摘要:

AbstractEndolymphatic sac ablation in the guinea pig can result in a dilated membranous labyrinth and low‐frequency hearing loss similar to patients with Meniere's disease. However, this animal model fails to develop analogous symptoms of a Meniere's crisis such as sudden hearing loss and marked vestibular imbalance. Possibly, factors in addition to endolymphatic hydrops must be present to result in a crisis episode. By placing animals in an inverted posture, their intralabyrinthine pressure was elevated, causing additional stress on the inner ears. Standard electronystagmographic techniques were used to monitor vestibular imbalance, which appeared as spontaneous nystagmus in the dark. Nineteen of 23 animals with unilateral endolymphatic hydrops showed spontaneous nystagmus in an inverted posture. Physiologic mechanisms explaining these results are describe

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00001

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractPhotoglottography and electroglottography are relatively noninvasive techniques that provide detailed information about vocal fold vibration. However, few significant clinical applications have been made by correlating photoelectric waveforms to specific pathologic changes in laryngeal vibration. Videostroboscopy has recently been used to document vibratory patterns of laryngeal paralyses in a canine model of phonation. A study of PGG and EGG waveforms correlated with videostroboscopy in an in‐vivo canine model of phonation with simulated unilateral recurrent or superior laryngeal nerve paralysis is presented. The shift quotient—a new glottographic parameter which identifies flaccid laryngeal paralyses—is pres

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00002

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractOver the past 5 years, the authors have treated 67 adult professional voice users with a musculoskeletal tension disorder involving the larynx and supporting structures and leading to vocal dysfunction. Common clinical features in both sexes were muscle tension in the neck, poor control of the breath stream, and an abnormally low‐pitched speaking voice. Most of the men sounded like Humphrey Bogart and the women like Lauren Bacall. These cases represent a discrete clinical vocal fatigue syndrome, the treatment of which is patient education and voice therap

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00003

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractAuditory brainstem, response (ABR) has been used by several investigators to study the role of the brain stem in the pathophysiology of obstructive sleep apnea (OSA). These studies have produced conflicting results.We studied 27 preoperative OSA patients and 17 controls using click stimuli presented at a slow (11.7/second) rate and at a fast (57.7/second) rate. ABR was repeated postoperatively in 18 patients.There were no statistically significant differences in the ABRs of preoperative OSA patients when compared with the control group. However, the preoperative recordings showed statistically significant prolonged latencies for wave III (p<0.01) and interpeak latency (IPL) I‐III (p<0.01) when compared to postoperative recordings. Rapid‐rate testing was not helpful.Although normal sleep does not cause ABR abnormalities, the pathological sleepiness seen in OSA patients may cause brainstem dysfunction manifested by prolonged ABR latencies. These abnormalities may resolve with treatment of

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00004

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractSelective vestibular neurectomy is considered an effective means of relieving intractable vertigo while preserving hearing. In order to determine the effectiveness of the retrolabyrinthine approach to selective vestibular neurectomy, we evaluated 161 patients who underwent vestibular neurectomy between April 1981 and September 1985. Questionnaire responses indicated that 97% of the Meniere's disease patients and 68% of the non‐Meniere's disease patients experienced a substantial improvement or resolution of their vertiginous symptoms. Hearing was maintained within 10 dB of the preoperative level in the majority of the patients. Neurological complications were limited to 2 cases of meningitis which resolved with medical therapy, 7 cases of cerebral spinal fluid leaks, and 3 cases of complete sensorineural hearing loss. Based on this review, we concluded that retrolabyrinthine vestibular neurectomy continues to be a safe and effective approach to relieve ear‐related vert

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00005

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractProgression of preexisting sensorineural hearing loss (SNHL) in infants and children has been considered an indication for fistula exploration: is this approach warranted? On exploring 36 middle ears in 26 such children, we found a perilymphatic fistula (PLF) in four ears (11%). Although there was radiographic evidence of inner‐ear deformity in one half of these children, a definite fistula was found in only four of 18 radiographically abnormal ears explored (22%). Even in the four patients with a history of an “event” that could implicate a fistula such as exertion or barotrauma, a fistula was found in only one.There are a number of possible causes for progression of a preexisting SNHL, and surgical exploration of the middle ear should not be recommended on the basis of progression alone. Instead, exploration for a suspected PLF should be strongly considered when there is also a history of an “event,” and/or radiographic evidence of inner‐ear abnormalities. Even under these conditions, one should be aware that fistulae are not likely

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00006

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe antigen recognition system which plays the major role in immunologic attraction mechanisms, including graft rejection, is the class II major histocompatibility complex containing the HLA‐DR locus. Few types of cells constitutively express this antigen, as it is a potent immunological activating signal usually confined to antigen processing cells, activated lymphocytes, and endothelium. Using indirect immunofluorescence, we have observed induction of the HLA‐ DR glycoprotein in selected head and neck squamous cell carcinoma tissue cultures treated with recombinant interferon gamma. This occurs in concert with growth arrest and morphological changes after rHuIFN‐γ treatment. This report describes the induction of a surface antigen that may have profound prognostic significance. Understanding the kinetics of HLA‐DR induction will aid in the design and assessment of adoptive immunotherapy with

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00007

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractTwo hundred twelve patients were treated for facial or skull trauma at the West Virginia University Hospital between the years 1977 and 1987. Sixty‐she of these patients had frontal sinus or nasofrontal duct trauma. Follow‐up information was obtained on 64 of these patients through clinic visits, chart review, questionnaires to patients and physicians, and telephone calls to the patients. Follow‐up greater than 1 year was obtained on 52 patients. Sixty‐four patients were managed either with a frontal sinus obliteration or with an open exploratory procedure. The incidence of complications occurring in the past 10 years after each of these procedures is compared. Because the indications for each procedure vary somewhat, data is presented on fracture etiology, associated injuries, specific fracture location, fracture displacement, severity of injury, and associated cerebrospinal flui

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00008

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe revascularization of a skin flap after flap transposition is an important step in flap survival. This study investigates the efficacy of certain angiogenic agents to expedite the neovascularization process and to increase the viability of skin flaps. Eighty‐four island skin flaps were designed on the auricles of 42 New Zealand White rabbits to achieve 90% necrosis over a 7‐day period. Thirty‐six flaps were treated with Endothelial Cell Growth Supplement (ECGS) or Endothelial Cell Growth Factor (ECGF) at several concentrations topically or immersed in Gelfoam. The remaining flaps were used as normal saline controls. Flap viability and peripheral neovascularization were documented by polar planimetry, angiography, and histological analysis.The flap viability of the ECGS‐Gelfoam(r)‐treated flaps was 100% greater than their normal saline‐Gelfoam controls (p= .021). Flap angiograms demonstrated increased vascular ingrowth among the treated flaps compared to the controls. This study suggests that angiogenic agents can expedite flap neovascularization and have the potential to increase fla

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00009

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe concomitant occurrence of Zenker's diverticulum and hiatus hernia in several patients prompted an investigation to determine whether there is a statistically significant increased incidence of hiatus hernia in patients with Zenker's diverticulum.Radiologic reports contained in 104 charts of patients from the University of Iowa with a diagnosis of Zenker's diverticulum were analyzed retrospectively for the presence of hiatus hernia. Radiologic reports contained in charts of a control group of patients, who had a barium swallow for work‐up of a head and neck malignancy, were also analyzed.The control group had a 16% incidence of hiatus hernia, which was consistent with published data. The Zenker's diverticulum group had a 39% incidence of hiatus hernia, a statistically significant increase over the control group. The pathophysiology linking these conditions and the clinical implications of their relationship are discusse

ISSN:0023-852X    

DOI:10.1288/00005537-198805000-00010

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY