摘要:

AbstractMost cases of osteomyelitis of the skull base occur as a result of inadequately treated localized malignant otitis externa. We present four patients with osteomyelitis of the skull base who did not present initially as malignant otitis externa. Increased morbidity may occur when these atypical cases are not promptly recognized and treated.

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00001

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractFlexible pharyngoscopy with the Müller maneuver has been proposed as a method for selection of uvulopalatopharyngoplasty candidates. In this prospective study, its predictive efficacy has been evaluated in 24 consecutive obstructive sleep apnea patients undergoing uvulopalatopharyngoplasty. FPMM enabled us to accurately predict the uvulopalatopharyngoplasty outcome in 12 of the 24 patients (50%).Although flexible pharyngoscopy with the Müller maneuver appears to be helpful in the selection of candidates for UPP, its distinct predictive efficacy is lo

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00002

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractIn 1983, Katzenstein,et al.first described a form of noninvasive sinusitis in adults, which was histologically identical to allergic bronchopulmonary aspergillosis, with mucin‐containing eosinophils, Charcot‐Leyden crystals, and fungal elements resemblingAspergillusspecies. The authors have treated six pediatric patients ages 8 to 16 who had findings typical of allergicAspergillussinusitis. All patients presented with nasal polyposis and progressive facial deformity. All patients had computed tomography findings of diffuse expansile sinus disease and four patients had evidence of bony erosion, raising the suspicion of malignancy. At surgery, all were found to have multiple sinuses densely packed with greenish‐black inspissated mucin. Therapy consisted of wide surgical drainage with careful follow‐up and nasal s

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00003

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractA previous publication by this author discussing complications of endoscopic intranasal ethmoidectomy indicated an overall complication rate of 29% in 90 patients (17% in 150 ethmoidectomies). Compared to published complications rates for traditional intranasal ethmoidectomy (2.7% to 3.7%), 17% is alarming and of concern.The complication results in 300 ethmoidectomies performed on 180 patients are presented. The overall complication rate was 9.3%. Only two further complications have occurred since the first reported series: a cerebrospinal fluid leak and one case of subcutaneous emphysema.Methods and techniques that have led to the reduction of complications are briefly discussed. Endoscopic ethmoidectomy is a valid, safe procedure in experienced hands.

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00004

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractPharyngeal reconstruction commonly involves grafts or flaps. Recent reports have emphasized the advantages of skin graft reconstruction. The purpose of this paper is to assess the results of pharyngeal reconstruction with the pectoralis musculocutaneous flap following composite resection and neck dissection. Thirty‐five patients who had predominantly advanced disease (88% stage IV) were treated in the Department of Otolaryngology at The Ohio State University. Oral diet was tolerated by 73.5% of the patients at the time of discharge. Of these, 80% were on a soft diet. Ultimately, 91% of the patients were able to tolerate an oral diet. The median hospital stay was 13 days. The estimated blood loss, blood replacement, complications, days to decannulation, and surgical time were analyzed. These results suggest that flap reconstruction leads to short hospitalization and provides an excellent opportunity for an oral die

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00005

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractThe best method for reconstructing the acutely fractured orbital floor is controversial. In this review, the outcome of 81 patients with an operatively confirmed pure orbital blow‐out fracture is evaluated with respect to postoperative enophthalmos, diplopia, infection, and extrusion. A Marlex®mesh implant was used to repair 58 of the fractures, with minimal resultant complications. We believe that Marlex®mesh is an ideal implant for use in repairing the early blow‐out fra

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00006

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractAlthough the protean manifestations of neurofibromatosis have been studied for many years, much is yet to be learned about this disease in young children. Specifically, little is known about the prevalence and significance of early neurotologic abnormalities in this population. Our review of the recent literature, however, failed to identify any publication on the use of ABR and acoustic reflex testing in the pediatric neurofibromatosis population.This study reports on a standardized differential diagnostic battery conducted on 44 children diagnosed as having neurofibromatosis. Results of the neuroaudiologic battery indicated that 32% of the children had significant abnormalities on ABR and acoustic reflex dynamic tests. This is a substantially higher prevalence of abnormalities than reported by another group at a recent NIH concensus meeting on neurofibromatosis.Discussion of the implications of these findings regarding evaluation protocols, as well as management for this select patient population, will follow.

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00007

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractDuring a 2‐year period ending in July 1987, nine patients were implanted with a percutaneous bone‐anchored hearing aid developed at the University of Gothenburg and Chalmers University of Technology, Sweden. Patient selection was based on the presence of conductive or mixed hearing loss in patients who are unable to wear a conventional hearing aid because of infection or ear canal problems. Patients had speech discrimination scores of at least 60% for phonetically balanced monosyllables (CID lists) at 40 dB above threshold, and a pure tone bone conduction average of 45 dB hearing loss or better.Patients were evaluated in sound field, preoperatively and postoperatively using warble tones, speech reception threshold, speech discrimination, and synthetic speech identification. The patient's unaided hearing and hearing with a bone‐anchored hearing aid were compared with the patient's hearing with a standard bone conduction hearing aid.Signal to noise ratio testing with the synthetic speech identification test demonstrated that the bone‐anchored hearing aid was comparable to a standard bone conduction aid. There were no complications in our series. Five patients who reported otorrhea with conventional hearing aids experienced no otorrhea after implantation. Patient satisfaction, as assessed by questionnaire, revealed that all patients preferred the bone‐anchored hearing aid to previously worn hea

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00008

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractAlthough compensation of voice with unilateral recurrent laryngeal nerve paralysis is commonly held to be the result of the unaffected vocal fold crossing past midline, or overcrossing, this mechanism of compensation has rarely been documented accurately. Beagle dogs were used to create a model of another proposed mechanism of compensation, known as midline drift. Six animals underwent sectioning of the left recurrent laryngeal nerve. One week later, three of the dogs underwent removal of the left posterior and lateral cricoarytenoid muscles. The effects of these procedures were studied by subjective assessment, direct laryngoscopy, and sound spectrographic analysis. Results indicate that glottal closure was improved after the second surgical procedure. The clinical implications of the results are discussed and compared with other manners of compensation hypothesized in the literature.

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00009

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY

摘要:

AbstractForty‐three cases of isolated sphenoid sinus disease were reviewed. In 33 cases, headache was a presenting symptom. Seven of 29 cases of inflammatory disease and nine of 13 patients with tumors of the sinus presented with cranial nerve findings. When nonspecific visual disturbances were eliminated, two of 29 cases of inflammation and eight of 13 cases of tumors of the sphenoid sinus had cranial nerve deficits. Ten of 12 CT scans performed on patients with tumors of the sinus demonstrated bony erosion or perisinus extensions. This was not found in any of the 27 scans of patients with inflammatory disease. A thorough cranial nerve examination and a CT scan should be performed early in patients who present with vague and unusual headache

ISSN:0023-852X    

DOI:10.1288/00005537-198907000-00010

出版商:John Wiley&Sons, Inc.    

年代:1989

数据来源: WILEY