bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scrofula — the dangerous masquerader
Authors: Levin‐Epstein Allan A. , Lucente Frank E. 
Published: October 2006

AbstractMycobacterial cervical lymphadenitis or scrofula continues to puzzle the clinician. Its propensity for mimicking other diseases delays treatment and increases the risk to the general public and hospital personnel. Historical data, physical findings and laboratory tests are often unreliable, thus delaying diagnosis and treatment. Sixteen patients with scrofula were treated from 1975 to 1980. Most patients were from India, Pakistan, or Latin‐America. Only 3/16 gave a positive history of TB contact, 6/16 had constitutional symptoms, 8/16 had matted nodes, 9/16 had nodes in the posterior triangle, and only 1/16 had a positive chest x‐ray. AFB stain was negative in 9/16 patients; culture was negative in 8/16. Skin testing and histologic analysis were more reliable, with 13/16 and 13/14 positive respectively. Our experience confirms both the importance of attempting excisional biopsy, where feasible, and the increased morbidity associated with incisional biopsy in the scrofula patient. All patients in our series responded well to treatment with combination standard antitubercular medications including isoniazid, ethambutol, pyridoxine and rifampin.
A method of predicting the length of intubation in Trauma‐Induced respiratory insufficiency.
Authors: Kaplan Jory , Weymuller Ernest 
Published: October 2006

AbstractA retrospective study of patients intubated for more than 24 hours was undertaken to assess the possibility of predicting the length of intubation. Patients requiring intubation for injuries secondary to motor vehicle accidents were scored according to a well‐documented grading system which enables a numerical assessment of the severity of injury.There appears to be a significant relationship between this score and the length of intubation. It also appears possible to estimate the duration of intubation within the first 24 hours after injury in this group of patients.This information could provide an objective criterion for the clinician who must choose between prolonged intubation or tracheotomy in the management of severely injured patients.
Modified supraglottic laryngectomy and resection of lesions of the base of tongue
Authors: Weisberger Edward C. , Lingeman Raleigh E. 
Published: October 2006

AbstractExtensive malignant tumors involving the base of tongue and adjacent pharyngeal walls usually require surgical resection combined with radiation therapy and sometimes chemotherapy. Often it is elected to perform a concomitant laryngectomy to prevent chronic aspiration, but not because of tumor extension to the larynx.A new technique allowing preservation of glottic function is described. This involved preservation of the false vocal folds and their surgical closure. The interarytenoid mucosa is preserved. This provides a fistula with a sphincteric function in the interarytenoid area. A permanent tracheostoma is created.This procedure has been used in the treatment of eight patients from April of 1979 to April of 1982. One patient died of sepsis in the early postoperative period. Of the seven evaluable patients, only one experienced significant aspiration postoperatively. All patients achieved adequate phonntion. Four patients developed good speech. The remaining three patients have some speech, but are limited in their articulation because of resection of a significant portion of the oral tongue. Three patients are alive and have developed a recurrence. Two patients are alive with recurrent disease and two patients died of their disease.This procedure appears to allow adequate surgical resection of extensive oropharyngeal neoplasms with preservation of the laryngeal functions of phonation and protection of the lower tracheal‐bronchial tree.
Lateral laryngeal suspension: A new procedure to minimize swallowing disorders following tongue base resection
Authors: Hillel Allen D. , Goode Richard L. 
Published: October 2006

AbstractFourteen patients who underwent composite resections for oropharynx and tongue base cancers had lateral laryngeal suspensions in order to improve postoperative swallowing ability, minimize the surgical defect, and decrease shifting of the mandible after composite resection. Eleven of these patients had significant base of tongue resections (30–90%) and 3 had oropharyngeal resections. Thirteen (93%) were able to eat by mouth, 14 patients (100%) had a normal airway, and 14 (100%) had intelligible speech.
The site and function of the nasal valve
Authors: Haight James S. J. , Cole Philip 
Published: October 2006

AbstractPrevious observers have suggested that the main site of respiratory airflow resistance is localized to the vestibular region of the nose. This resistive segment of the airway was investigated using a “head‐out” body plethysmograph in subjects with anatomically normal noses (a) untreated, (b) congested and (c) decongested. In all three conditions, 2/3 of the total nasal airflow resistance was found within the bony cavum in the vicinity of the pyriform aperture and about 1/3, in the cartilaginous vestibule. As might be expected, caval resistance changed proportionately with the degree of mucosal congestion; but, more surprisingly, vestibular resistance changed similarly. This was due in part to the observed forward expansion of the anterior ends of the inferior turbinates with congestion. EMG recordings in subjects breathing through both nostrils demonstrated a gradation of inspiratory alar dilator muscle activity with increased minute ventilation and with mucosal congestion, and there was no evidence of inspiratory alar collapse. But with elevated ventilation through one nostril only, or when the alar muscles were paralyzed by lidocaine block of the VIIth nerve, alar collapse occurred.These findings are of importance in the management of the congested but anatomically normal nose and in surgery of the nasal tip.
Allergic mucociliary dysfunction
Authors: Wanner Adam 
Published: October 2006

AbstractAllergic rhinitis is typically associated with excessive nasal secretions and morphologic changes of the nasal mucosa; however, an impairment of mucociliary transport, the ultimate expression of mucociliary function, has so far not been clearly demonstrated. Tracheal mucociliary transport rates are decreased in patients with allergic asthma, and inhalation challenge with antigen causes a further impairment that appears to be related to the liberation of chemical mediators, notably slow reacting substance of anaphylaxis. Physiologic studies of mucociliary function in the nose similar to those that have been reported for the lower airways will be required to assess the role of mucociliary dysfunction in allergic rhinitis.
Survival rates in 548 patients with multiple neoplasms of the upper aerodigestive tract
Authors: Gluckman Jack L. , Crissman John D. 
Published: October 2006

AbstractThe high incidence of multiple primary carcinomas occurring in the upper aerodigestive tract is well documented, with the accepted incidence being as high as 20–30%. The full clinical significance of this phenomenon is, however, only now becoming apparent. Herein 548 cases of documented multiple primary neoplasms, presenting initially in the upper aerodigestive tract, are evaluated retrospectively to establish the survival in these patients. The overall 5 year survival rate after diagnosis of the second neoplasm was found to be 22.3% which was significantly lower than a control group.The reasons for this poor survival are considered. These include: 1. the high incidence of second cancers developing in the lung and esophagus which have an extremely poor survival rate; 2. the frequent late diagnosis of the second lesions, with resultant advanced staging, and therefore poor prognosis; 3. inability to institute the appropriate therapy for these lesions due to the effects of previous radical therapy utilized for the first tumor.The clinical implications of this problem are discussed.
Incisions in tympanoplasty: Anatomic considerations and indications
Authors: Farrior Jay B. 
Published: October 2006

AbstractThe endaural, postauricular and transmeatal incisions are the most commonly used surgical approaches for tympanoplasty. Each incision used in tympanoplasty has its own advantages and limitations so that no single approach is the best approach for all tympanic membrane perforations. The incision selected for tympanoplasty should be determined by the location and extent of disease. Forty adult temporal bones were studied to understand the limiting factors for each surgical approach used in tympanoplasty.The external endaural incision has been modified to permit easier visualization of the crescentic endomeatal canal incisions. The anterior external endaural incision allows direct exposure of temporalis fascia, the external meatus, bony canal and perforation involving the posterior tympanic membrane and ossicular chain. The postauricular incision gives direct exposure of the anterior tympanic membrane with preservation of the anterior canal wall skin. The transmeatal approach should be reserved for smaller central perforations with limited risk for squamous ingrowth into the middle ear. In the transmeatal tympanoplasty, the ear canal should permit the use of a speculum large enough to expose the entire perforation.
Head and neck manifestations of gastroesophageal reflux
Authors: Bain Walter M. , Harrington James W. , Thomas Lawrence E. , Schaefer Steven D. 
Published: October 2006

AbstractGastroesophageal reflux (GER) is a common condition with many manifestations which are of interest to the otolaryngologist. Factors predisposing to GER include anatomic abnormalities of the esophagus and pharynx, neurogenic disease and diet induced decreased lower esophageal sphincter pressure. Three interesting cases are reported, including subglottic stenosis which has not previously been thought to be a complication of GER. A literature review of otolaryngologic symptoms, the problems of diagnosis, and a suggested treatment plan are presented.
Treatment of early vocal cord carcinoma: A comparison of apples and apples
Authors: Dickens W. Jackson , Cassisi Nicholas J. , Million Rodney R. , Bova Francis J. 
Published: October 2006

AbstractRadiation therapy, hemilaryngectomy, and even cordectomy will cure a very large percentage of patients with early vocal cord cancer and preserve the voice. However, hemilaryngectomy and cordectomy are conceded by most surgeons to usually produce a poorer voice, compared to radiation therapy, and the operations are restricted to certain anatomical distributions. Those surgeons advocating hemilaryngectomy or cordectomy have compared their results with radiation therapy series which include a proportion of patients with lesions not suitable for voice‐sparing operations. One hundred and thirty‐nine patients with T1–2 carcinoma of the vocal cords with a 2–15 year follow‐up, who were treated initially by radiation therapy, were analyzed in detail by initial extent of disease. Patients were identified whose lesions were anatomically suitable for hemilaryngectomy or cordectomy, and results for these patients compared to operative results. Since the curative results with voice sparing by irradiation were at least equal, and since the quality of the voice is thought to be much better, there is little justification for recommending a major operation except in specific situations. Lesions initially suitable for voice‐sparing operations which subsequently recur after irradiation can usually be treated by a voice‐sparing operation.
Problems with surgical (RLN section) treatment of spastic dysphonia
Authors: Dedo Herbert H. , Izdebski Krzysztof 
Published: October 2006

AbstractFor over a century spastic dysphoria — a disorder of phonation — remained enigmatic and highly resistant to treatment. Recurrent laryngeal nerve surgery provides patients with elimination of their spastic dysphonia symptoms. Maintenance of long‐term surgical results has been a problem in some cases. Management of this problem and of problems in the diagnosis and treatment of patients with spastic dysphonia are discussed. The observations and conclusions are based on almost 300 patients examined and/or treated for this disorder.
Malignant hyperthermia in the head and neck surgery patient: An update and review
Authors: Pollock Richard A. , Britt Beverley A. 
Published: October 2006

AbstractMalignant hyperthermia, a disorder often initiated by exposure to a variety of anesthetic agents, continues to be of major importance to the head and neck surgeon because:1. approximately 40% of all reported reactions have occurred during anesthesia for head and neck surgery;2. the possibility of mortality still exists despite the use of new pharmacologic agents, such as dantrolene; and,3. subtle variations in the intraoperative and postoperative presentation of malignant hyperthermia are being increasingly recognized and treated. The authors briefly tabulate the 280 cases — which have occurred worldwide during otolaryngologic, dental, facial plastic, ophthalmologic and neurosurgical procedures — that are registered with the Department of Anaesthesia, University of Toronto, Canada. A case report depicting a less‐than‐typical reaction is presented. The authors emphasize that early recognition of the clinical features of an ongoing reaction, whether mild or severe, is by far the most important factor in reducing morbidity and mortality of patients who suffer hyperthermic crises while undergoing head and neck surgery.
Behavior of cancer at the anterior commissure of the larynx
Authors: Bagatella Francesco , Bignardi Luigi 
Published: October 2006

AbstractThe present research is concerned with the behavior of the vestibular cancer with respect to the portion of the anterior commissure of the larynx which the authors have named the “x‐space.” The research is based on the analysis of semiseriated vertical sections showing cancers of the vestibule in stages T1 and T2 with histological gradings 1 and 2. The specimens show that, at least in the early stages of the neoplastic spread, the fibrous structures of the x‐space act as a fairly effective barrier to deep diffusion of the tumor. This fact enables the surgeon to estimate macroscopically the lower borders of the tumor growth on the basis of the superficial spread of the cancer in the zone of the x‐space.
Polytomographic evaluation of the clivus and petrous apices: A new view
Authors: De La Cruz Antonio 
Published: October 2006

AbstractThe base of the skull lesions that arise anterior to the porus acusticus, clivus, or from the jugular carotid or hypoglossal canals present difficult surgical access. Plain films, arteriograms, and the conventional AP, lateral, and full base tomograms have often fallen short in allowing an easy understanding of the surgical relationships between these structures.The objectives of this thesis are 1. to present a previously unpublished tomographic view based on the surgical relationships, as encountered by the surgeon, that complement the traditional views and simplify the preoperative assessment of the lesion, 2. to review the literature on the subject, and 3. to present the author's experience with this view in use since 1976.
Qualitative measurement of drugs
Authors: Westerman S. Thomas , Golz Avishay , Komorowski Frank S. , Gilbert Liane M. 
Published: October 2006

AbstractIt has been noted for several years that certain drugs produce abnormal test results in patients who are administered the elcctronystagmograph (ENG) test. Drug specific waveforms, termed drug evoked potentials (DEP), have been identified by using the ENG for alcohol, marijuana, cocaine, tranquilizers, amphetamines, barbiturates, opiates, hallucinogens, caffeine, aminophylline, dopamine, several gases and approximately 75 combinations of drugs (N=821). Tests for double blind diagnosis of drug intake as well as tests for repeatability within the same subject were conducted. Subjects included surgical candidates, healthy volunteers, and neonates (N=248). Drugs tested were ketamine hydrochloride, fentanyl, sodium pentothal, cocaine, dextroamphetamine, sodium seconal, morphine sulfate, phenobarbital, and meperidine. Placebos of dextrose in water and sucrose tablets were also used (N=25).Analysis of the waveforms produced by surgical candidates and healthy volunteers revealed no false negatives or false positives. Analysis of waveforms produced by neonates whose mothers had been administered meperidine demonstrated a diminishing effect over the course of a 3 day period.Results of repeated studies revealed reliability within subject. One subject who was administered dextroamphetamine did not produce a wave consistent with amphetamine with a dosage of 5 mg. He did, however, produce an amphetamine wave when administered 10 mg of dextroamphetamine. These findings suggest a dose related effect, indicating the need for establishment of minimal levels of detection.Results indicate that with refinement and further research, this method could be used for identification of drugs diagnostically.
University of pennsylvania smell identification test: A rapid quantitative olfactory function test for the clinic
Authors: Doty Richard L. , Shaman Paul , Kimmelman Charles P. , Dann Michael S. 
Published: October 2006

AbstractDespite the fact that clinical otolaryngologists are often presented with complaints of olfactory dysfunction, they have limited means to diagnose these problems. A major reason has been the lack of a clinically‐useful and reliable quantitative test of olfactory function. Recent work at our Clinical Research Center has resulted in the development of such a test. This test — the University of Pennsylvania Smell Identification Test (UPSIT) — can be self‐administered and uses microencapsulated odorants which are released by scratching standardized odor‐impregnated test booklets. As indicated in this paper, studies have demonstrated that the UPSIT can identify most malingerers and is sensitive to age, gender, smoking habits, and a wide variety of olfactory disorders. A description of this new test, along with some of its applications, is presented.
Comparative study in tympanoplasties with nitrous oxide anesthesia
Authors: Ramirez‐Camacho Rafael A. , Jimenez Dolores 
Published: October 2006

AbstractA number of intra and postoperative accidents in close cavity surgery when using nitrous oxide have been reported. In order to check the influence of nitrous oxide anesthesia in tympanic surgery, 38 patients were operated on by the usual techniques in middle ear surgery. Half the patients received continuous nitrous oxide inhalation throughout the procedure while, in the remaining cases, the anesthetic gas was suspended 30 minutes before applying the tympanic graft. Audiological differences in both groups, as controlled at 6 and 12 months, were negligible.
Bioactive glass‐ceramics in ear surgery: Animal studies and clinical results
Authors: Reck Ralf 
Published: October 2006

AbstractIn the search for better materials for middle ear reconstruction, ceramics have been suggested as an alternative. The bioactive glass‐ceramic Ceravital8 was made available to us for animal experiments and clinical trials.To test its suitability in ear surgery, 101 ear operations were carried out in 53 rabbits including the reconstruction of 78 posterior auditory canal walls and the insertion of 174 middle ear implants. Parameters studied include the effects of bone paté in inducing new bone growth, the chronological course of bone apposition and remodeling, microscopic examination of mucous membrane growth on the implants and degree of lysis of the implant.In the past two and one half years some 250 ossicular prostheses have been implanted in man for reconstruction of the ossicular chain. A statistical analysis of 119 tympanoplasties after a follow‐up of one and one half years shows no perforations of the tympanic membrane over the implants or rejection of the prosthesis from the middle ear. The audiological results achieved were more favorable with the use of ossicular prostheses made of bioactive glass‐ceramic than those using allogenic ossicular grafts.On the basis of the histologic findings and observed clinical results, the bioactive material Ceravital® is remarkably well suited for reconstruction of the posterior auditory canal wall and for implantation in direct contact with the tympanic membrane.
A prospective study of laryngotracheal sequelae in long‐term intubation
Authors: Whited Robert E. 
Published: October 2006

AbstractA series of 200 patients having endotracheal intubation between 2 and 24 days were studied prospectively. The data was organized into 3 groups as follows: Group I: 2 to 5 days intubation, (50); Group II: 6 to 10 days intubation, (100); and Group III: 11 to 24 days intubation, (50).For the Group I population, the most significant injury is in the posterior commissure of the larynx which in this site leads to acute and chronic sequelae. At these intubation times, cuff site injury has not been prominent.Despite the selection of patients for conversion to tracheotomy in order to prevent complications, there is an increased incidence of significant sequelae in Group II population. A most noticeable trend accompanying the increased incidence is the changing nature of the resultant stenosis to include continuous damage from the posterior glottis through the cervical trachea. These trends become evident in those patients having intubation times greater that 7 days.In Group III population, the increased incidence, as well as the severity of post‐intubation complications become clearly evident. Conversion to tracheotomy before serious organ disruption occurs at these prolonged intubation times is preventative.
Stapedectomy in residency training
Authors: Engel Thomas L. , Schindler Robert A. 
Published: October 2006

AbstractThe number of new patients with otosclerosis seen by the average otolaryngologist has declined over the past several years. As a result, a controversy has arisen regarding the ability to train residents adequately in the technique of stapedectomy. In this regard, we have analyzed 44 consecutive stapedectomies performed by senior residents, under direct faculty supervision, at the University of California, San Francisco. All procedures were total stapedectomies, performed under local anesthesia, utilizing either wire‐vein or wire perichondrium technique. Four of the ears required footplate or promontory drilling. Closure to within 10 dB of the preoperative bone conduction, averaged over the speech frequencies of 500, 1000, and 2000 Hz, was achieved in 75% of ears, and closure to within 20 dB in 93% of ears. In no patient was hearing made worse. While there were no permanent complications, self‐limited problems occurred in 9% of the procedures.Despite a declining caseload of otosclerotic ears in residency programs, it is possible to train residents safely in stapes surgery, given a program of consistent technique and close faculty supervision.