摘要:

AbstractTreatment of oral leukoplakia has been disappointing with the available treatment modalities, because of inaccurate removal and an approximate 30% to 35% rate of recurrence. The CO2laser has provided a promising new approach in the management of these lesions with very low morbidity and improved control. Twenty‐nine patients were treated with the CO2laser for 38 extensive (from 1 × 1 cm to 6 × 8 cm) intraoral leukoplakic lesions, 28 for cure and one for palliation. Microscopically the lesions varied from hyperkeratosis to carcinomain situ.Follow‐up of these patients ranges from 3 to 10 years, with an average of 5 years. An initial recurrence rate of 10.8% (4/37) was observed, and a 3‐year local control rate of 97% after one to two procedures. A malignant transformation rate of 2.6% was encountered. Excellent wound healing and few complications were observed with this treatment approach. Surgical technique and results are reported supporting the advantages of the CO2laser over conventional modes of treatment in the management of oral leuk

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00001

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractA series of 655 elective cricothyroidotomies presented by Brantigan and Grow in 1975 has fueled a recent explosion in the number of cricothyroidotomies being performed for elective tracheal access.This article reviews Jackson's classic 1921 paper on cricothyroidotomy, Brantigan and Grow's series, seven recent clinical series of elective cricothyroidotomies, and our experience.Voice change is the most frequent complication of cricothyroidotomy occurring in up to 50% of cases. Chronic subglottic stenosis occurs in approximately 2% of cases. Contraindications to cricothyroidotomy include prolonged intubation, airway obstruction following extubation, and laryngeal pathology of any kind.

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00002

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe position and shape of the jugular bulb are undependable, and thus can add difficulty to temporal bone surgery. The present study addresses the hypothesis that position and shape of the jugular bulb correlate with the extent of temporal bone pneumatization. Systematic study was done in 25 unilateral cadaver specimens. Pneumatization was determined using both the classic Runström II radiograph, and computed tomography. Jugular bulb shape and position were determined by anatomic dissection and computed tomography. No association of jugular bulb shape or position, with pneumatization, was found. However, the dissection‐determined distance from the plane of the lateral semicircular canal to the roof of the jugular bulb (2 to 15 mm), had a good correlation (r= 0.70,p<.001) with the distance from the internal auditory canal to the apex of the jugular bulb (1.5 to 15.0 m

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00003

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractSince episodic vertigo in the pediatric and adolescent age group is unusual and therefore not well known to most otolaryngologists, we present six cases to show some of the various presentations and different underlying causes. These cases covered a wide diagnostic spectrum: meningioma, medulloblastoma, childhood migraine with vestibular symptoms, childhood Meniere's syndrome (one case due to perilymph fistula), and benign paroxysmal vertigo of childhood. The two patients with tumor and the patient with perilymph fistula were treated surgically; the other patients are being managed conservatively since these childhood conditions usually tend to diminish with time.

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00004

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe entire upper aerodigestive tract must be evaluated at the time of initial tumor evaluation in patients with squamous cell carcinoma of the head and neck. The necessity of panendoscopy (laryngoscopy, bronchoscopy, esophagoscopy) in this evaluation has not been demonstrated convincingly. Between January 1, 1984 and December 31, 1985, 208 patients with previously untreated squamous cell carcinoma of the head and neck were analyzed prospectively. These patients underwent head and neck examination, chest radiograph, barium esophagram, and panendoscopy. Fifteen (7.2%) had synchronous malignancies of the upper aerodigestive tract. In four patients (1.9%) the synchronous primary tumor was found only by endoscopy. Three patients (1.4%) had cancers of the hypopharynx. One patient (0.5%) had a bronchial cancer detected only on bronchoscopy. No tumors were detected by esophagoscopy that were not also seen on barium esophagram. We conclude that endoscopic examination of the hypopharynx is very helpful in screening for additional tumors in head and neck cancer patients, but routine esophagoscopy cannot be supported. Screening bronchoscopy cannot be strongly supported due to its very low yield.

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00005

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractIn this review of 925 cases of total and anterior perforations of the tympanic membrane reconstructed through the use of formaldehyde‐formed‐fascia (3‐F) grafts, the postoperative nonperforation rate is 97.6%; blunting and/or lateralization of the graft was avoided in 93.5% of cases. Closure of the postoperative air‐bone gap within 20 dB was achieved in 70% of cases. This update of a previously reported paper reinforces our opinion that the 3‐F graft is an effective tool for the closure of tympanic membrane perforation with or without ossicular chain recon

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00006

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractFifteen consecutive patients undergoing extensive surgery for head and neck cancer involving the oral cavity and oropharynx were reconstructed using the technique of rigid internal fixation combined with various vascularized flaps. The follow‐up ranged from 6 to 18 months.Modifications in various myocutaneous or vascularized free flaps combined with an analysis of the radiation physics necessary to make this procedure a viable alternative for immediate and delayed mandibular reconstruction will be discussed. Consistently satisfactory functional and cosmetic results have been achieve

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00007

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThere are many transient neurologic disturbances associated with various types of migraine. Visual symptoms, such as scintillating scotomata are most common, but somatosensory, motor, cranial nerve, and brain stem symptoms also occur. Among the brain stem symptoms, vestibular manifestations are quite common and include nonspecific dizziness, disequilibrium, vertigo, and motion intolerance. Auditory symptoms are less common. These transient neurologic symptoms can precede the headache as an aura, can occur during the headache, or, uncommonly, can immediately follow the headache. It is also well documented that the neurologic symptoms can occur in the period between headaches, a situation termed “migraine equivalent.” Migraine equivalents usually occur in patients who have experienced typical migraine headaches earlier in life or who have migraine headaches at times other than when they experience equivalent symptoms. Rarely, typical migraine equivalent symptoms precede the development of the headaches by months or years, or occur in individuals who never develop headaches.Five patients with migraine equivalent symptoms that include vertigo are presented. The vertigo was the dominant symptom in some cases and was accompanied by nausea and vomiting. Differentiation from peripheral labyrinthine disorders is difficult, but a personal or family history of migraine, the temporal association of the neuro‐otologic symptoms with other migraine equivalent symptoms, a characteristic pattern of occurrence of the symptoms, and a positive response to antimigrainous therapy are features that strengthen the diagnosis of a migraine equivalent pheno

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00008

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractIn adults there has been an association noted between hyperlipidemia and sensorineural hearing loss. Etiologic considerations include hyperviscosity of the serum, vascular occlusion and an increased susceptibility to noise. Until now this correlation, to our knowledge, has not been made in the pediatric population. Several children with bilateral fluctuating sensorineural hearing losses have been identified with hyperlipidemia. The fluctuations in hearing varied with lipid levels. With dietary controls, the cholesterol levels returned to what would be near the norm for the pediatric population and hearing returned to near baseline. Unexplained fluctuating sensorineural hearing losses in children warrant the consideration of hyperlipidemia. Discovering a potentially reversible etiology for hearing loss is significant but more importantly, may lead to the early detection of hyperlipidemia in the young patient.

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00009

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe UCLA experience with juvenile angiofibroma (JNA) over a 25‐year period is reviewed. There were 83 patients, the majority being adolescent males. Surgery was the primary method of treatment for disease not extending intracranially; 63 of 68 patients (92.5%) became asymptomatic with this modality. In patients treated with a single course of primary radiation, 10 of 14 (78.5%) became asymptomatic. Trends in diagnosis and treatment were evaluated. Contrast computerized tomography reliably assesses tumor extent. Preoperative arteriography is essential for the evaluation and embolization of feeding vessels; this in turn significantly reduces operative blood loss and the need for transfusions. Radiotherapy should be reserved for disease extending intracranially and should be in doses of 3,600 cGy or large

ISSN:0023-852X    

DOI:10.1288/00005537-198802000-00010

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY