Archives of Otolaryngology

Coats, Alfred C.

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400001001pmid: 7213179

Abstract • We investigated the relationship between Meniere's disease and the abnormally enlarged summating potential (SP) in a series of patients and normal subjects. Cochlear and auditory nerve responses to rectangular-pulse clicks, delivered at a rate of 8/s and an intensity of 115 dB peak-equivalent sound pressure level, were recorded from ear canal skin. We performed a parabolic regression for SP amplitudes as a function of auditory nerve action potential (AP) amplitudes in normal ears and obtained the 95% confidence interval (±2 SD) for normal scatter around the fitted curve. Sixty-eight percent of SP amplitudes from ears with Meniere's disease exceeded the upper normal confidence limit. In contrast, only 7% of the cochlear ears and none of the retrocochlear ears had SP amplitudes above this normal upper limit. Cochlear microphonic potentials and APs from the ears with Meniere's disease also tended to be larger than normal, but this tendency was not strong enough to be of diagnostic use. (Arch Otolaryngol 1981;107:199-208) References 1. Eggermont JJ: Summating potentials in electrocochleography: Relation to hearing disorders , in Ruben RJ, Elberling C, Salomon G (eds): Electrocochleography . Baltimore, University Park Press, 1976, pp 67-87. 2. Yoshie N: Electrocochleographic classification of sensorineural defects: Pathological pattern of the cochlear nerve compound action potential in man , in Ruben RJ, Elberling C, Salomon G (eds): Electrocochleography . Baltimore, University Park Press, 1976, pp 353-386. 3. Gibson WPR, Moffat DA, Ramsden RT: Clinical electrocochleography in the diagnosis and management of Meniere's disorder . Audiology 1977;16:389-401.Crossref 4. Eggermont JJ: Summating potentials in Meniere's disease . Arch Otolaryngol 1979;222:63-75. 5. Ramsden RT, Moffat DA, Gibson WPR: Transtympanic electrocochleography in patients with syphilis and hearing loss . Ann Otol Rhinol Laryngol 1977;86:827-834. 6. Coats AC: On electrocochleographic electrode design . J Acoust Soc Am 1974;56:708-711.Crossref 7. Coats AC, Martin JL, Kidder HR: Normal short-latency electrophysiological filtered click responses recorded from vertex and external auditory meatus . J Acoust Soc Am 1979;65:747-758.Crossref 8. Coats AC, Kidder HR: Effect of earspeaker coupling on auditory action potential and brainstem responses . Arch Otolaryngol 1980;106:339-344.Crossref 9. Eggermont JJ, Odenthal DW: The summating potential in man: Identification and properties . Acta Otolaryngol 1974;316:52-53. 10. Hallpike CS, Cairns H: Observations on the pathology of Meniere's syndrome . J Laryngol Otol 1938;53:625-654.Crossref 11. Hallpike CS, Wright AJ: On the histological changes in temporal bones of a case of Meniere's disease . J Laryngol Otol 1940;55:59-66. 12. Brunner H: Meniere's disease . J Laryngol Otol 1948;62:627-638.Crossref 13. Lindsay JR: Hydrops of the labyrinth . Arch Otolaryngol 1960;71:500-512.Crossref 14. Kristensen HK: Histopathology in Meniere's disease . Acta Otolaryngol 1961;53:237-248.Crossref 15. Schuknecht HF, Benitez JT, Beekhuis J: Further observations on the pathology of Meniere's disease . Ann Otol Rhinol Laryngol 1962;71:1039-1053. 16. Schuknecht HF: Meniere's disease: A correlation of symptomatology and pathology . Laryngoscope 1963;73:651-665.Crossref 17. Altmann F, Kornfeld M: Histological studies of Meniere's disease . Ann Otol Rhinol Laryngol 1965;74:915-944. 18. Schuknecht HF: Pathology of Meniere's disease . Otolaryngol Clin North Am 1968;1:331-337. 19. Schuknecht HF: Pathology of the Ear . Cambridge, Mass, Harvard University Press, 1974. 20. Alford BR: Meniere's disease: Criteria for diagnosis and evaluation of therapy for reporting . Trans Am Acad Ophthalmol Otolaryngol 1972;76:1462-1464. 21. Croxton FE, Cowden DJ: Applied General Statistics . Englewood Cliffs, NJ, Prentice-Hall, 1955. 22. Aran J-M: Clinical measures of VIIIth nerve function . Adv Otorhinolaryngol 1973; 20:374-394. 23. Coats AC, Martin JL: Human auditory nerve action potentials and brain stem evoked responses: Effects of audiogram shape and lesion location . Arch Otolaryngol 1977;103:605-622.Crossref 24. Dallos P, Schoeny ZG, Cheatman MA: Cochlear summating potentials . Acta Otolaryngol 1972;302:1-43. 25. Aran J-M, de Sauvage RC: Clinical value of cochlear microphonic recordings , in Ruben RJ, Elberling C, Salomon G (eds): Electrocochleography . Baltimore, University Park Press, 1976, pp 55-65.

Jenkins, Herman A.;Fisch, Ugo

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400011002pmid: 6260069

Abstract • Since a previous study conducted at the Ear, Nose, and Throat Department, University Hospital, in Zurich, Switzerland, 16 additional cases of glomus jugulare of the temporal region have been evaluated and treated surgically in this department. This article describes our experience with these additional cases and gives an in-depth description of the surgical techniques that are used in the treatment of more complicated tumors. We report one case in detail. (Arch Otolaryngol 1981;107:209-214) References 1. Oldring D, Fisch U: Glomus tumors of the temporal region: Surgical therapy . Am J Otolaryngol 1979;1:7-18. 2. Janssen FP, Jongkees LBW, cited by Fisch U: Surgery for Bell's palsy . Arch Otolaryngol 1981;107:1-11.Crossref 3. Shapiro MJ, Neues DK: Technique for removal of glomus jugulare tumors . Arch Otolaryngol 1964;79:219-224.Crossref 4. Glasscock ME, Harris PF, Newsome G: Glomus tumors: Diagnosis and treatment . Laryngoscope 1974;84:2006-2032.Crossref 5. Brackmann DE, House WF, Terry R, et al: Glomus jugulare tumors: Effect of irradiation . Trans Am Acad Ophthalmol Otolaryngol 1972;76:1423-1431.

Saito, Ryusuke;Matsumura, Motoyoshi;Takata, Nobuaki;Ogura, Yoshio;Iwahori, Nobuaki;Hoshino, Kazumasa

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400017003pmid: 7213180

Abstract • We studied the histopathologic features of the temporal bones in a human embryo with unilateral aural atresia. The developmental stage of the embryo was at stage 22 in the Carnegie system, and the estimated ovulation age was 8 weeks. There were severe hypoplastic changes in Meckel's and Reichert's arch cartilages without differentiation of the auditory ossicles, hypoplasia of the tubotympanic recess, and resultant abnormal passing of the facial nerve in the affected ear. Abnormal lateral extension of the cartilaginous otic capsule replaced a posterior half of the middle ear region and seemed to form the so-called atresia plate. The external and middle ears of the unaffected side and the bilateral inner ears were morphologically normal. These findings might explain some parts of the complicated mechanism in the development of middle ear anomalies encountered in surgery for congenital aural atresia. (Arch Otolaryngol 1981;107:215-220) References 1. Iffy L, Shepard TH, Jakobovits A, et al: The rate of growth in young human embryos of Streeter's horizons XIII to XXIII . Acta Anat 1967;66:178-186.Crossref 2. O'Rahilly R: Guide to the staging of human embryos . Anat Anz 1972;130:556-559. 3. Marx H: Die Missbildungen des Ohres , in Denker A, Kahler O (eds): Handbuch der Hals-Nasen-Ohren-Heilkunde . Berlin, Julius Springer, 1926, vol 6, (pt 1) , pp 131-169. 4. Altmann F: Congenital atresia of the ear in man and animals . Ann Otol Rhinol Laryngol 1955;64:824-858. 5. Lapchenko SN: On surgery for improving hearing in congenital atresia of the external and middle ear . Vestn Otorinolaringol 1967;29:91-94. 6. Gill NW: Congenital atresia of the ear . J Laryngol Otol 1969;83:551-587.Crossref 7. Ombrédanne M: Chirurgie des surdités congenitales par malformation ossicularies . Acta Otorhinolaryngol Belg 1971;25:837-869. 8. Nager GT: Congenital aural atresia: Anatomy and surgical management , in Paparella MM, Shumrick PA (eds): Otolaryngology . Philadelphia, WB Saunders Co, 1973, vol 2, pp 3-23. 9. Colman BH: Congenital atresia of the ear: The otological problem . Proc R Soc Med 1974; 67:1203-1204. 10. Nishimura H: Developmental anatomy of microtia . Jpn J Plast Reconst Surg 1974;17:453-460. 11. Ruedi L: The surgical treatment of the atresia auris congenita: A clinical and histological report . Laryngoscope 1954;64:666-684.Crossref 12. Takahashi R, Nagakura K, Ohkawa K, et al: Histopathology of atresia auris congenita with microtia . Otorhinolaryngology 1958;1:275-281. 13. Masuda Y, Ohshima A, Endo Y, et al: Histologic report of a congenital atresia of the ear . Otolaryngology 1968;40:955-961. 14. Hiraide F, Nomura Y, Nakamura K: Histopathology of atresia auris congenita . J Laryngol Otol 1974;88:1249-1256.Crossref 15. Matsumura M, Saito R, Endo Y, et al: Early development of the auditory ossicles and the facial nerve in man . Audiology 1979;22:461-462.Crossref 16. Gasser RF: The development of facial nerve in man . Ann Otol Rhinol Laryngol 1967; 76:37-55.

Honjo, Iwao;Kumazawa, Tadami;Honda, Keiji

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400023004pmid: 7213181

Abstract • A simple impedance method to evaluate Eustachian tube function has been reported. The principle of the test consists of recording the impedance of the eardrum during Valsalva's maneuver and during swallowing. By this procedure, the inflow and outflow of air through the tube is recorded as a simple pattern of impedance change that is classified into the following three groups: normal, obstructive, and patent. The conformity of these test results to those of an aerodynamic test has indicated the reliability of the test for clinical use. (Arch Otolaryngol 1981;107;221-223) References 1. Kumazawa T, Honjo I, Honda K: Aerodynamic evaluation of Eustachian tube function . Arch Otorhinolaryngol 1974;208:147-156.Crossref 2. Kumazawa T, Honjo I, Honda K: Aerodynamic pattern of Eustachian tube dysfunction . Arch Otorhinolaryngol 1977;215:317-323.Crossref 3. Thomsen KA: Eustachian tube function tested by employment of impedance measuring . Acta Otolaryngol 1955;45:252-267.Crossref 4. Holmquist J: Eustachian tube function assessed with tympanometry . Acta Otolaryngol 1969;68:501-508.Crossref 5. Harford ER: Tympanometry for eustachian tube evaluation . Arch Otolaryngol 1973;97:17-20.Crossref 6. Williams PS: A tympanometric pressure swallow test for assessment of eustachian tube function . Ann Otol 1975;84:339-343. 7. Gersdorff MC: An exploration method of the Eustachian tube for intact and perforated drums: Tubal-impedance-manometry . Arch Otorhinolaryngol 1977;217:391-404.Crossref 8. Opitz H-J, Wedel H: Unsere Erfahrungen mit der Tubenmanometrie bei chronischen Mittelohrentzündungen . Laryngol Rhinol 1978;57:210-213. 9. Siedentop KH, Loewy A, Corrigan RA, et al: Eustachian tube function assessed with tympanometry . Ann Otol 1978;87:163-169.

Fee, Willard E.

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400026005pmid: 7213182

Abstract • Several clinical situations exist when only nonacoustic stimuli will provide data necessary for the correct neuro-otologic diagnosis. The tactile stapedius and the orbital air-jet reflexes have been used to aid in detecting the middle ear status in severe hearing losses, retrocochlear hearing losses, ossicular fixation, and facial paralysis. These reflexes also are useful in localization in some cranial nerve disorders. The equipment required to elicit these reflexes is inexpensive, and the test can be performed rapidly. Some pitfalls in interpretation are caused by the lack of precise correlative data. When properly used, performed, and interpreted, nonacoustic reflex response data supply information to the clinician that is otherwise unobtainable. (Arch Otolaryngol 1981;107:224-226) References 1. Klockhoff I: Middle ear muscle reflexes in man . Acta Otolaryngol Suppl 1961;164:3-92. 2. Djupesland G: Advanced reflex considerations , in Jerger J (ed): Handbook of Clinical Impedance Audiometry . New York, American Electromedics Corp, 1975, chap 5. 3. Fee WE, Dirks DD, Morgan DE: Nonacoustic stimulation of the middle ear muscle reflex . Ann Otol Rhinol Laryngol 1975;84:80-87. 4. Salamon G, Starr A: Electromyography of middle ear muscles in man during motor activities . Acta Neurol Scand 1963;39:161-168.Crossref

Prazma, Jiri;Biggers, W. Paul;Fischer, Newton D.

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400029006pmid: 7213183

Abstract • The effect of ethaverine hydrochloride on cochlear microcirculation was observed in short-term experiments on 11 guinea pigs. In these experiments, the endocochlear Po2, endocochlear potential (EP), cochlear microphonic (CM) potential, and blood pressure (BP) were recorded. Endocochlear Po2 was measured polarographically by gold electrodes in the scala media. Ethaverine hydrochloride was administered by intravenous infusion for ten minutes in doses of 2, 5, and 10 mg/kg. These experiments demonstrated that ethaverine hydrochloride in doses of 5 and 10 mg/kg caused significant elevation of endocochlear Po for 35 to 90 minutes, even when the BP temporarily declined. At the same time, it was observed that this improvement of cochlear microcirculation coincided with an increase of the CM potential. Decrease of the EP is probably the result of BP decline and a direct action of ethaverine on EP generation. (Arch Otolaryngol 1981;107:227-229) References 1. Snow JB, Suga F: Labyrinthine vasodilators . Arch Otolaryngol 1973;97:363-370.Crossref 2. Prazma J, Smith D, Jochem WJ: Current to voltage converter for measurement of oxygen . J Appl Physiol 1978;44:977-980. 3. Winder CV, Thomas RW, Kamm O: Relative experimental coronary vasodilator potencies of papaverine and its ethyl analogue ethaverine . J Pharmacol Exp Ther 1950;100:482-488. 4. Issekutz V, Leinzinger M, Dirner Z: Über die Wirkung der synthetischen Papaverinderivate: I. Mitteilung . Arch Exp Pathol Pharmakol 1932;164:158.Crossref 5. West TC, Hadden G, Farah A: Effect of anoxia on response of the isolated intestine to various drugs and enzyme inhibitors . Am J Physiol 1951;164:565-572. 6. Kukovetz WR, Pöch G: Inhibition of cyclic 3,5-nucleotide phosphodiesterase as a possible mode of action of papaverine and similarly acting drugs . Naunyn Schmiedebergs Arch Pharmacol 1970;267:189-194.Crossref 7. Markwardt F, Hoffmann A: Effect of papaverine derivatives on cyclic AMP phosphodiesterase of human platelets . Biochem Pharmacol 1970;19:2519-2520.Crossref 8. Santi R, Ferrari M, Contessa AR: On the mechanism of spasmolytic effect of papaverine and certain derivatives . Biochem Pharmacol 1964;13:153-158.Crossref 9. Prazma J: Active ion transport from the scala vestibuli into the scala media . Acta Otolaryngol 1969;67:631-638.Crossref 10. Hanna C, Parker RC: Papaverine analogs: VIII. Comparative actions of papaverine, ethaverine and dioxyline on the cardiovascular system . Arch Int Pharmacodyn Ther 1960;126:386-392. 11. Oswald WJ, Baeder DH: Pharmacology of ethaverine HCl: Human and animal studies . South Med J 1975;68:1481-1484.Crossref 12. Häggendal E: Effects of some vasoactive drugs on the vessels of cerebral grey matter in the dog . Acta Physiol Scand 1965;258( (suppl 66) ):55-79.Crossref 13. Jayne HW, Scheinberg P, Rich M, et al: The effect of intravenous papaverine hydrochloride on the cerebral circulation . J Clin Invest 1952;31:111-114.Crossref 14. Karlsberg P, Elliott HW, Adams JE: Effect of various pharmacologic agents on cerebral arteries . Neurology 1963;13:772-778.Crossref 15. Whittier JR: Vasorelaxant drugs and cerebrovascular disease . Angiology 1964;15:82-87.Crossref 16. Nikolov R, Leniger-Follert E: The effect of papaverine on local tissue Po2 and microflow in cat brain cortex . Naunyn Schmiedebergs Arch Pharmacol 1978;305:149-154.Crossref 17. Yagi N, Fisch U, Murata K: Perilymphatic oxygen tension and vasoactive drugs . Ann Otol Rhinol Laryngol 1978;87:364-369. 18. Clairmont A, Wright R, Dempsey E, et al: Blood flow in otorhinologic tissue after histamine and papaverine . Ann Otol Rhinol Laryngol 1973;82:69-74.

Palva, Tauno;Ylikoski, Jukka;Savolainen, Seppo;Mäkinen, Judit

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400032007pmid: 6783019

Abstract • The bulla in guinea pigs was filled with 0.01%, 0.1%, and 0.5% vitamin A acid (retinoic acid) solution once or twice daily for an average of five days. Pure arachnoid oil was used as a control solution. The mucous membrane appeared normal in the ears receiving arachnoid oil or 0.01% vitamin A acid. In bullae receiving 0.1% and 0.5% solutions, the epithelium remained close to normal, but there were small areas of ossification that were particularly notable in the submucosal layer. There was no indication that the normal guinea pig mucosa showed a metaplastic change into a secreting gland, forming epithelium. (Arch Otolaryngol 1981;107:230-232) References 1. Fell HB, Mellanby E: Metaplasia produced in cultures of chick ectoderm by high vitamin A . J Physiol 1953;119:470-488. 2. Palva T, Thesleff I, Saxén L: Organ culture studies on human skin and cholesteatoma epithelium contact with connective tissue exposure to vitamin A . Acta Otolaryngol 1978;85:307-312.Crossref 3. New DAT: Effects on excess vitamin A on cultures of skin from the tail and pads of the embryonic rat, and from the trunk, tail and pads of the embryonic rabbit . Exp Cell Res 1965;39:178-183.Crossref 4. Barnett ML, Szabo G: Effect of vitamin A on epithelial morphogenesis in vitro . Exp Cell Res 1973;76:118-126.Crossref 5. Duncan RB: Vitamin 'A' therapy of aural cholesteatoma , in McCabe BF, Sade J, Abramson M (eds): Cholesteatoma: First International Conference . Birmingham, Ala, Aesculapius Publishing Co, 1977, pp 404-409. 6. Anniko M: Problems and pitfalls in ototoxicity testing . Acta Otolaryngol 1980;89:66-70.Crossref 7. Vernon J, Brummet R, Walsh T: The ototoxic potential of propylene glycol in guinea pigs . Arch Otolaryngol 1978;104:726-729.Crossref 8. Grünberg H: Das Verhalten der Paukenschleimhaut gegenüber einigen in der Otochirurgie anwendbaren Medikamenten . Arch Ohren Nasen Kehlkopfheilkd 1964;181:524-529.Crossref

Musiek, Frank E.;Wilson, Donald H.;Reeves, Alexander G.

