bluuebunny/crossref_metadata_2025_split huggingface dataset:
Voice intensity of patients using a communi‐trach I® cuffed speaking tracheostomy tube
Authors: Leder Steven B. , Traquina Diana N. 
Published: October 2006

AbstractVoice intensity levels produced by 20 patients with cuffed speaking tracheostomy tubes (Communi‐Trach I®) at three different airflow rates were investigated. Results indicated that audible and intelligible speech was produced with significantly greater intensity over ambient room noise at 5 l/minute, 10 l/minute, and 15 l/minute of airflow. Criteria for use, common causes of malfunctioning, and rehabilitation techniques necessary for the successful use of cuffed speaking tracheostomy tubes are discussed.
Spontaneous otoacoustic emissions: Clinical interest
Authors: Bonfils Pierre 
Published: October 2006

AbstractSpontaneous otoacoustic emissions (SOEs) were recorded in a group of normally hearing participants (n=148 ears) and a group of patients demonstrating several common types of sensorineural hearing loss (n=136 ears) in order to study the clinical interest of spontaneous otoacoustic emissions. In the normal population, the incidence of SOEs decreased from 68% in the group of infants less than 18 months old to 0% after the age of 70 years old. On the other hand, the SOE incidence and the spectrum content did not change with sex. In the group of participants with sensorineural hearing loss, the incidence of SOEs decreased linearly with increasing click threshold or the detection‐threshold of evoked otoacoustic emission. No statistical difference in SOE incidence was found between participants with or without tinnitus. These results have several important applications concerning the possible clinical application of SOEs.
Bronchoscopic brachytherapy
Authors: Marsh Bernard R. 
Published: October 2006

AbstractIncreasing lung cancer mortality has created renewed interest in the bronchoscopic use of isotopes for palliation of recurrent airway carcinomas. In the first part of this paper we report our clinical experience with iodine‐125 implantation for treatment of endobronchial carcinomas in 18 patients followed until death. Symptoms of cough, hemoptysis, and dyspnea were most effectively relieved with tumors limited to the bronchial lumen. Contraindications to this procedure include extensive extrabronchial tumors causing airway compression and severe debility.In the second part of this paper the development of a new isotope delivery system designed to overcome technical difficulties experienced in the treatment of some patients with interstitial iodine 125 is described. An isotope capsule was constructed to permit insertion and removal by means of a fiberoptic bronchoscope. This device was successfully tested in animals and is now approved for clinical trials. It represents a unique, new modality for treatment of superficial, multifocal, and less‐advanced recurrent bronchogenic carcinomas.
An immunohistochemical study of the endolymphatic sac in patients with acoustic tumors
Authors: Bui Hang T. , Linthicum Fred H. , Hofman Florence M. , Bowman Carol A. , House William F. 
Published: October 2006

AbstractIntraosseous endolymphatic sacs obtained from patients with acoustic neuromas who had undergone total labyrinthectomy during tumor removal were examined for the presence of T helper/inducer and T suppressor/cytotoxic lymphocytes, B lymphocytes, plasma cells, and macrophages. Immunoperoxidase staining of cryostat sections revealed the presence of T helper/inducer lymphocytes, T suppressor/cytotoxic lymphocytes, and macrophages. The number of B lymphocytes and plasma cells was much smaller than the number of T lymphocytes. The number of T suppressor/cytotoxic lymphocytes was higher than the number of T helper/inducer lymphocytes. This study supports the notion of local immune responsiveness in the human inner ear. This is the first immunohistochemical study to analyze lymphocyte subpopulations; specifically, to provide insight into T‐cell function in the endolymphatic sac.
Post‐traumatic cholesteatoma
Authors: McKennan Kevin X. , Chole Richard A. 
Published: October 2006

AbstractCholesteatoma can develop as a late complication of fracture of the temporal bone. The otologist must be wary of it since the growth of the cholesteatoma resulting from a temporal bone fracture can be undetected for years allowing for invasive and extensive growth. Three illustrative cases are presented.
Adaptation to surgery for head and neck cancer
Authors: Krouse John H. , Krouse Helene J. , Fabian Richard L. 
Published: October 2006

AbstractWe examined the postoperative adjustment of 45 patients who underwent surgery for cancers of the head and neck: 23 who had laryngeal cancer, 18 who had oral cavity/oropharyngeal cancers, and 4 who had cancers of other sites. Patients were assessed preoperatively, and at 3 months and 9 to 12 months postsurgery. Interviews and questionnaires were used to assess depression, body image, limitations, pain, financial problems, need for help at home, and social interaction. Results revealed that pain, fatigue, weakness, and loss of speech were major concerns. Pain and financial concerns were worst at 3 months and then improved. Physical limitations increased steadily with time. Depression was a major factor in patients with oral cavity and oropharyngeal cancers. Of note, patients who underwent postoperative radiation therapy had the most difficulty adapting to their illness and treatment, with persistent limitations in function and social isolation. The implications of these findings are discussed.
Growth of the lateral surface of the temporal bone in children
Authors: Simms David L. , Neely J. Gail 
Published: October 2006

AbstractThe adaptation of implantable auditory prostheses for use in children has raised questions concerning both what effect growth may have on the implant and what effect the implant may have on growth. The purpose of this study is to describe temporal bone lateral surface dimensions in children of different ages to draw inferences about growth rates.Using a surface projected grid and point calipers, 158 intact temporal bones from 103 individuals of known ages between birth and 20 years were measured at six points from a fixed reference. These specimens were located in the skeletal collections of the Smithsonian Institute's Museum of Natural History, the Medical Museum of Walter Reed Hospital at the Armed Forces Institute of Pathology, and the Cleveland Museum of Natural History.Linear regression analysis helped clarify a bimodal pattern of growth in which marked increases in dimension occur from birth to 4 years of age and much less change is seen from age 4 to 20 years.These data suggest that implantation in children under 4 years of age is subject to maximal growth effects.
Replacement of upper esophagus: Results with myocutaneous flap and with gastric transposition
Authors: Silver Carl E. , Cusumano Robert J. , Fell Stanley C. , Strauch Berish 
Published: October 2006

AbstractThe authors reviewed 25 cases of pharyngoesophageal replacement. A tubed pectoralis major myocutaneous flap was employed in ten cases where an adequate distal resection margin could be obtained above the thoracic inlet. Total gastric transposition was used in 15 cases where resection extended into the mediastinum.The overall rates of complications (52%), postoperative mortality (20%), and satisfactory deglutition (80%) were similar for both operations and were superior to those achieved with reconstructive procedures previously used by the authors. The choice of method is influenced by the length of the pharyngoesophagus to be replaced and the general condition of the patient. Gastric transposition is a more versatile operation and is adaptable to replacement of the entire esophagus if necessary, while the tubed pectoralis major myocutaneous flap has proven particularly effective for the rehabilitation of elderly and severely debilitated patients.
Radiographic diagnosis, surgical treatment, and long‐term follow‐up of cholesterol granulomas of the petrous apex
Authors: Thedinger Britt A. , Montgomery William W. , Nadol Joseph B. , Thedinger Bradley S. , Greenberg Jeffrey J. 
Published: October 2006

AbstractCholesterol granuloma is an unusual lesion of the petrous apex. Accurate preoperative differentiation of the various lesions of the petrous apex by computed tomography scanning only has been difficult. We reviewed the clinical findings, computed tomography and magnetic resonance imaging scans, surgical approaches, and long‐term follow‐up in 10 patients with cholesterol granuloma of the petrous apex who were seen between 1971 and 1988. Headache and deficits of the 5th, 6th, 7th, and 8th cranial nerves were common presenting symptoms. Magnetic resonance imaging with special imaging techniques was accurate in diagnosing cholesterol granuloma in four patients preoperatively and three patients prior to revision surgery. The optimal surgical approach was chosen on the basis of clinical and radiographic findings and included the transsphe‐noidal, infralabyrinthine, transcochlear, and suboccipital routes. Our review reveals that magnetic resonance imaging is more specific than computed tomography in establishing a preoperative diagnosis and is also the technique of choice in follow‐up. The long‐term results are discussed.
Congenital aural atresia
Authors: Schuknecht Harold F. 
Published: October 2006

AbstractThis report is based on 25 years' experience in the surgical management of 69 ears with congenital aural atresia. There were 7 ears with meatal atresia, 11 with partial atresia, 50 with total atresia, and 1 with hypopneumatic total atresia. Meatoplasty was performed in 7 ears, canaloplasty was performed in 22 ears, canaloplasties with struts in 8 ears, and mastoidectomy with stapediopexy was performed in 26 ears. Of the 62 ears that had partial or total atresia, five (8%) had hidden cholesteatomas that were destined to create future complications by expansion and erosion had they not been removed. In five of the 62 ears, temporary facial palsy resulted from exposing the facial nerve in the atresia plate, and in another five ears, attempts to improve hearing were abandoned intraoperatively because of surgically insurmountable anomalies. A reasonable criterion for success in an operation for bilateral atresia is that the need for a hearing aid is obviated; whereas, for unilateral atresia, a successful procedure should largely eliminate the disadvantages of unilateral hearing loss. These criteria seem to be satisfied if the threshold of hearing can be brought to a level of 20 dB or better. This criterion was met in 30% of the group that underwent canaloplasty and in 8% of the group that underwent mastoidectomy with stapediopexy.
Osteocartilaginous necrosis of the sinonasal tract following cocaine abuse
Authors: Kuriloff Daniel B. , Kimmelman Charles P. 
Published: October 2006

AbstractAs cocaine abuse has become increasingly widespread, there has been a concomitant rise in associated medical complications. Nasal inhalation (“snorting”) causes profound effects on the upper respiratory tract in addition to the well known nasal septal perforation. Septal necrosis can be accompanied by bleeding, granulation tissue, ulceration, and sinusitis. There are few reports of extensive sinonasal tract osteocartilaginous necrosis from cocaine abuse. We present five patients with this complication, which must be distinguished from other destructive mid‐face lesions such as Wegener's granulomatosis and polymorphic reticulosis.
An experimental model for the endoscopic correction of subglottic stenosis with clinical applications
Authors: Healy Gerald B. 
Published: October 2006

AbstractThe use of long‐term endotracheal intubation in the treatment of respiratory distress syndrome in the newborn has seen an increase in the number of cases of acquired subglottic stenosis. Multiple methods of correction have been advocated in conjunction with the use of antibiotics, corticosteroids, and indwelling stents.An animal experiment utilizing 64 dogs was undertaken in an effort to devise an endoscopic procedure using the CO2 laser which might be successfully employed in the human patient. An attempt was also made to study the efficacy of antibiotics, corticosteroids, soft stents and rigid stents. Animals were divided into multiple groups, and their larynges were studied grossly and histologically some weeks after therapy was completed. Analysis of the results was undertaken, and the method with the best outcome was then employed in the human portion of the study.Twenty‐four human patients, 12 with severe stenosis and 12 with partial stenosis were evaluated, and their outcome is reported.
Severe soft tissue infection of the face and neck: A classification
Authors: Klabacha Martin E. , Stankiewicz James A. , Clift Susan E. 
Published: October 2006

AbstractSuccessful treatment of severe soft tissue infections of the face and neck necessitates early recognition followed by aggressive medical and surgical therapy. These infections often spread via tissue planes, and it is essential that all areas of necrosis be exposed, debrided, or excised according to tissue planes. A classification of soft tissue infection based upon tissue plane involvement is proposed as an aid to diagnosis and treatment. In addition, a protocol for management of these infections is presented.
Rhinocerebral mucormycosis: Predisposing factors
Authors: Mcnulty John S. 
Published: October 2006

AbstractRhinocerebral mucormycosis is, with few exceptions, only reported in patients with severe metabolic or immunologic imbalances. Factors which may predispose to the development of mucormycosis are reviewed. These factors include ketoacidosis and immunologic deficiency states due either to the primary disease or to the treatment for other diseases. An appreciation for these predisposing factors is very important in order that aggressive diagnosis and therapy be undertaken without delay.
Laryngeal papillomatosis: Recurrence after 33‐year remission
Authors: Bergstrom Lavonne 
Published: October 2006

AbstractAfter repeated laryngeal papilloma excisions, a 4‐year‐old Caucasian male became symptom‐free. Benign squamous papilloma recurred in the larynx and trachea at age 37 after a gunshot wound, prolonged nasogastric intubation, several laparotomies, endotracheal anesthesias, and massive weight loss. This case and others in the literature suggest that current therapy produces prolonged remission, not “cure.” Its course reinforces accumulating evidence for the existence of human papilloma viruses (HPV) whose DNA apparently becomes incorporated into host laryngeal cell DNA, supporting an hypothesis that HPV remains in normal‐appearing epithelium adjacent to papilloma. Like herpes zoster varicella virus, HPV may lie dormant until reactivated by host immunosuppression, trauma, malnutrition or sepsis, features also present in the patient described. Repeated intubation probably injured and destroyed cells, releasing viral material.Papilloma patients in remission probably should be warned of factors, including intubation for elective surgery, which could induce recurrence.
Argon laser use in papillomas of the larynx
Authors: Brophy John W. , Scully Peter A. , Stratton Clifford J. 
Published: October 2006

AbstractPapillomas of the larynx are discussed, including the use of lasers. Argon lasers' differences from CO2 lasers and techniques are outlined. Case reports are given in which laryngeal papillomas were removed from two patients with the argon laser and examined by transmission electron microscopy (TEM), scanning electron microscopy (SEM), and stereoscanning electron microscopy (SSEM). The depth and width of morphological changes are noted. Peripheral to the laser impact site, four zones were observed: 1. coagulation necrosis, 2. contracted epithelial cells, 3. minimally damaged epithelial cells, and 4. morphologically undamaged epithelial cells. In Zone 2, cells were violently popped‐off as heat was conducted through the epithelium. The potential for spread of papillomas was discussed and suction of the vapor plume recommended when removing laryngeal papillomas with the argon laser.
Bilateral palatal myoclonus
Authors: Litman Richard S. , Hausman Sanford A. 
Published: October 2006

AbstractPalatal myoclonus, which is a rare form of tinnitus, is described in this paper in a young child. Multiple etiologies and, therefore, multiple therapies have been described in many papers. In this case, the tinnitus stopped spontaneously after 4 months without therapy, causing one to question further the efficacy of the many recommended modalities of treatment.
Relation of lymph‐node metastasis to histopathologic appearance in oral cavity and oropharyngeal carcinoma: A case series and literature review
Authors: Rasgon Barry M. , Cruz Raul M. , Hilsinger Raymond L. , Sawicki John E. 
Published: October 2006

AbstractA number of histopathologic parameters in squamous cell carcinoma of the oral cavity and oropharynx have been identified as having a statistically significant correlation with regional lymph‐node metastasis. These parameters have been inconsistent and not readily reproducible.In an attempt to confirm these parameters, a retrospective analysis of 22 patients with Tl to T4 squamous cell carcinoma of the oral cavity and oropharynx was performed. Initially, these patients were managed with either wide local excision or surgical excision of the primary tumor combined with radical neck dissection. There was a minimum of 3 years of follow‐up.Chi‐square contingency tables and Fisher's Exact Test were used to correlate histopathologic parameters with lymph‐node metastasis. Statistically significant correlations were found for tumor thickness and inflammatory infiltrate.
Update of the cincinnati experience in pediatric laryngotracheal reconstruction
Authors: Cotton Robin T. , Gray Steven D. , Miller Robert P. 
Published: October 2006

AbstractSurgical endeavors in the field of laryngotracheal reconstruction in children have received much interest in the past 15 years. A unique experience with laryngotracheal reconstruction in 203 children is reviewed. The majority (194) of the cases were classified as acquired; only nine were classified as congenital. Excluded from the study were those cases of stenoses managed en‐doscopically, all resections and end‐to‐end anastomoses, all anterior cricoid split procedures, and all cases of anterior glottic stenosis repaired by a laryngeal keel. The degree of stenosis was graded into four categories. Five different methods of laryngotracheal reconstruction were used depending on the pathologic lesion in the larynx and trachea. Of the 203 children, 186 (92%) were decannulated. The results support the use of laryngotracheal reconstruction in children with grades 2, 3, and 4 laryngeal stenosis.
Theoretical and practical implications for plasmapheresis in autoimmune inner ear disease
Authors: Luetje Charles M. 
Published: October 2006

AbstractImmune‐mediated inner ear disease, by convention called autoimmune inner ear disease (AIED), has established clinical profile guidelines for diagnosis. Treatment consists of steroid and/or cytotoxic drug immunosuppression. The role of plasma‐pheresis (PMP) in the treatment of AIED has not been defined. Lack of a precise serological marker prevents accurate immuno‐logical understanding. Definition is, of course, difficult in a disease whose natural history is not well delineated.Successful use of PMP in one steroid and cytotoxic drug intolerant patient with AIED led to its use in a total of eight patients. The rationale for PMP was based on its known effectiveness in other autoimmune diseases and thus, its potential use in AIED. Improved auditory function occurred in 6 of the 8 patients, 3 of whom have been followed for over 3 years. Three of the six no longer require immunosuppressant medication. PMP can be used as an alternative or adjunctive therapy in AIED. These preliminary results suggest PMP can stabilize or improve auditory and vestibular symptoms in selected patients. Its use as a first line therapy followed by cytotoxic immunosuppres‐sants bears consideration.
Effects of stimulation by cochlear implant on the cochlear nerve
Authors: Terr Leonid I. , Sfogliano Guiseppe A. , Riley Solomon L. 
Published: October 2006

AbstractDegeneration of the cochlear nerve before and after placement of the cochlear implant might influence the efficacy of the device. We examined histological characteristics, including the caliber of the cochlear nerve fibers of the central segment proximal to the porus acusticus, in three profoundly deaf patients. Two of them used a cochlear implant for many years longer in one ear than in the other, and one used an implant in one ear only. No qualitative or quantitative differences between the two sides were found. However, in all three cases we found that the cochlear nerves on both sides were substantially degenerated. These results indicated no noticeable effects of stimulation by the cochlear implant on the central portion of the cochlear nerve.
Complete post‐traumatic ptosis: A mechanism for recovery?
Authors: Arden Richard L. , Moore Grant K. 
Published: October 2006

AbstractTraumatic blcphnroptosis, although considered relatively rare, is an entity which demands recognition if one is to achieve optimal results. Reports of levator injury following orbital, ocular, and adnexal surgery, as well as in cataract and blepharo‐plasty procedures, are well described. In most cases eventuating in complete ptosis, levator disinsertion is the anatomic correlate, the ptosis is usually permanent, and surgical intervention is often indicated.We have observed two cases of transient, complete post‐traumatic ptosis which have recovered by 6 weeks with expectant management. We believe this entity to be more pervasive than the current literature seems to reflect and emphasis is placed on nonoperative therapy. This paper reviews the anatomical considerations relevant to the function of the levator complex as well as the possible mechanisms for its injury.
Acoustic rhinometry: Evaluation of the nasal cavity with septal deviations, before and after septoplasty
Authors: Grymer L. F. , Pedersen O. F. , Hilberg O. , Elbrønd O. 
Published: October 2006

AbstractWe introduce acoustic rhinometry as a new, objective method to assess the geometry of the nasal cavity. The cross‐sectional area of the nasal cavity as a function of distance from the nostrils was obtained. A group of 21 patients with septal deformities was examined with acoustic rhinometry preoperatively and postoperatively. These values were compared with those of 21 normal control subjects.The minimal cross‐sectional area (MCA) is located in the anterior part of the nose, and it shifts anteriorly under the effect of decongestion. The preoperative value of MCA is related to the location and severity of the anterior septal deformity. Postoperative smaller MCA found in the opposite side of that narrowed by a severe anterior septal deformity may be explained by the impact of septoplasty without reduction of a hypertrophic tur‐binate. A highly significant relation between MCA and the subjective feeling of nasal patency, before and after surgery, suggests that MCA is a valuable parameter to express nasal patency. Correction of posterior septal deformities is found to increase significantly the cross‐sectional area posteriorly. The effect of decongestion in the postoperative values, however, suggests that the mucosa contributes even more to the cross‐sectional area of the posterior part of the nose.Acoustic rhinometry seems very suitable for evaluation of the nasal cavity in cases where septoplasty and turbinoplasty is considered, as well as for the postoperative evaluation.