bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Tissue welding” with the argon laser in middle ear surgery
Authors: Mckennan Kevin X. 
Published: October 2006

AbstractOver the past 10 years the argon laser has been recognized as a valuable adjunct to middle ear surgery. It has been used to vaporize and cut tissue and to coagulate micro‐bleeding. It has been used by many other surgical specialties to “weld” adjacent tissues together. This welding process appears to have a limited but helpful role in middle ear surgery. A pilot study of 30 surgical cases in which argon laser “tissue welding” has been used are reported. The benefits, limitations, and possible future implications are discussed.
Efficacy and morbidity of partial laryngectomy and postoperative radiation therapy
Authors: Wang Marilene B. , Calcaterra Thomas C. , Lavey Robert S. 
Published: October 2006

AbstractIn recent years, we have seen increasing use of partial laryngectomies for larger lesions that were previously treated by total laryngectomy. The resultant closer margins have made postoperative radiation therapy an important adjuvant treatment to conservation laryngeal surgery. We review the University of California, Los Angeles, experience with combination partial laryngectomy and postoperative radiation therapy between 1973 and 1987 for treatment of carcinoma of the larynx. Twenty‐four such patients who underwent partial laryngectomies and postoperative radiation therapy are examined. Techniques of treatment, complications, and the functional ability of the remaining larynx are discussed.The locoregional control rate at 5 years was 80%. Risk factors associated with an increased risk of recurrence were positive margins, vascular invasion, and extranodal spread. There were no major problems with postoperative wound healing or airway management during the radiation treatment. Vocal and swallowing function were well preserved in most cases. We conclude that combination partial laryngectomy and radiation therapy permits preservation of laryngeal function without serious complications, and therefore is an effective treatment for selected patients with carcinoma of the larynx.
1990 ogura memorial lecture: Moral dilemmas in head and neck cancer
Authors: Harrison Sir Donald 
Published: October 2006

AbstractNeither morality nor dilemma can be defined meaningfully in the concept of the practical management of head and neck cancer. Although both have important implications, particularly with regard to ethnic and social factors, they play a relatively minor role in determining management policy. With little knowledge of the intrinsic causes of cancer and with a treatment strategy limited to radiotherapy and surgery, our desire for cure must be tempered by concern to avoid any increase in patient privations. My philosophy, based upon the care of more than 3500 patients over almost 30 years, reflects some of the difficulties of applying the concept “do nothing that may cause harm,” while offering each patient the opportunity for long‐term cure.
The efficacy of comprehensive neck dissection with or without postoperative radiotherapy in nodal metastases of squamous cell carcinoma of the upper respiratory and digestive tracts
Authors: Leemans Charles R. , Tiwari Rammohan , Nauta Jos J. P. , Snow Gordon B. , Van Der Waal Isaac , Karim A. B. M. F. 
Published: October 2006

AbstractNeck recurrence‐free curves corrected for local recurrence were compared for 494 patients who underwent 565 comprehensive neck dissections. In 42 dissections, no radi‐cality could be obtained. Of the 523 histologically radical dissections, examination revealed tumor in 352 cases. Patients in whom three or more positive nodes or extranodal spread in one or more nodes were found received postoperative radiotherapy. In the histologically NO group, the incidence of neck recurrence after 5 years was 3%; in the N+ group as a whole, it was 10%. Analysis of the influence of extranodal spread and the number of positive nodes showed that the group with one or two positive nodes without extranodal spread (that did not receive postoperative radiotherapy) did not statistically differ from the other groups.This suggests that the results of the group with one or two positive nodes without extranodal spread can be improved by postoperative radiotherapy.
A new low‐resistance, self‐retaining prosthesis (Provox™) for voice rehabilitation after total laryngectomy
Authors: Hilgers Frans J. M. , Schouwenburg Paul F. 
Published: October 2006

AbstractProsthetic rehabilitation of voice after total laryngectomy has gained wide acceptance in the last 10 years. Several reliable voice prostheses have been developed and used successfully.Priorities for further development of the methods and instruments for prosthetic voice rehabilitation have led to the design of a low‐resistance, self‐retaining voice prosthesis (ProvoxTM) and an adapted replacement method. The results obtained in 79 patients are described. In vivo airflow resistance ranged from 1.0 to 3.8 kPa (mean = 1.9 kPa). Speech quality was good in 91% of the patients. The self‐retaining properties of the prosthesis appeared to be satisfactory. The average device‐life was more than 5 months.Replacement of the prosthesis with a new disposable guide wire was done quickly as an outpatient procedure. Maintenance of the prosthesis by the patient was simple. The new low‐resistance, self‐retaining ProvoxTM voice prosthesis and the modified replacement method appeared to further improve the results of prosthetic voice rehabilitation after total laryngectomy.
Carcinoma of the external auditory canal: An update
Authors: Shih Lucy , Crabtree James A. 
Published: October 2006

AbstractThis review is a continuation of the series of 35 cases of carcinoma of the external auditory canal originally reported by the senior author and colleagues. Eighteen additional cases have been evaluated and treated since 1976. Preopera‐tive high‐resolution computed tomographic scanning has replaced polytomography, and improved surgical skull base approaches have allowed for extended resections of advanced lesions. A revised classification for local and extensive lesions is presented. The prognosis for localized tumors treated by en bloc resection remains excellent, whereas prognosis for extensive lesions might be more dependent on histologic type and grade of tumor.
Fat myringoplasty in the Guinea pig
Authors: Gold Steven R. , Chaffoo Richard A. K. 
Published: October 2006

AbstractFat myringoplasty is a simple office technique for repairing tympanic membrane perforations. It involves wedging a piece of fat from the ear lobule into the perforation. A search of the literature failed to reveal any controlled studies on the efficacy of this method, which may allow patients to avoid more invasive procedures. Controlled perforations in guinea pig tympanic membranes were treated with fat my‐ringoplasties, paper patches, or no intervention. Four weeks following the procedures, ears were examined and photographed under the microscope and studied histologically. The fat myringoplasty healing rate exceeded the rates of both the control and paper‐patch groups. Results were stratified with respect to location and size of perforations. The results and histological studies suggest that controlled studies in humans are warranted.
Extended retrolabyrinthine transtentorial approach to petroclival lesions
Authors: Canalis Rinaldo F. , Black Keith , Martin Neil , Becker Donald 
Published: October 2006

AbstractIn this communication, an extension of the retro‐labyrinthine approach that has permitted safe, effective access to the petrous tip and clivus is presented. The basic technique involved complete mastoidec‐tomy, preservation of the middle and inner ear structures, removal of the sigmoid and middle fossa plates, middle and posterior fossa craniotomies, ligation of the superior petrosal sinus, and division of the ten‐torium. Nine cases that exemplified the versatility of this approach constituted the basis of this paper: 2 cholesteatomas, 2 basilar artery aneurysms, 2 chordomas, and 3 meningiomas. The indications for, and complications of, this method have been discussed.
Multichannel cochlear implant and electrically evoked auditory brainstem responses in a child with labyrinthitis ossificans
Authors: Lambert Paul R. , Ruth Roger A. , Hodges Annelle V. 
Published: October 2006

AbstractOssification of the cochlea following meningitis presents a surgical challenge. Electrode mapping, especially in the young child, is difficult given the uncertainty of electrode contact with viable neural elements. This paper reviews surgical technique and the use of auditory brainstem responses to map the electrodes.A 4‐year‐old child deafened by meningitis at age 20 months had bilateral cochlear ossification by computed tomography. At surgery, a canal wall‐down mastoidectomy and closure of the ear canal were performed. A trough around the modiolus was drilled, and the electrode array was placed in it. Post‐operatively, the patient gave aversive or no responses to electrode stimulation. To assess electrode function, auditory brainstem responses to individual electrode activation were obtained under general anesthesia. Functioning electrodes could thus be selected for mapping. The patient now responds well to sound.
Rapid sequence treatment of advanced squamous cell carcinoma of the upper aerodigestive tract: A pilot study
Authors: Moloy Peter J. , Moran Edgar M. , Azawi Samar 
Published: October 2006

AbstractA review of the literature suggested that prolonged treatment time may lessen the probability of cure for patients with advanced squamous cell carcinoma of the upper aerodigestive tract. To shorten treatment time, rapid sequence treatment (RST) was devised in which chemotherapy, surgery, and irrada‐tion were administered in a total treatment time of 8 weeks. Twelve patients were treated and followed 3 years or longer. Medical complications were minor. Osteonecrosis occurred in each of the first five patients and was the only major complication of the protocol. Surgical techniques were modified, and no additional patient developed osteonecrosis. No patient developed local or regional recurrence. Two patients developed distant metastases and three other patients developed second primaries. Absolute survival was 50%. Rapid sequence treatment is an aggressive and potentially hazardous protocol that yielded encouraging results in this pilot study.
Catastrophic otologic injury from oral jet irrigation of the external auditory canal
Authors: Dinsdale Robert C. , Roland Peter S. , Manning Scott C. , Meyerhoff William L. 
Published: October 2006

AbstractJet irrigation is an accepted method for removal of cerumen from the external auditory canal. Even at a submaximal power setting, oral jet irrigators can generate enough force to rupture the tympanic membrane. Parameters for safe use of these irrigators have never been established.Three cases are reported in which, in addition to tympanic membrane rupture, oral jet irrigators caused ossicular disruption, round and oval window fistulae, and subluxation of the stapedial footplate. A prospective study performed on 25 fresh cadavers demonstrated a 6% incidence of tympanic membrane perforation when the power setting was one‐third full power or greater. Recommendations are made for safe use of oral jet irrigators for removal of external auditory canal cerumen.
Otologic sequelae after pneumococcal meningitis: A survey of 164 consecutive cases with a follow‐up of 94 survivors
Authors: Rasmussen Niels , Johnsen Niels Jon , Bohr Vilhelm A. 
Published: October 2006

AbstractAs part of a comprehensive study on sequelae after pneumococcal meningitis, 94 of 111 consecutive survivors were re‐examined 4 to 16 years after discharge. Twenty‐three patients had otological sequelae after pneumococcal meningitis. In these patients, 17 had hearing losses, 7 had tinnitus, 9 had vertigo, 13 had vestibular areflexia, 4 had loss of smell, and 3 had loss of taste. Among the patients with hearing loss, 4 were bilaterally deaf, 6 were unilaterally deaf, and 2 had mild and 5 had slight hearing losses. From correlations with extensive data from the medical records, preadmission antibiotic treatment appeared to protect from acousticovestibular damage. Purulent otitis media and otosurgical intervention did not correlate to the fatality rate or the development of sequelae. Acute purulent otitis media appeared as a concomitant manifestation, rather than the focus of pneumococcal meningitis.
Facial reanimation after acoustic neuroma excision: The patient's perspective
Authors: Schaitkin Barry M. , Young Tymon , Robertson J. Scott , Fickel Virginia , Wiegand David A. 
Published: October 2006

AbstractFacial reanimation after acoustic neuroma excision is currently accomplished using a variety of surgical techniques. A multi‐institutional survey of patient perceptions of facial reanimation success was accomplished by mailing a questionnaire to 809 randomly selected members of the Acoustic Neuroma Association. Four hundred sixty patients who underwent 296 reanimation procedures responded. Facial to hypoglossal nerve anastomosis, tarsorrhaphy, and upper eyelid implants were most frequently performed. The patient's estimations of initial deficit, spontaneous recovery, and overall satisfaction with the reanimation procedures are discussed.
Surgical treatment of chronic otitis media and meniere's syndrome
Authors: Huang Tsun‐Sheng , Lin Ching‐Chen 
Published: October 2006

AbstractMeniere's symptom‐complex in conjunction with chronic otitis media (COM) has occasionally been encountered in otologic practice. This study compares the effects of various surgical techniques on patients with COM and Meniere's syndrome, primarily on incapacitating vertigo. One group of patients with incapacitating vertigo received endolymphatic system drainage procedures, either endolymphatic sac surgery (83 patients) or cochleosacculotomy (12 patients) simultaneously with surgery for COM. Another group (14 patients) had surgery for COM only. A comparison of the results for vertigo control between the two approaches indicates a significant difference in success rate in favor of endolymphatic system drainage procedures (80% versus 20%).COM is regarded as one of the causes of endolymphatic hydrops (EH). The results of this study seem to indicate both 1. the likelihood of the cause‐and‐effect relationship between COM and EH, and 2. the effectiveness of endolymphatic shunting procedures on control of incapacitating vertigo, thus supporting the contentions of other authors with regard to pathogenesis and sac enhancement in patients with COM and Meniere's syndrome.
The treatment of small acoustic tumors: Now or later?
Authors: Shelton Clough , Hitselberger William E. 
Published: October 2006

AbstractPrior to the advent of microneurosurgery, the operative mortality for acoustic tumor removal was high and management often consisted of observation until sufficient symptoms warranted removal. The treatment of these tumors has evolved, and recent introduction of gadolinium‐enhanced magnetic resonance imaging (MRI) allows the diagnosis of very small intracanalicular acoustic tumors before hearing has been significantly affected. For such tumors, some surgeons advocate the premicrosurgical philosophy of observation rather than removal.Our results of small acoustic tumor removal with attempt at hearing preservation were reviewed. From 1961 to June 1989, 39 acoustic tumors 0.5 cm or less were removed by the middle fossa approach. Measurable hearing was preserved in 67%, and facial function 1 year postoperatively was normal or nearly normal in 97%. There was no other permanent operative morbidity.Given our results, early surgical removal of small acoustic tumors is advocated.
The oxygen and nitrous oxide indices of flammability of endotracheal tubes determined by laser ignition
Authors: Simpson Joseph I. , Wolf Gerald L. , Rosen Arie , Krespi Yosef , Schiff Gerald A. 
Published: October 2006

AbstractThis study determines the flammability of polyvinylchloride (PVC), red rubber (RR), and silicone (Si) endotracheal tubes in oxygen‐ and nitrous‐oxide‐enriched atmospheres. Flammability is measured by using the oxygen and nitrous oxide indices of flammability with laser ignition. The laser‐ignited oxygen (O2) index of flammability of the endotracheal tubes is: PVC, 0.25; RR, 0.19; Si, 0.20. The laser‐ignited nitrous oxide (N2O) index of flammability of the endotracheal tubes is: PVC, 0.45; RR, 0.37; and Si, 0.41. These results are similar to the previously reported O2 and N2O indices of flammability with propane‐torch ignition. This study validates the concept that the indices of flammability are useful measures of endotracheal tube flammability and are independent of the ignition source.
The embryonic development of the lateral nasal wall from 8 to 24 weeks
Authors: Bingham Brian , Wang Rong‐Guang , Hawke Michael , Kwok Peter 
Published: October 2006

AbstractThis histological study of 20 fetal heads aged between 8 and 24 weeks of gestation demonstrates and describes the embryonic development of the lateral wall of the nose. The three turbinates (inferior, middle, and superior) arise as soft‐tissue swellings (preturbinates) by 8 weeks' gestation. A cartilage capsule surrounds the nose at 8 weeks and by 9 weeks, medially directed flanges of cartilage have invaded all three preturbinates. The uncinate process arises from the medial surface of the lateral cartilaginous capsule and is first identifiable by 10 weeks. An “air space” progressively develops from 11 to 12 weeks lateral to the cartilaginous uncinate process and from this space, the embryonic channel to the maxillary sinus develops. The embryonic woven bone of the maxilla can be identified from 9 to 10 weeks and enlarges both absolutely and relatively to the nasal cavity, so that by 13 to 14 weeks, this expanding bone forms the lateral wall of the inferior meatus as the cartilaginous nasal capsule regresses.
Origin of malignant centrofacial granulomas: Surface markers and gene rearrangement of malignant cells
Authors: Cabane J. , Raphaël M. , Lamas G. , Mossalayi Djavad , Dubois A. , Chomette G. , Godeau P. , Marty‐Double C. , Rossi J. F. 
Published: October 2006

AbstractMalignant centrofacial granuloma (MCFG) is a clinical entity characterized by a relentless ulceration of the upper airway involving the nose, palate, and face, without any demonstrable etiology. The origin of 11 cases were analyzed with the help of cell‐surface immunostaining in all and with T‐cell receptor gene (TCR) rearrangement in 3. The results show that most of the cases of MCFG are in fact T‐cell lymphomas with cell‐surface antigens (CD2, CD7, CD3) consistent with either early or mature T lymphocytes. However, some cases exhibit B‐lymphoid (CD19, CD20) or histiomonocytic (CD13, CD14) lineage‐specific markers. In conclusion, despite its remarkable clinical unity, MCFG is a heterogeneous group of neoplastic diseases, most but not all of which may be classified as T‐cell lymphoma.
Comparison of expandable endotracheal stents in the treatment of surgically induced piglet tracheomalacia
Authors: Mair Eric A. , Parsons David S. , Lally Kevin P. , Van Dellen Adrian F. 
Published: October 2006

AbstractPresent surgical alternatives for pediatric tracheobronchomalacia are limited and associated with many potentially undesirable complications. The feasibility of different intraluminal expandable endotracheal stents for the treatment of surgically induced tracheomalacia was analyzed in 27 piglets. A potentially fatal tracheomalacia was surgically created. Either a stainless steel “zig‐zag” stent or a woven polymeric stent was then implanted. Tracheal patency, mucosal function, histopathologic respiratory tract changes, and effects of the stent on esophageal motility were evaluated over a 16‐week period. Piglets with steel stents uniformly experienced intense inflammation leading to tracheal dysfunction and death. Piglets with polymeric stents experienced minimal respiratory symptoms. Expandable polymeric endotracheal stents alleviate surgically induced piglet tracheomalacia, were easy to insert, allowed for tracheal growth, and reduced the need for high‐risk surgical procedures with prolonged ventilatory support.
One‐eye and locomotor compensation in guinea pigs
Authors: Ishikawa Kazuo , Yamada Masaji , Masaki Masakazu , Togawa Kiyoshi 
Published: October 2006

AbstractThis study was carried out to examine the effect of blindfolding one eye on locomotor compensation after unilateral labyrinthectomy in guinea pigs. A platform runway, designed to examine the locomotion of this species of animals, was used. Eighteen Hartley‐strain albino guinea pigs were used. These animals were divided into three groups, with seven in the control group, six whose right eye had been surgically closed in another group, and five whose left eye had been surgically closed in yet another group. After 7 to 11 days of training, a chemical labyrinthectomy by chloroform injection into the middle ear was performed under light ether anesthesia. Animals were checked for locomotion daily by the aforementioned platform method for about a week until regaining preprocedure levels.The locomotor compensation, depicted through the decrement of the deviation count and running time, was observed. Results have shown that the animal's locomotor compensation retarded significantly in the one‐eye groups compared to the control group. In addition, those animals whose one eye, ipsilateral to the labyrinthectomy side, was closed required significantly longer time to resume the preprocedure running performance level than the animals whose one eye, contralateral to the lesion side, was closed. Thus, during locomotor compensation, the visual input obtained by animals with one eye ipsilateral to the labyrinthectomy side may be important compared to the visual input of the animals with the contralateral eye.
Treatment of oromandibular dystonia with botulinum toxin
Authors: Hermanowicz Neal , Truong Daniel D. 
Published: October 2006

AbstractBotulinum toxin produces muscle weakness by inhibition of acetylcholine release at the neuromuscular junction. The toxin has been used successfully for symptomatic treatment of focal dystonias. Our experience in the use of botulinum toxin for the treatment of oromandibular dystonia in five patients is reported. Improvement following treatment was reported as marked by 1 patient, moderate by 1 patient, and mild by 3 patients. Similar improvement was noted by the examiners. One patient with mild cosmetic improvement developed significant dysphagia requiring feeding by a nasogastric tube for a 3‐month period.
Feasibility of multichannel human cochlear nucleus stimulation
Authors: Luetje Charles M. , Whittaker C. Keith , Geier Lisa , Mediavilla Sarah Jo , Shallop Jon K. 
Published: October 2006

AbstractBipolar electrical stimulation of the brainstem cochlear nucleus (CN) following acoustic tumor removal in an only‐hearing ear can provide beneficial hearing. However, the benefits of multichannel stimulation have yet to be defined. Following removal of a second acoustic tumor in a patient with neurofibromatosis 2, a Nucleus mini‐22 channel implant device was inserted with the electrode array tip from the foramen of Luschka cephalad along the root entry zone of the eighth nerve, secured by a single suture superficially in the brain stem. Initial stimulation on the sixth postoperative day indicated that electrodes 18 to 22 were capable of CN stimulation without seventh nerve stimulation. Presumed electrode migration precluded further CN stimulation 1 month later. This report illustrates the feasibility of brainstem CN stimulation with an existing multichannel system.