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400035008pmid: 6783020

Abstract • Two young right-handed men with normal peripheral hearing underwent a "staged" commissurotomy procedure. At the first surgical setting, approximately the posterior half of the corpus callosum was sectioned. Approximately two months after the first operation, the remaining portion was surgically disconnected. Extensive central auditory assessment indicated little deficit after each surgery, which was not the case in previous data on patients with commissurotomy at one setting. We discuss possible mechanisms for these differing results, along with the advantages of the staged surgical procedure. (Arch Otolaryngol 1981;107:233-236) References 1. Sparks R, Geschwind N: Dichotic listening in man after section of the neocortical commissures . Cortex 1968;4:3-16.Crossref 2. Milner B, Sperry R, Taylor L: Lateralized suppression of dichotically presented digits after commissural section in man . Science 1968; 161:184-186.Crossref 3. Musiek F, Wilson D, Pinheiro M: Audiological manifestations in splitbrain patients . J Am Aud Soc 1979;5:25-29. 4. Musiek F, Wilson D: SSW and dichotic digit results pre- and post-commissurotomy: A case report . J Speech Hear Dis 1979;44:528-533. 5. Musiek F, Pinheiro M, Wilson D: Auditory pattern perceptions in 'split brain' patients . Arch Otolaryngol 1980;106:610-612.Crossref 6. Risse G, Ledoux J, Springer S, et al: The anterior commissure in man: Functional variations in a multisensori system . Neuropsychologia 1978;16:23-31.Crossref 7. Pandya D, Karol E, Heilbronn D: The topographical distribution of interhemispheric projections in the corpus callosum of the rhesus monkey . Brain Res 1971;32:31-43.Crossref 8. Damasio H, Damasio A: Paradoxic ear extinction in dichotic listening: Possible anatomical significance . Neurology 1979;29:644-653.Crossref 9. Wilson D, Reeves A, Gazzaniga M: Division of the corpus callosum for uncontrollable epilepsy . Neurology 1978;28:649-653Crossref 10. Cherry C, Taylor W: Some further experiments on the recognition of speech with one and two ears . J Acoust Soc Am 1953;26:554-559.Crossref 11. Lynn G, Gilroy J: Perception of rapidly alternating speech in patients with brainstem and cerebral hemisphere lesions. Read before the Ninth Colorado Medical-Audiology Workshop, Vail, Colo, March, 3, 1975. 12. Willeford J: Assessing central auditory behavior in children: A test battery approach , in Keith R (ed): Central Auditory Dysfunction . New York, Grune & Stratton, 1977, pp 43-73. 13. Matzker J: Team efforts for the assessment of central auditory functions in cases of brain disease . Ann Otol Rhinol Laryngol 1959;68:1185-1197. 14. Smith B, Resnick D: An auditory test for assessing brainstem integrity: A preliminary report . Laryngoscope 1972;32:414-424.Crossref 15. Katz J: The use of staggered spondaic words for assessing the integrity of central auditory nervous system . J Aud Res 1972;2:327-337. 16. Brunt M: The staggered spondaic word (SSW) test , in Katz J (ed): Handbook of Clinical Audiology. Baltimore, Williams & Wilkins Co, 1972, pp 334-355. 17. Kimura D: Cerebral dominance in perception of verbal stimuli . Can Gen Psychol 1961;15:166-171. 18. Pinheiro M, Ptacek P: Reversals in the perception of noise and tone patterns . J Acoust Soc Am 1971;49:1778-1782.Crossref 19. Pinheiro M: Auditory pattern perception in patients with right and left hemisphere lesions . Ohio J Speech Hear 1976;12:9-20. 20. Gazzaniga M: Brain mechanisms and behavior, in Gazzaniga M, Blahesvore C (eds): Handbook of Psychobiology . New York, Academic Press Inc, 1975, pp 565-588. 21. Diamond I, Neff W: Ablation temporal cortex and discrimination of auditory patterns . J Neurophysiol 1957;20:300-311. 22. Hamilton C, Brody B: Separation of visual functions within the corpus callosum of monkeys . Brain Res 1973;49:185-189.Crossref 23. Berlin C: Cirtical Review of the Literature on Dichotic Effects—1971 Reviews of Scientific Literature on Hearing . American Academy of Ophthalmology and Otolaryngology, 1972, pp 80-92. 24. Bryden M, Zurif E: Dichotic listening performance in a case of agenesis of the corpus callosum . Neuropsychologia 1970;8:371-377.Crossref

Ervin, Thomas J.;Miller, Daniel;Weichselbaum, Ralph;Fabian, Richard L.;Meshad, Michael

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400039009pmid: 6971090

Abstract • Optimal therapy for stage III and stage IV squamous carcinoma arising in the head and neck requires a multidisciplinary approach, including chemotherapy. Advances have identified several chemotherapeutic agents and combinations of agents that show substantial antitumor activity in this disease. While antitumor activity can be documented, experience indicates the duration of antitumor effect is short, and the toxicity may limit further therapy. To date, studies have not shown an advantage of combination chemotherapy over single agents. Theoretically, combination chemotherapy should increase patient survival through regression of the primary tumor as well as ablation of distant metastases. An analysis of recent trials with patients who received induction chemotherapy before definitive local treatment suggests that regression of tumor in stage III and stage IV lesions before definitive therapy may increase local treatment for regional disease. Randomized trials are needed to confirm or disprove the efficacy of combination chemotherapy for advanced squamous carcinoma of the head and neck. (Arch Otolaryngol 1981;107:237-241) References 1. Silverberg E: Cancer statistics 1980. CA 1980;30:23-38. 2. Goldsmith MA, Carter SK: The integration of chemotherapy into a combined modality approach to cancer therapy v. squamous cell cancer of the head and neck . Cancer Treat Rev 1975;2:137-158.Crossref 3. Carter SK: The chemotherapy of head and neck cancer . Semin Oncol 1977;4:413-423. 4. Khandekar JD, DeWys WD: Chemoimmunotherapy of head and neck cancer . Am J Surg 1978;135:688-695.Crossref 5. Elias EG, Chretien PB, Monnard E, et al: Chemotherapy prior to local therapy in advanced squamous cell carcinoma of the head and neck: Preliminary assessment of an intensive drug regimen . Cancer 1979;43:1025-1031.Crossref 6. Randolph VL, Vallejo A, Spiro RH, et al: Combination therapy of advanced head and neck cancer: Induction of remissions with diamminedichloroplatinum (II), bleomycin, and radiation therapy . Cancer 1978;41:460-467.Crossref 7. Leone LA, Ohnuma T: Combined high dose MTX rescue, bleomycin and cisplatinum for untreated stage III and localized stage IV advanced squamous carcinoma of the head and neck, abstracted . Proc Am Soc Clin Oncol 1979;20:374. 8. Berlinger NT, Tsakraklides V, Pollak K, et al: Immunologic assessment of regional lymph node histology in relation to survival in head and neck carcinoma . Cancer 1976;37:697-706.Crossref 9. Helman P, Sealy R, Malherde E, et al: Intra-arterial cytotoxic therapy and x-ray for cancer of the head and neck . Lancet 1965;1:128-130.Crossref 10. Kirkwood JM, Ervin T, Pitman S, et al: Twice weekly low-dose methotrexate-leucovorin (mtx-lv) for advanced squamous carcinoma of head and neck, abstracted . Proc Am Soc Clin Oncol 1979;20:314. 11. Vogl SE, Kaplan BH: Chemotherapy of advanced head and neck cancer with methotrexate, bleomycin, and cis-diammine dichloroplatinum II as an effective outpatient schedule . Cancer 1979;44:26-31.Crossref 12. Caradonna R, Paladine R, Ruchdechel JC, et al: Methotrexate, bleomycin and high dose dichlorodiammineplatinum (II) in the treatment of advanced epidermoid carcinoma of the head and neck . Cancer Treat Rep 1979;63:489-491. 13. Willis RE, Heller K, Randolph V, et al: Cis-dichlorodiammineplatinum (II)-based chemotherapy as initial treatment of advanced head and neck cancer . Cancer Treat Rep 1979;63:1533-1538. 14. Bianco A, Taylor SG, Reich S, et al: Combination chemotherapy pilot studies in head and neck squamous cell cancer . Cancer Treat Rep 1979;63:158-159. 15. Lyman GH, Armistead S, Williams CC, et al: Bleomycin and prolonged infusion cis-diamminedichloroplatinum (CDDP) in advanced squamous cell carcinoma of the head and neck, abstracted . Clin Res 1979;27:759. 16. Davis S, Kessler W: Randomized comparison of cis-diamminedichloroplatinum versus cis-diamminedichloroplatinum, methotrexate, and bleomycin in recurrent squamous cell carcinoma of the head and neck . Cancer Chemotherapy Pharmacology 1979;3:57-59.Crossref 17. Baker L, Al-Sarraf M: A comparative trial of cis-platinum (C) oncovin (0) and bleomycin (B) vs. methotrexate (M) in patients with advanced epidermoid carcinomas of the head and neck, abstracted . Proc Am Assoc Cancer Res 1979;20:202. 18. Taylor SG, Bytell DE, DeWys WD, et al: Adjuvant methotrexate and leucovorin in head and neck squamous cancer . Arch Otolaryngol 1978;104:647-651.Crossref 19. Ervin TJ, Weichselbaum RR, Miller D, et al: Improved survival for patients with advanced carcinoma of head and neck treated with methotrexate-leucovorin prior to definitive radiotherapy or surgery, abstracted . Proc Am Assoc Cancer Res 1980;21:141. 20. Weichselbaum RR, Miller D, Pitman SW, et al: Initial adjuvant weekly high dose methotrexate with leukovorin rescue in advanced squamous carcinoma of the head and neck . Int J Radiat Oncol Biol Phys 1978;4:671-674.Crossref 21. Al-Sarraf M, Binns P, Vaishampagan G, et al: The adjuvant use of cis-platinum, oncovin and bleomycin (COB) prior to surgery and/or radiotherapy in untreated epidermoid cancer of the head and neck , in Salmon SE, Jones SE (eds): Adjuvant Therapy of Cancer II . New York, Grune & Stratton Inc, 1979, pp 421-428. 22. Glick JH, Fazekas JT, Davis LW, et al: Combination chemotherapy-radiotherapy for advanced, inoperable head and neck cancer: A RTOG pilot study . Cancer Clin Trials 1979;2:129-136. 23. Pitman SW, Minor BR, Papac R, et al: Sequential methotrexate-leucovorin (MTX-LCV) and cis-platinum (CDDP) in head and neck cancer, abstracted . Proc Am Soc Clin Oncol 1979;20:49. 24. Fu KK, Silverberg IJ, Phillips TL, et al: Combined radiotherapy and multidrug chemotherapy for advanced head and neck cancer: Results of a radiation therapy oncology group pilot study . Cancer Treat Rep 1979;63:351-357. 25. Seagren S, Byfield J, Nahum A, et al: Concurrent cyclophosphamide, bleomycin and ionizing radiation in advanced squamous carcinoma of the head and neck, abstracted . Proc Am Soc Clin Oncol 1979;20:224. 26. Clifford P, O'Connor AD, Durder-Smith J, et al: Synchronous multiple drug chemotherapy and radiotherapy for advanced (stage III and IV) squamous carcinoma of the head and neck . Antibiot Chemother 1978;24:60-72. 27. Catane R, Schwade JG, Turrisi AT, et al: Pulmonary toxicity after radiation and bleomycin: A review . Int Radiat Oncol Biol Phys 1979;5:1513-1518.Crossref 28. Taylor SG, Bytell GA, Sisson GA, et al: Methotrexate-leucovorin with immunotherapy as adjuvant to surgery and radiotherapy in stage III-IV head and neck squamous cancer patients , in Salmon SE, Jones SE (eds): Adjuvant Therapy of Cancer . Amsterdam, Elsevier/North Holland Biomedical Press, 1977, pp 457-466. 29. Lustig RA, Demare PA, Kramer S: Adjuvant methotrexate in the radiotherapeutic management of advanced tumors of the head and neck . Cancer 1976;37:2703-2708.Crossref 30. Tarpley JL, Chretien PB, Alexander JC Jr, et al: High dose methotrexate as a preoperative adjuvant treatment of epidermoid carcinoma of the head and neck . Am J Surg 1975;136:481-486.Crossref 31. Nervi C, Arcangeli G, Badaracco G, et al: The relevance of tumor size and cell kinetics as predictors of radiation response in head and neck cancer . Cancer 1978;41:900-906.Crossref 32. Rosen G, Murphy ML, Huvos AG, et al: Chemotherapy, en bloc resection, and prosthetic bone replacement in the treatment of osteogenic sarcoma . Cancer 1976;37:1-11.Crossref 33. Strong MS, Vaughan CW, Kayne HL, et al: A randomized trial of preoperative radiotherapy in cancer of the oropharynx and hypopharynx . Am J Surg 1978;136:494-500.Crossref 34. Donegan WL, Harris P: Regional chemotherapy with combined drugs in cancer of the head and neck . Cancer 1976;38:1479-1483.Crossref 35. Rosencweig M, Von Hoff DD, Muggin FM: Investigational chemotherapeutic agents in head and neck cancer . Semin Oncol 1977;4:425-429. 36. Marmour JB, Kozak D, Hahn GM: Effects of systemically administered bleomycin or adriamycin with local hyperthermia or primary tumor and lung metastases . Cancer Treat Rep 1979;63:1279-1290. 37. Jacobs C, Bertino JR, Goffinet DR, et al: 24-hour infusion of cis-platinum in head and neck cancers . Cancer 1978;42:2135-2140.Crossref 38. Wittes RE, Cvitkovic E, Shah J, et al: Cis-dichlorodiammine platinum (II) in the treatment of epidermoid carcinoma of the head and neck . Cancer Treat Rep 1977;61:359-366. 39. Sako K, Razack MS, Kalrins I: Chemotherapy for advanced and recurrent squamous carcinoma of the head and neck with high and low dose cis-diamminedichloroplatinum . Am J Surg 1978;136:529-533.Crossref 40. Pitman SW, Frei E III: Weekly methotrexate-leucovorin: Phase II results . Proc Am Assoc Cancer Res 1977;18:494. 41. Kaplan BH, Vogl SE, Chinten D, et al: Chemotherapy of advanced cancer of the head and neck (HNCa) with methotrexate (M), bleomycin (B) and cis-diamminedichloroplatinum (D) in combination, abstracted . Proc Am Soc Clin Oncol 1979;20:384. 42. Holoye PY, Byers RM, Gard DA, et al: Combination chemotherapy of head and neck cancer . Cancer 1978;42:1661-1669.Crossref 43. Cortes EP, Amin VC, Artie J, et al: Combination of low dose bleomycin, followed by cyclophosphamide, methotrexate and 5-fluorouracil for advanced head and neck cancer, abstracted . Proc Am Assoc Cancer Res 1979;20:257. 44. Hong KH, Shapshay SM, Bhutani R, et al: Induction chemotherapy in advanced head and neck carcinoma with high-dose cis-platinum and bleomycin infusion . Cancer 1979;44:19-25.Crossref 45. Price LA, Hill BT: A kinetically based logical approach to the chemotherapy of head and neck cancer . Clin Otolaryngol 1977;3:339-345.Crossref 46. Shapshay SM, Hong WK, Incze JS, et al: Histopathologic findings after cis-platinum bleomycin therapy in advanced, previously untreated head and neck carcinoma . Am J Surg 1978;36:534-538.Crossref

Shamsuddin, Daliah;Tuazon, Carmelita U.

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400044010pmid: 7213184

Abstract • Cefoxitin sodium, a new cephamycin antibiotic, is active against many aerobic and anaerobic bacteria. Four patients with infections of the head and neck (otitis externa with cellulitis, parotiditis, tracheitis, and facial cellulitis), who had failed to respond to initial antibiotic regimens, responded satisfactorily to cefoxitin therapy. No adverse effects were noted in any of these patients. Results of this report suggest cefoxitin is a safe and well-tolerated antibiotic that is efficacious in the treatment of head and neck bacterial infections that are sensitive to this drug. (Arch Otolaryngol 1981;107:242-244) References 1. Neu HC: Cefoxitin: An overview of clinical studies in the U.S.A . Rev Infect Dis 1979;1:233-239.Crossref 2. Nair SR, Cherubin CE: Use of cefoxitin sodium in difficult-to-treat infections . Antimicrob Agents Chemother 1978;4:167-168. 3. Weinstein MP, Eickhoff TC: Clinical evaluation of cefoxitin in the treatment of respiratory tract and other acute bacterial infections . Rev Infect Dis 1979;1:158-163.Crossref 4. Ledger WJ, Smith D: Cefoxitin in obstetric and gynecologic infections . Rev Infect Dis 1979;1:199-204.Crossref 5. Rambo WM, DelBene VE, Delamar DK: Cefoxitin therapy for surgical infections . Rev Infect Dis 1979;1:195-198.Crossref 6. Neu HC: Comparative studies of cefoxitin and cephalothin: An overview . Rev Infect Dis 1979;1:144-150.Crossref 7. Nair SR, Cherubin CE: Use of cefoxitin, new cephalosporin-like antibiotic in the treatment of anaerobic infections . Antimicrob Agents Chemother 1978;14:866-875.Crossref

Mazzarella, Lawrence A.;Friedlander, Arthur A.

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400047011pmid: 7213185

Abstract • The removal of a full-thickness portion of the anterior part of the mandible can result in significant cosmetic deformity and serious functional disability. Anterior sagittal ostectomy of the mandible obviates the need for resection of the mandible. This surgical technique has the following advantages: (1) permits an en bloc resection of the entire lingual cortical plate of the mandible and the floor of the mouth, (2) maintains facial contour and oral cavity function, (3) can be combined with any soft-tissue reconstructive procedure, and (4) does not require a future mandibular reconstructive procedure. (Arch Otolaryngol 1981;107:245-248) References 1. Som ML, Nussbaum M: Marginal resection of the mandible with reconstruction by tongue flap for carcinoma of the floor of the mouth . Am J Surg 1971;121:679-683.Crossref 2. Marchetta FC, Sako K, Murphy JB: The periosteum of the mandible and intraoral carcinoma . Am J Surg 1971;122:711-713.Crossref 3. Ward GE, Robben JO: A composite operation for radical neck dissection and removal of cancer of the mouth . Cancer 1951;4:98-109.Crossref 4. Slaughter DP, Southwick HW: En bloc resection of cancer of the mouth and cervical lymphatics with preservation of the mandible . Ann Surg 1953;6:957-963. 5. Kremen AJ: Cancer of the tongue: A surgical technique for a primary combined en bloc resection of tongue, floor of mouth, and cervical lymphatics . Surgery 1951;30:227-238. 6. Greer DB, Smith RR, Klopp CT: A surgical method of treatment of carcinoma of the floor of the mouth . Surgery 1953;34:279-287.

Giordano, Anthony;Adams, George;Boies, Lawrence;Meyerhoff, William

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400051012pmid: 7213186

Abstract • Between 1972 and 1987, a total of 159 cases of esophageal foreign body were treated at the University of Minnesota Affiliated Hospitals, Minneapolis. Although coins were the most frequent offending agent in the pediatric group, meat was the most common in the entire series (60%). Eighty percent of coins were impacted in the upper esophagus, while meat impaction occurred most frequently in the distal esophagus (42%). Rigid esophagoscopy was performed in 134 patients. The foreign body was removed during esophagoscopy in 122 cases, advanced into the stomach in two cases, and not found in ten cases. In addition to esophagoscopy, when meat obstruction was suspected, several pharmacologic agents were successful in relieving the obstruction, such as parenterally administered diazepam (Valium) (8/27) and glucagon (6/14). Spontaneous passage was noted in seven cases. No cases of esophageal carcinoma were discovered in this series. (Arch Otolaryngol 1981;107:249-251) References 1. Richardson JR: A new treatment for esophageal obstruction due to meat impaction . Am Otol Rhinol Laryngol 1945;54:328-348. 2. Cavo JW, Koops HJ, Gryboski RA: Use of enzymes for meat impactions in the esophagus . Laryngoscope 1977;87:630-634. 3. Brooks JW: Foreign bodies in the air and food passages . Ann Surg 1972;175:720-732.Crossref 4. Palmer ED: Backyard barbecue syndrome: Steak impaction in the esophagus . JAMA 1976;235:2637-2638.Crossref 5. Robinson AS: Meat impaction in the esophgus treated by enzymatic digestion . JAMA 1962;181:1142-1143.Crossref 6. Ament ME, Christie DL: Upper gastrointestinal fiberoptic endoscopy in pediatric patients . Gastroenterology 1977;72:1244-1248. 7. Brady PG, Johnson WF: Removal of foreign bodies: The flexible fiberoptic endoscope . South Med J 1977;70:702-704.Crossref 8. DeLuca RF, Ferrer JP, Wortzel EM: Polypectomy snare extraction of foreign bodies from the esophagus . Am J Gastroenterol 1976;66:374-376. 9. Kline MM: Endoscopic snare in removal of an esophageal foreign body . Gastrointest Endosc 1974;20:165-166.Crossref 10. McCaffery TD, Lilly JO: The management of foreign affairs of the GI tract . Am J Dig Dis 1975;20:121-126.Crossref 11. Olsen H, Lawrence W, Bernstein R: Fiberendoscopic removal of foreign bodies from the upper gastrointestinal tract . Gastrointest Endosc 1974;21:58-60.Crossref 12. Roesch W, Koch H, Fruehmorgen P, et al: Operative endoscopy of the upper gastrointestinal tract . Gastrointest Endosc 1974;20:108-109.Crossref 13. Uthman SM, Kabakian HA, Nassar VH: The use of the flexible esophagoscope in the treatment of meat impaction of the esophagus . J Med Liban 1973;26:667-671. 14. VanThiel DH, Stafan NJ: Removal of soft foreign bodies from the esophagus using a flexible instrument . Gastrointest Endosc 1974;20:163-165.Crossref 15. Bigler FC: The use of a Foley catheter for removal of blunt foreign bodies from the esophagus . J Thorac Cardiovasc Surg 1966;51:759-760. 16. Crowe JE: Removal of blunt esophageal foreign bodies: Foley catheter technique . NC Med J 1976;37:431-432. 17. Devadason I: Removal of blunt oesophageal foreign bodies from children using a Foley catheter . Med J Malaysia 1976;30:321-322. 18. Goudswaard WB: Foreign body in the esophagus . Trop Doct 1976;6:95. 19. Nixon GW: Foley catheter method of esophageal foreign body removal: Extension of applications . AJR 1979;132:441-442.Crossref 20. Samara M, Melhem R, Rizk G: Catheter removal of radiopaque foreign bodies from the upper GI tract . J Med Liban 1973;26:661-666. 21. Ferrucci JT, Long JA: Radiologic treatment of esophageal food impaction using intravenous glucagon . Radiology 1977;125:25-28.Crossref 22. Glauser J, Lilja GP, Greenfield B, et al: Intravenous glucagon in the management of esophageal food obstruction . JACEP 1979;228-231. 23. Marks HW, Lousteau RJ: Glucagon and esophageal meat impaction . Arch Otolaryngol 1979;105:367-368.Crossref 24. Lerche W: The esophagoscope in removing sharp foreign bodies from the esophagus . JAMA 1911;56:634-637.Crossref 25. Baraka A, Bikhazi G: Oesophageal foreign bodies . Br Med J 1975;1:561-563.Crossref 26. Barrett JH: Foreign bodies in the air and food passages . Arch Otolaryngol 1951;54:651-665.Crossref 27. Clerf LH: Foreign bodies in the air and food passages . Surg Gynecol Obstet 1940;70:328-339. 28. Holinger PH, Johnston KC, Greengard J: Congenital anomalies of the esophagus related to esophageal foreign bodies . Am J Dis Child 1949;78:467-476. 29. Jackson CL: Foreign bodies in the esophagus . Am J Surg 1957;93:308-312.Crossref 30. Nandi P, Ong GB: Foreign body in the esophagus: Review of 2,394 cases . Br J Surg 1978;65:5-9.Crossref 31. Singh M, Gill P, Gill SS, et al: Foreign bodies in the tracheobronchial tree and oesophagus of children . Indian Pediatr 1976;13:25-30. 32. Spitz L: Management of ingested foreign bodies in childhood . Br Med J 1971;4:469-472.Crossref 33. Tandon RK, Patney NL, Srivastava VK, et al: Acute dysphagia due to foreign bodies in oesophagus . Indian Pediatr 1972;9:715-717. 34. Dalil-Tojari A: Foreign bodies of the tracheobronchial tree and esophagus . Acta Med Iran 1975;18:155-160. 35. Ritter F: Questionable methods of foreign body treatment . Ann Otol Rhinol Laryngol 1974;83:729-733. 36. Simpson J, Ruff T, Fearon B: Esophageal perforation during esophagoscopy in children . Ann Otol Rhinol Laryngol 1974;83:725-728.

Plasse, Harvey M.;Lieberman, Abraham N.

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400054013pmid: 7213187

Abstract • We report two cases of bilateral vocal cord paralysis in patients with Parkinson's disease and review the possible causes of this condition. We suggest that the vocal cord muscle paralysis is a manifestation of advanced disease. Bilateral vocal cord paralysis in Parkinson's disease may be seen more commonly in the future as therapy enables more patients to live longer. (Arch Otolaryngol 1981;107:252-253) References 1. Lieberman AN: Parkinson's disease: A clinical review . Am J Med Sci 1974;267:66-80.Crossref 2. Huppler EG, Schmidt HW, Devine K, et al: Causes of vocal cord paralysis . Mayo Clin Proc 1955;30:518-521. 3. Holinger LD, Holinger PC, Holinger PH: Etiology of bilateral vocal cord paralysis: A review of 389 cases . Ann Otol Rhinol Laryngol 1976;85:428-436. 4. Montgomery WW: Surgical laryngeal closure to eliminate chronic aspiration . N Engl J Med 1975;292:1390-1391.Crossref 5. Vas CJ, Parsonage M, Lord OC: Parkinsonism associated with laryngeal spasm . J Neurol Neurosurg Psychiatry 1965;28:401-403.Crossref 6. Schechter GL, Kostianovsky M: Vocal cord paralysis in diabetes mellitus . Trans Am Acad Ophthalmol Otolaryngol 1972;76:729-740. 7. Lieberman AN, Kupersmith M, Gopinathan G, et al: Bromocriptine in Parkinson disease: Further studies . Neurology 1979;29:363-369.Crossref 8. Israel RH, Marino JM: Upper airway obstruction in the Shy-Drager syndrome . Ann Neurol 1977;2:83.Crossref 9. Williams A, Hanson D, Calne DB: Vocal cord paralysis in the Shy-Drager syndrome . J Neurol Neurosurg Psychiatry 1979;42:151-153.Crossref 10. Lieberman AN, Horowitz L, Redmond P: Dysphagia in Parkinson's disease . Am J Gastroenterol , to be published.

Shanon, Eliahu;Himelfarb, Mordechai Z.;Gold, Shlomit

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400056014pmid: 7213188

Abstract • Hearing function and auditory brainstem potentials were evaluated in nine members of three generations of a family affected with Friedreich's ataxia. The characteristic findings were high-frequency sensorineural hearing impairment of varying severity and diminished or absent N1, N2, and N3 responses. These electrophysiologic aberrations correlate topographically with previously reported pathological observations. (Arch Otolaryngol 1981;107:254-256) References 1. Blackwood W, Corsellis JAN (eds): Greenfield's Neuropathology . London, Edward Arnold Publishers, 1976, pp626-629. 2. Bell J, Carmichael EA: On hereditary ataxia and spastic paraplegia , in Fisher RA (ed): The Treasury of Human Inheritance . London, Cambridge University Press, 1939, vol 4, (pt 3) . 3. Friedreich N: Ueber degenerative Atrophie der spinalen Hinterstraenge . Virchows Arch Pathol Anat 26:391-419, 433-459, 1863.Crossref 4. Franceschetti A, Klein D: Ueber das Vorkommen von hereditärer juveniler Maculadegeneration (Typ Stargardt) bei zwei Geschwisterpaaren der Friedreich-Sippe 'Glaser.' Arch Julius-Klaus Stift VererbForsch 16:460-493, 1941. 5. Montandon A: Les troubles cochléaires dans les héredo-ataxie . Rev Otoneuroophtalmol 20:181-213, 1948. 6. Spöndlin H: Optic and cochleovestibular degenerations in hereditary ataxias . Brain 97:41-48, 1974.Crossref 7. Sjögren T: Klinische und erbbiologische Untersuchungen ueber die Heredoataxien . Acta Psychiat Neurol , (suppl 27) , 1943. 8. Urich H, Norman RM, Lloyd OC: Suprasegmental lesions in Friedreich's ataxia . Confin Neurol 17:360-371, 1957.Crossref 9. Lubozynski MF, Roelofs RI: Friedreich's ataxia . South Med J 68:757-763, 1975.Crossref 10. Shanon E, Gold S, Himelfarb MZ: Assessment of functional integrity of brain stem auditory pathways by stimulus stress . Audiology , to be published. 11. Shanon E, Gold S, Himelfarb MZ, et al: Auditory potentials of cochlear nerve and brainstem in multiple sclerosis . Arch Otolaryngol 105:505-508, 1979.Crossref

Jahrsdoerfer, Robert A.;Richtsmeier, William J.;Cantrell, Robert W.

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400059015pmid: 7213189

Abstract Robert W. Cantrell, MD (moderator): Welcome to the Department of Otolaryngology and Maxillofacial Surgery's grand rounds. Our topic today is "Spontaneous CSF Otorrhea." The case report will be given by Dr William Richtsmeier, one of our chief residents, and the discussion will be by Dr Robert A. Jahrsdoerfer, vice-chairman. We are privileged to have some visiting dignitaries today; Dr Jack Pulec of Los Angeles and Dr George Gates, professor and chairman of otolaryngology at the University of Texas at San Antonio, who are in town for a meeting of the Virginia Society of Ophthalmology and Otolaryngology. We are also happy to have various visiting otolaryngologists from the state of Virginia. Dr Richtsmeier, would you please give the case report? PRESENTATION OF A CASE William J. Richtsmeier, MD: A 66-year-old retired man was watching television when he felt a "bump" behind his right ear. Upon retiring that evening, he noticed a References 1. Dedo HH, Sooy FA: Endaural brain hernia (encephalocele): Diagnosis and treatment . Laryngoscope 80:1090-1099, 1970.Crossref 2. Baron SH: Herniation of brain into the mastoid cavity: Post surgical, postinfectional, or congenital . Arch Otolaryngol 90:779-785, 1969.Crossref 3. Brow RE: Pre- and postoperative management of the acoustic tumor patient , in House WF, Luetje CM (eds): Acoustic Tumors: Management . Baltimore, University Park Press, 1979, vol 2, p 167. 4. Gacek RR, Leipzig B: Congenital cerebrospinal otorrhea . Ann Otol Rhinol Laryngol 88:358-365, 1979. 5. Montgomery WW: Surgery for cerebrospinal fluid rhinorrhea and otorrhea . Arch Otolaryngol 84:538-550, 1966.Crossref 6. Evans JP, Keegan HR: Danger in the use of intrathecal methylene blue . JAMA 174:856-859, 1960.Crossref 7. Mahaley MS Jr, Odom GL: Complication following intrathecal injection of fluorescein . J Neurosurg 25:298-299, 1966.Crossref 8. Crow HJ, Keogh C, Northfield DWC: The localization of cerebrospinal fluid fistula . Lancet 2:325-327, 1956.Crossref 9. Sinanan EN, Tenney R, McQueen D: An unusual case of occult cerebrospinal fluid rhinorrhea: And a method of its determination by the use of a tracer element (radioactive arsenic, AS-74) . Laryngoscope 76:102-108, 1966.Crossref 10. DeLand FH, James AE, Wagner HN, et al: Cisternography with 169Yb-DTPA . J Nucl Med 12:683-689, 1971. 11. Hosain F, Som P: Chelated111 In: An ideal radiopharmaceutical for cisternography . Br J Radiol 45:677-679, 1972.Crossref 12. Ahrén C, Thulin CA: Lethal intracranial complications following inflation in the external auditory canal in the treatment of serous otitis media and due to defects in the petrous bone . Acta Otolaryngol 60:407-421, 1965.Crossref 13. Fairman HD, Brown NJ, Hallpike CS: Air embolism as a complication of inflation of the tympanum through the external auditory meatus . Acta Otolaryngol 66:65-71, 1968.Crossref 14. Finsnes KA: Lethal intracranial complication following air insufflation with a pneumatic otoscope . Acta Otolaryngol 75:436-438, 1973.Crossref

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400064016

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Abstract Course.—A course on "Rhinoplasty and Otoplasty" will be held June 14-18, 1981, in New York. The course director is Sidney S. Feuerstein, MD, with a distinguished list of guest faculty and faculty. This course covers the basic principles of rhinoplasty, including otoplasty and reconstructive surgery of the nasal septum. Cadaver dissection available for each student. For more information, contact Sidney S. Feuerstein, MD, Page and William Black Postgraduate School of Medicine, 1 Gustave L. Levy Pl, New York, NY 10029. Course.—There will be a course on "Facial Plastic Surgery," June 19-20, 1981, in New York. The course director is William Lawson, MD, DDS. The guest faculty will include John Conley, MD, William H. Friedman, MD, and Richard C. Webster, MD. The faculty will include Jacob S. Aronoff, MD, Sidney S. Feuerstein, MD, and William Lawson, MD, DDS. This course will cover the face-lift procedure and will include attention

1981 Archives of Otolaryngology

doi: 10.1001/archotol.1981.00790400064017

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.