摘要:

AbstractNaso‐orbital trauma can cause medial orbital wall disruption and detachment of the medial canthal ligament. Damage to the nasolacrimal drainage apparatus, cerebrospinal fluid rhinorrhea and frontal sinusitis can occur. Twelve cases of naso‐orbital trauma have been reviewed. There is a high incidence of associated injury to adjacent structures. Medial canthal ligament separation was missed acutely in a number of cases leading to the necessity of delayed repair. Important diagnostic and therapeutic points are stressed in the acute and delayed management, particularly medial canthal ligament separation. A wire to intranasal button technique for the delayed repair of traumatic telecanthus is presen

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00001

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractFive percent of all head injuries affect some portion of the visual system, and the most common locus of injury is the canalicular segment of the optic nerve. The classic surgical approach to this area is via the transfrontal craniotomy, although the Japanese have utilized an external ethmoidal technique to provide limited extracranial access to the optic canal. Harvey Cushing utilized the transsphenoidal hypophysectomy principally for pituitary tumors causing visual deficits. This paper presents a variation of the transsphenoidal hypophysectomy technique which will allow exposure of the optic nerve from the orbital apex to the optic chiasm through the use of microsurgical instrumentation. A detailed step‐wise description of the surgical methodology is presented, along with drawings to define the approach fully. Four case reports and representative pre and postoperative radiographs illustrate the actual approach in the clinical settin

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00002

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractSevere sensorineural hearing loss occurs in less than 1% of stapedectomized ears.1−2This low percentage remains as an irreducible minimum even among the most experienced and competent surgeons. The etiology has been hypothesized; however, the actual cause remains unknown.The rare occurrence of sensorineural hearing loss of undetermined etiology in the un‐operated‐on side was reported first in 1967 by Armstrong3who presented a series of three patients. No other references have been found since this initial report.Recently three unilateral stapedectomized patients who developed sudden severe sensorineural hearing loss in the unoperated‐on ear were studied during the years 1971 through 1979. The hearing loss occurred within 1 week, 6 weeks, and 12 years postoperatively. Although the number is small, a study of this group, in addition to Armstrong's, leads to several interesting considerations:1Is the incidence of sudden sensorineural type hearing loss greater, the same as, or less than that which develops in the non‐otosclerotic general population?1Is there a possibility that the sudden sensorineural hearing loss of undetermined origin would occur at the time of surgery? Would this then be considered as a predisposing if not the actual etiology?The present series of six cases is so small that a conclusion is not possible and inference is only conjecture. It is hoped, however, that this may stimulate past, present, and future search for this unusual occurrence. This may help determine whether or not there is a causal or merely a coincidental rel

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00003

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractA review of 14 cases of occult neoplasms associated with facial paralysis indicated that when the onset was gradual over a period of weeks or months, when all of the scientific and technological investigations, including CT scanning, polytomes, neurosensory and otologic tests, sialography, lacrimation, taste, internal acoustic meatus, evaluation of the deep lobe of the parotid, and clinical examination of the parotid and neck were negative, the tumor was almost always found in association with the main trunk of the extratemporal portion of the parotid gland. Of these neoplasms, 80% were malignant tumors of the parotid gland and 15% were neurilemomas of the main trunk of the facial nerve.The above situation is an indication for human assessment by surgical investigation of the facial nerve, with the first priority being given to the main trunk of the extratemporal portion.

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00004

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractFour patients who had undergone operative procedures, wherein substantial segments of the VIIth cranial nerve had been resected, experienced some degree of reanimation of the muscles of expression despite the fact that no restitutive measures were employed. The site of insult was in the face in two; the temporal bone in one; and the fourth occurred in the cerebellopontine angle.Teeth‐clenching and grimacing were practiced before a mirror by each subject, and one wonders if “re‐education” of dormant trigeminal nerve fibers might have facilitated the rehabilitation which was a

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00005

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00006

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractA staged method of repair of extended tracheal and combined laryngotracheal stenosis is presented. This entails creation of a trough by exteriorization of the involved segment, implantation of an alloplastic material adjacent to it, and the subsequent hinged rotation of the embedded implant over the trough to create a semi‐rigid anterior wall to the airway. The development, indications, technique and complications of this method of tracheal reconstruction are discusse

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00007

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractSevere glottic and subglottic stenosis in infants and children is a formidable disease for a child and a difficult reconstructive problem for the surgeon. Twelve consecutive patients are described in this series, 7 of whom had complete airway obstruction; 9 patients have been extubated with satisfactory voices. Long‐term follow‐up indicates no cases of decreased development of the lar

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00008

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractThe most common cause of laryngotracheal stenosis is trauma. The stenotic area may involve the larynx, subglottis, or trachea. A hyoid bone graft has been used in 22 cases for reconstruction of the stenotic area. The hyoid graft may be used with other concomitant laryngeal procedures. A vascularized sternohyoid — hyoid graft has been used in some cases. Of the 22 cases all but 3 have been successful. The advantages of the hyoid graft are:1Firm graft to maintain the architecture of the lumen.2Accessibility in the same operating field.3Patient's own graft material decreases immune rejection possibility.4The vascularized pedicle graft decreases possibility of hyoid resorptio

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00009

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractReconstruction of the larynx and trachea is most often needed after conventional methods of repair have failed. The advanced stenotic lesion can be adequately corrected with a composite nasal septal graft in a one stage procedure. Severe glottic stenosis from crush injuries or following partial laryngectomy, subglottic stenosis, and high tracheal stenosis are most amenable to this type of reconstruction. The surgical technique is presented, and six cases of clinical utilization are reviewed.

ISSN:0023-852X    

DOI:10.1288/00005537-198102000-00010

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY