bluuebunny/crossref_metadata_2025_split huggingface dataset:
Otitis media with effusion and chronic upper respiratory tract infection in children: A randomized, placebo‐controlled clinical study
Authors: Otten Floris W. A. , Grote Jan J. 
Published: October 2006

AbstractThis study was performed to investigate the course of spontaneous recovery from otitis media with effusion in children with chronic rhinosinusitis treated in various ways. One hundred forty‐one children between 3 and 10 years of age were selected for the presence of chronic rhino‐sinusitis and unilateral or bilateral otitis media with effusion.The children were assigned at random to one of four treatment groups, i.e., placebo, amoxicillin combined with xylometazoline hydrochloride nose drops, maxillary sinus drainage, or a combination of the latter two forms of therapy. The follow‐up period was 6 months. Drainage of the maxillary sinus had no effect on either the recovery of the chronic upper respiratory tract infection or otitis media with effusion. Amoxicillin combined with xylometazoline nose drops had no significant effect on recovery from the upper respiratory tract infection, but did have a small but significant effect on recovery from otitis media with effusion. However, the general tendency of the upper respiratory tract and ears to recover was poor. Persistence of the chronic upper respiratory tract infection during the follow‐up period proved to be a negative prognostic factor with respect to cure of otitis media with effusion.Children with chronic rhinosinusitis as defined in this study appear to have a high risk of developing chronic otitis media with effusion. The results of the study are discussed.
Nasal antral windows in children: A retrospective study
Authors: Muntz Harlan R. , Lusk Rodney P. 
Published: October 2006

AbstractA retrospective study of 39 patients with 46 sets of bilateral nasal antral windows was undertaken to assess the effect of this procedure on chronic sinusitis in children. All patients had symptoms of sinusitis for at least 3 months with plain radiographic documentation of maxillary sinus disease. Only medical failures were surgical candidates. Forty percent of the patients were improved at 1 month, but the success rate at 6 months decreased to 27%. It was necessary to repeat the nasal antral window procedure because of recurrent or persistent sinusitis in 7 of 39 patients. An additional 11 patients required endoscopic ethmoidectomy and maxillary antrostomy. Based on this experience, the nasal antral window procedure does not appear to be effective in treating chronic sinusitis in children.
Endoscopic sinus surgery in children with chronic sinusitis: A pilot study
Authors: Lusk Rodney P. , Muntz Harlan R. 
Published: October 2006

AbstractThis pilot study assessed the safety and preliminary data on the efficacy of endoscopic ethmoidectomy in children with chronic sinusitis. A total of 168 patients were evaluated for chronic sinusitis, and 31 were deemed appropriate candidates for ethmoidectomy. All patients were medical management failures. Twenty‐six percent of the patients had asthma, 23% had some immune deficiency, 23% had allergies, and 2 patients (1%) had cystic fibrosis. All patients were followed for at least 1 year postoperatively. The only surgical complication was minor middle meatal scarring that developed in two patients. Overall, 71% of the patients were considered normal by their parents 1 year postoperatively. Of the 24 patients who did not have an underlying systemic disease (immune deficiency or cystic fibrosis) postoperatively, 80% were considered normal by their parents, 12% were improved but continued to have some symptoms, and 8% had unsatisfactory results. Seven children with underlying systemic disease had to undergo revision ethmoidectomy for persistent symptoms.
Curvularia/Drechslera sinusitis
Authors: Killingsworth Stephen M. , Wetmore Stephen J. 
Published: October 2006

AbstractSinusitis due to unusual fungal pathogens is thought to occur primarily in immunocompromised individuals. However, the fungi Curvularia, Drechslera, and others produce sinusitis in healthy young adults. The signs and symptoms produced by these organisms are usually considered to be complications of sinusitis. Of the three cases that we report, two manifested decreased visual acuity, and the third presented with acute onset of seizures. Computed tomography scans were helpful in delineating the extent of disease and in following the results of therapy. Aggressive surgical treatment is necessary; indeed, two of our cases required a second operation to eradicate all disease. If histopathology shows tissue invasion by the fungus, intravenous am‐photericin B is recommended. Fungal cultures and smears should be obtained when healthy patients present with complications of sinusitis.
Benign lesions of the larynx: Should the laser be used?
Authors: Shapshay Stanley M. , Rebeiz Elie E. , Bohigian R. Kirk , Hybels Roger L. 
Published: October 2006

AbstractThe use of the carbon dioxide (CO2) laser in the treatment of patients with benign laryngeal lesions, excluding respiratory papillomatosis, has been questioned because of potential adverse thermal effects on surrounding tissue. We question whether wound healing and subsequent quality of voice would be better if the surgeon used the “cold technique” with microlaryngeal instruments. Since the advent, in 1987, of a small‐spot (0.3 mm) CO2 laser micromanipula‐tor and more precise microlaryngeal instruments, we have redefined our use of the CO2 laser for benign laryngeal lesions. Over the past 4 years, in a series of 68 consecutive patients with vocal cord nodules, polyps, polypoid changes, or granulomas, the CO2 laser was useful for mucosal micro‐flap dissection techniques and for vascular lesions. Smaller pedunculated lesions, such as vocal cord nodules, were more efficiently removed with the new microlaryngeal instrumentation. The combined selective use of a microspot CO2 laser at low‐power settings (1 to 3 W), with 0.1‐second pulses, and with precise microlaryngeal instruments will give the best results.
The nasogastric tube syndrome
Authors: Sofferman Robert A. , Haisch Carl E. , Kirchner John A. , Hardin Nicholas J. 
Published: October 2006

AbstractThe nasogastric tube can produce sudden, life‐threatening bilateral vocal cord paralysis and is often an unrecognized cause of this clinical entity. The pathophysiologic mechanism is thought to be paresis of the posterior cri‐coarytenoid muscles secondary to ulceration and infection over the posterior lamina of the cricoid. Since our initial report of this entity in 1981, several cases have been photo‐documented. Study of whole organ sections of an involved larynx have demonstrated the histopathology. Diabetic renal transplant patients appear to be particularly susceptible to the condition, due to prolonged gastroparesis and requirement for nasogastric tube drainage. Esophagoscopy should be performed promptly in these patients when pha‐ryngodynia, hoarseness, or evolving stridor present in the postoperative period.
Embryology of the facial nerve and its clinical applications
Authors: Sataloff Robert Thayer 
Published: October 2006

AbstractAlthough many studies have investigated facial nerve development, most have been limited by available specimens and have not provided a comprehensive description of the development of this important structure. Even the best and most comprehensive articles on this subject have not systematically integrated the descriptions of facial nerve embryology with a summary of the development of other otologic structures. This study describes the parallel development of the facial nerve and ear, emphasizing practical applications for the otologic surgeon. The validity of these predictions has been tested through surgical procedures on patients with malformed ears.
Familial vocal cord dysfunction associated with digital anomalies
Authors: Hawkins Donald B. , Liu‐Shindo Maisie , Kahlstrom Emily J. , Maclaughlin Eithne F. 
Published: October 2006

AbstractFamilial vocal cord dysfunction is a rare condition that has been reported in only a few instances. This is a report of identical male twins, both of whom had congenital bilateral abductor vocal cord paresis associated with finger deformities. The vocal cord paresis progressed to paralysis that required tracheotomy, then returned to a slowly resolving paresis during which the vocal cords had incoordinated motion generally known as synkinesis. Another male sibling and the mother had a history of stridor during infancy and finger deformities. Several other relatives had digital abnormalities, and an infant first cousin with finger abnormalities required a tracheotomy for vocal cord paralysis.
Long‐term results with a simple surgical treatment of bilateral vocal cord paralysis
Authors: Geterud Ake , Ejnell Hasse , Stenborg Rune , Bake Björn 
Published: October 2006

AbstractSince 1979, we have treated patients suffering from bilateral vocal cord paralysis with laterofixation of one vocal cord, a simple and comparatively atraumatic method. To evaluate the long‐term results of this method of laterofixation, 11 consecutive patients were examined at least 5 years postoperatively regarding breathing capacity, voice function, and swallowing ability. Breathing capacity was assessed by determination of orolaryngeal (upper) airway resistance and spirometry. Voice function was judged by two listening panels. Swallowing ability was studied by barium contrast radiography. Postoperative improvement of breathing capacity was, in most cases, found to be long lasting. Furthermore, there was no deterioration of voice function, nor were there aspiration problems during the postoperative follow‐up period. We suggest this method of laterofixation as the treatment of choice in patients suffering from breathing difficulties due to bilateral vocal cord paralysis.
Auditory‐evoked responses in benign intracranial hypertension syndrome
Authors: Sismanis Aristides , Callari Richard H. , Slomka William S. , Butts Frank M. 
Published: October 2006

AbstractIn this study, auditory brainstem‐evoked responses were conducted on 28 patients with otologic symptoms (pulsatile tinnitus, hearing loss, aural fullness) secondary to benign intracranial hypertension syndrome. Abnormalities consisting mainly of prolonged interpeak latencies were detected in one third of these patients. It is speculated that the pathophysiologic mechanisms responsible for these auditory brainstem‐evoked abnormalities are stretching‐compression of the cochlear nerve and brainstem caused by the intracranial hypertension and/or primary edema of the same structures due to the benign intracranial hypertension syndrome itself. Normalization or improvement was noticed in the majority of the patients after management. Since the number of patients in this study is small, it is felt that the diagnostic and prognostic value of this test needs further evaluation.
Angioedema from angiotensin converting enzyme inhibitors: A cause of upper airway obstruction
Authors: Gannon Timothy H. , Eby Thomas L. 
Published: October 2006

AbstractAngiotensin‐converting enzyme (ACE) inhibitors have several side effects of concern to the otolaryngologist. Angioedema is a rare, but potentially lethal adverse effect when associated with upper airway obstruction. Four cases of ACE‐inhibitor‐induced angioedema, three with significant upper airway obstruction, are reported.Angioedema secondary to ACE inhibition appears to be mechanism based. The probable link is the potentiation of bradykinin, which results in vasodilation, increased vascular permeability, and angioedema. Since angioedema can progress to upper airway obstruction, otolaryngologists must be aware of this association. The differential diagnosis and treatment of this adverse effect is discussed, as well as a review of ACE inhibitors and other causes of angioedema.
Intraoral‐extramaxillary sinus approach for ligation of the maxillary artery: An anatomic study with clinical correlates
Authors: Stepnick David W. , Maniglia Anthony J. , Luke Bold E. , Victor Maniglia J. 
Published: October 2006

AbstractSurgical control of severe epistaxis is usually reserved for cases refractory to more conservative techniques. We present our experience with intraoral ligation of the maxillary artery as it courses through the buccal fat pad before it enters the pterygopalatine fossa and branches posterior to the maxilla. This technique has been found useful in the control of nasal hemorrhage as well as an adjunct to other surgical procedures, such as removal of benign and malignant neoplasms involving the maxilla and paranasal sinuses. This technique was used for ligation of the maxillary artery in 20 patients.The artery was readily identified in some cases, but required more extensive dissection in others; therefore, an anatomic study in 18 preserved and fresh cadaver specimens was undertaken to investigate the variability of the maxillary artery in the region of the buccal fat pad. There appeared to be significant variation in the distance from the buccal mucosal incision site, as well as variation in the relationship to the pterygoid muscles. This relationship to the pterygoids explains the occasional difficulty in locating the artery for ligation.This technique represents a reasonable alternative to the more traditional transantral approach to ligation of the maxillary artery, as long as the surgeon understands the anatomy of the region, its variations, and where the artery may be located if not immediately apparent. No major complications have been experienced.
The efficacy of brainstem auditory evoked potentials in acoustic tumor surgery
Authors: Kveton John F. 
Published: October 2006

AbstractAs the identification of patients with small acoustic neuromas and salvageable hearing increases, intraoperative auditory nerve monitoring has been used increasingly in an attempt to improve the hearing preservation rate. Far‐field recordings obtained by brainstem auditory evoked potentials (BAEP), at times enhanced by electrocochleography, have become a standard method of intraoperative auditory nerve assessment. To evaluate the usefulness of this monitoring technique, the hearing preservation results of a series of unmonitored acoustic tumor removals were compared to a series of patients monitored via the standard brainstem auditory evoked potentials. With comparable average tumor sizes, 4 of 7 unmonitored patients had hearing preserved at preoperative levels compared to 4 of 9 monitored patients. Neither preoperative BAEP assessments nor absolute tumor size were predictive of hearing preservation. This report brings into question the effectiveness of far‐field intraoperative BAEP monitoring during acoustic tumor resection and suggests that direct auditory nerve monitoring may be more appropriate.
Flexible nd: Yag laser palliation of obstructive tracheal metastatic malignancies
Authors: Castro Dan J. , Saxton Romaine E. , Ward Paul H. , Calcaterra Thomas C. , Oddie James W. , Layfield Lester J. , Lufkin Robert B. 
Published: October 2006

AbstractFlexible NdtYAG endoscopic laser surgery may become an effective new modality for palliation in patients with obstructive endotracheal metastatic malignancies. We report the results of the treatment of two patients with severely obstructing intraluminal tracheal metastatic melanoma and medullary thyroid carcinoma, using the neodymium‐YAG laser via the flexible fiberoptic bronchoscope. Both patients complained of significant dyspnea, orthopnea, cough, and hemoptysis and were not candidates for rigid bronchoscopy because of underlying medical contraindications and anatomical problems. Multiple treatment sessions were used with treatment intervals of 1 to 2 weeks. All treatments were performed in the operating room under sedation, without intubation, with topical lidocaine and standard superior laryngeal nerve block. Successful relief of airway obstruction with complete regression of the endotracheal masses was achieved and no recurrences were seen after 9 months' follow‐up. Flexible Nd:YAG laser bronchoscopy offered an alternative for the relief of obstructing endotracheal or bronchial malignancies in patients in whom the rigid bronchoscope could not be passed. It seemed to prolong survival in selected cases, and provided definite improvement in quality of life.
Artificial restoration of voice. I: Experiments in phonatory control of the reinnervated canine larynx
Authors: Broniatowski Michael , Davies Charles R. , Jacobs Gordon B. , Jasso Jerome , Gerrity Ross G. , Nosé Yukihiko , Tucker Harvey M. 
Published: October 2006

AbstractCoordinated electronic pacing of implanted nerve pedicles into paralyzed laryngeal muscles has allowed selective dynamic control of abduction, adduction, and elongation of the vocal cords. Modifications of the original circuit in a cervical muscle model has added fine tuning to basic “all‐or‐none” pacing. Rehabilitation of phonation illustrated the sophisticated nature of voice and the need for restoration of fine tuning. Five mongrel dogs received nerve‐muscle pedicles into the thyroarytenoideus, cricothyroideus, and posterior cricothyroideus after denervation of one hemilarynx. Following appropriate reinnervation time, pedicles and intact recurrent laryngeal nerves were injected with currents of variable amplitudes and pulse widths to achieve graded vocal fold control while air was blown intratracheal‐ly towards the glottic chink. Videoscopic and spectral analyses indicated that artificial phonation could be restored to frequencies measured in the normal state. These experiments suggested that rehabilitation of the impaired voice by servocontrol might eventually be feasible.
Indications of the carbon dioxide laser in tracheobronchial pathology of the infant and young child: 14 cases
Authors: Garabedian Eria‐N , Denoyelle Francoise , Grimfeld Alain , Lacombe Hervé 
Published: October 2006

AbstractFourteen children aged between 6 months and 7 years (mean age = 3.5 years) were treated by CO2 broncholaser in the ENT Department of Trousseau Hospital.Three groups of diagnostic indication were identified: 1. Granulomas treated after mucosal trauma (tracheotomy, foreign body). 2. Granulomas due to pulmonary and/or lymph node tuberculosis. 3. Adhesions and stenosis secondary to neonatal ventilation.The operative and anesthetic technique is described in detail, together with any possible adverse events.The CO2 broncholaser appears to be a technique of choice in this age group, in which the narrowness of the airways makes any endoscopic procedure difficult. The broncholaser allows the early treatment of obstructive tracheobronchial pathology with its risks of severe ventilatory sequelae.
An in vivo canine model for testing treatment effects in laryngeal hyperadduction disorders
Authors: Green David C. , Berke Gerald S. 
Published: October 2006

AbstractAdductor spastic dysphonia is a voice disorder characterized by a strained, squeezed, effortful voice produced by true and false cord hyperadduction. An in vivo canine model has been developed to simulate hyperadduction of the true cords. Using this model, the thyroarytenoid muscle was found to have a greater effect on intraglottic and subglottic pressure than cricothyroid muscle contraction. The intraglottic and subglottic pressure was reduced after simulated recurrent laryngeal paralysis. This model can be used in future studies to compare laryngeal treatment modalities for disorders that have a component of vocal cord hyperadduction, such as spastic dysphonia.
Otolaryngologic management of patients with subdural empyema
Authors: Hoyt David J. , Fisher Samuel R. 
Published: October 2006

AbstractFrom 1979 to 1988,17 patients presented to Duke University Medical Center for treatment of subdural empyema. Empyemas were caused by sinusitis in 53% of the patients and by otitis media in 12%. None of those with otologic causes required mastoid drainage, while all patients with sinus infections required sinus drainage. External frontoethmoidectomies were associated with a lower incidence of fronto‐ethmoid re‐exploration (P = 0.048), and antrosto‐mies with a lower incidence of maxillary re‐exploration (P = 0.111), than were more limited drainage procedures. Sinus drainage performed simultaneously with neurosurgical drainage reduced the incidence of sinus re‐exploration (P = 0.167), neurosurgical re‐exploration (P = 0.048), and length of hospitalization (P = 0.020).
Hematoporphyrin photodynamic therapy: Is there truly a future in head and neck oncology? Reflections on a 5‐year experience
Authors: Gluckman Jack L. 
Published: October 2006

AbstractPhotodynamic therapy, which consists of the selective destruction of tumors using a combination of a photosensitizer administered systemically (dihe‐matoporphyrin ether) and an argon dye‐pumped laser, has provoked profound interest amongst oncologists and has particularly titillated head and neck oncologists with its potential. Unfortunately, no multi‐institutional trials for head and neck tumors have been introduced, and the literature is replete with anecdotal reports from individual researchers on the management of advanced cancers for palliation, superficial early cancers, and field cancerization of the mucosa (“condemned mucosa”)‐ A personal 5‐year experience with 41 head and neck cancers was reviewed, as was the current literature. An attempt was made to place in perspective the true role and future direction of this technology.
Monothermal differential caloric testing in patients with Meniere's disease
Authors: Wexler David B. , Harker Lee A. , Voots Richard J. , McCabe Brian F. 
Published: October 2006

AbstractThe monothermal differential caloric test allows determination of vestibular recruitment and de‐cruitment, variables which may help discriminate peripheral from central vestibular lesions. Previous reports indicated a strong association between vestibular recruitment and Meniere's disease. This study examined patients having unilateral Meniere's disease. Nystagmus beat frequency (NBF) and slow‐component velocity (SCV) responses were recorded by electronystagmography (ENG). Electronystagmo‐graphic findings showing unilateral dysfunction were present in 54% of patients by slow‐component velocity and in 31% by nystagmus beat frequency. Unilateral hypofunction was the most frequent lat‐eralizing ENG finding. Absolute vestibular recruitment occurred in less than 10% of patients but relative recruitment was found in nearly 20% of patients. Slow‐component velocity had higher sensitivity than nystagmus beat frequency, with excellent clinical concordance. Monothermal caloric testing as described in this study best detects peripheral vestibular disease in Meniere's patients using slow‐component velocity to determine unilateral hypofunction and relative vestibular recruitment.
Comparison of evoked electromyography of the larynx to electrical and magnetic stimulation of the motor cortex of the dog
Authors: Haghighi Siavash S. , Estrem Scott A. 
Published: October 2006

AbstractThe electromyographic and contractile properties of the laryngeal muscles upon stimulation of the laryngeal nerve have been described before. In the present investigation, we used electrical and magnetic stimulation to activate the vocalis muscle in dogs. Stimulation of the vagus nerve at the brain stem exit point resulted in evoked vocalis compound muscle action potential identical in onset latency and configuration to that obtained by the transcranial single‐shock magnetic stimulation at high intensity (>80%). Electrical stimulation of the laryngeal representation of the somatomotor cortex resulted in a contra‐lateral evoked vocalis compound muscle action potential. Central delay time for the 10th cranial nerve was calculated by subtracting the latency of the vocalis recorded by stimulation of the vagus nerve as it exited the brain stem from the latency obtained by direct cortical stimulation.