found to be misleading in most cases and the final decision on the procedure can be determined only at the time of surgery.
Schwann cell tumors of the facial nerve
Authors: Conley John , Janecka Ivo 
Published: September 2006

AbstractAn unusual group of tumors originating from Schwann cells of the facial nerve has been studied. Twenty‐three neurilemmomas were found in 17 patients. Nine originated in the temporal bone, and the remaining 14 tumors arose from the peripheral portion of the facial nerve. All tumors were treated by excision, with partial or total resection of the facial nerve. The resultant facial nerve deficit was then reconstructed with a hypoglossal nerve crossover or a free autogenous nerve graft.
Localized enlargement of the thyroid gland presenting as a pyriform sinus mass.
Authors: Snyder G. Gordon , Toomey James M. 
Published: September 2006

AbstractMass lesions of the hypopharynx and pyriform sinus are usually malignant neoplasms. Benign tumors do occur but are uncommon. In a review of the literature, no case of impingement of a thyroid mass upon the hypopharynx and pyriform sinus was found. An unusual case of localized enlargement of the superior pole of the thyroid gland which impinges on the hypopharynx and pyriform sinus is presented.