ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00001

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe facial nerve is often injured in head trauma. Computed tomography (CT) is the diagnostic study most frequently used to evaluate temporal bone fractures, but it does not demonstrate all soft tissues well. Recently, magnetic resonance imaging (MRI) has been used to evaluate certain soft tissues, including cranial nerves. Experience with MRI evaluation of temporal bone trauma is limited and consists primarily of anecdotal reports. This study assesses the accuracy of MRI in evaluating experimentally induced acute intratemporal facial nerve lesions. The tympanic segments of the right facial nerve in nine rabbits were contused, and MRI scans were performed without and with gadolinium‐diethyl‐triamine‐pentaacetic acid (Gd‐DTPA) at varying intervals after surgery. MRI with Gd‐DTPA accurately identified the lesion site in eight of nine subjects. Gd‐DTPA‐enhanced MRI appears to be useful in the evaluation of traumatic facial n

ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00002

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractA prospective randomized study analyzing the safety and efficacy of a single dose of ototopical antibiotics following human middle ear tympanostomy tube insertion was performed. Fifty children undergoing bilateral tympanostomy tube insertion were studied by the placement of 0.5 mL of Cortisporin Otic Suspension (COS; Burroughs Wellcome Co., Research Triangle Park, N.C.) to one middle ear space by random assignment. Preoperative and postoperative audiograms were obtained, and the presence of otorrhea was noted. In one patient sensorineural hearing loss of 6 dB developed bilaterally, which was symmetric in both the treated and the untreated ear. This preliminary study showed no statistical difference in hearing loss or postoperative otorrhea associated with a single application of Cortisporin to the middle ear space.

ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00003

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractEvaluating surgical margins during composite resection of carcinoma is limited by analysis of the bone margins. The standard pathologic evaluation of bone is by decalcification. A method of analysis was devised based on histologically proven methods of cortical invasion and subsequent spread. Frozen section analysis (FSA) of the cancellous bone was investigated as a rapid method of evaluating adequacy of the mandibular resection. Subjects consisted of 29 patients undergoing full‐thickness mandibular resection, with 16 cases of histologically proven mandibular invasion qualifying for evaluation. Results of FSA were then compared to the permanent section analysis of the cancellous bone and to the decalcified specimen. Complete correlation was found between frozen and permanent section results. Frozen section analysis was able to correctly predict adequacy of resection in 32 (97%) of 33 margin

ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00004

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractMycosis fungoides (MF) is a cutaneous T‐cell lymphoma that may progress to involve lymph nodes, the spleen, and other visceral organs. We have retrospectively reviewed our 10‐year experience with MF at the Johns Hopkins Hospital. Forty‐five patients received treatment for MF between 1983 and 1992. Approximately 70% of the patients with MF presented with cutaneous or extracutaneous lesions of the head and neck. The head and neck manifestations, clinical assessment, and treatment of our patient population are presented. Mycosis fungoides is a potentially lethal disease that frequently involves the head and neck region and should be included in the differential diagnosis of cutaneous head and neck le

ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00005

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractType I thyroplasty and arytenoid adduction have been used for the treatment of symptomatic unilateral vocal fold paralysis since the mid‐1970s. To this date, the vibratory patterns of the vocal folds in patients with unilateral vocal fold paralysis undergoing thyroplasty have not been studied in depth. Abnormal vibration of the vocal fold mucosa often contributes to voice problems in persons diagnosed with vocal diseases or disorders. The preoperative and postoperative videostroboscopic vibratory patterns including mucosal wave, amplitude, glottic closure, and symmetry were studied in 12 patients who underwent unilateral type I thyroplasty separately or in combination with an arytenoid adduction. The observed changes and clinical implications are discusse

ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00006

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractReconstructive options following total laryngo‐pharyngectomy include thin, pliable free tissue segments, approximating the natural thickness of the pharyngeal wall. The authors have investigated outcomes in the following clinical series, emphasizing speech and swallowing.Twelve cancer patients underwent laryngopharyngectomy with or without glossectomy. Eight jejunal, 1 radial forearm, and 3 innervated latissimus dorsi flaps were used for vibratory segment (VS) reconstruction, and all 12 patients underwent tracheoesophageal puncture (TEP).Eleven patients achieved intelligible speech, with a median intelligibility of 93%. The vibrating segments showed fluttering of the free flap tissue when studied by videopharyngography. Vocal quality was lower pitched and softer than “conventional” TEP speech. All patients achieved oral intake as their primary mode of nutrition.Free flaps are a successful option for VS reconstruction in patients undergoing laryngopharyngectomy or glossopharyngolaryngectomy, obviating the need for written or electrolarynx communic

ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00007

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractA number of studies have suggested that tumor thickness may be a valuable prognostic indicator in the evaluation of head and neck cancers. This study examined the relationship between tumor thickness measured in preliminary biopsy specimens with the final specimens obtained in 31 patients patients with floor of mouth epidermoid carcinoma. There was a significant statistical correlation between biopsy and final specimens. The Pearson's product‐moment correlation coefficient was 0.58, which corresponded to a significance level of P<.0005. The results of this study showed that those patients who had biopsies with a thickness less than or equal to 1 mm were likely to have final specimens with a thickness less than 2 mm. All patients with a thickness greater than 2 mm had a final specimen with a thickness greater than 3.5 mm. Modification of current biopsy techniques may result in values more predictive of final thickness measurement

ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00008

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractAbsorbable sutures have been advocated for tracheal anastomosis to reduce fibrosis and foreign body reaction leading to recurrent stenosis. Fibrin tissue adhesive (FTA) and diode laser welding with indocyanine green‐dyed fibrinogen were evaluated in tracheal anastomosis to reduce the number of sutures and to improve healing. In vitro studies demonstrated strong anastomoses with a combination of laser welding and FTA with minimal tissue damage. In a controlled in vivo study, circumferential resections of canine tracheas were repaired with laser welding and FTA augmented with a few stay sutures. These anastomoses had less fibrosis and tissue damage than anastomoses in control animals repaired with sutures alone. This study supports investigation of laser welding and FTA in human beings for tracheal anastomosis and other procedures in which suturing may be difficul

ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00009

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractHistorically, clinicians have used subjective assessment and perceptual judgments, supplemented with acoustic measures, aerodynamic studies, and videostroboscopy, to determine the effects of phonosurgery. When phonosurgical results are poor, magnetic resonance imaging (MRI) can be useful in determining how the surgical modifications contributed to the anatomical and functional status of the vocal folds.The authors present examples of MRI following vocal fold medialization by injection, thyroplasty, and arytenoid adduction. Findings reveal that the superior contrast resolution of MRI can precisely identify placement and persistence of injected implants and is particularly helpful in showing effects of the size and shape of alloplastic prostheses on vocal fold displacement. Such information is useful in troubleshooting suboptimal results and in planning revision thyroplasty by defining modification in the design of prostheses and the placement of cartilaginous windows in medialization thyroplasty. MRI can also aid in confirming indications for and limitations of certain procedures.

ISSN:0023-852X    

DOI:10.1288/00005537-199505000-00010

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY