摘要:

AbstractInterruption of laryngeal innervation may partially or totally impair respiration, deglutition and phonation — the three basic laryngeal functions.Tucker has developed a principle of muscle‐nerve pedicle transfer for laryngeal reinnervation to relieve airway obstruction following bilateral recurrent laryngeal nerve injury. We have applied the principle of reinnervation proposed by Tucker to treat patients not only with airway obstruction, but also with aspiration and impaired phonation due to interruption of laryngeal innervation. There were 23 patients in this study. The functional defects included: Voice alteration in 10 patients, airway obstruction in 8 and aspiration, as well as a voice change, in 5.The causes of injury were surgery in 9 patients, trauma in 5, tumor in 3, polio in 1 and a birth defect in 1 patient. No cause of nerve injury could be determined in 4 patients.The technique employed involved selective reinnervation of the laryngeal nerve branches to one or more laryngeal muscle groups; the muscle groups reinnervated were selected so as to overcome the functional defect of each particular patient.The patients have been followed for 6 mo. or longer. The results have been independently evaluated by a speech pathologist and documented by indirect and direct endoscopic observations, as well as by audio and audio‐video recordings. In some cases, there was further documentation by cine‐fluoro‐audio tape recordings, laryngo‐pharyngography, laryngeal tomography and pulmonary function studes.The muscle‐pedicle transfer technique described by Tucker was found to be useful to correct laryngeal dysfunction in carefully s

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00001

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractCarcinoma of the lip is a common variety of head and neck malignancy frequently seen in the elderly Caucasian male. Three hundred and fifty consecutive cases of invasive squamous cell carcinoma of the lip are analyzed and the treatment methods and their results are presented. Surgical management is recommended for most patients because of the advantage of tumor margin assessment, avoidance of radiotherapy complications, and rapid rehabilitation.

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00002

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractA series of nine cases of first branchial cleft anomalies treated at Children's Hospital of Michigan from 1970‐1978 is presented. A review of the literature and analysis of these cases reveals that the accepted criteria for classification of these anomalies are confusing and inadequate as they preclude the proper classification of a number of these cases. The embryogenesis of these anomalies is discussed with attention given to their relationship to the facial nerve. A proper classification is suggeste

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00003

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractGenetic disorders involving the ear, nose and throat can be looked at in essentially the same way that one would view other genetic problems. It is important to differentiate genetic disorders from those due to environmental influences. This may be difficult on clinical grounds, since similar clinical features may be produced by different environmental factors or by different genes or groups of genes. When the cause of the disorder can be established, the risks involved in a family having further offspring usually can be determined reasonably readily. In the uncharacterized situations, empiric risk figures are employed. Abnormalities of genetic origin fall into one of three main groupings: Chromosomal abnormalities, single gene mutations or polygenic inheritance. These situations are discussed and examples are given.

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00004

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe use of homologous fat in obliterating frontal sinus operations has proved to be a satisfactory technique. It does entail, however, a separate procedure to obtain the graft. Furthermore, the implanted fat has a tendency to shrink or absorb in varying degrees.Proplastr̀ has been used in a series of osteoplastic frontal sinus operations. The implant block is a highly porous preparation of Teflonr̀ fluorocarbon polymer and vitrous carbon fibers. It can be easily carved into desired shapes or it may be implanted in pieces. The porosity of the substance permits in‐growth of connective tissue. Eight obliterating frontal sinus procedures using the osteoplastic flap technique and implanting the synthetic material are reported. There have been no failures to date after 1 to 5 years follow

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00005

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractInverting papilloma of the nose and paranasal sinuses can sometimes be very difficult to distinguish from other nasal tumors, and the confusion ranges from allergic nasal polyposis to carcinoma. They are also certainly characterized by multiple recurrence, particularly after limited operations.The experience with 34 cases seen at UCLA over the past two decades is analyzed and a philosophy of treatment is outlined. We favor wide local excision which generally necessitates a lateral rhinotomy and medial maxillectomy. The operative approach will be described in detail.

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00006

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractAdenocarcinoma of the ethmoid sinus is rare, representing only 4‐8% of malignancies of the paranasal sinuses. An extraordinary case of papillary adenocarcinoma of the ethmoid sinus arising 30 years following high‐dose radiotherapy for bilateral retinoblastoma is presented.Retinoblastoma, though occurring only once in every 23,000 to 34,000 births, is the most common malignant intraocular tumor of childhood. Second fatal mesenchymal and epithelial primaries have been described in 8.5% of patients with bilateral retinoblastomas previously treated with radiotherapy; however, papillary adenocarcinoma arising within the paranasal sinuses has not been reported. Histologically, the findings of a papillary pattern of poorly differentiated, mucicarmine‐staining cells enclosing gland‐like spaces, and the absence of pseudorosettes, melanin, mesenchymal and peripheral neural elements supports an epithelial origin of this tumor.Aggressive treatment including partial maxillectomy, radical pansinusectomy, radical neck dissection followed by regional radiotherapy and systemic chemotherapy failed to prevent the development of fatal hepatic metastases. The high incidence of second fatal primary neoplasms in patients with bilateral retinoblastomas receiving radiation suggests an innate susceptibility that may add to the risk of radiotherapy. Careful long‐term head and neck surveillance is mandatory if early aggressive management of these extremely lethal tumors is to be s

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00007

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractAural cholesteatoma may present itself as an unexplained hearing impairment without either perforation or otorrhea and without radiologic evidence of bone destruction. The etiology is probably congenital.In our cholesteatoma cases, 3.7% occur in individuals with an intact tympanic membrane. Most of these patients have had the disease 5 years or less and 50% are under 20 years of age. Complications of the disease are uncommon in this group.All but 1 of our 41 cases were managed with the intact canal wall technique. Most were reexplored (planned second‐stage) and residual disease was encountered in 32%.One should keep the possibility of a congenital cholesteatoma in mind whenever encountering a unilateral serous otitis media or an unexplained unilateral conductive hearing impairment, regardless of the patient's ag

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00008

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe patient presenting with a red mass behind the eardrum and a pulsating tinnitus may well have a vascular tumor. One must be ever mindful, however, that the mass may represent a congential vascular anomaly. The most common one seen is the uncovered jugular bulb in which the vessel extends superiorly into the middle ear to or above the incudostapedial joint. More rare is the uncovered and posteriorly displaced carotid artery.The purpose of this paper is to review the literature on the subject of vascular anomalies of the middle ear and temporal bone and to discuss the diagnosis and management of these lesions. Illustrative case reports with color photographs are presented as well.

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00009

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe skull base approach to the jugular bulb provides a better opportunity to preserve facial nerve function. Specifically, this applies to glomus jugulare tumors. Adequate exposure to remove even an extensive glomus jugulare tumor may be obtained by the skull base approach, working between the VIIth nerve left in its bony sheath and the lateral process of the first cervical vertebra.

ISSN:0023-852X    

DOI:10.1288/00005537-198001000-00010

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY