bluuebunny/crossref_metadata_2025_split huggingface dataset:
The bifid UVULA: Is it a marker for an otitis prone child?
Authors: Schwartz Richard H. , Rodriquez William J. , Hayden Gregory F. , Shprintzen Robert J. , Cassidy J. William 
Published: October 2006

AbstractAll children seen by a pediatrician in a suburban practice during an 18‐month interval were examined carefully for the presence of an abnormal uvula. Isolated bifid uvula, without overt cleft palate, was detected among 44 children who had been followed in the practice during the first three years of life. A chart review was performed to determine the frequency of acute otitis media (AOM) and of insertion of tympanostomy tubes among these study patients and among age‐matched controls with normal uvulas. Compared to control children, a slightly higher proportion of children with bifid uvulas had experienced more than one episode of AOM (64% vs. 49%) and more than three episodes of AOM (16% vs. 8%) during the first year of life, but these differences were not statistically significant. By age 3 years, the incidences of AOM in the compared groups were more nearly equal. Insertion of tympanostomy tubes during the first three years of life for persistent middle ear effusion was slightly more common among the bifid uvula group than among the controls (14% vs. 10%), but this difference again was not statistically significant. Children with bifid uvula may be at slightly increased risk of middle ear problems during the first years of life, but the magnitude of this increase, if any, appears small.
Value of ct scan in the diagnosis of temporal bone diseases in children
Authors: Zalzal George H. , Shott Sally R. , Towbin Richard , Cotton Robin T. 
Published: October 2006

AbstractCT scan of the temporal bone has become a frequently ordered test for diagnosis of temporal bone pathology. We retrospectively examined our experience with CT scans of the temporal bones in 124 consecutive children from January 1983 to September 1984 in an attempt to assess its usefulness in diagnosis and treatment of ear disease in children. Patients were divided into six categories according to their pre‐scan diagnosis, (trauma, congenital aural atresia, dizziness, facial nerve paralysis, middle ear disease, congenital sensorineural hearing loss) and CT findings were compared to data found by physical examination, by otologic studies such as audiogram and BSER, by other x‐ray studies and ultimately compared to findings at surgery when applicable.CT was found to be instrumental in diagnosing middle ear disease; gave necessary preoperative information in children with aural atresia; delineated most temporal bone fractures; ruled out gross inflammatory, neoplastic, or traumatic etiologies in dizzy patients and in facial nerve abnormalities; and provided anatomic information about the inner ear in patients with sensorineural hearing loss. In our group of patients with sensorineural hearing loss, a 6.8% incidence of anatomic malformations was found by CT. However, CT had major limitations in stapes and oval window areas, especially in cases of perilymph fistulas. CT use was also limited in children because of the difficulty in achieving projections that require active patient cooperation.
Partial laryngectomy for vocal cord cancer with marked limitation or fixation of the vocal cord
Authors: Biller Hugh F. , Lawson William 
Published: October 2006

AbstractPartial laryngectomy was the procedure utilized to treat 26 patients with either marked limitation of vocal cord motion or fixation. The absolute 24‐month tumor free control rate was 73% (19 of 26). Extended hemilaryngectomy with cricoid resection should be performed if subglottic extension of 5 mm or greater is present. Extended hemilaryngectomy has a greater complication rate than the classical hemilaryngectomy.
Epiglotto‐Aryepiglottopexy: A surgical procedure for severe aspiration
Authors: Laurian N. , Shvili Y. , Zohar Y. 
Published: October 2006

AbstractThe loss of the protective function of the larynx is a severe complication of major ablative procedures in the upper aerodigestive tract and of certain severe neurological disorders. This may result in chronic life‐threatening aspiration. Anterior pharyngotomy was used to perform epiglotto‐aryepiglottopexy in four patients. The aim of this procedure is to close the laryngeal inlet and thus prevent aspiration without permanent loss of speech. In two of the patients, it was necessary to reoperate because of partial detachment of the epiglottis. This was performed successfully using the endoscopic approach. As a result, three patients have no aspiration and one has mild aspiration following epiglotto‐aryepiglottopexy.
Autoimmune thyroiditis: Pathophysiology and relationship to thyroid cancer
Authors: Maceri Dennis R. , Sullivan Michael J. , Mcclatchney Kenneth D. 
Published: October 2006

AbstractAutoimmune thyroiditis (Hashimoto's disease) is one of a myriad of clinical entities associated with the endocrine system. The disease is thought to be a defect in the immune regulatory system. The following report is a study of 112 cases of Hashimoto's thyroiditis treated over a 10‐year period. The incidence of malignancy associated with autoimmune thyroiditis in this study was 6.3%, which correlates well with the incidence of thyroid cancer seen in the general population at autopsy. We have concluded from this study that patients with autoimmune thyroid endocrinopathy are at no greater risk for the development of thyroid malignancy than the general population.A review of the pathophysiology of autoimmune disorders is discussed and recommendations for treatment of patients with Hashimoto's disease is provided.
Nonrecurrent laryngeal nerves and their clinical significance
Authors: Friedman Michael , Toriumi Dean M. , Grybauskas Vytenis , Katz Arthur 
Published: October 2006

AbstractThe anomalous position of a nonrecurrent laryngeal nerve predisposes the nerve to injury during thyroidectomy and to compression by a thyroid mass. We present three cases in which a seemingly benign thyroid mass traumatized a nonrecurrent laryngeal nerve resulting in either vocal cord paralysis or a vague pressure sensation over the larynx. Some of these patients feel as if they need to clear a foreign body and present with a chronic cough. Normally the nerve is protected from thyroid masses as it passes through the tracheoesophageal groove. In all three patients, surgical excision of the thyroid mass and release of the nerve resulted in recovery of the nerve and resolution of the symptoms. We have found that small, benign, or otherwise asymptomatic lesions of the thyroid gland have a greater tendency to cause vocal cord paralysis in patients with nonrecurrent laryngeal nerves. The surgeon must always be aware of the possibility of the presence of a nonrecurrent laryngeal nerve.
Osteomyelitis of the base of the skull
Authors: Chandler James R. , Grobman Lawrence , Quencer Robert , Serafini Aldo 
Published: October 2006

AbstractInfection in the marrow of the temporal, occipital, and sphenoid bones is an uncommon, but increasing occurrence. It is usually secondary to infections beginning in the external auditory canal and is caused almost uniformly by the gram negative Pseudomonas aeruginosa bacteria. Technetium and gallium scintigraphy help in the early detection of such infections while CT scans demonstrate dissolution of bone in well‐developed cases. Headache is the predominant symptom. Dysphagia, hoarseness, and aspiration herald the inevitable march of cranial nerves. We have diagnosed and treated 17 cases of osteomyelitis of the skull base. Although the total mortality rate is 53%, it is now a curable disease. Six of our last 8 patients remain alive, although 1 is still under treatment. Treatment is medical and requires the long‐term concomitant intravenous administration of an aminoglycoside and a broad spectrum semisynthetic penicillin effective against the causative organism.
Intracranial otogenic complications: a persisting problem
Authors: Samuel Julian , Fernandes Carlos M. C. , Steinberg Johannes L. 
Published: October 2006

AbstractThree hundred thirty‐five cases of acute mastoiditis with complications due to extension of infection beyond the mastoid are reported. Two hundred twenty‐four of those presented with intracranial sepsis. Meningitis occurred in 83 cases, brain abscess in 53, extradural abscess in 49 cases, and lateral sinus thrombosis in 39 cases.Intracranial complications are frequently seen in this group of patients with neglected otitis media. The complications occurred frequently in children and young adults (74%) with an overall mortality rate of 14%.Meningitis was the most common complication (37%); brain abscess had the highest mortality rate (36%). The overall mortality rate from intracranial complications was reduced in comparison with previous reported series. This is attributed to antibiotic treatment, the use of CT scan in excluding other intracranial complications, and close cooperation between the otologist and neurosurgeon.
Pathology of surgery after induction chemotherapy: an analysis of resectability and locoregional control
Authors: Norris Charles M. , Fabian Richard L. , Miller Daniel , Clark John R. , Ervin Thomas J. , Fallon Barbara , Tuttle Stephanie A. , Frei Emil 
Published: October 2006

AbstractAt the Dann‐Farber Cancer Institute Head and Neck Cancer Clinic, 114 previously untreated patients with advanced squamous cell carcinoma of the head and neck (17% stage III; 83% stage IV) were managed with induction chemotherapy using cis‐platinum, bleomycin, and methotrexate, followed by definitive extirpative surgery and/or radiation therapy. The present report evaluates this group from a surgical and surgical pathology standpoint. The following aspects are evaluated: 1. predictability of, and conversion to, resectability during induction chemotherapy; 2. ease of surgical technique and intraoperative assessment; 3. patterns of pre‐op and postop risks and complications; 4. gross and histopathologic observations of the extent and character of residual primary and nodal disease, particularly after a response to chemotherapy; 5. patterns of locoregional control or failure related to treatment variables.The issues subsequently addressed include: how does chemotherapy affect the operative candidacy and resectability of proposed surgical patients? Could, or should surgery be eliminated in the management of some patients treated with induction chemotherapy? Can less radical surgery be contemplated in patients significantly “downstaged” by prior chemotherapy treatment? Is increased locoregional or distant metastatic control observed in these patients? What is the role of surgery in the responder to chemotherapy?
Tonsillectomy: A clinical study comparing the effects of local versus general anesthesia
Authors: Mcclairen Willie C. , Strauss Melvin 
Published: October 2006

AbstractThe purpose of tonsillectomy is the complete removal of the palatine tonsils with minimal blood loss while avoiding unnecessary trauma to adjacent tissue. Despite the fact that advances in modern general anesthetic techniques have lessened risks, it has not been clear what specific differences there are when using local versus general anesthesia for tonsillectomy. In order to provide some objective information as to the advantages or disadvantages of performing tonsillectomy using local or general anesthesia, a retrospective analysis was performed on 73 fully evaluable cases of adult tonsillectomy performed in an 8 1/2‐year period. Approximately one half of these were performed using local and one half general anesthesia. Analyses of the data indicated statistically significant differences in the methods. With local anesthesia the operation required less time, produced less intraoperative hemorrhage, and was less costly. However, there was no significant difference in the incidence of postoperative complications or morbidity.
Surgical complications following twice‐a‐day versus once‐a‐day radiation therapy
Authors: Metson Ralph , Freehling Deborah J. , Wang C. C. 
Published: October 2006

AbstractWith increasing numbers of radiotherapists using twice‐a‐day (BID) rather than conventional once‐a‐day (QD) radiation therapy to treat carcinomas of the head and neck, we attempted to determine whether the increased tissue reaction seen with a BID program results in greater morbidity for subsequent surgery. Postoperative complications in 24 patients receiving prior BID irradiation were compared with 37 controls receiving QD treatments. The incidence of major surgical complications for BID and QD groups was equivalent (20.8% and 18.9%, respectively). The incidence of minor complications was almost three times greater for the BID group (37.5% vs. 13.5%). Patients receiving BID radiation therapy required twice as many intraoperative transfusions (2.13 us. 1.11) and five additional days of postoperative hospitalization (23.7 vs. 18.2). These differences are statistically significant with p‐values of <0.5 and <0.1, respectively. We consider this increase in surgical morbidity to be acceptable if BID radiation therapy leads to improved tumor control.
The second Joseph H. Ogura memorial lecture complications of laryngeal surgery: Etiology and prevention
Authors: Waed Paul H. 
Published: October 2006

AbstractConservation, surgery has developed into the fine‐tuned, state‐of‐the‐art procedure during the past century. With success have come the complications of stenosis, edema, infection, granulation tissue, scarring, paralysis of the laryngeal nerves, slough, aspiration, and recurrence of tumor. Some of these problems can be prevented by solid anatomical knowledge and meticulous surgery.
Evaluation of olfactory dysfunction in the connecticut chemosensory clinical research center
Authors: Cain William S. , Goodspeed Ronald B. , Gent Janneane F. , Leonard Gerald 
Published: October 2006

AbstractThe olfactory test administered to patients at the Connecticut Chemosensory Clinical Research Center combines stability of outcome with sensitivity to variables known to affect olfaction (age, sex). The test, which pairs an odor threshold component with an odor identification component, readily resolves differences in function between patients and controls. It reveals differences in the distribution of functioning for various probable causes (nasal/sinus disease, postupper respiratory infection, and head trauma), proves sensitive to improvements in function caused by therapeutic intervention (ethmoidectomy, steroid administration for nasal/sinus disease), and correlates with objective signs of nasal/sinus disease (visual exam, x‐ray). The two components of the test agree well, though the odor identification component seems somewhat more sensitive than the threshold component as currently designed.
The superior laryngeal nerve: Its projection to the dorsal motor nucleus of the vagus in the guinea pig
Authors: Basterra J. , Chumbley C. C. , Dilly P. N. 
Published: October 2006

AbstractThe distribution of neurons in the dorsal motor nucleus of the vagus nerve (DMNV) that innervate the supraglottic and glottic areas of the larynx of the guinea pig have been studied using the horseradish peroxidase (HRP) technique. Following soaking of the superior laryngeal nerve in a solution of HRP, labeled neurons were always located ipsilaterally, at levels between the estria acustica and the caudal end of the inferior olivary nucleus. Characteristically, the neurons were small or medium in size.
Laryngotracheal injury following cricothyroidotomy
Authors: Kuriloff Daniel B. , Setzen Michael , Portnoy William , Gadaleta Dominick 
Published: October 2006

AbstractAirway complications following elective cricothyroidotomy were reviewed in 48 adult cardiothoracic surgery patients. A 52% incidence of airway complications was found and manifested by failed or delayed decannulation, extensive subglottic granulation tissue, stenosis, vocal cord paralysis, and aspiration pneumonia. The most common cause for decannulation difficulty was subglottic stenosis (50%).Several risk factors were specifically identified, including a period of cricothyroid cannulation exceeding 30 days, the presence of diabetes, and advanced age.These findings suggest that airway sequelae following cricothyroidotomy in cardiothoracic surgery patients is higher than previously reported. Indications and risk factors for cricothyroidotomy are discussed.
High‐activity iodine‐125 endocurietherapy for head and neck tumors
Authors: Pradeep Kumar P. , Good Roger R. , Yonkers Anthony J. , Ogren Frederic P. 
Published: October 2006

AbstractInoperable solid tumor recurrence within a surgical bed or within a previously irradiated field usually responds poorly to re‐treatment with conventional external beam irradiation (EXRT) and/or chemotherapy. We present a new, alternative method of re‐treatment used in two patients with recurrent head and neck cancer involving the parotid (adenocarcinoma) and neck nodes (squamous cell carcinoma). These patients were successfully re‐treated with high‐activity 125iodine (I‐125) permanent implantation.
A porcine model for multiple musculocutaneous flaps
Authors: Haughey Bruce H. , Panje William R. 
Published: October 2006

AbstractThe purpose of this study was to develop and describe in detail a reproducible porcine model for musculocutaneous flap study. The model was required to demonstrate the following: 1. consistent, easily identifiable anatomical landmarks for muscles and muscular vascular pedicles; 2. flap survival, consistent with the musculocutaneous perforator arrangement of blood supply; 3. ease of islanded‐or free‐flap formation; 4. arrangement of flaps on each animal, allowing paired studies of control and experimental flaps; and 5. a maximum number of flaps per animal, without undue morbidity or mortality.Pilot dissections were made of the pectoralis, trapezius, latissimus dorai, gracilis, biceps femoris, and tensor fasciae latae muscles and their major vascular pedicles. After establishing the anatomical landmarks, we formed musculocutaneous flaps at each site to verify the above five requirements. A total of 72 muscle/vessel pedicle dissections were performed, incorporating formation of 61 island musculocutaneous flaps. The skin component overlying an islanded muscle block survived in 60 instances, confirming the reliability of the flap model.We concluded that five pairs of musculocutaneous flaps could be fashioned on one pig, using the bilateral control/experimental paradigm if desired. The pectoralis, latissimus dorsi, trapezius, gracilis, and biceps femoris muscles were used. The ventral muscle group (pectoralis, gracilis) was raised in one operating session, and the lateral muscles (trapezius, latissimus dorsi, biceps femoris) were raised in one further session per side. Three new porcine flaps are described—the pectoralis, biceps femoris, and trapezius. Morbidity was confined to mild splinting of the limbs for one day.This is also the first example of the use of ten musculocutaneous island flaps on one pig, and represents an opportunity for performing physiological, pathological, or pharmacological experiments on the musculocutaneous flap.
Speech tracking in the evaluation of a multichannel cochlear prosthesis
Authors: Jenkins Herman , Chmiel Rose , Jerger James 
Published: October 2006

AbstractIndividual speech tracking data were analyzed in relation to other variables in 11 adult users of the Nucleus multichannel cochlear implant. Patients were categorized according to postoperative speech tracking results. The resultant groups could also be differentiated on the basis of postoperative MAC scores, surgeon's rating of overall success, and duration of deafness before implantation. The speech tracking paradigm appears to be a useful technique for the evaluation of performance with a cochlear prosthesis.
Bacteriology of tonsil surface and core in children
Authors: Surow Jason B. , Handler Steven D. , Telian Steven A. , Fleisher Gary R. , Baranak Christine C. 
Published: October 2006

AbstractThe tonsils of 97 children undergoing tonsillectomy were studied to determine the correlation between surface culture swab and culture of tonsillar core. In many cases, pathogenic organisms were found in the tonsil core, despite the fact that surface cultures revealed only normal respiratory flora. The tonsil core cultures showed a high incidence of Hemophilus influenzae and Staphylococcus aureus, which was rarely reflected on surface culture.The study indicates that pharyngeal swab cultures do not reliably reflect the presence of pathogens in the tonsil core. The value of parameters such as history of recurrent bouts of tonsillitis and presence of erythema or cryptic debris on physical examination for predicting the differential bacteriology of the tonsil is studied. The implications for treatment of children with adenotonsillar hypertrophy are discussed.
Fatal and major complications secondary to nasal and sinus surgery
Authors: Maniglia Anthony J. 
Published: October 2006

AbstractThe purpose of this study was to review 40 major or fatal complications secondary to nasal and sinus surgery that were referred to the author for consultation or other reasons. The most frequent complications were intracranial, which occurred in 13 cases, and resulted in four deaths. Blindness occurred in ten patients (two bilaterally). Three other fatalities resulted from internal carotid artery damage. Three patients died of anesthesia‐related problems and one survived malignant hyperthermia. In all, ten patients died as a result of intracranial catastrophe, hemorrhage, or general anesthesia complications. Although some complications are preventable, others may be unavoidable, even in the hands of well‐trained, experienced surgeons.
Preoperative assessment of parotid masses: A comparative evaluation of radiologic techniques to histopathologic diagnosis
Authors: Byrne Maria N. , Gershon J. Gershon , Garvin Charles F. , Gado Mokhtar H. 
Published: October 2006

AbstractA double‐blind, retrospective analysis of 110 sequentially operated parotid masses compared the usefulness of preoperative radiologic evaluation to histopathologic diagnosis. The radiologic assessment included 25 sialograms, 162 computed tomography scans, and 10 nuclear magnetic resonance images.The diagnosis is influenced by the following four parameters of computed tomography: tumor borders, density, homogeneity, and enhancement. Well‐defined borders, a homogeneous appearance, and high density strongly favor the diagnosis of a benign tumor or a low‐grade malignancy (96.7%). Ill‐defined tumor borders, heterogeneity, and high density indicate mainly a high‐grade or recurrent malignancy (68.8%). Ill‐defined borders, a heterogeneous appearance, and mixed density identify a lymphoepithelial lesion, lymphangioma, or sialoadenitis (100%).Sialography is cost effective in the evaluation of lymphoepithelial lesions. Computed tomography sialography offers no advantages over computed tomography with intravenous contrast. High‐resolution computed tomography with intravenous contrast is highly sensitive for tumor detection (97%). Magnetic resonance imaging is complementary or superior to computed tomography (100%).