bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strap muscle neurovascular supply
Authors: Wang Robert C. , Puig Christine M. , Brown Deanna J. 
Published: November 2003

AbstractObjectives/Hypothesis: Knowledge and preservation of the neurovascular supply to strap muscles, such as the sternohyoid (SH) muscle, used in laryngotracheal reconstruction are important in preventing loss of tissue and bulk from ischemia and/or denervation. Study Design: Arteriovenous and neural supply variations to the strap muscles were examined in cadaver specimens. Methods: Strap muscle neurovascular supply was studied in 16 cadavers, including one transparent corrosion cast specimen with injected vessels. Results: For the upper SH and upper belly of the omohyoid (OMO), the arterial supply consistently arose from a branch of the superior thyroid artery (STA) most commonly terminating at the cricothyroid membrane. The inferior SH was supplied by the inferior thyroid artery. The ansa cervicalis innervated the SH inferiorly with a branch below the loop. Each arterial branch to the muscles had an accompanying venous tributary. The corrosion cast specimen demonstrated that the arterial lumen diameters were almost threefold larger in branches entering the upper SH, compared with the lower SH or OMO. Small intramuscular arteries without axial supply were found within the middle third of the upper SH, the lower SH, and the upper OMO. Conclusions: It is possible to preserve neurovascular integrity in an inferiorly based SH flap. The superior and medial borders are released, with dissection of vascular supply laterally and deep to the muscle, and preservation of the inferior terminal ansa branch.
Nodal disease in purely glottic carcinoma: Is elective neck treatment worthwhile?
Authors: Yang Caroline Y. , Andersen Peter E. , Everts Edwin C. , Cohen James I. 
Published: November 2003

AbstractObjective: Although there is a generalized understanding of the relatively low overall incidence of nodal disease from purely glottic carcinoma, the exact role for elective neck treatment in the management of this disease remains controversial. The purpose of this study was to identify the incidence of occult nodal disease (including paratracheal) in patients who have glottic carcinoma without significant extra‐glottic extension and to identify which patients are at risk for this. A retrospective chart review of 92 such patients who had either undergone neck dissection or been observed for a minimum of 2 years was performed. Results: For the 92 patients, neck treatment consisted of observation in 68 patients, paratracheal node dissection in four, unilateral neck dissection in four, unilateral neck dissection and excision of paratracheal nodes in 14, and bilateral neck dissection with paratracheal node excision in two. Of the 24 nodal dissections performed, four were positive for occult metastatic disease. No patient in the observation group developed nodal disease. Conclusion: The incidence of occult nodal disease in NO glottic carcinoma is low, 0% in early stage disease (T1–T2) and 19% in late stage disease (T3–T4). Nodes at highest risk included only the paratracheal, level II, and level III. Elective neck treatment should only be undertaken for advanced (T3–T4) disease and even then is of questionable benefit. If undertaken, it should have a low potential morbidity, such as selective neck dissection or radiation. Computed tomography was not useful in staging the neck for this subset of patients.
A functional anatomic study of the relationship of the nasal cartilages and muscles to the nasal valve area
Authors: Bruintjes Tjasse D. , Van Olphen Adriaan F. , Hillen Berend , Huizing Egbert H. 
Published: November 2003

AbstractThe functioning of the nasal valve area is largely determined by the stability and the mobility of the lateral nasal wall. To gain insight into the kinematics of the lateral nasal wall, we studied the functional anatomy of the nasal muscles and the intercartilaginous and osseous‐cartilaginous junctions. We performed gross and microscopic nasal dissection and serial sectioning in 15 human cadaveric noses. In addition, two noses were used for three‐dimensional reconstruction of the nasal cartilages. We conclude that the lateral nasal wall can be seen as made up of three parts. At the level of the osseous‐cartilaginous chain of bone, lateral nasal cartilage, and lateral crus, the lateral nasal wall is relatively stable, limited mobility being allowed by translation and rotation in the intercartilaginous joint and a coupled distortion of the cartilages. At the level of the hinge area the lateral nasal wall is supported by one or more accessory cartilages, embedded in soft tissue, and therefore much more compliant. The alar part of the nasalis muscle, which originates from the maxilla and inserts on these cartilages, may dilate the valve area by drawing this hinge area laterally. The third and most compliant part of the lateral nasal wall is the part that is not supported by cartilage, the ala. The dilatator naris muscle largely occupies the ala and is attached to the lateral crus; it opens the vestibule and nostril. The third nasal muscle that influences the lateral nasal wall is the transverse part of the nasalis muscle. It overlies the nose but is not attached to it. This muscle stabilizes the lateral nasal wall, in particular, the lateral nasal cartilage, the intercartilaginous junction, and the hinge area, by moving the nasal skin.
On the duality of the facial nerve ganglion
Authors: Gacek Richard R. 
Published: November 2003

AbstractObjectives: Describe quantitatively the number of ganglion cells in the geniculate (G) and meatal (M) segments of the human facial nerve. Study Design: One hundred human temporal bone specimens that were sectioned horizontally and stained with hematoxylin and eosin were selected from a temporal bone collection on the basis of minimal artifact and absence of pathology involving the facial nerve. Methods: Cells with a nucleolus in all sections through the facial nerve were projected on tracing paper with a camera lucida and counted manually. A modified Abercrombie technique was employed to compute total cells in the G and M segments. Results: Ages of patients ranged from 1 month to 92 years; the male‐to‐female ratio was 56:44. The total number of cells in individual temporal bones ranged from 589 to 4183 (mean, 2162 cells). The range of cells in the G ganglion was from 66 to 4017 (mean, 1713 cells); in the M ganglion the number ranged from 0 to 2764 (mean, 448 cells). There was no correlation of total ganglion cell number to age or sex. The majority of cells were found in the G ganglion in 88% of temporal bones. In 8% temporal bones the majority of cells were in the M ganglion and in 4% the M and G ganglions contained an equal number of cells. Conclusions: The facial nerve sensory ganglion consists of two components: G and M. The G ganglion outnumbers the M component in the majority of temporal bones (88%). The M ganglion was equal to or greater in number than the G ganglion in 12% of temporal bones.
Variability of repeated facial nerve electroneurography in healthy subjects
Authors: Sittel Christian , Guntinas‐Lichius Orlando , Streppel Michael , Stennert Eberhard 
Published: November 2003

AbstractBackground: Facial electroneurography is an objective measurement of a muscle compound action potential. The amplitude ratio between the paretic and the normal side is used as a basis for estimating the prognosis of facial palsy. According to Esslen, the difference of amplitudes in healthy subjects is only 3%. Twenty healthy test persons were investigated with the aim of 1. reproducing the published data on the left‐right difference in normal test subjects and 2. determining whether the amplitude ratio is constant over time after repeated measurements. Study Design: Bilateral electroneurography was conducted on 20 healthy volunteers (age range, 23–36 y; 12 men, eight women). Two investigators performed four measurements at 1‐week intervals on every subject. Results: Mean amplitude ratio was 32.5%. Repeated measurements on the same individual differed considerably—from 0% to 80%. The 99% confidence interval computed from the data ranged from 26% to 39% amplitude ratio. Conclusion: The symmetry of facial evoked compound potentials postulated by Esslen and Fisch is not supported by these data. As have other investigators, the authors found significant left‐right differences in healthy subjects. Furthermore, they showed for the first time that the amplitude ratio is not constant in every individual at repeated measurements. In light of these data, prognosis of facial palsy based on electroneurographic data alone seems doubtful.
Surgical exposure of the fundus of the internal auditory canal: Anatomic limits of the middle fossa versus the retrosigmoid transcanal approach
Authors: Haberkamp Thomas J. , Meyer Glenn A. , Fox Mary 
Published: November 2003

AbstractObjective: To define the anatomic limitations and advantages of the middle cranial fossa and the retrosigmoid transcanal approaches in the exposure of the fundus of the internal auditory canal (IAC). Study Design: A series of 15 cadaver temporal bone specimens were dissected and the measurements of the lateral recess of the IAC were made with a millimeter rule and rounded to the nearest quarter millimeter. Methods: Retrospective case review, surgical observation, review, and measurements recorded from magnetic resonance scans. Surgical observations and measurements recorded from cadaver specimens. Results: These results were compared with historical studies of the retrosigmoid transcanal approach. The results utilizing a combination of these approaches to remove acoustic neuromas at a tertiary referral center during the preceding 11 years are also presented. Previous studies have shown that for the retrosigmoid transcanal approach, it is impossible to expose 3 to 4 mm of the lateral recess of the IAC without violating the vestibule and/or the endolymphatic duct. This has led some authors to advocate the middle cranial fossa approach to the IAC when hearing preservation is a consideration. The current study shows that the falciform crest obscures the inferior half of the fundus. This creates a pocket that cannot be visualized, which on average is 1.82 × 2.33 mm. Conclusion: The fundus of the IAC cannot be completely exposed without violating the labyrinth through either the posterior fossa or middle fossa approach. The clinical implications of these studies are unknown at this time. Low recurrence rates are achieved with both approaches. The anatomic limitations of both approaches must still be considered when planning or performing these approaches, to minimize the risk of recurrence.
Sphincter pharyngoplasty: Speech outcome and complications
Authors: Sie Kathleen C. Y. , Tampakopoulou Dimitra A. , De Serres Lianne M. , Grass Joseph S. , Eblen Linda E. , Yonick Tracey 
Published: November 2003

AbstractObjectives: To assess the speech outcomes and complications in children who had undergone sphincter pharyngoplasty (SP) for management of velopharyngeal insufficiency (VPI). Study Design: Retrospective chart review. Methods: Charts from patients who had sphincter pharyngoplasty between January 1993 and June 1996 were reviewed. Syndrome diagnosis and presence of repaired cleft palate were reviewed. Preoperative speech assessment, videofluoroscopic and nasopharyngoscopic evaluations, age at time of surgery, and postoperative speech assessments were reviewed for all patients. Postoperative videofluoroscopy and nasopharyngoscopy were performed for those patients who had persistent VPI. Obstructive sleep symptoms were also assessed. Results: Thirty patients were identified; six patients had no follow‐up evaluation, leaving 24 patients included in this study. Average follow‐up was 11.7 months (range, 2–35 mo). Velocardiofacial syndrome (VCFS) was the most commonly identified syndrome. Postoperatively, 15 of 24 patients (62.5%) had complete resolution of their VPI; five of 24 (20.8%) had significant improvement; one of 24 (4.2%) had minimal to no change; and three of 24 (12.5%) were hyponasal. Of the six patients with some degree of persistent VPI, three underwent revision surgery. All three patients had complete resolution of their VPI after revision surgery, resulting in an overall success rate of 18 of 24 (75%). Conclusions: Sphincter pharyngoplasty has wide application in the management of children with VPI, including those with VCFS. The procedure is readily modified to accommodate an individual patient's needs as determined by preoperative VPI evaluation. A modification of the procedure is described to minimize the risk of postoperative airway obstruction and hyponasality, both regarded as airway complications of sphincter pharyngoplasty.
Adenoid cystic carcinoma of the trachea
Authors: Azar Taraneh , Abdul‐Karim Fadi W. , Tucker Harvey M. 
Published: November 2003

AbstractObjective: Primary tracheal tumors are rare, occurring in 0.2 per 100,000 persons per year. Adenoid cystic carcinoma (ACC) is the second most common histologic type of tracheal malignancy. Its clinical behavior is different from the other tracheal neoplasms and thus should be studied separately. Study Design/Methods: Retrospective review of the medical records of six patients with tracheal ACC who were treated at University Hospitals of Cleveland between 1971 and 1996 and literature review. Results/Conclusion: Tracheal ACC is an indolent tumor that affects people at any age but has a peak incidence in the fifth decade. There is a nearly equal male‐to‐female ratio. Almost half of tracheal ACCs occur in the proximal trachea, accounting for the most common presenting symptoms: dyspnea, cough, and hoarseness. Because of the hoarseness, patients are often referred to an otolaryngologist. Complete resection provides the best chance for increased survival. Neutron beam radiotherapy holds promise for adjuvant therapy. Key Words: Tracheal neoplasm, adenoid cystic carcinoma, hoarseness.
Paradoxical spread of renal cell carcinoma to the head and neck
Authors: Gottlieb Marc D. , Roland J. Thomas 
Published: November 2003

AbstractObjectives: To present cases of renal cell carcinoma presenting with only head and neck metastases, to review theories of physiology and anatomy describing this phenomenon, and to discuss the role of the otolaryngologist in the treatment of these lesions.Study Design: Retrospective review of the records of three patients who presented with renal cell carcinoma with head and neck metastases over the 3‐year period from 1992 to 1995.Methods: Retrospective review of the records of three patients who presented with renal cell carcinoma with head and neck metastases. In addition, English‐language literature was reviewed with special focus on the anatomic and physiologic pathways possible to allow for such a phenomenon.Conclusions: Renal cell carcinoma has an occasional presentation as a head and neck mass without evidence of disease elsewhere. Various routes of spread have been postulated. Batson's venous plexus, as postulated by Nahum and Bailey,2is an anatomic route through which emboli could navigate to the head and neck and avoid pulmonary vascular filtration. Interactions on the cellular level may also be responsible for the seemingly paradoxical spread. We recommend local excision of head and neck metastases of renal cell carcinoma without sacrifice of vital structures as a sound treatment regimen.
Pharyngo‐UES contractile reflex in patients with posterior laryngitis
Authors: Ulualp Seckin O. , Toohill Robert J. , Kern Mark , Shaker Reza 
Published: November 2003

AbstractBackground: Earlier studies have shown that stimulation of the human pharynx by injection of minute amounts of water stimulates the pharyngo‐UES contractile reflex. It has been suggested that this reflex may be activated during pharyngeal reflux of gastric and/or esophageal content, thus increasing the UES pressure and possibly preventing further entry of the refluxate into the pharynx. However, the integrity of this reflex in patients with posterior laryngitis has not been studied. Aim: Evaluate the pharyngo‐UES contractile reflex in a group of patients with objective findings of posterior laryngitis. Methods: Fourteen consecutive patients with posterior laryngitis (mean age, 48 ± 6 y) and 13 healthy volunteers (mean age, 53 ± 6 y) were studied by concurrent pharyngeal water stimulation and UES manometry. Results: The threshold volume required to evoke the pharyngo‐UES contractile reflex in the laryngitis group (0.4 ± 0.05 mL) was significantly higher than that of the control (0.2 ± 0.04 mL) (P < .05). Following stimulation of the pharyngo‐UES contractile reflex, the maximum postinjection pressure in patients (75 ± 6 mm Hg) was similar to that of the controls (78 ± 6 mm Hg). The percent increase in UES pressure following stimulation of the reflex in the laryngitis group (99% ± 15%) was significantly higher than that of controls (55% ± 11%) (P < .05). Conclusions: Compared with normal controls, a significantly larger volume of liquid is required to trigger this reflex in patients with posterior laryngitis. When triggered, the maximum UES pressure induced by the pharyngo‐UES contractile reflex is similar between the two groups. These findings suggest an altered afferent sensory limb of this reflex in patients with posterior laryngitis. Key Words: Upper esophageal sphincter, reflux laryngitis, airway protection.
Auditory neuropathy in childhood
Authors: Doyle Karen Jo , Sininger Yvonne , Starr Arnold 
Published: November 2003

AbstractObjectives: Auditory neuropathy is a recently described disorder in which patients demonstrate hearing loss for pure tones, impaired word discrimination out of proportion to pure tone loss, absent or abnormal auditory brainstem responses, and normal outer hair cell function as measured by otoacoustic emissions and cochlear microphonics. We have identified eight pediatric patients having hearing deficits that are most likely due to a neuropathy of the eighth nerve. In this study, the results of audiologic testing performed with these eight children are described. Study Design: Retrospective review of audiologic findings in eight children with auditory neuropathy. Methods. Each subject was tested with pure tone and speech audiologic testing, auditory brainstem response, and click‐evoked otoacoustic emissions. Results of these tests were tabulated and summarized. Results: Pure tone audiologic testing revealed five children with upsloping sensorineural hearing loss, two with high frequency loss, and one with a mild, flat configuration. Six children demonstrated poor word discrimination scores, and the other two had fair to good word discrimination. All eight subjects had normal distortion product and transient otoacoustic emissions. All eight children demonstrated absent or marked abnormalities of brainstem auditory evoked potentials. These findings suggest that while cochlear outer hair cell function is normal, the lesion is located at the eighth nerve. Conclusions: Recent advances in otoacoustic emissions testing permit differentiation of neural deafness from sensory deafness. This paper describes the clinical presentation and audiologic findings in pediatric auditory neuropathy, as well as the recommended management of these patients. Otolaryngologists should be aware of this disorder and implications for its management, which differs from treatment of sensorineural hearing loss. Key Words: Auditory neuropathy, childhood, hearing loss, auditory brainstem response, evoked otoacoustic emissions.
Middle fossa transpetrosal approach for petroclival and brainstem tumors
Authors: Slater Patrick W. , Welling D. Bradley , Goodman Joseph H. , Miner Michael E. 
Published: November 2003

AbstractObjective: The purpose of the study was to demonstrate the utility of the middle fossa transpetrosal approach with anterior petrosectomy for difficult‐to‐access petroclival and pontine lesions. Study Design: Retrospective case review in academic tertiary referral center. Methods: Patients for inclusion had pontine and prepontine lesions of the petroclival region. Middle fossa transpetrosal approach with anterior petrosectomy with excision or biopsy of the lesion was performed. The main outcome measure was postoperative neurologic status including motor and cranial nerve function. Results: No patient experienced neuromuscular compromise or cranial nerve deficits as a direct result of the surgical procedure. Complications consisted of a subdural temporal lobe hemorrhage and one case of cerebrospinal fluid rhinorrhea. Conclusions: The middle fossa transpetrosal approach with anterior petrosectomy was utilized for five patients with petroclival or pontine tumors. In this small series, it served well to spare cranial nerves and allowed avoidance of serious vascular injury. To our knowledge, this is the first reported use of this procedure for pontine venous angiomas.
Overexpression of scatter factor and its receptor (c‐met) in oral squamous cell carcinoma
Authors: Marshall Darby D. , Rornberg Lori J. 
Published: November 2003

AbstractHypothesis: Scatter factor (SF) is a pleiotropic growth factor that recently has been shown to induce epithelial cell proliferation, random motility, and invasion via interaction with its receptor, a tyrosine kinase encoded by the c‐met proto‐oncogene. Studies involving a variety of solid tumors have suggested that overexpression of the SF/c‐met ligand‐receptor pair is associated with the acquisition of a malignant phenotype. We hypothesize that SF and c‐met are overexpressed in epithelial malignancies of the head and neck including squamous cell carcinoma (SCC) of the oral cavity. Study Design: Immunohistochemical staining of randomly selected normal, dysplastic, and malignant oral tissues. Methods: Formalin‐fixed, paraffin‐embedded tissues were obtained from the Department of Oral Pathology at Shands Hospital (University of Florida), Gainesville, Florida. Examples of mild dysplasia, severe dysplasia, well‐differentiated SCC, moderately differentiated SCC, and poorly differentiated SCC were randomly selected from the dictated reports of one of two staff oral pathologists. Histologically normal margins of each specimen served as normal controls. The tissues were immunohistochemically stained using commercially available antibodies against SF and c‐met. Appropriate negative controls were run with each batch to ensure staining specificity. Evaluation of staining intensity was carried out using a computerized image analysis system. A one‐way analysis of variance (ANOVA) with pairwise multiple‐comparison procedures (Fisher method) was used to analyze the data. Results: Statistically significant differences (P < .0001) in the intensity of staining were noted between the malignant and normal and the malignant and dysplastic tissues for both SF and c‐met. No differences were appreciated when staining of normal and dysplastic sections of the SF‐stained tissue were compared. Conclusions: The results suggest that the SF/c‐met ligand‐receptor pair is overexpressed in SCC of the oral cavity.