bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impaired Ranvier Node Sodium‐Potassium Adenosine Triphosphatase May Induce Facial Palsy
Authors: Kanoh Naoyuki , Sakagami Masafumi 
Published: November 2003

AbstractTo clarify the part of the neuron essential for myelinated nerve conduction, the cytochemical localization of potassium ion (K+)‐dependent p‐nitrophenylphosphatase (K‐NPPase) activity was investigated in the normal and reserpine‐treated facial nerve of guinea pigs. In the normal animals, K‐NPPase activity was localized to the internodal axolemma and Schmidt‐Lanterman incisures. In the Ranvier nodes, enzyme activity was observed along the paranodal and nodal axolemma. In reserpinized nerves, K‐NPPase activity was absent along the internodal axolemma and Schmidt‐Lanterman incisures. In the Ranvier nodes, however, enzyme activity was detectable only in the nodal axolemma. The reserpinized animals demonstrated no evidence of facial palsy. Because K‐NPPase is essential for nerve conduction, these results indicate that the location of enzyme activity in reserpinized animals, namely the nodal axolemma, may be of prime importance in saltatory nerve conduction.
Aging of the Normal Nose in Adults
Authors: Edelstein David R. 
Published: November 2003

AbstractLike other organs, the nose changes as the body ages. A review of the literature reveals a basic understanding of the aging process in the nose but a paucity of documentation and few organized studies. This study was designed to identify systematically the age‐related changes in the normal, nondiseased adult nose.A nasal‐sinus laboratory was created, and a computerized patient database was developed. Four separate investigations were conducted. First, 111 subjects ranging in age from 21 to 94 years of age were studied prospectively using 135 variables. The following data were collected: history, symptoms, physical examination, rhinomanometry, ciliary beat frequency, smell testing, and incentive spirometry. Second, photographs of a separate group of 105 subjects 20 to 86 years of age were studied to ascertain the facial cephalometric changes that occur with aging. Third, a histopathologic examination of the nasal septum was performed in 20 additional subjects to evaluate the cellular changes that accompany aging. Finally, an epidemiologic study analyzing the prevalence of various nasal complaints by age was conducted, based on a review of more than 11,000 patient charts from surgeries and office visits.A number of specific age‐related changes in the nose were identified, including an increased likelihood of certain nasal complaints, a pattern of increasing airflow resistance, and a decrease in physical abnormalities in the nasopharynx. The appearance of the nose, as measured by the nasolabial angle and the height/length ratio, was also found to change with age.Laryngoscope, 106:(suppl 81):1‐25, 1996
Pediatric Neurotologic Skull Base Surgery
Authors: Jackson C. Gary , Pappas Dennis G. , Manolidis Spiros , Glasscock Michael E. , Von Doersten Peter G. , Hughes C. Anthony , Marrero Rafael J. 
Published: November 2003

AbstractThe objectives of neurotologic skull base surgery are complete resection of the lesion and high‐grade function following surgery. There is a perception that these goals are more difficult to achieve in children than in adults. Skull base disease in children and adolescents is rare. Of the 292 skull base tumors treated from 1970 to 1995 by The Otology Group in Nashville, 15 were in patients 21 years of age or younger, with only 5 patients under 10 years old. In this retrospective study, the authors review these 15 cases and compare them to their adult series.The pathology encountered in the 15 young patients with skull base tumors included 8 glomus lesions and 4 schwannomas. In these patients, 13 tumors occurred sporadically, and 2 tumors were related to neurofibromatosis type 2. Advanced‐stage disease and malignancy were prevalent in this younger patient group. All patients underwent excision of their skull base tumor, with one procedure considered a subtotal resection.As compared with an adult glomus tumor series, postoperative cranial nerve function and complication rates were generally worse in the young glomus patients. However, postoperative function and complications were consistent with the extensive procedures required for the treatment of advanced disease. Despite the advances that have been made in imaging and treatment modalities, this study illustrates the need for more timely diagnosis in younger patients with skull base tumors.Laryngoscope, 106:1205‐1209, 1996
Extended Middle Meatal Antrostomy: The Treatment of Circular Flow
Authors: Coleman John R. , Duncavage James A. 
Published: November 2003

AbstractIntranasal surgery has changed significantly over the years. The inferior meatal antrostomy has lost favor to the more physiologic middle meatal antrostomy which includes the natural ostium. Difficult‐to‐cure patients may exhibit mucous stasis due to circular flow between ostomies. Kennedy described circular flow in both the experimental model and the clinical arena. We have enlarged his definition of circular flow to include the flow of mucus from the natural ostium or a surgically created ostium to any accessory ostium, either natural or surgically created. We present the extended middle meatal antrostomy, a technique which prevents circular flow and allows the mucociliary system to provide for physiologic drainage of the maxillary sinus. This technique is demonstrated in this report to be safe and effective in the treatment of chronic maxillary sinusitis.Laryngoscope, 106:1214‐1217, 1996
Temporal Bone Carcinoma: Contemporary Perspectives in the Skull Base Surgical Era
Authors: Pensak Myles L. , Gleich Lyon L. , Gluckman Jack L. , Shumrick Kevin A. 
Published: November 2003

AbstractHistorically, malignant tumors that arose within the temporal bone or that intimately juxtaposed the petrous ridge portended an ominous prognosis. Perusal of the surgical literature from 1950 to 1975 strongly supports the impression that despite heroic surgical efforts many of these patients sustained significant morbidity and a high mortality rate.This report reviews data accumulated over a 10‐year period study from July 1984 to June 1994 that examines the changing clinical approach to these lesions from both a diagnostic and therapeutic perspective. Analysis of data from 46 patients cared for at the University of Cincinnati Medical Center is presented with a minimum follow‐up of 16 months to a long‐term follow‐up of 11 years. A management algorithm is presented that reflects our contemporary approach to assessment and management of this select patient population.Laryngoscope, 106:1234‐1237, 1996
Manometric Study of Complete Ostial Occlusion in Chronic Maxillary Atelectasis
Authors: Kass Erik S. , Salman Salah , Montgomery William W. 
Published: November 2003

AbstractThe effect of complete ostial occlusion on static pressure within the human maxillary sinus has not been previously studied. In this study, a novel way to directly determine maxillary sinus pressure is described. Maxillary sinus pressures were measured in five patients with chronic maxillary atelectasis (CMA); these values were compared to values obtained from the contralateral side and from patients with chronic sinusitis.Measurements were made by introducing an 18‐gauge needle probe through the membranous fontanel of the maxillary sinus and recording the pressure value with an amplified, pressure‐sensitive transducer. The average value recorded in five patients with atelectasis of the maxillary sinus and complete ostial occlusion was ‐8.4 ± 2.6 cm H2O (mean ± standard deviation). Static pressure measurements of the contralateral antrum were isobaric, as were measurements found in patients with chronic sinusitis.This study reports for the first time the sinus pressure of completely occluded maxillary ostia in patients with CMA. These results may improve our understanding of the development of ostial occlusion and its role in the pathogenesis of CMA and sinusitis.Laryngoscope, 106:1255‐1258, 1996
Retrospective DNA Ploidy Analysis by Image and Flow Cytometry in Head and Neck Cancer
Authors: Epp Robert A. , Justice William M. , Garcia Fernando U. , McGregor Douglas H. , Giri Shankar P.G. , Kimler Bruce F. 
Published: November 2003

AbstractA retrospective analysis of DNA content (DNA ploidy) was conducted in formalin‐fixed specimens from patients with advanced, unresectable head and neck cancer who were treated on a single defined protocol with accelerated fractionation radiation therapy and concomitant cisplatin(Platinol®) chemotherapy. Specimens from 31 tumor sites were analyzed by image cytometry using the Feulgen staining method. Fifteen specimens were analyzed by flow cytometry after deparaffinization, nuclear disaggregation, and staining with propidium iodide.By image analysis, 10 (32%) of 31 specimens contained only diploid tumor cells, while 21 (68%) specimens exhibited at least one aneuploid tumor component. Seven of the eight tumors with a single G0/G1 peak by image analysis had a single peak by flow analysis. Five of the seven tumors with multiple peaks by image analysis had multiple peaks by flow analysis.Histology was also reevaluated, and tumor grade was determined, reflecting tumor cell differentiation based on keratinization, mitotic activity and the degree of nuclear polymorphism. For this well‐defined patient population managed according to a uniform therapeutic approach, DNA ploidy status and histology provided a suggestion of prognostic separation; however, statistical significance was not obtained, most likely due to the small number of patients.Laryngoscope, 106:1306‐1313, 1996
Alternating Unilateral Botulinum Toxin Type A (BOTOX®) Injections for Spasmodic Dysphonia
Authors: Koriwchak Michael J. , Netterville James L. , Snowden Todd , Courey Mark , Ossoff Robert H. 
Published: November 2003

AbstractInjection of botulinum toxin type A (BOTOX®) into both thyroarytenoid muscles is an accepted treatment for spasmodic dysphonia. The authors of this study identified patients who could not tolerate the interval of breathy voice that immediately follows bilateral injections. These patients were offered a protocol in which the injection side was alternated on subsequent treatments. Eighteen patients who received at least two bilateral injections and two unilateral injections were reviewed.Alternating unilateral injections yielded a shorter breathy interval by an average of 12.7 days (P=.0007) and a shorter duration of return of spasmodic symptoms by an average of 26.0 days (P=.0006). Compared with bilateral injections, alternating unilateral injections yielded an average(median) of 3.2 more days of strong voice per day of breathy voice (P=.001). However, unilateral injections had a shorter average interval of strong voice (27.4 days; P=.007), as well as a slightly higher failure rate (4.9% vs. 1.1%). The authors conclude that alternating unilateral botulinum toxin type A injections are useful in patients with spasmodic dysphonia who have difficulty with the breathy voice that follows bilateral injection.
Patterns of Facial Nerve Synkinesis
Authors: Moran C. John , Neely J. Gail 
Published: November 2003

AbstractFacial nerve synkinesis is an extremely distressing sequela of facial paralysis, and its prevention and treatment are less than adequate. Improved therapeutic interventions await better understanding of its pathogenesis.In this study, 11 patients with synkinesis and 11 normal control subjects were quantitatively assessed using a new computer‐assisted, motion‐sensitive system. Two additional, informative cases presenting at the completion of the study are also briefly reported.The observed synkinetic patterns appear predictable and nonrandom. In addition, these observations tend to raise doubts that the aberrant fiber regeneration hypothesis is the sole explanation of synkinesis. They further implicate facial nuclear hyperexcitability as an explanation in at least some cases of synkinesis.Understanding these patterns enhances clinical detection and evaluation and may lead to a better knowledge of the fundamental pathophysiology of synkinesis and its prevention.
Acid‐Induced Laryngospasm in a Canine Model
Authors: Loughlin Christopher J. , Koufman James A. , Averill David B. , Cummins Michelle M. , Kim Yong‐Jae , Little John P. , Miller Inglis J. , Meredith J. Wayne 
Published: November 2003

AbstractA canine model was used to investigate the efferent laryngeal responses to stimulation by topically applied acid and pepsin. Five adult mongrel dogs were studied. Electromyographic recordings from the thyroarytenoid muscle were measured with hooked‐wire electrodes as an acid solution (normal saline/hydrochloric acid at pH 6.0, 5.0, 4.0, 3.0, 2.5, 2.0, 1.5, and 1.0) was sequentially instilled into the larynx. Laryngospasm (tonic, sustained contraction of the thyroarytenoid muscle) occurred in all animals at pH 2.5 to 2.0 or less. Control substances such as neutral pH isotonic saline, hypotonic saline, hypertonic saline, water, and pepsin alone failed to produce laryngospasm. Next, solutions containing both acid (in the same pH range) and pepsin were tested. The laryngeal responses were similar to those of acid alone. The superior laryngeal nerves were sectioned bilaterally and the above experiments repeated. None of the test solutions produced laryngospasm; however, when capsaicin (1%) was instilled into the subglottis, laryngospasm occurred. Thus, chemoreceptors in the subglottis (supplied by the recurrent laryngeal nerves) appear to be responsive to capsaicin stimulation but not to acid stimulation. The data suggest that pH‐sensitive chemoreceptors in the canine larynx cause laryngospasm (when the pH of the test solution is 2.5 or less) and that these acid receptors are supplied by the superior laryngeal nerves.
Cricoarytenoid Joint Mobility After Chronic Vocal Cord Paralysis
Authors: Gacek Mark , Gacek Richard R. 
Published: November 2003

AbstractEleven whole organ laryngeal specimens (10 human and 1 dog) with a history of long‐standing (6 months to 17 years) paralysis were studied histopathologically for changes in the cricoarytenoid (CA) joints and the intrinsic laryngeal musculature. In 9 cases the paralysis was unilateral and in 2 bilateral. No evidence of CA joint ankylosis (fibrous/osseous obliteration of joint space or degeneration of articular surfaces) was seen in the specimens. The absence of CA joint ankylosis permits the efficacy of thyroplasty medialization procedures.
Auricular Reconstruction of Congenital Microtia (Grade III)
Authors: Aguilar E. Fred 
Published: November 2003

AbstractThe auricular deformity of congenital microtia (Grade III) is almost always associated with congenital atresia, an affliction that can cause devastating physical and psychological trauma in children. Auricular reconstruction for congenital microtia (Grade III) should provide a child with a reasonable facsimile of an ear through a limited number of surgical procedures, with minimum complications.To achieve this result, the author developed the Integrated Auricular Reconstruction Protocol (IARP). The IARP consists of five stages: Stage I‐framework construction and placement; Stage II‐lobule creation; Stage III‐atresia repair; Stage IV‐tragal creation; and Stage V‐auricular elevation. Over a period of 5.5 years, the author performed 188 surgical procedures on 63 patients, completing 31 ears.This thesis has four objectives. The first is to strongly recommend that a child with congenital microtia and atresia be seen as early as possible by both a plastic surgeon and an otologist. The second objective is to describe a protocol by which both defects can be corrected without endangering the integrity of either. The third objective is to advocate the involvement, from the very beginning, of not only the child but also the family‐a critical but often overlooked component of the treatment of congenital microtia and atresia. The fourth and final objective is to propose that plastic surgeons interested in auricular reconstruction dedicate themselves to the performance of at least 10 such reconstructions per year.
Virtual Endoscopy of the Paranasal Sinuses Using Perspective Volume Rendered Helical Sinus Computed Tomography
Authors: Gilani Sapideh , Norbash Alexander M. , Ringl Helmut , Rubin Geoffrey D. , Napel Sandy , Terris David J. 
Published: November 2003

AbstractOur goal was to use three‐dimensional information obtained from helical computed tomographic (CT) data to explore and evaluate the nasal cavity, nasopharynx, and paranasal sinuses by simulated virtual endoscopy (VE). This was done by utilizing a new image reconstruction method known as perspective volume rendering (PVR). Thin‐section helical CT of the nasal cavity, nasopharynx, and paranasal sinuses was performed on a conventional CT scanner. The data were transferred to a workstation to create views similar to those seen with endoscopy. Additional views not normally accessible by conventional endoscopy were generated. Key perspectives were selected, and a video “flight” model was choreographed and synthesized through the nasal cavity and sinuses based on the CT data.VE allows evaluation of the nasal cavity, nasopharynx, and paranasal sinuses with appreciation of the relationships of these spatially complex structures. In addition, this technique allows structural visualization with unconventional angles, perspectives, and locations not conventionally accessible. Although biopsies, cultures, and lavages routinely done with endoscopy cannot be performed with VE, this technique holds promise for improving the diagnostic evaluation of the nasal cavity, the nasopharynx, and the paranasal sinuses. The unconventional visual perspectives and very low morbidity may complement many applications of simple diagnostic endoscopy.
Particulate Matter in the Posterior Semicircular Canal
Authors: Welling D. Bradley , Parnes Lorne S. , O'Brien Blaize , Bakaletz Lauren O. , Brackmann Derald E. , Hinojosa Raul 
Published: November 2003

AbstractThe pathoetiology of benign paroxysmal positional vertigo (BPPV) is controversial. Particulate matter within the posterior semicircular canal has been identified intraoperatively in patients with BPPV but has also been reported in non‐BPPV patients at the time of translabyrinthine surgery (Parnes LS, McClure JA. Free‐floating endolymphatic particles: a new operative finding during posterior semicircular canal occlusion. Laryngoscope 1992;102:988‐92; Schuknecht HF, Ruby RRF. Cupulolithiasis. Adv Otorhinolaryngol 1973;20:434‐43; Kveton JF, Kashgarian M. Particulate matter within the membranous labyrinth: pathologic or normal? Am J Otol 1994;15:173‐6). The nature of the particulate matter remains unknown.The purpose of this study was to prospectively examine the posterior semicircular canal of patients with and without a clinical history of BPPV for the presence of particulate matter. Seventy‐three patients without BPPV symptoms undergoing labyrinthine surgery (vestibular schwannoma excision or labyrinthectomy) and 26 patients with BPPV undergoing the posterior semicircular canal occlusion procedure were compared. Additionally, 70 archived temporal bones without a history of BPPV were examined microscopically for the presence of particulate matter within the lumen of the membranous labyrinth.No particles were observed intraoperatively in any of the 73 patients without a history of BPPV. Particulate matter was observed in 8 of 26 patients at the time of the posterior semicircular canal occlusion procedure for intractable BPPV.Of the 70 temporal bones examined, 31 did not show significant postmortem changes and also did not demonstrate cupulolithiasis or canalithiasis.Particulate matter from within the membranous posterior semicircular canal was removed from one patient at the time of posterior semicircular canal occlusion for intractable BPPV symptoms and was examined by scanning electron microscopy. The particulate matter appeared morphologically consistent with degenerating otoconia.These data show a statistically significant association between the presence of particles within the posterior semicircular canal in this study and the symptom complex of BPPV.
Liquid Household Bleach Ingestion in Children: A Retrospective Review
Authors: Harley Earl H. , Collins Millicent D. 
Published: November 2003

AbstractCurrent literature and some standard reference textbooks fail to adequately delineate the management of liquid household bleach (sodium hypochlorite) as different from other caustic agents. A literature review and retrospective study were conducted to focus attention on the clinical course and the low potential for development of long‐term sequelae secondary to liquid household bleach ingestion in children. The records of 19 patients were reviewed. The mean age of children ingesting bleach was 24 months. Most children obtained the liquid from an open container such as a cup. There were no short‐ or long‐term sequelae.We introduce an algorithm for the management of accidental ingestion of liquid household bleach in children. We conclude that in the United States accidental bleach ingestion in children is usually associated with a benign clinical course and usually does not require hospitalization, corticosteroids, or antibiotics unless there is severe dysphagia or signs of significant injury. Esophagoscopy may not be necessary, but fiberoptic examination of the pharynx and larynx should be included in the assessment of these children.
Intraotic Administration of Gentamicin: A New Method to Study Ototoxicity in the Crista Ampullaris of the Bullfrog
Authors: Carranza Angelica , Lopez Ivan , Castellano Philip , Hoffman Larry , Honrubia Vincente 
Published: November 2003

AbstractA new method of local gentamicin administration was tested in the bullfrog inner ear to achieve ototoxic‐induced hair cell destruction. Gelfoam pledgets soaked with known amounts of gentamicin were inserted into the perilymphatic cisterna of the bullfrog through a ventral surgical approach. A dose of 1.20 mg gentamicin, consistent with a perilymphatic concentration of 65 μg/ml, resulted in the desired ototoxic‐induced hair cell damage, that is, complete hair cell destruction with minimal disruption of other components of the sensory epithelium. This study demonstrates that this is a useful and simple method to investigate the process of vestibular ototoxicity and hair cell regeneration, including aspects of hair cell destruction and repair.
Autologous Fat Injection into the Vocal Folds: Technical Considerations and Long‐Term Follow‐up
Authors: Shaw Gary Y. , Szewczyk Mark A. , Searle Jeff , Woodroof Janet 
Published: November 2003

AbstractNumerous materials have been used over the years for vocal fold augmentation. Early use of bioreactive compounds, such as paraffin, gave way to relatively inert substances, such as Teflon. More recently biocompatible materials, such as collagen and autologous fat, have gained wider acceptance. Autologous fat, in particular, is an easily obtainable source for potential rehabilitation of scarred, paralytic, and atrophic vocal folds. However, long‐term systematic follow‐up has been lacking. Since 1991 we at the University of Kansas Center for Voice and Swallowing Disorders have employed autologous fat for vocal fold augmentation, primarily for either paralysis or repair of a volume‐deficient vocal fold segment. Twenty‐two patients have completed ≥1 year of follow‐up studies, including graded videolaryngostroboscopy, electroglottography, computerized acoustic analysis, and blinded perceptual analysis by two speech‐language pathologists. Statistically significant improvement was demonstrated in many parameters tested, frequently improving with time. Although the volume‐deficient group had more “normal” values, the paralysis group had greater improvement in many variables using fat injection. We conclude that while autologous fat injections of the vocal fold may have long‐term benefits, certain technical considerations and criteria of selection of patients are critical for success.