ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00001

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractTransmastoid labyrinthectomy is an effective procedure for the control of episodic vertigo due to unilateral peripheral vestibular dysfunction. However, its application in older patients has been limited, primarily because of concerns that older patients may not compensate well postoperatively. Poor vestibular compensation results in constant disequilibrium, motion intolerance, and visual symptomatology. The purpose of this report is to review our results with transmastoid labyrinthectomy in patients over the age of 65. Complete records were available for 22 patients operated on between July 1984 and June 1994. Patient's records were reviewed for age, preoperative duration of symptoms, coexistent medical conditions, vertigo control, and postoperative disequilibrium. Advanced age need not be a contraindication to transmastoid labyrinthectomy.Laryngoscope, 105:1152‐1154, 19

ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00002

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractMinor salivary gland tumors of the palate are rare and may pose a diagnostic and therapeutic dilemma for the head and neck surgeon. The authors reviewed their 46 years of experience with minor salivary gland tumors of the palate to determine the factors that influence outcome and their implications for treatment.Malignant tumors were seen in 116 patients (78%) and benign tumors were found in 33 patients (22%). Adenoid cystic carcinoma was the most common malignant tumor, occurring in 43 patients, and pleomorphic adenoma was the most common benign tumor, occurring in 30 patients.Univariate analysis on the malignant lesions showed that grade 3 tumor histology (P<.001), tumor size greater than 3 cm (P<.001), perineural invasion (P=.031), bone invasion (P=.012), positive surgical margins (P<.001), and positive initial but negative final margins (P=.004) were all associated with decreased survival.With multivariate analysis, tumor size, margin status, and grade were shown to be independently associated with decreased survival (P<.05). The recurrence rate at the primary site was significantly higher for adenoid cystic carcinoma than for other histologies (P=.0059). The 2‐, 5‐, and 10‐year disease‐specific survival rates for patients with malignant disease were 96%, 87%, and 80%, respectively.Wide surgical excision with adequate margins is essential for a favorable outcome in patients with malignant minor salivary gland tumors. Postoperative radiotherapy is reserved for patients with grade 3 tumor histology, large primary lesions, perineural invasion, bone invasion, cervical lymph node metastasis, and positive margins, although a clear‐cut survival advantage has not been proven. Recurrence, especially regional and distant metastasis, portends an extremely poor prognosis.Laryngoscope, 105:1155

ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00003

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe Lothrop procedure resects the medial frontal sinus floor, superior nasal septum, and intersinus septum to create a large frontonasal communication. However, the external approach often allowed medial collapse of soft tissue and stenosis of the nasofrontal communication. We describe a modified transnasal endoscopic Lothrop procedure in which drills are used for cases in which frontal recess exploration fails to relieve obstruction of the frontal sinus. The lateral bony walls are preserved, and medial collapse does not occur. The mucosa of the posterior table and posterior nasofrontal duct is preserved, and a single common frontal opening is created. We have found this approach to be safe and reliable. Fourteen patients have undergone this procedure without complication, achieving resolution or improvement of their symptoms and maintaining wide patency of the frontonasal opening. We recognize that long‐term follow‐up will be required but remain encouraged with our favorable results to date.Laryngoscope, 105:1161‐1166

ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00004

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractAlthough acetylcholine (ACh) has been identified as the primary neurotransmitter of the efferent vestibular system in most animals studied, no direct evidence exists that ACh is the efferent neurotransmitter of the human vestibular system. Choline acetyltransferase immunohistochemistry (ChATi), acetylcholinesterase (AChE) histochemistry, and α‐bungarotoxin binding were used in human vestibular end‐organs to address this question. ChATi and AChE activity was found in numerous bouton‐type terminals contacting the basal area of type II vestibular hair cells and the afferent chalices surrounding type I hair cells; α‐bungarotoxin binding suggested the presence of nicotinic acetylcholine receptors on type II vestibular hair cells and on the afferent chalices surrounding type I hair cells. This study provides evidence that the human efferent vestibular axons and terminals are cholinergic and that the receptors receiving this innervation may be nicotinic.Laryngoscope, 105:1167

ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00005

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractA retrospective review was performed to assess the surgical complications of thyroidectomy performed by otolaryngology residents under close supervision by faculty. One hundred eighty‐six consecutive cases of thyroidectomy performed by the residents in the Department of Otolaryngology—Head and Neck Surgery at the University of Southern California were reviewed. Sixty‐nine percent of thyroidectomies were performed for malignant or possible malignant diseases, and 31% were performed for benign conditions. Transient (less than 2 weeks in duration) hypocalcemia occurred in 26% of the patients; the vast majority of cases resolved within the first week. Five percent of the patients developed persistent hypocalcemia requiring prolonged replacement therapy. The incidence of unexpected postoperative permanent vocal cord paralysis was 0.9%. These complication rates are comparable to those in previously published large series on results of thyroidectomy. Thyroidectomy performed in an otolaryngology residency training program is a safe procedure when closely supervised by experienced faculty.Laryngoscope, 105:1173‐11

ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00006

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractWounds of the lip and chin resulting from microscopically controlled (Mohs) surgery are often repaired immediately. However, wounds allowed to heal by secondary intention have the advantage of optimal cancer surveillance, simplified wound care, and avoidance of the costs and potential complications associated with reconstructive procedures. Accurate prediction of the course of wound healing would allow a rational approach to selection of surgery or healing by secondary intention.The authors evaluated 105 patients with defects of the lip and chin after Mohs excision for cancer who healed by secondary intention. Forty‐six patients treated surgically were followed for comparison. The lip and chin were divided into subunits and the wound location, size, and depth were recorded. Patients were followed at intervals and a final determination regarding cosmesis was made after 6 or more months.It is concluded that the final cosmetic result can be confidently predicted on the basis of location by subunit, size, and depth of the wound.Laryngoscope, 105:1176‐1183,

ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00007

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractCochlear implantation has proven beneficial for numerous children with profound congenital hearing impairments. Some congenitally deaf ears, however, may have anatomical malformations. This study reports the authors' recent experience with cochlear implants in patients with congenital inner ear malformations.Since 1987, 10 patients with congenital abnormal inner ear structures have been implanted at the House Ear Clinic; 8 with abnormal cochleas and 2 with enlarged vestibular aqueducts. Nine patients received the Nucleus 22 device and 1 patient was implanted with the 3M/House device. Some modifications of the routine surgical approach were required in 5 patients. A cerebrospinal fluid (CSF) leak occurred in 4 of the 10 cases. There was a relationship between the degree of abnormality and the number of electrodes that could be inserted. All 10 patients can perceive sound and are active users of their implants.Laryngoscope, 105:1184‐1187, 19

ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00008

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractChildren with IgG2deficiency commonly develop recurrent acute otitis media. It is believed that these infections are secondary to impaired antibody response rather than eustachian tube dysfunction and are therefore less responsive to treatment with tympanostomy tubes.The authors compared the incidence of acute otitis media in IgG2‐deficient patients following tympanostomy tube placement with controls in a retrospective cohort study. The charts of 20 patients (10 with IgG2deficiency and 10 controls) were reviewed. Episodes of otitis media were recorded for 12 months. IgG2‐deficient patients experienced three times as many occurrences of otitis media as did controls. This suggests that otitis media is much more common in these patients following tympanostomy tube placement. We believe that an immunodeficiency workup should be considered in patients with multiple episodes of otitis media following placement of tympanostomy tu

ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00009

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY

摘要:

AbstractIn recent preclinical and clinical trials, topoisomerase I inhibitors have shown great promise as antitumor agents. These agents are most effective against tumors with high topoisomerase I activity. Therefore, determining topoisomerase I activity in advance may predict response to topoisomerase I inhibitors.Squamous cell carcinoma of the head and neck and normal tissue samples were obtained from 12 patients. Cellular extracts were prepared, and topoisomerase I activity assays were performed. The results suggest that topoisomerase I activity in squamous cell carcinoma of the head and neck is increased approximately sixtyfold compared to normal tissue.Increased activity often correlates with clinical responsiveness; these results predict that topoisomerase I inhibitors should be effective and selective against squamous cell carcinoma of the head and neck.

ISSN:0023-852X    

DOI:10.1288/00005537-199511000-00010

出版商:John Wiley&Sons, Inc.    

年代:1995

数据来源: WILEY