摘要:

AbstractThe present study was performed to demonstrate a cortical projection to the facial nucleus of the cat. The right facial nucleus of 16 cats was injected with the retrograde tracer horseradish peroxidase (HRP). After allowing 36 hours for the retrograde transport of HRP, the animals were sacrificed by perfusion. The cortex, midbrain, and brain stem were removed, frozen sectioned, and reacted for HRP activity. Labeled pyramidal type cells were found bilaterally in layer V of the anterior sigmoid, presylvian, and coronal gyri of the frontal cerebral cortex. A significantly greater number of labeled cells were present in the contralateral motor cortex. Labeled cells were also found in the contralateral red nucleus, ipsilateral oculomotor nucleus, and periaqueductal gray substance of the midbrain.

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00001

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractThe purpose of this paper is to report our experience in the surgical management of choanal atresia. All of the patients in our series have been treated by endonasal puncture and application of a movable stent. Seventeen patients were operated on using this technique between July 1978 and January 1984. Eleven of the 17 were bilateral atresias and the remaining 6 were unilateral. All 17 cases were successfully treated using this technique. Based on our experience, we believe the key to successful repair of choanal atresia lies not in the method of opening the atretic plate, but in providing a stent that is movable and will thus reduce the occurrence of restenosis. At the same time, we propose a simple method of diagnosis.

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00002

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractThere have been dramatic improvements in the treatment of facial paralysis. These include the successful use of free autogenous nerve grafting, nerve crossover techniques, regional masticatory muscle transposition, and free muscle grafts. The techniques are applied to total, partial, and regional paresis. The bulk of information on rehabilitation of the face has come from clinical empiricism, but basic research in nerve and muscle physiology and attempts at multiple classifications regarding indications and criteria have added to the splender of this drama. One facet that has not been emphasized is the use of cheiloplasty in long‐standing facial paralysis.Long‐standing facial paralysis has both a neural and muscular deficit that cannot be rectified by a single concept or operation. It is essential to regionalize the rehabilitation, implant a kinetic muscular potential, supply some static support and elevation, and address the nonfunctional muscles about the paralyzed lips. This latter concept includes lip shortening and lip‐flap transposition. A coordinated combination of these techniques has the best opportunity of maximizing the improvement in long‐standing facial paralysis associated with severe muscle

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00003

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractTympanomastoid surgery is considered standard management for chronic suppurative otitis media (CSOM) without cholesteatoma, which is unresponsive to ototopical/oral antimicrobial therapy. The following makes this sequence of management less attractive today:1.potential ototoxicity of ototopical agents;2.lack of oral antimicrobial agents effective against most common pathogens (e.g., Pseudomonas aeruginosa);3.frequent occurrence in children who have tympanostomy tubes; and4.failure of tympanomastoid surgery to eradicate the disease in all cases. We conducted a study in 36 pediatric patients with chronic suppurative otitis media, in which all received parenteral antimicrobial therapy and daily aural toilet (mean duration of treatment = 9.7 days). Thirty‐two patients (89%) had resolution of their infection with medical therapy alone; four children required tympanomastoidectomy. Further investigation is needed to understand the etiology, pathogenesis, and most effective methods of management/prevention of CSOM in childre

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00004

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractAs a primary physician for most deaf children, the otolaryngologist must be able to identify signs and symptoms of sexual abuse. Child sexual abuse is a topic of national concern as epidemiologic data indicate more than 100,000 American children become victims annually. This paper provides an overview of the incidence, demographic characteristics, risk factors, and dynamics of child sexual abuse within both the general handicapped and, specifically, the hearing imparied populations. Strategies for identifying the sexually abused hearing impaired child are delineated including the physical appearance and behavioral manifestations of child victims, as well as the characteristics of abusive caretakers and perpetrators. Case summaries are presented which illustrate these characteristics. A national center specializing in the evaluation and treatment of abused handicapped children is described.

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00005

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractThis report presents the results of 210 cases over a 10‐year period using PORPs, TORPs, and notched incus homografts (NIH), for ossicular reconstruction in chronic ear surgery. There were 192 adults and 18 children. The surgical technique utilized temporalis fascia in an underlay technique with canal skin covering the outer surface of the fascia. Intact canal wall mastoid‐tympanoplasty, as a one‐stage procedure, was used for most cases. Homograft nasal cartilage was placed between the Plasti‐Pore® prosthesis and the graft. Notched incus homografts were prepared prior to surgery and stored in 4% formalin. There were 149 mastoid‐tympanoplasties and 61 tympanoplasties performed. Revsion of our cases was performed in 16.6%.Within 3 months of surgery, 86% of adults, and 44% (8/18) of children had dry, healed ears free of disease. The graft take rate was 96%. In adults, a total of 99 NIH, 50 TORPs, and 43 PORPs were implanted. In adults, the closure of the air‐bone gap to 20 dB or less occurred in 58% using TORPs, 67% using PORPs, 76% using NIH‐Partial replacement, and 20% using NIH‐Total replacement. Excluding the cases that failed for reasons other than conductive hearing loss, the results improved to 69% for TORPs, 77% for PORPs, 77% for NIH‐P, and 27% for NIH‐T. In adults, the extrusion rate was 5.5% for Plasti‐Pore® and 3% for NIH. In children, the extrusion rate was 17% for Plasti‐Pore® prostheses.From this study, it appears that PORPs and TORPs with homograft nasal cartilage are satisfactory prostheses for chronic ear surgery in adults. In children, Plasti‐Pore® prostheses should be avoided unless the ear is healed, aerated, and stable. NIHs are good prostheses when the stapes is intact, but they are inferior to the TORP when placed on the footplate. Also, the NIH requires preparation prior to surgery and may be difficult to obtain. We plan to continue using PORPs and TORPs in chronic ear surgery until a better technique is found, or the complicat

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00006

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractReview of the otolaryngologic literature reveals no reports of sudden sensorineural hearing loss resulting from manipulation of the cervical spine. Indeed, in previously reported cases of vertebrobasilar artery injury following spinal manipulation, hearing loss has received little attention. Two patients with sudden sensorineural hearing loss following cervical spine manipulation are presented. The audiologic findings and cerebral arteriograms are reviewed and treatment is discussed. A review of the anatomy and pathophysiology is also included, and a possible mechanism of injury to the vertebral artery is proposed.

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00007

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractRecent advances in reconstructive surgery for head and neck cancer have improved the cure rate of advanced carcinoma, and the function of the organ. However, it still remains difficult to repair the mandible and oral floor. We devised a combined flap of myocutaneous latissimus dorsi and iliac bone, and applied it to two patients with advanced carcinoma of the oral cavity that invaded to the mandible (T4N3M0). Each patient received preoperative irradiation, totalling 30 Gy and 40 Gy. Two weeks before the extensive resection, a sufficient bony mass for the presumed mandibular defect was taken from the iliac crest and transplanted beneath the latissimus dorsi muscle. Defects of the mandible and oral floor were reconstructed using this combined flap immediately after the resection. The patients began to eat 2 weeks after surgery.

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00008

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractA series of experiments was performed to study electrically evoked potentials as indicators of subject response to cochlear implantation.1.Brain stem evoked responses to electrical stimulation were compared to those obtained by acoustic stimulation in guinea pigs. The response pattern was similar and was independent of the site of placement of the stimulus electrode (cochlear base or apex) or of the extracochlear ground electrode (eustachian tube or temporalis muscle) when evoked electrically.2.Electrically evoked middle latency responses were recorded and compared to subjective behavioral thresholds in patients who had received a single channel cochlear implant (House‐Urban). The behavioral responses to the same stimuli were similar.3.Electrically evoked auditory brain stem responses were studied in single channel cochlear implant subjects (3M/House). When evoked electrically, potential latencies were shorter and interpeak intervals narrower than acoustically evoked potential

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00009

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractTwenty‐five hyperlipidemic, neurologically and audiologically asymptomatic patients were compared to 20 normolipemic control subjects regarding different interpeak latency differences (IPLD) of auditory brain stem evoked potentials (ABEP). ABEP were recorded in response to click stimuli presented at a rate of 10/sec and 55/sec. The net effect of increasing stimulus rate (ISR) on IPLD of ABEP was significantly greater in the hyperlipidemic patients for IPLD (V‐I) and IPLD (III‐I). ISR of ABEP indicates a trend of subclinical impairments of brain stem function in hyperlipidemic patients, probably due to ischemia accelerated by their cond

ISSN:0023-852X    

DOI:10.1288/00005537-198602000-00010

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY