摘要:

AbstractAs reported previously, it remains our conclusion that the radical neck dissection can be performed expediently in a reasonable period of time, usually without the need of blood replacement, and is not characterized by major physiologic disability or wound complications secondary to the neck dissection alone. The presence of preoperative radiation, composite resections entering the oral cavity or pharynx, and systemic disease or debilitation, however, vastly enhance the risk of significant life threatening complications and prolong hospitalization; therefore, the use of postoperative radiation therapy in combined treatment, the use of planned fistulas and generally accepted reconstructive techniques, and a careful evaluation of the methods and technique for protection of the carotid artery are recommended.

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00001

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractSeventy‐three tracheostomies performed in children three years of age and under in a 52‐month period are discussed. Thirty‐six were under one year of age. Forty‐one were performed for upper airway obstruction, 23 for ventilation or suction, and nine for a combination of upper airway obstruction and lower bronchopulmonary

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00002

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractThe distressing nature of laryngeal papillomatosis and lack of clinical progress in its treatment are reviewed. Presently accepted and investigative methods of therapy are reviewed with special attention being given to immune therapy. Support for the concept of a viral etiology is discussed and other etiologic agents considered. Known and possibly significant roles of wart virus antibodies are discussed and the importance of complex interplay between maternal and fetal immune systems explored as a possible explanation for some puzzling aspects of laryngeal papillomatosis.Finally, a proposed experimental design is outlined, the purpose of which is to provide a useful animal model to investigate immune changes in laryngeal papillomatosis, as well as effects of surgical or medical therapy.

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00003

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractNineteen cases with major resections of the head and neck were treated with laryngeal suspension and cricopharyngeal myotomy in an attempt to allow swallowing function postoperatively and avoid a total laryngectomy. Sixteen cases were available for evaluation. Eight cases (50 percent) were able to eat by mouth, 15 patients (94 percent )had a normal airway and 14 patients (87 percent) had intelligible speech.

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00004

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractA single stage dermal pedicle graft method for reconstruction of oropharyngeal defects is presented. Its successful clinical use is described. The advantages of the method include large surface‐to‐surface anastomosis which appears to minimize breakdown secondary to hypovascularity of an irradiated recipient bed. Other advantages include its single stage feature, persistent blood supply, avoidance of external tubed pedicles and intermediate salivary fistulas. A histologic study in pigs preceded its clinical use in humans. Findings of both aspects of the study are discus

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00005

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractNasopharyngeal angiofibromas have traditionally been difficult tumors to manage. Their extreme vascularity has led to excessive bleeding during surgical removal, which often obscured the surgical field and contributed to high recurrence rates because of incomplete removal. High recurrence rates have also been clue to failure to recognize the full size and extent of these tumors preoperatively by routine physical examination and X‐ray techniques.A combined experience of the authors with over 45 cases from the University of Michigan and the University of California, San Francisco, is presented to review the problems in management of these tumors and to present techniques of diagnosis and management which have been used to overcome some of these problems. The most important advances in diagnosis have been the radiographic techniques of laminagraphy and carotid angiography. Previously unrecognized tumor extensions into the areas surrounding the nasopharynx have been quite clearly demonstrated by these techniques. Improved surgical treatment of these tumors by wider surgical exposure and removal, utilizing multiple approaches when necessary, and by better control of bleeding by ligation and embolization of the main arterial supply, has led to fewer recurrence

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00006

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractIn recent years the cochlear implant has been a subject of much discussion and controversy. The clinician has often been confused by the conflicting reports of success and failure. In this paper the development of the cochlear implant is reviewed and its present status summarized. It is hoped that the clinician may thereby gain an understanding of this device so that he can better evaluate its present and future status.Selection of Patients for Cochlear Implantation.The cochlear implant will benefit only those patients with hair cell loss who have remaining viable auditory neurons. In order to determine whether viable neurons remain, an electric current is passed through a small needle which is placed onto the promontory through the tympanic membrane. If patients experience an auditory sensation as a result of this electrical stimulation, it is felt that they are suitable candidates for a cochlear implant.Feasibility of Long‐Term VIIIth Nerve Stimulation.Information Transfer by Electrical Stimulation.Single‐channel stimulation produces only periodicity pitch, and information transfer is insufficient for speech discrimination.Present Status of the Cochlear Implant.To the present time 15 patients have been implanted with a unipolar electrode under the direction of the Ear Research Institute. These patients have all benefited from their devices. They are able to perceive background sounds and receive a cadence or rhythm to speech which makes the device helpful in lipreading. None of the patients have developed significant speech discrimination.Future of the Cochlear Implant.It is our opinion that the present single‐channel cochlear implant is a clinically useful device. Work is continuing on the thorough evaluation and rehabilitation of patients with this device.Development of a multiple‐channel electrode and stimulator is the goal of several groups active in the cochlear implant field. The theoretical model for the future cochlear implant is an eight or more channel device with each electrode stimulating a different population of nerve fibers. The stimulator will separate the incoming signal into eight or more frequency bands and then differentially stimulate the separate electrodes with a coded signal.It is hoped that sufficient information may thereby be provided for understanding of speech. Preliminary studies give hope that this may be p

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00007

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractWe reviewed the findings in 1,220 cases of sudden sensori‐neural hearing impairment encountered over a nine‐year period at the Otologic Medical Group. A thorough neuro‐otologic evaluation is indicated in each case. Ten patients had an acoustic tumor.A vasodilator regimen was prescribed in 380 cases and resulted in hearing improvement in 40 percent. Favorable prognostic findings were a low tone loss and absence of ve

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00008

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractHearing impairment is not often considered a potential complication of general anesthesia; however, four patients who sustained hearing loss following nitrous oxide inhalation anesthesia have recently come to the authors' attention. The cases are presented and middle ear pressure measurements taken during endotracheal inhalation anesthesia with various agents are reported. Factors predisposing to hearing loss during anesthesia are discussed.

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00009

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractSuccessful management of carcinoma of the external auditory canal depends upon four factors:1.early diagnosis is imperative if a high cure rate is to be expected;2.correct evaluation of the extent of the malignancy;3.adequate surgery based upon correct evaluation; and4.postoperative radiation in certain selected cases.In this review of 35 cases, two factors were used to determine whether the disease was localized or extensive. When extension occurs into the mastoid as deep as the middle ear cleft or into the facial nerve, it should be designated as extensive tumor. Tumors which do not go as deep as the facial nerve or involve the mucosa of the middle ear should be designated as localized tumors.In localized tumors, it is possible to perform a wideen blocresection of the bony and cartilaginous external auditory canal including the tympanic membrane and malleus, and if necessary, including the superficial lobe of the parotid. Postoperative radiation is indicated when the pathological specimen shows unclear margins in the surgical dissection.With localized tumors,en blocresection of the external auditory canal offers a high cure rate. In extensive lesions, anen blocdissection removing the bulk of the tumor mass, followed by irradiation, seems to offer at least as good a prognosis as more radical surgery.

ISSN:0023-852X    

DOI:10.1288/00005537-197603000-00010

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY