bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of lacerations and scars
Authors: Farrior Richard T. 
Published: September 2006

AbstractThe purpose of this paper is to review and update the subject of management of scars and lacerations. The surgeon who accepts responsibility for management of soft tissue injuries must be aware of fundamental surgical principles as well as detailed technique. Knowledge of basic anatomy and wound physiology is utilized and applied.Emphasis is placed on management of the total patient. The specialist must accept the role of team captain and establish an order of priority in management and in wound analysis. By having a basic knowledge of wound healing and the lines of favorable contracture, one is better able to prognosticate the eventual healing of the wound after proper management. By being able to predict wound contracture and scar maturation, the patient can be better informed as to what to expect during the period of healing. With lacerations immediate repair is carried out. With scars there is more time for planning and photographic analysis. The contracting forces will by this time have identified themselves and the degree of release of the contracture or camouflage can be determined.Specific wound management emphasizes meticulous closure in layers and the use of skin hooks with the interrupted subcuticular suture. Skin sutures with both the continuous subcuticular suture and interrupted sutures of monofilament nylon using the spring‐loop are described. Emphasis is placed on the preparation of the skin margins with slight beveling of the skin edges and undermining with precise even thickness of the skin especially at the wound margin. For scar revisions a minimum time of six months should elapse, and 12‐18 months is better.Complications include infection, hematoma, wound separation, and rejection of suture materials. Keloids are disciissed briefly, particularly regarding the use of intralesional injection of steroids.Broken line camouflage techniques are discussed with regard to breaking up contracture without lengthening. Lengthening either existing or anticipated contractures is accomplished with Z‐plasty. The multiple Z‐plasty, W‐plasty, and Zig‐Zag plasty are aimed towards creating a less conspicuous scar and creating some diffusion of the forces of contracture. A technique for a “practical Z‐plasty” is described.Both free grafts and skin flaps sometimes must be utilized to fill tissue defects and break up lines of contracture.The materials presented and conclusions drawn are based on 25 years of active emergency room coverage and long term follow‐up of treated patients. It is the responsibility of the physician to act within the first few hours and to take the time necessary for accurate approximation and realignment of both soft tissue and bone injuries. Minimal scarring depends on accurate approximation of skin margins without tension. The need for early meticulous repair, so that unsightly scars and disfigurements may be prevented, cannot be overemphasized.
Dental aspects of maxillofacial injuries
Authors: Keyes Kenneth S. 
Published: September 2006

AbstractThe chief progress of maxillofacial surgery in recent years has been the preservation and the retention of functional tissue. The recent advances in microvascular and reimplantation surgery are examples. Similarly the preservation of the masticatory apparatus is best served by the retention of all viable components. Additional benefits derived from this approach include the facilitation with alignment of the bony fragments, proper occlusion of the teeth and maintenance of the vertical relationship between the upper and lower jaws; in addition to the restoration of appearance and the functions of mastication and speech. Although injuries of the teeth and their supporting structures at first glance may seem to be simple problems, frequently they turn out to be complicated.The most common injury is partial avulsion of the alveolar bone with loss of attached teeth, which may produce a severe defect in the jaw bone. During healing there is additional resorbtion of alveolar bone, which is quite a normal physiologic phenomenon. Therefore, the eventual defect is likely to be more severe yet. For this reason more concern should be shown for these lesser injuries.
Mandibular fractures: A review of 156 consecutive cases
Authors: Bernstein Leslie , Mcclurg F. L. 
Published: September 2006

AbstractThis report deals with a consecutive series of 156 mandibular fractures that were managed during a three‐year period. The age and sex incidence are presented and the causative factors of the trauma are discussed. The fractures are classified according to anatomic site and laterality.The majority of the patients were treated with closed reduction techniques and the reasons for open reduction are tabulated. The results and complications of the treatment are enumerated. A conservative technique is described for open reduction of fracture‐dislocations of the condylar head.
Proboscis lateralis: Case report and embryologic analysis
Authors: Rontal Michael , Duritz Gilbert 
Published: September 2006

AbstractA child with a lateral trunk replacing one side of the external nose is presented with a detailed X‐ray study of the deformed head. In the explanation of the etiology and teratogenesis of this facial anomaly, the modern embryologic development of the head is reviewed and correlated with the findings of this anomaly. It is felt that the lesion responsible for a proboscis lateralis involves the organizer tissue for the naso‐face. As a secondary phenomenon, the development of the maxillary process is retarded and a spectrum of defects, common to many mid‐face derangements, is identified and explained.
Treatment of alopecia in temporal region following rhytidectomy procedures
Authors: Parkes Morey L. , Kamer Frank M. , Bassilios Maurice I. 
Published: September 2006

AbstractSatisfactory treatment of alopecia following rhytidectomy is discussed using the punch graft technique. In spite of the presence of scar tissue following rhytidectomy, this procedure has been quite successful because of the rich blood supply in that area.
Surgical obliteration and silastic arthroplasty of the canine cricoarytenoid joint
Authors: Miller David W. , Spector Gershon J. 
Published: September 2006

AbstractThe effects of surgical trauma on the cricoarytenoid joint were analyzed using canine models. The cricoarytenoid joints of seven dogs were surgically disrupted. In four of the dogs an arthroplasty with silastic implantation was simultaneously performed. The histologic findings and the unsuccessful functional results are presented and discussed.
Audiological and vestibular function tests in hypothyroidism
Authors: Bhatia P. L. , Gupta O. P. , Agrawal M. K. , Mishr S. K. 
Published: September 2006

AbstractA battery of audiological and vestibular function tests have been performed in 72 cases of confirmed hypothyroidism. The severity of hypothyroidism was graded as mild, moderate or severe depending upon serum protein‐bound iodine estimation. The incidence of hearing impairment, tinnitus and vertigo was correlated with the severity of the disease process. The site of lesion causing sensorineural hearing impairment in 25 cases was pinpointed audiologically.
Facial plexiform neurofibroma
Authors: Smith Richard F. , Toomey James M. , Snyder G. Gordon 
Published: September 2006

AbstractFacial plexiform neurofibroma is a relatively rare manifestation of Von Recklinghausen's neurofibromatosis. Two patients with extensive facial tumor involvement are presented, each having undergone wide local resection after multiple previous local excisions had failed to control the tumor and its locally deforming and destructive effects. A discussion of the problem, its etiology, pathogenesis, natural history, prognosis and suggested treatment is presented.
Cholesteatoma surgery: Management of the labyrinthine fistula—A report of 97 cases
Authors: Sheehy James L. , Brackmann Derald E. 
Published: September 2006

AbstractPreoperative, operative and postoperative findings in 97 cases of labyrinthine fistula are presented.Most of these patients had had symptoms of chronic otitis media for 20 years or more and manifested some degree of sensorineural hearing impairment. Two‐thirds had experienced dizziness.The fistula was limited to the lateral semicircular canal in 83 cases and involved the labyrinth more extensively in 14 instances. The intact canal wall technique was used in less than 60% and an open cavity technique in 25% of the cases.Severe or total sensorineural hearing impairment developed postoperatively in 8% of the lateral canal cases and in over half of the extensive fistula cases. Five percent had incapacitating dizziness for up to six months postoperatively.When a labyrinthine fistula is encountered in an only hearing ear we usually recommend a classical modified radical mastoidectomy. In other instances the procedure performed will vary with the status of the opposite ear, the extent of the fistula, the sensorineural function of the involved ear and the size of the mastoid.
Mucoepidermoid carcinoma of the air passages: Report of three cases
Authors: Kaznelson Dan J. , Schindel Jehuda 
Published: September 2006

AbstractA review of the literature on tumors of the small salivary and mucous glands reveals that mucoepidermoid carcinoma of the upper respiratory system is a very rare occurrence. Three such cases are reported in detail, representing 3% of all tumors of small salivary and mucous gland origin recorded by the authors over a period of 20 years. This incidence is high. Follow‐up was from 3 to 12 1/2 years.
Transbronchial drainage of pulmonary abscesses with the flexible fiberoptic bronchoscope
Authors: Rowe Lee D. , Keane William M. , Jafek Bruce W. , Atkins Joseph P. 
Published: September 2006

AbstractFlexible fiberoptic bronchoscopy with multiplanar flouroscopic control is shown to be effective in the transbronchial drainage of pulmonary abscesses. A new technique which permits the intracavitary placement of brush forceps and fine arterial catheters is described. This has facilitated the rapid defervescence of fever and established immediate endobronchial drainage. Seventy percent of patients had complete radiographic closure of their abscess cavities at three months. Clinical findings are presented and the role of aspiration in pathogenesis of pulmonary abscess is stressed.
Surgical pathology of middle ear implants
Authors: Schuknecht Hahold F. , Shi Shan‐Rong 
Published: September 2006

AbstractDuring the past 15 years a series of 25 middle ear implants was removed at the time of revision surgery and prepared for histological study. These revision operations were performed because of failure to control the disease and/or persistent or recurring hearing loss. The ossicular and cortical bone autografts showed similar behavior in that they underwent creeping substitution with vitalized bone in amounts varying from 0% to 83%. There was no correlation to duration of implantation. The four cartilage grafts, on macroscopic evaluation, showed a loss of rigidity. Two of three cartilage autografts showed a high rate of survival of chondrocytes. The two TORP prostheses showed extensive invasion of their porous spaces with foreign body giant cells. One of the latter, implanted for over four years showed fibrous replacement of plastic material. The two polyethylene tubes showed intraluminal foreign body reaction and new bone formation.
Basal lamina breaks in the histogenesis of cholesteatoma
Authors: Chole Richard A. , Tinling Steven P. 
Published: September 2006

AbstractAural cholestentomas may arise in the middle ear by a variety of mechanisms; in some cases it appears that cholesteatomas arise within or behind an intact tympanic membrane. We have observed that microcholesteatomas arise within the tympanic membrane of mongolian gerbils which have keratin accumulations on the lateral surface of the tympanic membrane. An ultrastructural study of the keratinizing epithelium of these animals showed that breaks in the basal lamina allow pseudopods of epithelial cells to extend into the lamina propria and form epithelial cones. The basal lamina later reconstituted itself. Keratinization may occur within these ingrowing cones forming microcholesteatomas. This sequence of events may explain the occurrence of intratympanic cholesteatomas in humans in the absence of invagination or perforation.
Glomus jugulare tumors revisited: A ten‐year statistical follow‐up of 231 cases
Authors: Brown James S. 
Published: September 2006

AbstractGlomus jugulure tumors are rather common in the middle ear and temporal bone. They are usually easy to diagnose and surgically remove.However, there are a comparatively large number of these growths which not only cause extensive local destruction, but can spread distally and even have endocrine manifestations. This group is difficult to diagnose and manage despite recent advances in diagnostic procedures and the advent of skull base surgery. There is a void in the literature of a large series of cases being followed for a long period of time.This paper presents a comprehensive detailed statistical ten‐year follow‐up of 231 glomus jugulare tumors. The results suggest that our present diagnostic procedures often are inadequate in finding small tumors, and our treatment and follow‐up are lacking because these tumors tend to recur often at a late date and in a different form.A comprehensive method of approach of diagnosis and treatment is described to manage all cases of glomus jugulare.
Prostaglandins in squamous cell carcinoma of the head and neck: A preliminary study
Authors: Jung Timothy T. K. , Berlinger Norman T. , Juhn S. K. 
Published: September 2006

AbstractIt has already been demonstrated in human and animal systems that PGE2 is a suppressor signal For many immune functions. These include T‐lymphocyte blastogenesis, natural killer cell activity, and cytolytic T‐lymphocyte activity. These functions are important for destruction of tumor cells. Conceivably, suppression of these functions by excessive PGE2 restricts tumor cell kill, and reversal of suppression by an inhibitor of prostaglandin synthesis such as indomethacin could increase tumor cell kill. The purpose of this study was to determine the kind of prostaglandins (PGs) produced by tissues with squamous cell carcinoma of head and neck and to measure the concentrations of PGE2, 6‐keto‐PGF1a, and thromboxane (Tx) B2 in the tumor tissue and in the corresponding control tissue.Tumor and normal control tissues at the margin of the resection were obtained from surgical specimens. The production of PGs was determined by incubation of tissue homogenates with 14C‐arachidonic acid, by thin layer chromatography, autoradiography, and scintillation counting. Concentrations of PGs were measured by radioimmunoassay. Tumor tissues produced PGD2, E2, TxB2, F2a, and 6‐keto‐F1a, and 15‐, 12‐, and 5‐monohydroxyeicosatetraenoic acid (HETE). Concentrations of PGE2 were four times higher in the tumor tissues compared to those in control tissues. There was no difference between the levels of TxB2 and 6‐keto‐PGF1a in the tumor tissues and those in control tissues.The results of this study will serve as basic information necessary for the potential use of inhibitors of PG‐synthesis in the treatment of head and neck carcinoma.
Arnold‐chiari malformation and the otolaryngologist: Place of magnetic resonance imaging and electronystagmography
Authors: Longridge Neil S. , Mallinson Arthur I. 
Published: September 2006

AbstractThe Arnold‐Chiuri malformation (ACM) is a rare congenital condition in which there is a downward displacement of the cerebellum through the foramen magnum. Patients with this condition frequently develop symptoms of ataxia, imbalance, or vertigo. As a result the patient is often referred to an otolaryngologist. Such a case is reported. A patient presented with imbalance, had downbeating nystagmus on down gaze, and had other eye movement abnormalities recorded on electronystagmography (ENG) which were strongly suggestive of central pathology. Although her computerized tomography (CT) scan was normal, the eye findings and neurological evaluation were strongly suggestive of an ACM. A repeat CT scan with intrathecal metrizamide was abnormal. A definite diagnosis of ACM was confirmed using the new investigative technique of magnetic resonance imaging (MRI).
Cheiloplasty in the treatment of facial paralysis
Authors: Conley John 
Published: September 2006

AbstractThere have been dramatic improvements in the treatment of facial paralysis. These include the successful use of free autogenous nerve grafting, nerve crossover techniques, regional masticatory muscle transposition, and free muscle grafts. The techniques are applied to total, partial, and regional paresis. The bulk of information on rehabilitation of the face has come from clinical empiricism, but basic research in nerve and muscle physiology and attempts at multiple classifications regarding indications and criteria have added to the splender of this drama. One facet that has not been emphasized is the use of cheiloplasty in long‐standing facial paralysis.Long‐standing facial paralysis has both a neural and muscular deficit that cannot be rectified by a single concept or operation. It is essential to regionalize the rehabilitation, implant a kinetic muscular potential, supply some static support and elevation, and address the nonfunctional muscles about the paralyzed lips. This latter concept includes lip shortening and lip‐flap transposition. A coordinated combination of these techniques has the best opportunity of maximizing the improvement in long‐standing facial paralysis associated with severe muscle atrophy.
Medical management of chronic suppurative otitis media without cholesteatoma in children
Authors: Kenna Margaret A. , Bluestone Charles D. , Reilly James S. , Lusk Rodney P. 
Published: September 2006

AbstractTympanomastoid surgery is considered standard management for chronic suppurative otitis media (CSOM) without cholesteatoma, which is unresponsive to ototopical/oral antimicrobial therapy. The following makes this sequence of management less attractive today: 1. potential ototoxicity of ototopical agents; 2. lack of oral antimicrobial agents effective against most common pathogens (e.g., Pseudomonas aeruginosa); 3. frequent occurrence in children who have tympanostomy tubes; and 4. failure of tympanomastoid surgery to eradicate the disease in all cases. We conducted a study in 36 pediatric patients with chronic suppurative otitis media, in which all received parenteral antimicrobial therapy and daily aural toilet (mean duration of treatment = 9.7 days). Thirty‐two patients (89%) had resolution of their infection with medical therapy alone; four children required tympanomastoidectomy. Further investigation is needed to understand the etiology, pathogenesis, and most effective methods of management/prevention of CSOM in children.
A comparison of porp, torp, and incus homograft for ossicular reconstruction in chronic ear surgery
Authors: Silverstein Herbert , Mcdaniel Alan B. , Lichtenstein Richard 
Published: September 2006

AbstractThis report presents the results of 210 cases over a 10‐year period using PORPs, TORPs, and notched incus homografts (NIH), for ossicular reconstruction in chronic ear surgery. There were 192 adults and 18 children. The surgical technique utilized temporalis fascia in an underlay technique with canal skin covering the outer surface of the fascia. Intact canal wall mastoid‐tympanoplasty, as a one‐stage procedure, was used for most cases. Homograft nasal cartilage was placed between the Plasti‐Pore® prosthesis and the graft. Notched incus homografts were prepared prior to surgery and stored in 4% formalin. There were 149 mastoid‐tympanoplasties and 61 tympanoplasties performed. Revsion of our cases was performed in 16.6%.Within 3 months of surgery, 86% of adults, and 44% (8/18) of children had dry, healed ears free of disease. The graft take rate was 96%. In adults, a total of 99 NIH, 50 TORPs, and 43 PORPs were implanted. In adults, the closure of the air‐bone gap to 20 dB or less occurred in 58% using TORPs, 67% using PORPs, 76% using NIH‐Partial replacement, and 20% using NIH‐Total replacement. Excluding the cases that failed for reasons other than conductive hearing loss, the results improved to 69% for TORPs, 77% for PORPs, 77% for NIH‐P, and 27% for NIH‐T. In adults, the extrusion rate was 5.5% for Plasti‐Pore® and 3% for NIH. In children, the extrusion rate was 17% for Plasti‐Pore® prostheses.From this study, it appears that PORPs and TORPs with homograft nasal cartilage are satisfactory prostheses for chronic ear surgery in adults. In children, Plasti‐Pore® prostheses should be avoided unless the ear is healed, aerated, and stable. NIHs are good prostheses when the stapes is intact, but they are inferior to the TORP when placed on the footplate. Also, the NIH requires preparation prior to surgery and may be difficult to obtain. We plan to continue using PORPs and TORPs in chronic ear surgery until a better technique is found, or the complication rate becomes unacceptable.
The disease of emperor frederick III
Authors: Minnigerode Bernhard 
Published: September 2006

AbstractThe disease and death of German Emperor Frederick III has often been described in historical and medical treatises. These were all based on official political and medical reports published during 1887–1888, the time of the disease. The assertion of laryngologists, made while Frederick III was still alive, that the laryngeal carcinoma developed from a specific syphilitic infection is examined here. On the basis of the relevant laryngological literature, as well as less well‐known sources, the probability of this assumption, the particular symptoms, and the fulminant course of the disease are documented. The behavior and the personality of Sir Morell Mackenzie is accordingly seen in a different light than in the past.
Videofluoroscopic and scintigraphic analysis of dysphagia in the head and neck cancer patient
Authors: Humphreys Brian , Mathog Robert , Rosen Robert , Miller Peter , Muz Jaroslaw , Nelson Richard 
Published: September 2006

AbstractThis paper presents two advances in the evaluation of swallowing function which better define the swallowing processes in the head and neck cancer patient. Videofluoroscopy, improved by computer‐assisted image analysis, provides more accurate information regarding oral and pharyngeal movement of structures. Radionuclide scintigraphy, a complementary technique, quantitatesbolus flow (transit times) and the degree of aspiration. Several cases demonstrate the advantages of the methods and their usefulness in evaluating the effects of cancer treatment. The improved techniques also provide opportunity for designing new strategies of medical and surgical rehabilitation.
Treatment of tinnitus with electrical stimulation: An evaluation of the audimax theraband
Authors: Thedinger Bradley S. , Karlsen Elizabeth , Schack Stanley H. 
Published: September 2006

AbstractSeveral treatment forms exist for tinnitus. These multiple treatments speak to the elusive etiology of tinnitus. Many authors have reported tinnitus reduction or elimination with electrical stimulation. This study evaluates a new device (Audimax Theraband•) which delivers inaudible, transdermal, mastoid electrical stimulation. Thirty patients suffering from chronic tinnitus were evaluated in a single‐blind crossover fashion. Since the electrical stimulation is inaudible, each patient served as his or her own control. Patients received actual or placebo stimulation over a period of 2 weeks. They rated their tinnitus levels and the effectiveness of the device before and after using the Theraband. Only 2 subjects out of 30 (7%) obtained true positive results. Side effects were minimal and reversible.