bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mini‐craniotomy for management of csf otorrhea from tegmen defects.
Authors: Adkins W. Y. , Osguthorpe J. D. 
Published: October 2006

AbstractCSF otorrhea arising from defects in the tegmen and middle fossa dura may be congenital or acquired. It may be spontaneous or secondary to trauma, chronic ear disease, tumor or surgical treatment. In the six cases presented, the tegmen defect and associated CSF leak were secondary to chronic ear disease in two cases, to mastoid surgery in two cases, to temporal bone fracture and congenital origin in one case each. The successful management of these patients utilizing a mini‐craniotomy in conjunction with mastoid surgery is described. Mini‐craniotomy facilitates precise extradural, intracranial placement of an autogenous graft over the tegmen defect which can be technically difficult in the transmastoid approaches, yet avoids the morbidity and potential complications of a full middle fossa craniotomy. It does not significantly add to the length of the mastoid procedure or its complications.
Tip suspension suture for superior tip rotation in rhinoplasty
Authors: Davidson Terence M. , Murakami Wilson T. 
Published: October 2006

AbstractSuperior tip rotation is sometimes necessary to relieve functional obstruction as well as improve the esthetic appearance in the aging nose and the thick skinned heavy tip nose. Conventional techniques including thinning resection, rim strip, lateral crural flap and even external skin excisions are often inadequate to obtain and maintain sufficient superior tip rotation. A technique is described to permanently suture the lower lateral crus to the upper lateral cartilages and to the cartilaginous septum. Long‐term follow‐up supports this technique's cosmetic and functional effectiveness.
Histological acoustic tumor involvement of the viith nerve and multicentric origin in the viiith nerve
Authors: Luetje Charles M. , Whittaker C. Keith , Callaway L. Alan , Veraga Gerardo 
Published: October 2006

AbstractThe surgical plane between the VIIth nerve and acoustic tumor is often elusive. This histological relationship was reviewed in three patients who underwent VII‐VII neuroanastomosis at tumor removal disclosing an inseparable surgical plane in two. In the third patient, tissue sections did not accurately show the relationship. In all three, surgical planes were not apparent at tumor removal.Another patient had a second, isolated tumor in the same VIIIth nerve proximally at the brain stem root entry zone. This was seen only on permanent section.In considering “total” tumor removal by microsurgical standards, these histological findings should be kept in mind. We advocate removal of the entire VIIIth nerve to the brain stem root entry zone along with smaller tumors.
Role of the tympanic ring in the pathogenesis of congenital cholesteatoma
Authors: Aimi Kenji 
Published: October 2006

AbstractTopographic study of congenital cholesteatomas revealed that the majority of these congenital epidermal cysts occur near the tympanic isthmus of the middle ear. Since this is the junction of the first and second brachial arch, the origin of the cholesteatoma could be linked to the migration of the external canal ectoderm into the middle ear at the early stage of development.Embryologic study showed that the tympanic ring plays an important role in limiting the medial extent of the external canal to the level of the tympanic annulus. Migration of the ectodermal tissue into the middle ear beyond the annulus is likely to be caused by the failure of this inhibitory function of the tympanic ring.Microscopic sections of human fetuses were studied to determine the developmental relationships between the external canal ectoderm and the tympanic ring. A section from a 16 1/2‐week fetus showed significant papillary ectodermal tissue projection into the mesenchyme near the tympanic isthmus, while the tympanic ring was absent in that site.Anatomical distance between the tympanic ring and the internal auditory canal is extremely short in these fetuses. This is suggestive of the source of petrous cholesteatomas from the canal ectodermal migration.These observations form the basis of the author's theory that the pathogenesis of congenital cholesteatomas is caused by migration of external canal tissue into the tympanic isthmus or into the petrous bone as a result of developmental error in which the advancing external canal ectoderm failed to receive stop signal of the tympanic ring that contains the ectoderm at the annular plane.
Cervical vertebrae subluxation
Authors: Hopla Dan M. , Mazur John M. , Bass Richard M. 
Published: October 2006

AbstractRotary subluxation of the atlantoaxial joint is an uncommon complication of head and neck surgery and infections. Reported sequelae of this disorder range from torticollis to death from compression of the spinal cord. Two cases of C1‐C2 rotary subluxation will be discussed. These complications occurred following otitis media, repair of choanal atresia, and an adenoidectomy. The literature is reviewed.
Radiographic assessment of squamous cell carcinoma of the temporal bone
Authors: Olsen Kerry D. , Desanto Lawrence W. , Forbes Glenn S. 
Published: October 2006

AbstractSquamous cell carcinoma of the temporal bone usually presents with tumor and edema occluding the external auditory canal. Accurate evaluation of the extent of such a tumor is therefore difficult. Assessment of these tumors and subsequent surgical management depends primarily on the preoperative radiographic findings. This paper discusses the evolution of the radiographic assessment of carcinomas of the ear canal. Certain cases have been selected to demonstrate the advantages and disadvantages of the radiographic studies in use. Mastoid x‐ray views and petrous tomograms have been the standard methods of studying these lesions. Their interpretation, however, often exaggerates or underestimates the true extent of these carcinomas. Early and later generation computed tomography (CT) scans offered improvement in determining tumor involvement but still did not give the needed detail for surgical planning. High‐resolution CT scanning of the petrous bones now offers the surgeon excellent views of these tumors. This paper places special emphasis on this technique and also discusses indications for operability.
The argon laser in surgery for chronic ear disease and otosclerosis
Authors: Mcgee T. Manford 
Published: October 2006

AbstractThe use of the argon laser in chronic ear disease and otosclerosis surgery is reviewed. Its advantages and limitations are discussed, and safe parameters for use established. The argon laser is an effective tool to remove, cut, and coagulate tissue. It was used in over 500 microsurgical otologic procedures without deleterious effects. One hundred primary laser stapedotomies were performed, and the audiological results were compared to those obtained using conventional small fenestra stapedectomy techniques. No significant statistical difference was present in the audiologic results after 1 year of observation. The clinical course of the laser stapedotomy patients suggested this technique was less traumatic than conventional techniques.
Neuropathology of spasmodic dysphonia
Authors: Schaefer Steven D. 
Published: October 2006

AbstractSpasmodic dysphoria is a devastating voice disorder of unknown etiology, with a variable clinical presentation and response to treatment. Three independent evaluations of brain stem function were performed on spasmodic dysphonic patients, and age and sex‐matched controls. Statistically significant (p < 0.01˜0.05) differences were noted between these groups, and the findings were consistent with impairment of somatic and visceral brain stem pathways.A significant correlation (p < 0.05) was found between the severity of tested central nervous system impairment and vocal tremor, number of associated neurologic signs and duration of illness. Possible etiologies (viral or traumatic), age, and sex, did not correlate with the severity of brain stem impairment. Clinical signs and the brain stem findings appeared to stabilize 3 to 5 years after onset of dysphonia. The investigation of other spasmodic cranial nerve disorders afforded insight into the etiology and therapy for spasmodic dysphonia. Drawing upon previous observations and the results of the brain stem tests, two models are proposed for neuronal processing in spasmodic dysphonia, and future strategies are discussed.The evidence cited in this research project are consistent with spasmodic dysphonia being one of several spasmodic brain stem disorders with variable presentation which are known by the cranial nerve nuclei or pathways of major clinical involvement.
Self‐induced orbital emphysema as a presenting sign of munchausen's syndrome
Authors: Winans James M. , House Leland R. , Robinson Harrell E. 
Published: October 2006

AbstractA bizarre case of severe, debilitating pneumo‐orbit resulting in proptosis, blindness, and eventual exenteration of the right eye and threatening the same fate for the left eye was worked up painstakingly for over 10 years before a final diagnosis of Munchausen's syndrome was uncovered. Five days after the diagnosis was made and appropriate management was instituted the severely proptotic left eye had returned to normal and the patient was discharged for out‐patient psychiatric follow‐up. A discussion of the differential diagnosis of pneumo‐orbit is presented and Munchausen's syndrome, the final diagnosis in this case, is discussed from both an historical and psychiatric perspective.
Halo external fixation of nasal fractures
Authors: Wurman Leonard H. , Sack J. Garry , Flannery John V. 
Published: October 2006

AbstractThe halo, long in medical use for cervical traction, subsequently has been adapted as a method of external fixation for severe facial fractures. We have recently used a light‐weight halo in four patients with severe mid‐facial fractures and crushed nasal skeletons. External traction proved to be superior to any method we have previously used to support the repositioned nasal bones. We strongly recommend external traction for severe nasal fractures in which other methods may not give a complete and stable bony reduction.
An igd extramedullary plasmacytoma involving the sphenoid sinus at onset: An immunohistochemical study
Authors: Humphrey David M. , Aufdemorte Thomas B. , Gates George A. 
Published: October 2006

AbstractA 60‐year‐old man developed a left VIth‐nerve paralysis and underwent biopsy of an extramedullary plasmacytoma in the sphenoid sinus. Immunohistochemistry demonstrated cytoplasmic IgD and lamba determinants. Subsequent specimens from left clavical and thoracic epidural lesions also showed a plasma cell neoplasm with IgD and lamba determinants. No abnormal plasma cells were found in bone marrow specimens. Lambda Bence‐Jones protein and monoclonal IgD‐lambda protein in the serum were detected several months after onset. The patient died with disseminated plasmacytoma 1 year after diagnosis. The mode of presentation, pattern of metastasis, and secretory features were typical of extramedullary plasmacytoma arising in the upper airway. Immunohistochemistry was more productive than serum electrophoresis and immunoelectrophoresis for following the course of this neoplasm.
Anatomical characteristics of the anterior vestibular nerve of the bullfrog
Authors: Honrubia Vicente , Sitko Stefan , Kuruvilla Alexander , Lee Regina , Schwartz Ilsa R. 
Published: October 2006

AbstractStudy was made of the dimensions of the nerves to the receptor organs in the anterior branch of the bullfrog vestibular nerve. The number of fibers and their diameters and trajectories in the nerve and Scarpa's ganglion were studied. A correlation was made between the anatomical and physiological properties of neurons identified with intracellular injections of horseradish peroxidase. The data suggest a specific pattern of innervation of the organs, organization of fibers and cells in the vestibular nerve, and significant correlation between the anatomical and physiological properties of individual neurons. A comparison was made between the information obtained from the bullfrog and that from other animals, which suggests a similarity between species and supports the hypothesis of a differential physiological role of the neurons in each vestibular organ according to anatomical characteristics.
Otorhinological brain abscess therapy – past and present
Authors: Brand Benjamin , Caparosa Ralph J. , Lubic Lowell G. 
Published: October 2006

AbstractIn the past several years a concensus approach has been reached in diagnosis and therapy of brain abscess. The ease and accuracy of evaluation of intracranial lesions afforded by third generation computerized tomography scanners has lead to reliable, quick, nonsurgical diagnoses and monitoring which is relatively non‐invasive. The use of multiple agent, increased spectrum, antimicrobials has resulted in acceptable reduced morbidity and mortality. This has decreased the need for therapeutic surgical intervention.The non‐surgical approach was preceded by several other modes of management which were acceptable in their time. During the past 21 years, 17 patients have been under the care of one or more of the above authors. A review of these cases is presented with instructive and informative histories. A knowledge of past therapeutic modalities and their attendant complications compared with present medical therapy assures an acceptance of the latter as the method of choice. A search of the general literature shows wide acceptance in other fields; however, no reference could be found in the recent otolaryngological literature to support a non‐surgical approach.
Temporomandibular joint surgery: Results of a 14‐year joint implant study
Authors: House Leland R. , Morgan Douglas H. , Hall William P. , Vamvas S. James 
Published: October 2006

AbstractThis paper analyzes the surgical techniques that are now used in treating organic temporomandibular joint (TMJ) disease. The authors attempt to evaluate the high condylectomy procedure which has been recommended by one group as the only surgical approach. In particular, the authors describe their experiences in using metallic and/or metal and plastic prosthetic devices for repairing damaged joints. The procedure used most frequently is a form of joint resurfacing, although total TMJ replacement is also described.On January 9, 1978, 205 questionnaires were mailed to patients who had undergone TMJ implant surgery. The population surveyed, representing 314 TMJ procedures, were asked to make a subjective overall assessment of the surgical result, and to rate the improvement, elimination, or worsening of each of 22 surgical indications (whenever such indications were applicable to themselves). The survey was done by the Clinical Research Division of a major company in the orthopedic field. The authors did not see the results of the evaluation until they were computed and analyzed by this independent group.The overall group assessment results were: Excellent — 41.7%; Good — 28.8%; Fair — 14.1%; and Poor — 15.3%. The 5 most common symptoms of patients who had surgery were a grating sound in the joint, partial inability to open the mouth, pain in the joint, clicking in the joint, and headaches.A review of TMJ surgical procedures other than TMJ implants is also presented.
Cryotherapy for chronic vasomotor rhinitis: Technique and patient selection for improved results
Authors: Bumsted Robert M. 
Published: October 2006

AbstractCurrent methods of therapy of chronic vasomotor (non‐allergic) rhinitis are frequently unsuccessful. This led to the development of a standardized technique of intranasal cryotherapy (longer freeze duration and larger area of therapy than previously reported) which was utilized in 50 patients. Indications for cryotherapy included: Failure of medical therapy in anatomically normal patients with mucosal disease caused only by vasomotor rhinitis. Minimal follow‐up was 2 years. Obstructive symptoms (subjective and objective evaluation) were eliminated in 92% and markedly improved in the remaining 8%. Excessive drainage (subjective) was relieved in 47%, markedly improved in 41%, and minimally improved (therapeutic failure) in 12%. Complications were minor; however, increased postoperative pain, drainage and healing duration (compared to prior series) were encountered. This cryotherapy technique provides significantly improved results in the treatment of vasomotor rhinitis when proper patient selection and technique are utilized.
Castleman's disease — The lymphoma impostor
Authors: Denenberg Steven , Levine Paul A. 
Published: October 2006

AbstractThe asymptomatic neck mass in the middle‐aged adult is not an uncommon clinical dilemma for the otolaryngologist‐head and neck surgeon. After a complete medical evaluation and panendoscopy with multiple “blind” biopsies, the patient usually comes to excisional biopsy, when the prior work‐up has not added any positive information. Most commonly, in this age group, the mass represents metastatic cancer from a head and neck primary, a carcinoma from a distant site, or a lymphoma. We present a case of Castleman's disease, a benign lymphoepithelial disease that can easily be mistaken for lymphoma.
Primary and secondary keratomas of the frontal sinus
Authors: Hopp Martin L. , Montgomery William W. 
Published: October 2006

AbstractKeratomas in the paranasal sinuses have been described in the world literature with variable frequency and the inaccurate terminology of cholesteatoma. This paper describes an illustrative case and provides a discussion of the etiology and pathology of this disease. Because the pathologic findings are that of a true keratoma, classification of this disease as primary and secondary keratomas is recommended. The classification 1. primary keratoma is recommended for the epidermal cyst of congenital rest origin and 2. secondary keratoma is suggested for epithelial layers and cysts that are secondary to squamous cell implantation or migrations.
Subglottic hemangiomas in infants: Treatment with CO2 laser
Authors: Mizono Gary , Dedo Herbert H. 
Published: October 2006

AbstractSubglottic hemangiomas in infants are rare but potentially lethal. Although the majority tend to regress after 12 to 18 months, lethal compromise of the airway is always possible until then, A plethora of treatments have been advocated for subglottic hemangiomas, each with significant morbidity. Eleven consectuve patients have undergone laser resection of subglottic hemangiomas at the University of California, San Francisco. Three infants have been managed without a tracheotomy. If a tracheotomy is required, earlier removal can be achieved with laser resection. No subglottic stenosis or hemorrhage has occurred following laser resection. CO2 laser resection is now the safest and most effective treatment available.
Sudden hearing loss: Eight years' experience and suggested prognostic table
Authors: Byl Frederick M. 
Published: October 2006

AbstractThe etiology, incidence, acute and late prognosis, and treatment of sudden hearing loss (SHL) are described variously in the literature. In an 8‐year prospective study of 225 SHL patients, initiated in July 1973, overall, normal, or complete recovery occurred in 45% of patients and late otologic complications in 28%. Important prognostic indicators were severity of initial hearing loss and vertigo, time to initial audiogram, and elevated erythrocyte sedimentation rate; other indicators were age >60 and <15 years, midfrequency audiogram configuration, and hearing status of the opposite ear. A common inflammatory cause is suggested for all degrees of severity in SHL, and a prognostic table is provided to aid the practitioner in predicting recovery. There is still no evidence that treatment achieves a result better than expected with spontaneous recovery.
Microscopic rhinoscopy in the treatment of inverted papillomas
Authors: Hoffman Sanford R. , Stinziano Gerald D. , Goodman Denise 
Published: October 2006

AbstractInverted papillomas are endophytic lesions arising from tissues in the nose and paranasal sinuses noted for their local destruction, propensity to recur, and tendency for malignant transformation. It has been well documented that complete removal is essential in the prevention of recurrence; however, use of the operating microscope to ensure this has not been widely described in the past. We present 4 patients, ages 36 to 56, for whom the operating microscope was used intra‐operatively and for follow‐up examinations. The patients have been followed for 1 to 5 years without any evidence of recurrence to date. We submit that the operating microscope is an extremely valuable tool for the surgical treatment of this lesion in light of the absolute necessity for its complete removal.
Steroid use in idiopathic sudden sensorineural hearing loss
Authors: Moskowitz Dan , Lee K. J. , Smith Howard W. 
Published: October 2006

AbstractFew studies have investigated the effect of steroids on idiopathic sudden hearing loss (ISHL). Recently, Wilson, et al., reported a double blind study demonstrating a statistically significant improvement of hearing using steroids in ISHL. This report, fashioned after the Wilson study, confirms his findings and analyzes the relationship of several factors to the probability of hearing recovery.
Identification of subsets of lymphocytes infiltrating head and neck tumor tissue: A preliminary report
Authors: Rabin Bruce S. , Johnson Jonas , Claassen Diana 
Published: October 2006

AbstractMonoclonal antibodies reactive to distinct subclasses of lymphocytes were used to identify lymphocytes infiltrating tissue obtained from patients with squamous cell carcinoma of the head and neck. The majority of lymphocytes present were T‐cells with very few B‐lymphocytes and natural killer cells present. A variety of patterns of infiltration and relationship of T‐helper to T‐suppressor lymphocytes was noted. Long‐term follow‐up studies will be required to determine the clinical significance of infiltration by different T‐lymphocyte subclasses.
The clinical significance of radionuclide bone and gallium scanning in osteomyelitis of the head and neck
Authors: Noyek Arnold M. , Kirsh Joel C. , Wortzman George , Freeman Jeremy L. , Greyson N. David , Jazrawy Helen , Blair Robin L. , Chapnik Jerry S. 
Published: October 2006

AbstractOsteomyelitis of the head and neck remains a difficult clinical problem both in diagnosis and treatment evaluation. The purpose of this manuscript is to review our clinical experience with 25 cases of osteomyelitis distributed evenly among the temporal bone and skull base, the paranasal sinuses, and the mandible. Radionuclide bone and gallium scan images accurately depicted the biologic activity of the disease process and permitted accurate treatment evaluation and patient monitoring. This work demonstrates the potentials and limitations of radionuclide imaging with bone and gallium scan agents and attempts to define a role for their contemporary use in the management of osteomyelitis of the head and neck.
Past, present, and future applications of the auditory middle latency response
Authors: Musiek Frank E. , Geurkink Nathan A. , Weider Dudley J. , Donnelly Karen 
Published: October 2006

AbstractFor many years (auditory) middle latency response (MLR) reportedly has been an excellent electrophysiological procedure for estimating frequency specific auditory thresholds. Currently the 40 Hz potential, a derivative of the MLR, holds even greater promise for threshold testing. MLR also appears to have potentially valuable applications in the evaluation of functional hearing loss and assessment of higher auditory function. However, MLR is not without controversy. Questions of origin, filtering effects, and its use in pediatric assessment are current issues surrounding applications of MLR. The following article analyzes the values and limitations of MLR within the framework of past, present, and future research and clinical uses.