bluuebunny/crossref_metadata_2025_split huggingface dataset:
A targeted problem and its solution: A new method of needle‐electrode placement in the posterior cricoarytenoid muscle for electromyography
Authors: Mu Liancai , Yang Shilin 
Published: October 2006

AbstractIn 1979 the authors developed a new method of needle‐electrode placement in the posterior cricoarytenoid muscle (PCA) for electromyography. The PCA muscle is easily reached by inserting a needle electrode through the cri‐cothyroid membrane at the midline and penetrating the lamina of the cricoid cartilage in the subglottic cavity. Access to the PCA muscle for electrode insertion was best afforded by a percartilaginous approach. This report details the new technique used at our laboratory. To our knowledge, this is the first report of needle‐electrode placement in the PCA muscle by a percartilaginous approach.This new electrode insertion technique has been applied to more than 100 dogs for research purposes and to 1200 patients with laryngeal motor disorders for clinical diagnosis. This is a simple technique requiring the usual skills. Reliable electromyographic recordings have been obtained by this new method. No untoward effects, such as hematoma or infection from repeated placements were observed in approximately 3200 examinations performed to date. It is reasonable to assume that the percartilaginous route for electrode insertion in the PCA muscle is feasible in man.Techniques of electrode placement in the intrinsic laryngeal muscles are reviewed and compared.
Otolaryngologic aspects of lyme disease
Authors: Moscatello Augustine L. , Worden Douglas L. , Nadelman Robert B. , Wormser Gary , Lucente Frank 
Published: October 2006

AbstractLyme disease is a systemic illness caused by the spirochete Borrelia burgdorferi and transmitted by the bite of a tick in the Iocodes ricinus complex. While the illness is often associated with a characteristic rash, erythema migrans, patients may also present with a variety of complaints in the absence of the rash. The otolaryngologist may be called upon to see both groups of patients, with any number of signs and symptoms referable to the head and neck, including headache, neck pain, odynophagia, cranial nerve palsy, head and neck dysesthesia, otalgia, tinnitus, hearing loss, vertigo, temporomandibular pain, lymphad‐enopathy, and dysgeusia. We review our institutional experience with 266 patients with Lyme disease, 75% of whom experienced head and neck symptoms. We also summarize the diagnostic and treatment modalities for this illness.
Congenital cholesteatoma of the middle ear in children: A clinical and histopathological report
Authors: Mcgill Trevor J. , Merchant Saumil , Healy Gerald B. , Friedman Ellen M. 
Published: October 2006

AbstractForty‐one children with congenital cholesteatoma of the middle ear seen from 1978 through 1989 are reviewed. The most common presentation was that of an asymptomatic white mass behind a normal intact tympanic membrane. Computed tomography (CT) scan was useful in documenting extension beyond the mesotympanum. Surgical removal was performed using an extended tympanotomy for lesions in the middle ear and tympanomastoidectomy for those that had extended into attic and mas‐toid air cells. Observation over an average 3.1‐year period indicated that 80% of children were free of disease after initial surgery. Residual disease that required further surgery was present in 20%.The importance of early diagnosis of congenital cholesteatoma is strongly advocated. The prognosis is better when the cholesteatoma is confined to the anterosuperior quadrant of the middle ear. Seventeen patients in this study had such a lesion, and extended tympanotomy allowed removal of an encapsulated closed cholesteatoma with normal postoperative hearing and no residual cholesteatoma. The average age was 2.3 years.Temporal bone histopathological studies of three cases of congenital cholesteatoma demonstrate two distinct pathological types of congenital cholesteatoma. A “closed” keratotic cyst in the anterior mesotympanum, which is easily removed, and an “open” infiltrative type in which there is no containment of the keratotic debris and the cholesteatoma matrix is in direct continuity with middle ear mu‐cosa. Surgical extirpation of the “open” type is difficult and more likely to be associated with residual disease.
Necrotizing soft‐tissue infections in the head and neck: A clinicopathological study
Authors: Tovi Ferit , Fliss Dan M. , Zirkin Howard J. 
Published: October 2006

AbstractThe clinicopathological aspects of 15 patients with necrotizing soft‐tissue infections in the head and neck are reviewed. Our relatively large series suggests that the disease occurs more frequently than described in the literature.Histological studies showed that tissue superficial and deep to the fascia is frequently involved with the infectious inflammatory process, even in early stages of the disease. These pathologic changes were also found in healthy‐appearing tissues at the periphery of the lesions.The early recognition of the disease and the prompt and aggressive surgical and medical therapeutic approach have resulted in far lower mortality rates (7%) than those reported in the literature. Frozen‐section examination contributed to the maximal eradication of the pathologic process. This successful outcome was achieved in spite of the adverse associated clinical conditions, such as old age, debilitating disease, or complications, observed in half of the patients.
Antibody response against the epstein‐barr virus‐coded nuclear antigen2 (EBNA2) in nasopharyngeal carcinoma
Authors: Chatani Masashi , Teshima Teruki , Inoue Toshihiko , Yoshino Kunitoshi , Ikegami Nobuko , Shimakage Misuzu , Hirai Kanji 
Published: October 2006

AbstractSpecific antibody responses against the Epstein‐Barr virus‐coded nuclear antigen2 (EBNA2) were evaluated. Thirty‐five sera from pretreatment patients of nasopharyngeal carcinoma (NPC) and 12 from healthy adults were tested. Although the anti‐EBNA2 response did not show any correlation with T stage, overall stage, or histopathology, it showed a correlation with the N stage of the disease. In a se‐rological follow‐up study, 17 (85%) of 20 patients showed a correlation on the change of antibody levels to EBNA2 and clinical progression. This suggests that EBNA2 serology might represent a useful marker relative to tumor status.
Double‐blind controlled study of botulinum toxin in adductor spasmodic dysphonia
Authors: Truong Daniel D. , Rontal Michael , Rolnick Michael , Aronson Arnold E. , Mistura Kathy 
Published: October 2006

AbstractThe treatment of adductor spasmodic dysphonia using botulinum toxin A was conducted in 13 patients as a double‐blind, placebo‐controlled study. Patients were diagnosed independently by an interdisciplinary team consisting of speech pathologists, an otolaryngol‐ogist, and a neurologist. The toxin or saline was injected into each thyroarytenoid muscle under electro‐myographic and laryngoscopic guidance. Botulinum toxin A markedly reduced perturbation, decreased fundamental frequency range, and improved the spectrographic characteristics of the voice. Fundamental frequency and phonation time remained unchanged. Patients injected with botulinum toxin A noticed significant improvement in their voices in comparison with the placebo‐treated group. Excessive breathiness of the voice occurred in two patients, and mild bleeding in one patient in the botulinum toxin A‐treated group. Injection with saline resulted in edema of the vocal cord in one patient. Botulinum toxin A proved to be an effective and safe treatment of adductor spasmodic dysphonia.
Nasopharyngeal carcinoma treated at the finsen institute, Copenhagen 1965‐1985: Survival and some prognostic factors
Authors: Bentzen Jens K. D. , Ockelmann Hans H. , Albeck Henrik , Olsen Jens , Hansen Hanne S. 
Published: October 2006

AbstractClinical data from 218 patients consecutively treated for nasopharyngeal carcinoma at the Finsen Institute in Copenhagen during the period 1965 through 1985 have been analyzed for factors of prognostic importance. Of the 218 patients, 47 were Greenland Inuit eskimos and 169 were white Danish. The 5‐year crude survival for the entire group of patients was 30%.The two groups of patients differed with respect to the importance of different prognostic factors. Keratinizing tumors were only present in the Danish population. These patients had a highly significant worse outcome than the rest of the Danish (P<0.00001). Age, stage, and T classification were important prognostic factors in the Danish population, but not in the Inuit population.
Transient retrocochlear low‐frequency sensorineural hearing loss: A new clinical entity
Authors: Fukaya Takashi , Nomura Yasuya , Fukushima Takanori 
Published: October 2006

AbstractSensorineural hearing loss (SNHL) of varying types and extent developed in a number of the 963 patients who underwent microvascular decompression for hemifacial spasm. Fourteen of the patients with hearing loss had transient low‐frequency SNHL. Low‐frequency SNHL is seldom noted in patients with retrocochlear hearing loss, but five of these patients had Homer's syndrome or bulbar palsy. The results of Békésy audiometry, auditory brainstem response, and electrocochleography in the patients were also suggestive of brainstem pathology. Surgical records revealed that all of them had excessively short perforating arteries surrounding the entry zone of nerves VII and VIII, so that they had to be stretched during surgery. Occlusion of perforating arteries is suspected to have caused lateral brainstem infarction around the entry zone of nerves VII and VIII, and resulted in low‐frequency SNHL.
The measurement and manipulation of intralabyrinthine pressure in experimental endolymphatic hydrops
Authors: Andrews James C. , Bohmer Andreas , Hoffman Larry F. 
Published: October 2006

AbstractThree to four months after unilateral surgical ablation of the endolymphatic duct and sac, endolymphatic and perilymphatic pressures were measured in both the normal and hydropic ears of 11 guinea pigs. In normal ears, endolymphatic pressure always approximated perilymphatic pressure. Endolymphatic pressure exceeded perilymphatic pressure in all ears with hydrops, except one in which these pressures were equal. The effect of postural inversion on inner ear pressures were studied in both normal and hydropic inner ears. Normal ears showed endolymphatic and perilymphatic pressure to rise equally during this maneuver. In hydropic ears, the difference between endolymphatic and perilymphatic pressure was notably reduced from measurements obtained in the prone position. This study indicates that an alteration in pressure regulation within the inner ear may be important in the pathogenesis and manifestation of experimental endolymphatic hydrops in the guinea pig. Physiologic mechanisms and clinical implications of these results are described.
Primary mandibular reconstruction: Analysis of 64 cases and evaluation of interface radiation dosimetry on bridging plates
Authors: Gullane Patrick J. 
Published: October 2006

AbstractThe combination of a myocutaneous flap or free cutaneous tissue transfer with a three‐dimensional bendable reconstruction plate either of stainless steel or titanium has provided very satisfactory results in primary restoration of mandibular defects following surgical resections in irradiated patients or in those who require postoperative radiotherapy. Sixty‐four cases have been treated and evaluated pro‐spectively using this technique. Fifty‐three of the patients had the soft‐tissue defect restored with a myocutaneous flap, 8 had a free cutaneous tissue flap, 2 were reconstructed with tongue flaps, and 1 closed primarily. The stainless steel plate of the A.O. type was used in 53 cases and the titanium plate system and hollow screws in the other 11 cases. A success rate of 78.9% was found with a median follow‐up of 384 days. Thirty of the 64 cases had preoperative irradiation and 15 were treated postoperatively. A plate failure rate of 23% was encountered in those treated with preoperative irradiation and in 20% with those having postoperative irradiation. Forty‐nine of the 64 patients or 76.5% experienced no perioperative complications. Five or 7.8% of the complications were minor. Ten patients or 15.6% experienced a major complication with one death due to a myocardial infarct. A radiation dosimetric model was employed using both stainless steel and titanium. The results from this study showed that, when using a parallel pair of beams, an excess dose of irradiation for the lowest energy cobalt‐60 is 13%, for 6 mV it is 15%, and for 18 mV it is 20%. The excess tissue dose, both for stainless steel and titanium plates, extends for about 0.2 mm for cobalt‐60, 1.1 mm at 6 mV, and for 25 mm at 18 mV. Patients with plates, therefore, can be treated safely with postoperative irradiation using either cobalt‐60 or 6‐mV energy.
Management of the internal carotid artery during carotid body tumor surgery
Authors: Anand Vinod K. , Alemar Gilberto O. , Sanders Tammy S. 
Published: October 2006

AbstractPatients with carotid body tumors require accurate preoperative assessment of vessel involvement and the probable impact of interrupting blood flow through the internal carotid artery. Recent developments in imaging, methods of measuring cerebral blood flow, balloon occlusion testing, and techniques to maintain vascular flow when a graft is required have improved the surgeon's ability to completely resect these tumors with reduced complications. We discuss these methods with respect to our review of 20 carotid body tumors in 18 patients. Twenty‐five percent of patients were misdiagnosed, and in four patients injury to the vessel wall required appropriate surgical intervention.
Insulin‐dependent diabetic microangiopathy in the inner ear
Authors: Smith Timothy L. , Raynor Eileen , Prazma Jiri , Buenting John E. , Pillsbury Harold C. 
Published: October 2006

AbstractThickening of the basement membrane in capillaries is implicated in the microangiopathic complications of diabetes mellitus. This study was designed to evaluate microangiopathic changes of the inner ear associated with insulin‐dependent diabetes mellitus (IDDM) and concurrent moderate‐intensity noise exposure.Male Sprague‐Dawley rats were injected with streptozotocin (65 mg/kg) to induce IDDM. Half of the control and diabetic animals were exposed to chronic noise of 95 dB over the 6‐month study period. Photomicrographs of the capillaries in the stria vascularis were obtained by transmission electron microscopy, and basement‐membrane thickness was measured with an image processing system.This study quantitatively demonstrates basement‐membrane thickening consistent with diabetic microangiopathy in the inner ear of IDDM rats. Noise exposure did not significantly change basement‐membrane thickness in either diabetic or control animals.
Detection of metastases from head and neck cancers
Authors: Troell Robert J. , Terris David J. 
Published: October 2006

AbstractBefore treatment for head and neck malignancies is begun, a search for distant metastases (DM) is performed. The first objective of this review was to determine the accuracy of liver function tests (LFT), alkaline phosphatase (AP) tests, and chest radiographs (CXR) in detection of DM. Second, an effort was made to identify tumor characteristics which are associated with a higher incidence of DM and therefore justify the use of more precise screening tools.An analysis of 97 patients with noncutaneous squamous cell carcinomas presenting to the Stanford Head and Neck Tumor Board in 1991 revealed 17 DM in 14 patients. There were 10 pulmonary metastases, 5 bone metastases, and 2 hepatic metastases. CXR had a sensitivity of 50% and a specificity of 94% for detection of pulmonary DM. AP tests showed a sensitivity of 20% and a specificity of 98% for detection of bone DM. LFT had a sensitivity of 50% and an 81% specificity for demonstration of hepatic DM.A separate analysis of 79 patients with known DM from two hospitals showed the incidence of DM to be increased in patients who had tumors of advanced stage, advanced T status, and poor histologic differentiation and to also be increased in the presence of local‐regional recurrence. There was little association of DM with N status.The sensitivity of CXR and laboratory tests, which are currently used in evaluation for DM at most cancer centers, is disappointing; these tests should be viewed as gross screening examinations. We recommend a chest computed tomography scan in the event of an abnormal CXR, a bone scan in the event of an elevated AP, and either an ultrasound or computed tomography/magnetic resonance imaging scan of the liver when elevated LFT levels are present, depending on tumor stage and differentiation.
Management of thyroid nodules during pregnancy
Authors: Doherty Carolyn M. , Shindo Maisie L. , Rice Dale H. , Montero Martin , Mestman Jorge H. 
Published: October 2006

AbstractGuidelines for the management of thyroid nodules discovered during pregnancy have not yet been established. The authors reviewed the records of 23 patients with thyroid nodules that were first detected during pregnancy. These patients were divided into three groups according to how they were managed. Seven patients who presented early in pregnancy had their work‐up completed during pregnancy, 11 patients underwent biopsy after delivery, and 5 patients were managed with observation alone. The incidence of malignancy in the series was 39%. Four patients underwent surgery during pregnancy, and 7 patients were operated on in the postpartum period. No fetal morbidity or mortality occurred.The authors recommend that fine‐needle aspiration be performed in patients who present before 20 weeks of gestation with rapidly enlarging thyroid nodules, nodules associated with palpable cervical adenopathy, solid nodules larger than 2 cm, or cystic nodules larger than 4 cm. Growth of a nodule while a patient is receiving thyroid hormone suppression therapy is highly suspicious for malignancy; in this situation, consideration should be given to performing biopsy later in gestation.
Quantitative measures of laryngeal function following teflon® injection or thyroplasty type I
Authors: D'Antonio Linda L. , Wigley Terry L. , Zimmerman Grenith J. 
Published: October 2006

AbstractLaryngeal/voice function was evaluated in six patients with unilateral true vocal fold paralysis following treatment with Teflon® injection (TEF) compared to six patients treated with thyroplasty type I (THY). Auditory perceptual, aerodynamic, and endoscopic assessments were conducted. Three judges rated nine voice characteristics. Aerodynamic measures included estimated subglottal pressure, airflow, and laryngeal resistance. Two judges rated laryngeal characteristics from flexible fiberoptic assessment. The THY group had significantly better voice quality and better quantitative aerodynamic findings compared to the TEF group. The TEF group also was more likely to have an irregular vocal fold edge, an irregular glottal closure pattern, a higher occurrence of hyperfunction and hypertrophy of the false vocal folds, edema, and erythema of the paralyzed folds. Results suggest that THY was associated with more favorable measures of laryngeal/voice function than TEF. It is likely that the poorer perceptual, aerodynamic, and endoscopic findings associated with TEF injection may be due to violation of the true vocal fold cover, particularly increased true vocal fold mass and stiffness.
Posterior semicircular canal occlusion for benign paroxysmal positional vertigo—CO2laser‐assisted technique: Preliminary results
Authors: Kartush Jack M. , Sargent Eric W. 
Published: October 2006

AbstractBenign paroxysmal positional vertigo (BPPV) is a common vestibular end‐organ disorder that in the majority of patients resolves with conservative management. In the occasional patient who has unremitting BPPV despite conservative treatment, posterior semicircular canal occlusion (PCO) may be effective in eliminating symptoms. In an attempt to minimize the risk of hearing loss, a modified procedure was developed that uses the CO2laser to shrink the membranous vestibular posterior semicircular canal prior to mechanically plugging the canal. Preliminary results of this CO2laser‐assisted occlusion technique used in four patients are presented.
Acoustic rhinometry in the evaluation of nasal obstruction
Authors: Roithmann Renato , Cole Philip , Chapnik Jerry , Shpirer Isaac , Hoffstein Victor , Zamel Noe 
Published: October 2006

AbstractAcoustic rhinometry (AR) is a recently developed objective technique for assessment of geometry of the nasal cavity. The technique is based on the analysis of sound waves reflected from the nasal cavities. It measures cross‐sectional areas and nasal volume (NV). To obtain dependable assessments of nasal resistance by rhinomanometry or cross‐sectional area measurements by AR, it is essential that the structural relations of the compliant vestibular region remain undisturbed by the measuring apparatus. The use of nozzles in making these measurements carries a great risk of direct distortion of the nasal valve. We used a nasal adapter that does not invade the nasal cavity and a chin support that stabilizes the head. In 51 healthy nasal cavities, the average minimum cross‐sectional area (MCA) was 0.62 cm2 at 2.35 cm from the nostril and 0.67 cm2 at 2 cm from the nostril, respectively, before and after topical decongestion of the nasal mucosa. The MCA and NV findings in this group were significantly higher than MCA and NV (P<0.001) in people with structural or mucosal abnormalities before mucosal decongestion. After mucosal decongestion, the MCA and NV were significantly higher in healthy nasal cavities than in nasal cavities with structural abnormalities (P<0.001) but were not higher than nasal cavities with mucosal abnormalities (MCA, P = 0.05; NV, P = 0.06). A nozzle was applied in 20 healthy nasal cavities after mucosal decongestion, and a significantly higher MCA was found compared to measurements made with the nasal adapter (P = 0.02). We conclude that the nasal adapter, which does not invade the nasal cavities, avoids the distortion of the nasal valve and gives more accurate results.
Inverted papilloma: A report of 112 cases
Authors: Lawson William , Ho Bryan T. , Shaari Christopher M. , Biller Hugh F. 
Published: October 2006

AbstractInverted papilloma is a benign sinonasal tumor which is locally aggressive and has a significant malignant potential. This report updates the experience of the two senior authors, who have treated 112 patients with inverted papilloma at the Mount Sinai Medical Center over a 20‐year period.As clinical examination often underestimates tumor extent, preoperative radiographic assessment is of paramount importance in guiding selection of surgical therapy. Complete en bloc excision via lateral rhinotomy and medial maxillectomy was the method of treatment in the majority of patients (84%). In selected patients with limited disease, or in patients who refused en bloc excision, conservative therapy employing intranasal or transantral ethmoidectomy was performed. The recurrence rates for the two groups were 14% and 20%, respectively. Recurrent disease developed throughout the paranasal sinuses, with the maxillary antrum and ethmoid labyrinth constituting the major sites. In two patients presenting with anterior skull base erosion, craniofacial resection was undertaken to eradicate disease. The latter cases underscore the aggressive nature of the tumor if left untreated. The overall rate of squamous carcinoma in this series was 5%.Given the predilection for local recurrence, multicentricity, and the possibility of malignancy, the authors continue to recommend lateral rhinotomy and medial maxillectomy as the standard therapy for the majority of cases. Management principles as well as a review of the literature are discussed.