摘要:

AbstractThe long‐term results of 375 primary mastoidectomy operations for chronic otitis media and chronic mastoiditis are described and discussed. Two‐thirds of these cases were open cavity mastoidectomies and 1/3 closed cavity mastoidectomies. Primary pathology was cholesteatoma in 1/3 and granulation tissue in 2/3 of the cases. The method of reducing the size of the mastoid cavity by sculpturing mastoid cortical bone is most important in avoiding large postoperative cavity problems.Principles and methods are described. Healing (dry ear) is a more important management objective than hearing and, indeed, enhances the prospects of obtaining a long‐term hearing result. Three important phases of controlling mastoid disease (preoperative, operative, and postoperative) are equally stressed. Intact wall tympanomastoidectomy is not recommended in sclerotic mastoids (the majority of our cases) as being unsafe and unnecessary. Revisions, mostly minor, were done in 31% of the cases for a total of 521 procedures. We recommend a one‐stage tympanomastoidectomy. Multiple planned procedures are, in the main, unnecessary and should be avoided to reduce unnecessary hospitalization and

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00001

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractVerrucous carcinoma, because of its oftentimes unusual clinical appearance, may be misdiagnosed if there is not good communication between the surgeon and the pathologist. We have reviewed our series of 20 cases of verrucous carcinoma from 1964 through 1974 and have analyzed the results of our therapy. We have concluded that verrucous carcinoma is a slow‐growing, locally invasive lesion that does not metastasize to the cervical lymph nodes. Radiation therapy does not seem to be an effective method of treatment; the recurrence rate is high. Conservative laryngeal surgery is the preferred method of treatment in these patients and should prevent loss of life and spare laryngeal functio

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00002

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractIn the 100 years since Bilroth first undertook a total laryngectomy, general improvements in the prevention and management of childhood and adult disease have led to continuing increase in life expectancy to the point that, in many developed countries, 25% or more of the population is over the age of 65. Although many of these individuals are in otherwise reasonable health, major head and neck procedures are often not performed in favor of radiation therapy for cure, even for lesions that would otherwise be considered amenable to surgery in younger patients, on the grounds that the patient is too old to tolerate the necessary procedure. The same argument has been employed in favoring total laryngectomy over subtotal procedures in the older patient.Review of the author's experience (27 cases) with conservation laryngeal surgery in patients over the age of 65 at the time treatment was undertaken reveals that such procedures are well tolerated in this age group. There were no mortalities and an overall complication rate of 11.1% resulted. These findings compare favorably with complication rates reported for similar patients and surgery in the under 65 age group and strongly suggest that chronologic age alone need not be a contraindication to such surgery.

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00003

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractInvasive malignant melanoma of the conjunctiva is a rare neoplasm fatal in 40% of cases. Accepted techniques of surgical management include wide local excision, conjunctivectomy, and exenteration. Recently lymphatic dissections have been proposed, but not described, for invasive conjunctival melanoma. We present five cases of invasive conjunctival melanoma, including two with intraglandular parotid metastases. The surgical management of these patients is presented, and a proposal is made for radical bloc dissection of the orbital contents and regional lymphatics. The histology of conjunctival melanoma is discussed, and a classification proposed to assist the head and neck surgical team in the management of this disease.

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00004

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractIn order to evaluate the relative sensitivity of caloric and sinusoidal angular acceleration tests, thermal and rotational stimuli were administered to cats rendered vestibulotoxic with streptomycin sulfate. Three groups of six cats each, receiving daily subcutaneous injections of saline, 100 mg/kg streptomycin or 200 mg/kg streptomycin, were administered optokinetic, caloric and sinusoidal stimuli. Vestibular responses were evaluated by changes in the total slow phase displacement of the eyes and frequency of nystagmic beats.The results demonstrated that the saline treated animals had a decrease in response consistent with habituation; whereas, experimental animals showed a marked, rapid abolition of eye movement. The decrease in response was greater for the larger dose of streptomycin. Caloric or sinusoidal acceleration tests were equally sensitive in monitoring the degree of nystagmic depression. The data suggested that sinusoidal acceleration tests could be easily applied to the clinical vestibular assessment of ototoxicity.

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00005

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractNineteen normal and 22 hearing impaired subjects were used in this study. Thresholds were determined by the following methods: 1. behavioral continuous tone, 2. behavioral tone burst, and 3. the brain stem electric response (BER) with tone bursts. A comparison of the BER thresholds with the behavioral thresholds are made for each subject. The difference between these three measures of threshold suggests that audiograms can be derived from the brain stem response threshold. The derived audiogram compares favorably with conventional audiograms. However, it must be remembered that the brain stem response is not hearing.

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00006

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractExperience with the transnasal microsurgical correction of bilateral congenital choanal atresia is presented. Four case reports are presented to illustrate the advantages of this surgical approach utilizing standard otosurgical instruments and supplemental fiberoptic nasopharyngeal visualization.

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00007

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractFive cases of tracheal stenosis are presented, and aspects of etiology and pathophysiology of the disease are discussed. A new soft, flexible T‐tube is described along with a method of endoscopic introduction. Although many patients with tracheal stenosis will eventually need tracheal reconstruction, stenting may be definitive in selected case

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00008

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractSarcoidosis is a multisystem granulomatous disease of unknown etiology, occasionally presenting with signs or symptoms that occur within the head and neck.The diagnosis may be made by a combination of histological evaluation of involved tissue, the presence of a relative cutaneous anergy, a positive Kveim test, and certain abnormal laboratory or radiographic findings.Although pulmonary sarcoidosis is by far the most common manifestation of the disease, an occasional patient will present with involvement of the nose, tonsils, larynx, or parotid gland. The otolaryngologist should include this entity in his differential diagnosis of lesions which occur in these areas.

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00009

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe effects of surgical trauma on the cricoarytenoid joint were analyzed using canine models. The cricoarytenoid joints of seven dogs were surgically disrupted. In four of the dogs an arthroplasty with silastic implantation was simultaneously performed. The histologic findings and the unsuccessful functional results are presented and discussed.

ISSN:0023-852X    

DOI:10.1288/00005537-197712000-00010

出版商:John Wiley&Sons, Inc.    

年代:1977

数据来源: WILEY