摘要:

AbstractTwenty‐seven subjects with borderline velopharyngeal valving mechanisms diagnosed as having hoarseness with or without vocal cord pathology participated in a follow‐up study. The mean age of the subjects was 13 years, two months, and they were recalled an average of 4.7 years following initial study.The reassessment protocol included an evaluation of speech, velopharyngeal valving, behavioral and health histories, and laryngoscopy. Upon follow‐up, 70 percent of the subjects retained vocal cord abnormalities. The eight subjects who had normal cords continued to demonstrate hoarse voice quality. Only 53 percent of the subjects who retained some atypical condition of the cords showed the same condition upon re‐evaluation. In each case, the condition retained was vocal cord nodules.The subjects who no longer showed vocal cord pathology had an average age of 15 years, eight months, as opposed to an average of 12 years, one month for those children who retained abnormalities. This difference was significant, indicating that age was an important factor in remission.Surgical removal of vocal cord nodules without attention to improving the velopharyngeal valving mechanism proved to be an ineffective approach to management; however, improvement in valving mechanism was usually associated with improvement in the vocal cord condition although it did not always eliminate it.None of the subjects in this study demonstrated an unequivocally adequate velopharyngeal valving mechanism. This was true even in the group of subjects who retained hoarseness but lost vocal cord pathology.The study suggests that careful differential diagnosis is essential in the management of these laryngeal problems which are perhaps the result of laryngeal modification compensatory to poor velopharyngeal valving mechanisms. Investigations of laryngeal anatomy and physiology and study of functional correlates to both hoarseness and vocal cord pathology in these patients, is es

ISSN:0023-852X    

DOI:10.1002/lary.5540831101

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY

摘要:

AbstractIn order to understand the limitations imposed by middle ear pathology encountered in tympanoplasty and to compare statistically postoperative results of the various techniques used, a classification of cases is required. Until recently attempts to represent adequately each case in a classification seemed impossible because of the large number of variables to be considered; however, the variables can be included in two broad groups: one group represents the pathology of the conductive mechanism in the middle ear. This relates directly to the type of reconstruction possible and the degree of hearing improvement expected. The second group of variables relates to middle ear infection. Long lasting good hearing depends on a stable postoperative ear, free of infection. This classification is valuable as a guide for evaluating and grading of the pre‐operative ear with respect to the chances for obtaining a postoperative, stable ear free of infection. A dual classification is, therefore, proposed, representing the major variable factors which are basic to all cases and significantly influence the results obtained in tympanoplast

ISSN:0023-852X    

DOI:10.1002/lary.5540831102

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY

摘要:

AbstractThe purpose of this study is to evaluate the Asai procedure in terms of the postoperative fundamental vocal frequency of a group of native Japanese Asai speakers and to ascertain if auditory impressions are related in fact to acoustical impressions of higher fundamental vocal frequency. Study results indicate a postoperative vocal frequency of 97 Hz, which is significantly higher than the previous frequencies reported near 65 Hz. Of special note is the much higher percentage of aperiodicity among the Asai speakers when compared with a group of United States superior esophageal speakers.

ISSN:0023-852X    

DOI:10.1002/lary.5540831103

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY

摘要:

AbstractSeven patients with acute injuries of the parotid duct have been treated in the Department of Otolaryngology and Maxillofacial Surgery at the University of Iowa in the last five years. Two patients had lacerations of the buccal region of the duct and were treated successfully by reimplantation of the remaining duct into the oral cavity. The five patients with lacerations of the masseter portion underwent primary anastomosis. Two of these five patients demonstrated salivary flow from Stenson's duct on follow‐up. Of the three remaining patients, one healed but failed to show salivary flow at follow‐up; one patient had deliberate proximal duct ligation because of a large gap in the duct after excision of a basal carcinoma, and one patient developed a salivary fistula requiring radiation therapy for gland suppression. A technique for primary anastomosis of the parotid duct is descri

ISSN:0023-852X    

DOI:10.1002/lary.5540831104

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY

摘要:

AbstractA critical review of recent articles in which the surface preparation technique was employed is presented. Many of the reports were deficient in terms of five important criteria which would insure reproducibility of experiments, comparability of results from different investigators, and detection of a low level of cellular pathology. These criteria are: inclusion of concurrent controls; use of adequate number of control and treated animals to insure the detection of meaningful treatment‐control differences; adequate examination of controls; quantitative expression of cellular pathology, and the use of statistical analyses to test for significant differences.When these criteria were employed, methyl mercury was identified as a unique ototoxic agent. It caused a low level of outer hair cell pathology in all four turns of the guinea pig cochlea. Statistically significant damage occurred in the outer row of outer hair cells at 2½ turns from the cochlear base (P<.01) and in the inner row at 3½ turns (P<.05). When damage for all rows at each turn was considered, methyl mercury produced significant damage (P<.05) at 2½ turns from the cochlear

ISSN:0023-852X    

DOI:10.1002/lary.5540831105

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY

摘要:

AbstractA tympanometric configuration is described which is found in cases of both early and resolving serous otitis media. This tympanogram is useful in diagnosing the stage between negative middle ear pressure and serous effusion, and also in predicting resolution of serous effusion.

ISSN:0023-852X    

DOI:10.1002/lary.5540831106

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1002/lary.5540831107

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY

摘要:

AbstractBleeding can be minimized during general endotracheal anesthesia for mastoid‐tympanoplasty surgery by a satisfactory anesthesia, normal spontaneous ventilation without expiratory or inspiratory obstruction, proper positioning of the patient, and controlled hypotension at 95 systolic blood pressure with oxygen 6 liters/min. and halothane 1.5‐2 percent. Trimethaphan 0.1 percent may be added. The degree of hypotension is controlled by the depth of anesthesia with halothane, positioning, and if it is required, titration with trimethaphan.Controlled mild hypotension with halothane facilitates mastoid‐tympanoplasty surgery. It has been used in more than 300 patients, with ages ranging from six to 72 years. The results have been highly successful and satisfactory. There was no morbidity or mortality related either directly or indirectly to the use of this tech

ISSN:0023-852X    

DOI:10.1002/lary.5540831108

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY

摘要:

AbstractIn the Mongolian gerbil's middle ear, response to the presence of blood clot is characterized by mucosal hypertrophy and a vigorous organizational response within a two‐week period. Another three to four weeks are necessary for complete assimilation of remaining inflammatory products by active phagocytosis and absorption through a multi‐layered muc

ISSN:0023-852X    

DOI:10.1002/lary.5540831109

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY

摘要:

AbstractAlteration in pulmonary physiology occurred in 20 patients who had nasal packing, bed rest and sedation for control of epistaxis. While the packs were in place there was a uniform decrease in the arterial PO2and an increase in the arterial PCO2which was statistically significant. These changes were most marked in six patients who had pre‐existing chronic obstructive pulmonary disease. Removal of the packing or ligation of the internal maxillary artery quickly reversed the hypoxic state.It is postulated that the cardiovascular stress resulting from purposely inducing a hypoxic state with nasal packing, bed rest, and sedation may be the underlying etiology for sudden death. The alternative of using internal maxillary artery ligation not only avoids this hypoxic state but can also shorten the hospital stay and eliminate the discomfort and local complications known to occur with nasal packin

ISSN:0023-852X    

DOI:10.1002/lary.5540831110

出版商:John Wiley&Sons, Inc.    

年代:1973

数据来源: WILEY