摘要:

AbstractThe clinical, radiographic, and pathologic records of 39 patients with peripheral facial nerve dysfunction seen from October 1981 through July 1984 are reviewed. The extent of preradiologic clinical localization of suspected lesions and their subsequent pathologic confirmation is correlated to the number, sequence, and type of radiographic evaluations performed.Based on this review, an imaging protocol for patients with clinically occult lesions of the peripheral facial nerve is presented.

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00001

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractSpontaneous enophthalmos has been reported to occur after demineralization of the orbital floor from chronic maxillary sinusitis. We report a 24‐year‐old female who developed spontaneous enophthalmos without demineralization of the orbital floor. A contracture from the maxillary sinus apparently pulled the orbital floor downward. Release of the fibrous tissue through a combined orbital and sinus approach produced satisfactory correction of the enophthalmos without the use of alloplastic implants. This case suggests that fibrotic contraction in the maxillary sinus pulling the floor of the orbit downward can produce spontaneous enophthalmos without boney destruct

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00002

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractWe present a patient with severe obstructive sleep apnea syndrome (OSAS), including O2 desaturations to 11%, who was successfully managed with myocutancous fenestration tracheostomy.The myocutaneous fenestration technique employs bilateral horizontal skin‐platysma advancement flaps sutured directly to a trachecal fenestra created between rings two to four. It conforms ideally to the unique physical and psychological demands of the sleep apnea patient. Rapid healing time and minimal granulation tissue, combined with a permanently functional, yet reversible and minimally disfigurative stoma, highlight the advantages of the technique over standard tracheostomy. The myocutaneous fenestration tracheostomy is uniquely applicable to the surgical treatment of patients with moderate to severe obstructive sleep apne

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00003

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractEleven patients suspected of having perilymphatic fistulas were evaluated. A perilymphatic fistula was demonstrable in ten of these patients. In six patients, fistulas of one of the windows, or both were found. In two patients, combined fistulas of both the round window and lateral semicircular canal were found. In two other patients, fistulas were found only in the lateral semicircular canal. The patients in whom fistulas were found and repaired improved dramatically. The patient without a demonstrable fistula remained symptomatic.We have shown that perilymphatic fistulas can occur in the lateral semicircular canal, and suggest exploring this area when indicated.

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00004

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractPectoralis major myocutaneous flap is the most commonly used versatile flap in head and neck reconstructive surgery.The use of entirely tubed pectoralis major myocutaneous flap for reconstruction of the hypopharynx following total laryngectomy and total pharyngectomy has a disadvantage of bulkiness of the flap and poor postoperative deglutition.One‐stage reconstruction of the entire hypopharynx utilizing a combination of pectoralis major myocutaneous flap and dermal graft minimizes bulkiness, thus achieving satisfactory to excellent functional results. The operation has been performed on four patients with excellent deglutition. The pectoralis major myocutaneous flap is utilized to reconstruct the anterior and lateral walls of the hypopharynx, the dermal graft for the posterior wall as far superior as the vault of the nasopharynx. The operative procedure is described.Pectoralis major myocutaneous flap usually provides enough length to reach the distant site of the surgical defect. On occasion, however, additional length is desirable to avoid tension along the suture line. This becomes apparent when a random portion of elevated pectoralis major myocutaneous flap presents questionable viability which may require further trimming. Resection of the medial half of the clavicle can provide additional length of this flap by 2 cm to 2.5 c

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00005

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractOculopharyngeal muscular dystrophy is a rare, autosomal dominant disorder which has been traced through 11 generations of a French Canadian family. The classic presenting complaints are palpebral ptosis and oropharyngeal dysphagia. The dysphagia is usually progressive and leads to repetitive regurgitation, increased alimentation time, and weight loss. Immunologic studies generally reveal elevated levels of IgA and IgG, while manometry demonstrates poor pharyngeal contraction. The dysphagia is frequently relieved by cricopharyngeal myotomy. We present two case reports and also a new ultrastructural finding of abnormal metallic mitochondrial inclusions. This finding has not been previously described in this disorder.

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00006

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractThis study attempted to determine whether or not nasal and sinus surgery had a beneficial or deleterious effect upon the asthma of patients with nasal polyps and aspirin idiosyncrasy. There were 205 patients in this study. A classification system was devised to provide a means of determining the severity of asthma before and after surgery. The data indicate that surgery does improve the patient's asthma for relatively long periods of time.

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00007

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractWe present a newborn with a unilateral complete facial palsy caused by birth trauma, and discuss the differential diagnosis, pathophysiology, and management of this common, usually benign, condition. This child made a rapid, complete, spontaneous recovery despite a severe initial injury. Surgical exploration of the facial nerve should be considered only for infants with complete paralysis, clinically and electrophysiologically, who demonstrate no improvement by 5 weeks of age.

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00008

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractNinety‐four percent of 508 patients operated on between 1960 and 1975 have been followed‐up at yearly intervals. Their status as of 1977 was assessed in order to determine their mean duration of socially adequate hearing levels and to relate the type of surgical procedure to the interval between operation and hearing aid requirement. Postoperative hearing losses due to conduction and sensorineural deficits resulted in preoperative bone/postoperative air gaps greater than 10 dB in up to 40% of large fenestra operations and in 15% of small fenestra operations at 5 years. On average, a large fenestra ear would require amplification at 13 years and a small fenestra ear at 21 years postoperativ

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00009

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY

摘要:

AbstractPrimary laryngeal melanomas (LM) are rare. In a review of all mucosal melanomas of the head and neck (MMHN) at Memorial Hospital from 1949 to 1983 we identified only three such cases. Review of the literature shows that LM usually involve the supraglottic larynx of elderly males. Although survival is as poor as for other MMHN, local recurrence is less frequent, even when primary therapy consists of more conservative surgical procedures than total laryngectomy.

ISSN:0023-852X    

DOI:10.1288/00005537-198604000-00010

出版商:John Wiley&Sons, Inc.    

年代:1986

数据来源: WILEY