摘要:

AbstractA one stage reconstruction of the tympanic membrane and the ossicular chain using a composite graft of tragal perichondrium with cartilage is described (Type III tympanoplasty). The long‐term results in 18 operated cases reveals closure of the air‐bone gap to within 0 to 10 dB in 72% of the cases.The above procedure used autologous graft material, does not disturb the remaining middle ear structures, can be performed under local anesthesia, and in most cases is done on an outpatient ba

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00001

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractA retrospective analysis of 171 patients with carcinoma of the tonsillar region is presented. The majority of patients (79%) presented with stage III and IV disease. Three year determinate survival was 81% ‐ T1, 74% ‐ T2, 59% ‐ T3, and 20% ‐ T4. The presence of nodal disease decreased survival by one half.Radiotherapy alone was highly successful in controlling early T1and T2lesions of the tonsillarfossa. Surgery alone or combined radiotherapy and surgery was more successful than radiotherapy in controlling early T1and T2lesions of the tonsillar pillar. More advanced T3and T4lesions also did poorly with radiotherapy alone. An analysis of these results and a review of the literature is pr

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00002

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractInfection in the marrow of the temporal, occipital, and sphenoid bones is an uncommon, but increasing occurrence. It is usually secondary to infections beginning in the external auditory canal and is caused almost uniformly by the gram negativePseudomonas aeruginosabacteria. Technetium and gallium scintigraphy help in the early detection of such infections while CT scans demonstrate dissolution of bone in well‐developed cases. Headache is the predominant symptom. Dysphagia, hoarseness, and aspiration herald the inevitable march of cranial nerves. We have diagnosed and treated 17 cases of osteomyelitis of the skull base. Although the total mortality rate is 53%, it is now a curable disease. Six of our last 8 patients remain alive, although 1 is still under treatment. Treatment is medical and requires the long‐term concomitant intravenous administration of an aminoglycoside and a broad spectrum semisynthetic penicillin effective against the causative organ

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00003

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractAn anatomic classification of lesions affecting the skull base is proposed according to which this region can be divided into amidline compartmentand two lateral compartments: apetrotemporaland aninfratemporal.The majority of lesions studied radiographically in 56 patients were confined to one of these anatomic subdivisions. The advantages of such a classification are discussed. The surgical approaches to these compartments and to the anterior middle and posterior cranial fossae are described relative to the lesions we have encountered.

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00004

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractMalignant external otitis (nccrotizing otitis externa) is an infectious process which occurs most often in middle‐aged and elderly diabetic patients and is characterized by cultures positive forPseudomonasand granulation tissue at the junction of the bony and cartilaginous portion of the external auditory canal. Epidermoid carcinoma of the external auditory canal is also seen most often in the middle‐aged and elderly population. To the best of our knowledge, no case of acute necrotizing otitis externa occurring concomitantly with epidermoid carcinoma of the external auditory canal has been documented.A case is presented and discussed here and the importance of biopsy of the external auditory canal is stressed.Theoretical considerations of the possible relationship between these two disorders are discussed.This case illustrates the need to discontinue the use of the term “malignant external otitis” and replace it with the term “necrotizing otitis

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00005

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractMagnetic resonance imaging using a 1.5 tesla magnet and a spin echo technique has revealed a remarkably intense signal from abnormal tissue in the human paranasal sinuses. Inflammatory disease in the maxillary, sphenoid, ethmoid, and frontal sinuses has been detected and demonstrated with greater clarity than any other available technique. The pathophysiologic basis for the intense signal has not been defined. These observations do, however, provide an opportunity to discover, clarify, and study paranasal sinus disease. Acute upper respiratory disease, allergic episodes, and the effect of drug treatment based on the MR signal and pathology can now be investigated with this technique. In addition, this may form a basis for assessing the epidemiology of paranasal sinus pathology.

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00006

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractThree hundred thirty‐five cases of acute mastoiditis with complications due to extension of infection beyond the mastoid are reported. Two hundred twenty‐four of those presented with intracranial sepsis. Meningitis occurred in 83 cases, brain abscess in 53, extradural abscess in 49 cases, and lateral sinus thrombosis in 39 cases.Intracranial complications are frequently seen in this group of patients with neglected otitis media. The complications occurred frequently in children and young adults (74%) with an overall mortality rate of 14%.Meningitis was the most common complication (37%); brain abscess had the highest mortality rate (36%). The overall mortality rate from intracranial complications was reduced in comparison with previous reported series. This is attributed to antibiotic treatment, the use of CT scan in excluding other intracranial complications, and close cooperation between the otologist and neurosurg

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00007

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractEpistaxis is the second most common cause of spontaneous bleeding. Of the two categories of epistaxis, mundane and severe, the mundane, usually anterior epistaxis, is the more common. It has been reported that 60% of individuals report at least one episode of epistaxis during their lifetime. Eighty percent of epistaxis occurs in Kiesselbach's plexus, a vascular network in the anterior portion of the nasal septum. We have designed a nasal tampon to control this common variety of epistaxis which is a fast, efficient, and cost‐effective method of anterior epistaxis control.The material used in the manufacture of the device (MerocelTM) has been used for over 5 years by the author, both in treatment of severe epistaxis and as a postoperative nasal packing. The design presented here has been used for anterior epistaxis for 18 months without untoward sequelae and with universal succes

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00008

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractA retrospective review of 282 consecutive patients with squamous cell carcinoma of the head and neck that were seen in the Radiation Oncology Department from January 1, 1980, through December 31, 1983, was performed. From this population a subgroup of six patients was identified that experienced growth of tumor in the radiation field during treatment. All except one of these patients expired from progression of cancer within 16 months. At the time of writing, the one remaining patient has progressive cancer in spite of additional therapy.Growth of cancer in the radiation field during therapy is unusual. It appears to be associated with a very poor prognosis even with aggressive salvage therapy. This observation should be taken into consideration in the medical/surgical management of these patients.

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00009

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractWe utilized low‐field magnetic resonance imaging (MRI) to evaluate 12 patients with head and neck lesions and suspected skull base or facial bone destruction. All except one had high resolution computed tomography (CT). MRI was performed on a 0.15 tesla (low‐field) resistive unit, with routinely good resolution due mainly to the use of specially designed rf receiver coils (surface coils). T1 and T2 weighted spin echo images were performed in all cases. In three instances axial, coronal, and sagittal images were done. All CTs were done with high resolution techniques on state‐of‐the‐art equipment. Comparison of the CT and MR images (at low‐field strength) showed that MRI's main strength lies in its freedom to perform images in any plane and to visualize intracranial lesions with early brain involvement. Otherwise, the two modalities are comparable. Bone destruction seen on CT was always detectable on MRI, although CT is clearly superior in resolving bone detail. MRI is recommended when direct coronal CT scans are not obtainable to evaluate superiad tumor extension. The improved visualization of nasopharyngeal soft tissue and cavernous sinus region is likely to make MRI the examination of first choice in evaluating lesions of the nasopharynx, skull base, and cave

ISSN:0023-852X    

DOI:10.1288/00005537-198603000-00010

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY