摘要:

AbstractPosterior fossa cisternography is a basic method for confirming the presence of acoustic and other tumors of the cerebellopontine angle. A modified outpatient procedure with use of new instrumentation is described here, and comparisons are made to the conventional hospital procedure.A series of patients selected for outpatient posterior fossa cisternography was studied using data processing techniques. Presenting symptoms and preliminary test results were compiled, and an impression established as to the likelihood of a tumor being present. Outpatient posterior fossa cisternography was performed, with examination under fluoroscopy in certain circumstances; surgery was performed in certain instances.The results of diagnostic procedures, surgical procedures, and follow‐up studies were coded, analyzed by computer, and conclusions draw

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00001

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractAutopsy findings and case histories of 64 cases of epidermoid carcinoma of the head and neck at the Denver Veterans Administration Hospital between 1967 and 1977 were reviewed. Forty percent of these cases had metastases below the clavicles at autopsy. Incidence of metastasis was related to size of the primary lesion. Correlation with nodal involvement was equivocal. Our data was combined with that of similar studies done by O'Brien in 1970 and Gowen in 1963 and resulted in a combined autopsy series of 247 cases. Overall, 47% had distant metastases at autopsy.

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00002

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractA technique for reconstruction of the lateral pharyngeal wall, with a buccal mucosal rotation flap is presented for use in patients following extensive resections of the lateral pharyngeal wall with partial mandiblectomy. Reconstruction of the base of the tongue, utilizing midline tongue flaps and/or the epiglottis, is also illustrated. These innovative techniques frequently obviate forehead and chest flaps, aid in vocal rehabilitation, and allow single stage resection and reconstruction in nonradiated patients.

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00003

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractTherapy for early carcinoma of the floor of the mouth is difficult because of the tendency for local invasion of muscle and extension onto the mandible and alveolus. Nearly 100% local control of disease without mandibular complication has been possible with a wide local three‐dimensional resection including marginal mandibulectomy with split thickness skin grafting. The operative technique and special considerations including management of the mandible, submandibular ducts, and airway are detailed. Lymph node metastases have been uncommon. The primary disease and pathology are correlated with regional metastasis, and based on this a treatment plan is recommende

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00004

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe presence of perilymph fistula has been difficult to determine because of the lack of efficient and reliable testing methods. The condition is suspected on the basis of history alone and confirmed by surgery.This paper details a quick, reliable procedure called the ENG fistula test, using impedance bridge for pressure change and electronystagmography to aid the establishment of nystagmus and dizziness. To evaluate this procedure, a combination of tests were performed, including Valsalva maneuver, tragal compression, and pneumatic otoscopy, which were previously considered helpful in the diagnosis of fistula. Of them, Valsalva maneuver and tragal compression proved inconclusive; pneumatic otoscopy proved to be helpful. In comparison, however, the ENG fistula test proved most valuable, with results surgically confirmed in 90.8% of cases in this series.This study involved 74 patients whose primary complaint was dizziness. Only some patients simultaneously experienced hearing loss. Included are 5 patients whose positive ENG fistula test results and 15 whose negative test results were confirmed by surgery. Selected case histories are presented.

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00005

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe expected success rate in primary stapedectomy is well documented in recent literature, but few reports have commented on the difficulties or the expected results in revision stapes surgery. Reports have dealt with different techniques, but the surgeon and the patient should be aware of the problems and risks involved in revision stapedectomy.The records of 35 patients who had undergone revision stapedectomy were analyzed to determine the following: 1. cause of failure, 2. how to avoid these difficulties, 3. hearing results, and 4. possible identifying factors which might pinpoint those patients with a high risk for sensorineural hearing loss.A review of these cases demonstrates that the results of revision stapedectomy are different than those for primary stapedectomy.

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00006

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe argon laser microscope recently developed by the author is used to vaporize the stapes tendon, the posterior crus and a rosette of holes in the stapes footplate in the surgical treatment of otosclerosis. An autogenous vein—stainless steel piston assembly is used to reconstruct the stapes portion of the ossicular chain.The surgical technique and results in a preliminary series of 11 patients are reported. Rationale and advantages over conventional stapedectomy are discusse

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00007

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThis investigation is a human application of previously reported work from our laboratories on experimental acoustic tumor effects on the stapedius reflex in monkeys. In this study, the contralateral stapedius reflex was elicited in human controls and in subjects with an acoustic tumor. Acoustic impedance was recorded on magnetic tape for offline analysis of reflex threshold, latency, rise, amplitude, decay, and relaxation.Typical tumor effects on threshold and decay were observed. Most important was the demonstration that decay measured at 20 db SL was more sensitive and more specific for tumor than decay measured at the conventional 10 db SL. Stapedius reflex latency, rise, and amplitude were more sensitive to the presence of a tumor than were measures of threshold and decay. These data indicate that qualification of the reflex will increase the utility of the test.

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00008

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractAlthough initial manometric studies of Eustachian tube ventilatory function in both normal and abnormal ears suggested that this technique provided an accurate physiologic assessment of ventilatory function, recent studies have questioned the physiologic nature of these tests. In an effort to clarify this controversy, the tubal ventilatory capacity of 51 ears in which Eustachian tube function was clinically normal was assessed manometrically. Similar measurements were made in 18 ears in which Eustachian tube function was clinically normal except for a complaint of aural fullness. This group showed poorer ventilatory function than normal ears, but the most striking result was the inability of over 50% of the normal group to equilibrate negative pressure to a level within the normal range of 0 to—50 mm H2O. It is postulated that Eustachian tube ventilatory function exhibits a range of individual variability such as is characteristic of other biologic system

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00009

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractBrain stem auditory evoked potential (BAEP) test results are reported on seven children (2 1/2‐13 years) with brain stem neoplasms. In each case, the BAEP test results clearly indicated the site of lesion as determined by computerized tomography and observation during surgery. Seven criteria for the assessment of BAEP test results are also presented: 1. Peak latency, 2. Intra‐peak latency, 3. Inter‐peak latency, 4. Response stability, 5. Amplitude, 6. Waveshape, and 7. Peak presence. Six children had positive indications on at least four of the seven criteria described, while one child had two positive indications. However, dramatic abnormality on any single criterion warrants serious investig

ISSN:0023-852X    

DOI:10.1288/00005537-198002000-00010

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY