摘要:

AbstractIn a series of chronic renal and congenitally deaf patients 24 were identified as having inborn renal and otologic disease. Sixteen patients, representing 14 families, had genetic disorders. Only two had the features of Alport's syndrome.The patients were classified as follows: 1) Probable Alport's — 2 patients (1 family); 2) Atypical hereditary nephritis and sensorineural hearing loss — 7 patients; 3) Renal and inner ear anomalies — 1 patient; 4) Renal, inner ear and multiple anomalies — 4 patients. The temporal bone pathology in one case showed primary neural atrophy and a mild Mondini malformation. In another a Scheibe defect and unusual calcific structures were found in the cochlear duct. 5) Renal, external or middle ear and multiple anomalies — 6 patients (5 families); 6) Renal, middle and inner ear anomalies and multiple anomalies — 2 patients. A temporal bone obtained from one case showed combined middle and inner ear defects. In the other, who had a chromosome defect, predominantly middle ear anomalies were found. 7) Nephrotic syndrome and congenital hearing loss — 1 patient; 8) Unclassified — 1 patient.Some cases represent entities apparently not previously described. Probably most interesting is the delineation of hereditary nephritis and deafness distinct from A

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00001

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractTransmeatal atticotomy, a common otosurgical procedure near the turn of the century, has since enjoyed only sporadic periods of popularity. An earlier report illustrated the efficacy of the atticotomy operation in ablating cholesteatoma in 83% of cases. However, the ossicular chain usually suffers discontinuity either through erosion by cholesteatoma or surgical disarticulation. In ears with an intact chain, the incudostapedial joint is usually separated to avoid injury that may be transmitted to the inner ear if the rotating burr contacts the ossicles.The purpose of this paper is to portray the types of hearing restoration attempted and the results achieved in 55 patients who had an atticotomy procedure and had been followed for six months to eight years. The number of patients who attained serviceable hearing are compared to those that did not, with regard to such factors as the hearing level and state of the ossicles preoperatively as well as the extent of the surgery required for removal of the disease.The hearing results in these patients who underwent atticotomy compare favorably to those cited in the literature for tympanoplasties done with the modified radical mastoidectomy or the intact canal wall tympanomastoidectomy.

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00002

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractWhen centered in the petrous apex, meninglomas behave like other neoplasms occurring in that region. The petrous apex can be approached by several routes: posterior craniectomy; middle fossa craniectomy; translabyrinthine, transcochlear, and transeth‐moidosphenoid approaches. A patient harboring a malignant meningioma in her petrous apex is presented. A middle fossa craniectomy, coupled with posterior displacement of the facial nerve, allowed access to the entire temporal bone from above. The patient received postoperative irradiatio

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00003

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractEsthesioneuroblastoma is an uncommon malignant nasal tumor which may be difficult to diagnose. Once diagnosed, selection of treatment may be a dilemma. Some advocate preoperative radiation and surgery; others, surgery and postoperative radiation if needed. A case that developed brain necrosis from postoperative radiation is presented. It is felt that the possibility exists that the patient might still be living with tumor had irradiation not been given. This is a plea for the conservative approach to treatment. The author agrees with John S. Lewis that it is unwise to use all modalities at once as there is no definite evidence that any one method of treatment or a combination of surgery and irradiation will alter the prognosis. The paper stresses the brain hazards of irradiation.

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00004

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractOriginally isolated as an antibiotic, bleomycin is a complex mixture of glycopeptides currently utilized against a variety of malignancies, among them epidermoid cancer of the head and neck. Because of unique independent pharmacological properties, bleomycin may be effectively used at several points in the natural history of tumors. Use of bleomycin as a single agent, as an adjunct to surgery and irradiation and as a palliative drug in head and neck cancer, is now advocated in scattered reports. The rationale for the utilization of bleomycin at the University of California, San Diego and San Diego Veterans Administration Hospitals is discussed. In addtion, examples from the authors' personal series of both response and adverse effects, suggestions for appropriate clinical monitoring to detect early toxicity, and tennets for management of side effects are included in the presentation.

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00005

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractElectron microscopy has proved to be a valuable diagnostic tool in surgical pathology. As shown in three illustrative cases, the procedure is most useful in accurately classifying light microscopically diagnosed undifferentiated tumors of the head and neck, and is also helpful in predicting the origin of cervical lymph node metastasis in occult cancer. It also serves to quality control diagnoses made by light microscopy.All surgical specimens are fixed in a fixative that gives adequate ultrastructural preservation and allows retrieval and examination by electron microscopy, if indicated. Recent technical improvements have resulted in a turn‐around time of less than two days, thus making diagnostic electron microscopy clinically useful. The ultrastructural examination of undifferentiated tumors has a high diagnostic yield, often obviating additional diagnostic procedures and exploratory surgery. The correct diagnosis results in appropriate therapy and accurate assessment of prognosi

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00006

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractThe problem of management of patients with spastic dysphonia has been complicated by a general resistance to speech therapy, psychotherapy, hypnotherapy, and drug therapy. Dedo introduced the concept of recurrent laryngeal nerve section in an attempt to eliminate the hyperfunction and excessive adduction of the vocal folds.Eleven patients were treated by RLN section with satisfactory results in 8 and some improvement in the other 3. The operation was found to be generally uncomplicated and required on average 4 days of hospitalization.Dedo's theory that spastic dysphonia is caused by a neurotropic viral‐induced proprioceptive nerve deficit represents a new search for organic cause. His most recent report of finding unmyelinated fibres in one‐third of the resected recurrent laryngeal nerves is of questionable significance. The evidence of deep emotional conflict and/or compulsive lifestyle is found in the majority of the patients, but the syndrome is not typical of an hysterical or conversion neurosis.Regardless of etiologic theory, RLN section is an effective treatment in selected, longstanding, and resistant instances of spastic dyspho

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00007

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractEvery Head and Neck surgeon has special techniques which he uses to get maximum rates of five‐year survival and minimum fistula formation, especially major fistula and carotid rupture. The literature reflects a wide variation in the rate of fistula formation. We reviewed the senior author's prior 78 total laryngectomies and noted a fistula rate of 10.3% (6.4% minor fistulae and 3.9% major fistulae). We also reviewed contributing factors and discuss surgical techniques designed to minimize fistula formatio

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00008

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractA retrospective study of 227 traumatic tympanic membrane perforations was made. These perforations were treated in a clinical practice of otolaryngology between January 1969 and July 1977. The following conclusions were supported by the data obtained:1Larger perforations are less likely to heal spontaneously.2Lightning and molten metal injuries are less likely to heal spontaneously.3Final healing and hearing results are good regardless of the mode of therapy employed.4Spontaneous healing gives better results than early surgical intervention.5Infection adversely affects healing in traumatic perforations.Based on information delineated in the paper, a logical plan of treatment for traumatic perforations is presented.

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00009

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractA neuroendocrine secreting tumor, initially presenting as a laryngeal problem, is reported. Subglottic biopsy, first interpreted as paraganglioma, was finally diagnosed as medullary carcinoma of the thyroid.The complex testing required to arrive at an accurate diagnosis of this uncommon thyroid malignancy is discussed. The sparse occurrence of the neoplasm in the laryngologic field, as well as the necessity for differentiating it from other neuroendocrine tumors, bear consideration.

ISSN:0023-852X    

DOI:10.1288/00005537-197902000-00010

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY