Archives of Otolaryngology - Head & Neck Surgery

MATHOG, —ROBERT H.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280015002

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 At the 1988 annual meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Washington, DC, Robert W. Riley and colleagues, Palo Alto, Calif, presented a new technique for the management of obstructive sleep apnea. Relying on their experience and that of others, they concluded that there were a number of uvulopalatopharyngoplasty failures as a result of pharyngeal obstruction, and that these patients could be helped by a mandibular osteotomy and hyoid suspension procedure. With these techniques, they showed that they could increase the "responders," patients with a respiratory disturbance index less than 20%, from less than 50% to 67%. Those patients who did not respond were noted to have a structural deficiency, and, if they were treated with a maxillary, mandibular, and hyoid advancement procedure, they could affect a further reduction in signs and symptoms. Several patients in their series who had failed palatopharyngoplasty were helped with the

STIERNBERG, CHARLES M.;DRAKE, —AMELIA F.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280015001

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 Teichgraeber and Goepfert, from the M. D. Anderson Cancer Center, Houston, reported on their experience with patients with nasal skin cancer requiring full-thickness resection of nasal skin. Their report was presented at the recent meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Washington, DC. They emphasized the nature of aggressive nasal lesions as being usually squamous cell carcinoma or basal cell carcinoma, with a prior history of previous treatment. Of these, 62% of squamous cell carcinoma and 80% of all lesions greater than 4 cm required rhinectomy. They noted a worse prognosis in this series overall, and recommended delay in reconstruction for two years. The authors note that their series of 147 patients, of whom 37% had previous treatment prior to referral, had a worse prognosis than reported in other series, representing more advanced lesions of this type. They were able to correlate poor prognosis to size

WETMORE, STEPHEN J.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280015003

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 The use of osseointegrated implants in mandibles reconstructed with microvascular free-bone transfer was reported at the annual meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Washington, DC, by Howard Urken and colleagues, New York. In seven of nine cases they inserted the osseointegrated screws through the bone graft during the tumor ablation procedure, making certain that the bone graft and screws were covered by muscle, and either skin or mucosa. In the other two cases, the screws were inserted in a secondary operation. In either event, four months later the screws were uncovered and posts were inserted that protruded through the oral mucosa or skin. Either permanent dentures or removable dentures were applied to the posts, thereby providing excellent dental rehabilitation. At the time of this report, seven of nine patients had been fitted with dentures. Of the five patients who received radiotherapy, four received it preoperatively.

HUNSAKER, DARRELL H.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280015004

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 During the fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Washington, DC, William J. Wolfenden, Jr, San Francisco, presented a technique of jowl sculpting by buccal fat removal and rhytidectomy. According to Wolfenden, 20% of patients undergoing rhytidectomy could benefit from reduction of the cheek rounding accomplished by this procedure. He has used this technique since 1987 in 20% of rhytidectomies performed, and, in an occasional patient, as the only procedure. The technique is strictly intraoral through a 1-mm incision just inferior and posterior to the parotid duct orifice. The buccal fat pad is uncovered with a blunt-tip suction cannula or scissors. A suction-assisted lipectomy is then performed removing half to two thirds of the fat pad. The mucosal incision is closed with an absorbable suture. Perioperative cephalosporin is used to prevent infection. Wolfenden cautions that outcome cannot be appreciated before one year, at which time

CALHOUN, KAREN H.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280017005

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 At the recent meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Washington, DC, Theodore Staahl, Modesto, Calif, presented a method for reconstruction of the lower eyelid. He proposes a new technique for reconstruction of full-thickness lower eyelid defects, such as those occurring after excision of a basal or squamous cell carcinoma of the free margin of the lower eyelid. Modifying a technique used by Segal for ectropion repair, he develops a skin-muscle flap from the upper eyelid, being sure to maintain at least an 8-mm pedicle of muscle laterally. This bipedicled flap is swung inferiorly. The lining of the flap is created by a composite upper lateral nasal cartilage-plus-mucosa graft. The curve and thinness of this graft closely mimic the tarsal plate. The flap and graft are joined to the superior margin, and the rest of the flap and graft are sutured in place. The advantages

DAVIS, —R. Kim

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280017007

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 Bruce H. Haughey and associates at the Washington University School of Medicine, St Louis, and at the University of Texas Health Science Center, San Antonio, reported to the American Academy of Otolaryngology–Head and Neck Surgery in Washington, DC, on three cases of midline cerebral shift documented by computed tomographic scanning following flap reconstruction of lateral craniofacial-craniotemporal resections. The authors reported that three other patients undergoing anterior craniofacial resection showed no evidence of intracerebral shift. They reported that the cerebral component of the cranial contents is vulnerable to rising extrinsic pressure once the rigid protective covering of the skull is removed. Intracranial pressure falls, brain compliance rises, and contralateral cerebral shift will occur. This has been documented when craniectomy alone is performed, but certainly can be accentuated when flaps filling the surgical defect add further compression by weight or swelling. They describe several strategies to decrease the likelihood of shift.

SHUMRICK, —KEVIN A.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280017006

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 At the recent fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery held in Washington, DC, Donna J. Millay and Wayne F. Larrabee, Jr, Seattle, presented a paper on subcutaneous pedicle flaps detailing the development of an experimental model and clinical applications. The experimental portion of the presentation consisted of the development and evaluation of subcutaneous pedicle flaps in the porcine model. This was performed on three juvenile pigs in which subcutaneous pedicle flaps of various lengths with various angles of rotation were developed. Blood flow in the flaps was then estimated with Doppler lasers at various stages of flap development. Using this model, it was noted that there was no change in flap profusion with the initial skin and subcutaneous incisions. However, the authors found that there was a marked drop in blood flow to the flap, with undermining and production of the subcutaneous pedicle. It

HANSON, DAVID G.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280017008

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 At the annual meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Washington, DC, Paul A. Levine and colleagues, University of Virginia, Charlottesville, reported their 11-year experience with craniofacial resection for nasal and sinus tumors. The report included 27 anterior base of skull resections performed in 25 patients. The majority (17) of the operations were for esthesioneuroblastoma, and nearly all patients had received previous treatments, including radiation. The report discussed a variety of approaches possible for resection of these tumors, including different means of closure of the surgical defect. Reported complications were largely transient and were treated successfully. Resection was achieved without orbital exenteration, and with acceptable ophthalmologic sequelae of mild diplopia, enophthalmos, dystopia, and epiphora. The authors did not discuss in detail the long-term survival and length of follow-up for these patients. However, their report emphasized that tumors of the nose and sinuses that extend to the

PERKINS, —STEPHEN W.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280024010

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 The following discussion by Dr Stephen W. Perkins, Indianapolis, Ind, is taken from a workshop at the fall meeting of the American Academy of Facial Plastic and Reconstructive Surgery on ambulatory health care. The workshop stressed a practical approach to improve ambulatory health care through self-assessment and accreditation. Whether to seek formal accreditation for your outpatient operating area, and, if so, from which organization (such as the Accreditation Association for Ambulatory Health Care or Medicare) are decisions that need to be made locally and regionally. There are no absolute guidelines, but the following discussion by Dr Perkins certainly defines some important areas that should be considered by anyone maintaining an outpatient operating area, whether or not an election to become formally accredited is made.—ED. In today's competitive environment for patients who intend to undergo facial cosmetic surgery, it behooves each facial plastic surgeon to establish an office-based surgical facility in

CLOUSSON, JERRY P

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280024009

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 (Jerry Clousson presented a workshop, "Negotiating for Your Future," at the 1988 annual meeting of the American Academy of Facial Plastic and Reconstructive Surgery. As we all become more involved in negotiating with insurance companies, governmental agencies, alternative health delivery systems, and, in some cases, our own institutions, he provides some helpful advice.) Preparation should create assertiveness. Exercise it! Make the other side react to you. THE OPENING POSITION Your opening position probably is the most crucial step you will take. Before declaring it, know what you want! Never enter discussions until you do, even if the discussion is supposedly only for preliminary informational purposes. It is almost impossible to avoid giving some signal, sometimes before you have thought out your long-term position.Your opening position will box you in and lessen your flexibility in subsequent talks. When you take it, grab and hold the initiative. Play from your game

BAILEY, BYRON J.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280031011pmid: 2923684

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 We practice our profession in a specialty that is devoted to preserving and restoring the health of the upper aerodigestive tract. By choice and training, we have shouldered a major responsibility for all aspects of patient care, from the cradle to the grave, in these anatomic regions, including patient education and disease prevention. For these reasons, we have an obligation to understand the disease of tobaccoism (an addictive, fatal attraction more prevalent than alcoholism, drug addiction, acquired immunodeficiency syndrome, and trauma combined) and the progress that is being made to combat its spread. It has been 25 years since Surgeon General Luther Terry issued the first official, comprehensive report on January 11, 1964, that linked smoking to premature death. There have been 20 such reports since that time, and tremendous progress has been made, including the mandatory warnings on cigarette packages in 1972, the numerous public awareness campaigns, restrictions on

Arnstein, David P.;Berke, Gerald S.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280033012pmid: 2923685

Abstract • Repair of nasoseptal perforations is a difficult problem for the otolaryngologist. Recently, there has been an increased incidence among patients, particularly with the rise in cocaine abuse and trauma. The variety of proposed methods of repair points to the lack of a definitive solution for successful surgical treatment of nasoseptal perforations. Successful septal perforation repairs using an open rhinoplasty approach with bipedicled mucoperichondrial flaps and temporal fascia grafts were achieved in eight of nine patients in a series. Resident otolaryngologists in training were the primary surgeons in all nine patients. The References 1. Fairbanks DNF, Fairbanks GR: Surgical management of large nasal septal perforations . Br J Plast Surg 1971;24:382-387.Crossref 2. Belmont RB: An approach to large nasoseptal perforation and attendant deformity . Arch Otolaryngol Head Neck Surg 1985;111:450-455.Crossref 3. Fairbanks DNF, Chen SCA: Closure of large nasal septal perforations . Arch Otolaryngol Head Neck Surg 1970;91:403-406.Crossref 4. Meyer R: Neurungen in der Nasenplastik . Pract Otolaryngol 1951;13:373-376. 5. Goodman WS, Strezlow VV: The surgical closure of nasoseptal perforations . Laryngoscope 1982;92:121-124. 6. Gollum J: Perforation of the nasal septum: The reverse flap technique . Arch Otolaryngol Head Neck Surg 1968;88:518-522.Crossref 7. Wright WK: Tissues of tympanic grafting . Arch Otolaryngol Head Neck Surg 1963;78:291-296.Crossref 8. Fairbanks DNF: Closure of nasal septal perforations . Arch Otolaryngol Head Neck Surg 1980;106:509-513.Crossref 9. Wright WK, Kridel RWH: External septorhinoplasty: A tool for teaching and improved results . Laryngoscope 1981;91:945-951.

Derkay, Craig S.;Hirsch, Barry E.;Johnson, Jonas T.;Wagner, Robin L.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280037013pmid: 2923686

Abstract • The use of antimicrobial prophylaxis in the presence of posterior nasal packing for the treatment of posterior epistaxis remains controversial. Twenty patients were prospectively randomized into this placebo-controlled, double-masked pilot study to receive either placebo or cefazolin sodium. Antibiotic-impregnated posterior gauze packing was employed in all patients. No infectious complications were noted in either group. The packings from the patients in the placebo group were foul smelling and heavily colonized with gram-negative bacteria while the packings from the antibiotic group were odor-free and lightly colonized with gram-positive organisms. This preliminary study suggests the usefulness of antimicrobial prophylaxis for preventing complications from posterior nasal packing, although a larger sample size will be needed to decrease the type II (β) error. (Arch Otolaryngol 1989;115:439-441) References 1. Hirsch BE: Antibiotic use with nasal packing , in Johnson JT (ed): Antibiotic Therapy in Head and Neck Surgery . New York, Marcel Dekker Inc, 1987, pp 113-123. 2. Slavin SA, Rees TD, Guy CL, et al: An investigation of bacteremia during rhinoplasty . Plast Reconstr Surg 1983;71:196-198. 3. Herzon AS: Bacteremia and local infections with nasal packing . Arch Otolaryngol Head Neck Surg 1971;94:317-320.Crossref 4. Weimert TA, Yoder MG: Antibiotics and nasal surgery . Laryngoscope 1980;90:667-672.Crossref 5. Marples RR, Fulton JE, Leyden J, et al: Effect of antibiotics on the nasal flora in acne patients . Arch Dermatol 1969;99:647-651.Crossref

Ishikawa, Yasuyuki;Kawano, Michio;Honjo, Iwao;Amitani, Ryoichi

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280040014pmid: 2923687

Abstract • To determine the reason for the high incidence of nasal sinusitis in patients with cleft palate, the type of cleft, degree of nasal septal deviation, velopharyngeal function, and presence of pharyngeal flap were investigated in relation to nasal sinusitis. We also examined the relationship between the side of sinusitis and the cleft side in patients with unilateral cleft palate. Development of maxillary sinus, nasal mucociliary transport, and ciliary beating frequency of ciliated cells were also examined. The saccharin test indicated that nasal mucociliary transport was impaired. This impairment is believed to be one of the reasons for the high incidence of sinusitis in patients with cleft palate. (Arch Otolaryngol Head Neck Surg 1989;115:442-446) References 1. Jaffe BF, Deblanc CB: Sinusitis in children with cleft lip and palate . Arch Otolaryngol Head Neck Surg 1971;93:479-483.Crossref 2. Ishikawa Y, Tasaka Y, Kawano M, et al: Nasal disease in cleft palate patients . J Jpn Cleft Palate Assoc 1986;11:199-205. 3. Kurihara K, Sakurai N: A roentgenographic cephalometric analysis of cleft lip and palate: Their long term follow up studies of the development pattern . J Jpn Cranio Max Fac Surg 1986;3:1-16. 4. Robinson HB, Zertin GK, Passy V, et al: Maxillary sinus development in patients with cleft palates as compared to those with normal palates . Laryngoscope 1982;92:183-187. 5. Havlova V, Brejcha K, Hajnis J, et al: Development of sinus maxillaris in children with complete unilateral clefts . Acta Chir Plast 1970; 12:65-76. 6. Eckel W, Beisser D: Untersuhungen zur frage eines enflusses der Gaumenspaltbildung auf die Kieferhohlengrosse . Z Laryngol Rhinol 1961:40:23. 7. Norwak RV: X-ray film analysis of the sinus paranasales from cleft patients (in comparison with a healthy group) . Anat Anz 1977;142:451-470. 8. Andersen I, Camner P, Jensen PL, et al: Nasal clearance in monozygotic twins . Am Rev Respir Dis 1974;110:301-305. 9. Takasaka T: Mucociliary clearance: Its function, morphology and pathology . Otolaryngology 1982;54:663-674. 10. Pedersen M, Sakakura Y, Winther B, et al: Nasal mucociliary transport, number of ciliated cells, and beating pattern in naturally acquired common colds . Eur J Respir Dis 1983;64:355-364. 11. Ukai K, Bang BG, Bang FB: Effect of mechanical stimulation on mucociliary clearance of chicken sinus . Rhinology 1984;22:35-43.

Thomsen, Jens;Sederberg-Olsen, Jørgen;Balle, Viggo;Vejlsgaard, René;Stangerup, Sven-Eric;Bondesson, Göran

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280045015pmid: 2647105

Abstract • A double-blind, randomized, place-bo-controlled clinical trial was conducted to evaluate one month of amoxicillinclavulanate potassium treatment of children with secretory otitis media. In total, 264 children, aged 1 to 10 years, were randomly assigned to either antibiotic or placebo treatment; 43 patients were excluded during treatment, equally distributed in both groups, leaving 221 patients completing the trial. The inclusion criterion was a type C2 and type B tympanometry result of at least three months' duration. Tympanometry was performed every month for 12 additional months. At the end of the treatment period, the disease was reversed in 61% in the antibiotic-treated group compared with 30% in the placebo-treated group P<.0001), and the improvement was References 1. Cantekin EI, Mandel EM, Bluestone CD, et al: Lack of efficacy of a decongestant-antihistamine combination for otitis media with effusion ('secretory' otitis media) in children . N Engl J Med 1983;308:297-301.Crossref 2. Healy GB, Teele DW: The microbiology of chronic middle-ear effusions in children . Laryngoscope 1977;87:1472-1478.Crossref 3. Marks NJ, Mius RP, Shaheen OH: A controlled trial of cotrimoxazole-therapy in serous otitis media . J Laryngol Otol 1981;95:1003-1009.Crossref 4. Healy GB: Antimicrobial therapy of chronic otitis media with effusions . Int J Pediatr Otorhinolaryngol 1984;8:13-17.Crossref 5. Sundberg L: Antibiotic treatment of secretory otitis media . Acta Otolaryngol Suppl 1984; 407:26-29.Crossref 6. Mandel EM, Rockette HE, Bluestone CD, et al: Efficacy of amoxicillin with or without decongestant-antihistamine for otitis media with effusion in children . N Engl J Med 1987;316:432-437.Crossref 7. Cantekin EI, McGuire TW, Hughson TL: Antimicrobial therapy for otitis media with effusion ('secretory' otitis media) . Otol Head Neck Surg , in press. 8. Tos M, Stangerup SE, Hvid G, et al: Epidemiology and natural history of secretory otitis , in Sadé J (ed): Proceedings of the International Conference on Acute and Secretory Otitis Media, Part I . Amsterdam, Kugler Publications, 1986, pp 95-106.

Chambers, Ron D.;Rowan, Lynne E.;Matthies, Melanie L.;Novak, Michael A.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280050016pmid: 2923688

Abstract • The auditory brain-stem responses (ABRs) of 18 children who received tympanostomy tubes due to well-documented history of otitis media with effusion (OME) were compared with a matched control group with little or no history of effusion. The subjects in the OME group had significantly longer ABR latencies for waves III and V, with the most compelling delay for wave III and the III-I interwave interval. Although wave I prolongation in the OME group was not significant, the possible contribution of a peripheral effect on the latencies of waves III and V was investigated. The typical gender effect for the ABR latencies was unaltered in the OME group, and there was no group by gender interaction. We suggest that although the data support increased ABR latencies for children with a history of OME, they do not establish a causal relationship. (Arch Otolaryngol Head Neck Surg 1989;115:452-457) References 1. Stockard JE, Stockard JJ: Recording and analyzing , in Moore EJ (ed): Bases of Auditory Brain-Stem Evoked Responses . New York, Grune & Stratton, 1983, pp 255-286. 2. Eggermont JJ: The inadequacy of auditory brainstem responses in audiological applications . Ann NY Acad Sci 1982;388:707-709.Crossref 3. McGee TJ, Clemis JD: Effects of conductive hearing loss on auditory brainstem response . Ann Otol Rhinol Laryngol 1982;91:304-309. 4. Borg E, Lofqvist L, Rosen S: Brainstem response (ABR) in conductive hearing loss . Scand Audiol 1981;13( (suppl) ):95-97. 5. Fria TJ, Sabo DL: Auditory brainstem responses in children with otitis media with effusion . Ann Otol Rhinol Otolaryngol 1980; 68:200-206. 6. Finitzo-Hieber T, Hecox K, Cone B: Brainstem auditory evoked potentials in patients with congenital atresia . Laryngoscope 1979;89:1151-1158.Crossref 7. Mendelson T, Salamy A, Lenoir M, et al: Brain stem evoked potential findings in children with otitis media . Arch Otolaryngol Head Neck Surg 1979;105:17-20.Crossref 8. Gunnarson A, Finitzo T: Effects of fluctuating conductive hearing loss in infancy on auditory brain-stem responses and binaural interaction measured at age 5 . J Acoust Soc Am 1987; 82( (suppl 1) ):S5.Crossref 9. Anteby I, Hafner H, Pratt H, et al: Auditory brainstem evoked potentials in evaluating the central effects of middle ear effusion . Int J Pediatr Otorhinolaryngol 1986;12:1-11.Crossref 10. Hafner H, Anteby I, Pratt H, et al: Auditory brainstem evoked potentials in evaluating the efficacy of surgical ventilation of the middle ear . Int J Pediatr Otorhinolaryngol 1986;12:13-22.Crossref 11. Greville KA, Keith WJ, Laven JW: Performance of children with previous OME on central auditory measures . Aust J Audiol 1985;7:69-78. 12. Lenhardt ML, Shaia FT, Abedi E: Brainstem evoked response waveform variation associated with recurrent otitis media . Arch Otolaryngol Head Neck Surg 1985;111:315-316.Crossref 13. Folsom RC, Weber BA, Thompson G: Auditory brainstem responses and children with early recurrent middle ear disease . Ann Otol Rhinol Laryngol 1983;92:249-253. 14. Webster DB: Conductive hearing loss affects the growth of the cochlear nuclei over an extended period of time . Hear Res 1988;32:185-192.Crossref 15. Webster DB: Auditory neuronal sizes after a unilateral conductive hearing loss . Exp Neurol 1983;79:130-140.Crossref 16. Webster DB, Webster M: Neonatal sound deprivation affects brain stem auditory nuclei . Arch Otolaryngol Head Neck Surg 1977;103:392-396.Crossref 17. Clopton BM, Silverman MS: Changes in latency and duration of neural responding following developmental auditory deprivation . Exp Brain Res 1978;32:39-47.Crossref 18. Doyle WJ: Maturation of the auditory brainstem response in rhesus monkeys with and without conductive hearing loss , in International Electric Response Audiometry Study Group X Biennial Symposium . Charlotteville, Va, 1987, Abstract A-11, p 30. 19. Maurer K, Rochel M: Brainstem auditory evoked potentials (BAEP) in childhood-normative data and diagnostic usefulness in children with neoplastic lesions in the brainstem , in Rothenberger A (ed): Event-Related Potentials in Children . New York, Elsevier Biomedical Press, 1982, pp 89-98. 20. Salamy A, McKean CM: Postnatal development of the human brainstem potentials during the first year of life . Electroencephalogr Clin Neurophysiol 1976;40:418-426.Crossref 21. Hecox K, Galambos R: Brain stem auditory evoked responses in human infants and adults . Arch Otolaryngol Head Neck Surg 1974;99:30-33.Crossref 22. Stockard JE, Stockard JS, Westmoreland BF, et al: Brainstem auditory-evoked responses: Normal variation as a function of stimulus and subject characteristics . Arch Neurol 1979;36:823-831.Crossref 23. Coats A, Martin J: Human auditory nerve action potentials and brain stem evoked responses: Effects of audiogram shape and lesion location . Arch Otolaryngol Head Neck Surg 1977; 103:602-622.Crossref 24. Keith WJ, Greville KA: Effects of audiometric configuration on the auditory brain stem response . Ear Hear 1987;8:49-55.Crossref 25. Moller AR: Physiology of the ascending auditory pathway with special reference to the auditory brainstem response (ABR) , in Pinheiro ML, Musiek FE (eds): Assessment of Central Auditory Dysfunction, Foundations and Clinical Correlates . Baltimore, Williams & Wilkins, 1985, pp 23-41.

Burton, Martin J.;Miller, Josef M.;Kileny, Paul R.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280056017pmid: 2923689

Abstract • We investigated the relationship between thresholds of the electrically evoked auditory brain-stem response (EABR) and the electrically evoked middle-latency response (EMLR), and the variation in EMLR thresholds and dynamic ranges with site of stimulation. The EABRs and EMLRs were recorded in albino guinea pigs in response to electrical stimulation at the round window, promontory, scala tympani, and modiolus. The EABR and EMLR thresholds were similar. There was no significant difference between thresholds for round-window and scala tympani stimulation. Amplitude/intensity functions for the EMLR differed with site of stimulation. The EMLR seems to be comparable with the EABR for assessing the electrical excitability of the auditory pathway with less electrical artifact contamination. In this respect, round-window and scala tympani stimulation sites are equally efficacious. (Arch Otolaryngol Head Neck Surg 1989;115:458-461) References 1. Miller JM, Clopton BM, Kimm J, et al: Brain stem evoked responses elicited by cochlear stimulation, abstracted. Abstracts of the Association for Research in Otolaryngology Midwinter Research Meeting, Jan 30-Feb 1, 1978. 2. Simmons FB: Electrical stimulation of the auditory nerve in cats: Long term electrophysiological and histopathological results . Ann Otol 1979;88:533-539. 3. Dobie RA, Kimm J: Brain stem responses to electrical stimulation of the cochlea . Arch Otolaryngol Head Neck Surg 1980;106:573-577.Crossref 4. Gyo K, Yanagihara N: Electrically and acoustically evoked brain stem responses in guinea pig . Acta Otolaryngol 1980;90:25-31.Crossref 5. Marsh, RR, Yamane H, Potsic WP: Effect of site of stimulation on the guinea pig's electrically evoked brain stem response . Otolaryngol Head Neck Surg 1981;89:125-130. 6. Yamane H, Marsh RR, Potsic WP: Brain stem response evoked by electrical stimulation of the round window of the guinea pig . Otolaryngol Head Neck Surg 1981;89:117-124. 7. Snyder RL, Gardi J: Physiological (ABR) and anatomical (2 deoxyglucose) studies of auditory CNS activation by electrical stimulation of the cochlea, abstracted. Abstracts of the Association for Research in Otolaryngology Midwinter Research Meeting, Jan 18-21, 1982. 8. Clopton BM, Spelman FA: Neural mechanisms relevant to the design of an auditory prosthesis: Location and electrical characteristics . Ann Otol Rhinol Laryngol 1982;91( (suppl 98) ):9-14. 9. Clopton BE, Bosma MM: Effectiveness of middle ear electrical stimulation for activating central auditory pathways . Ann Otol Rhinol Laryngol 1982;91:285-291. 10. Kileny PR, Kemink JL: Electrically evoked middle latency auditory evoked potentials in cochlear implant candidates . Arch Otolaryngol Head Neck Surg 1987;113:1072-1077.Crossref 11. Burton MJ, Miller JM, Kileny PR: Middle-latency response: I. Electrical and acoustic excitation . Arch Otolaryngol Head Neck Surg 1989;115:59-62.Crossref 12. Kraus M, Smith DI, Grossman J: Cortical mapping of the auditory middle latency response in the unanesthetized guinea pig . Electroencephalogr Clin Neurophysiol 1985;62:219-226.Crossref 13. Van den Honert C, Stypulkowski PH: Characterization of the electrically evoked auditory brain stem response (ABR) in cats and humans . Hear Res 1986;21:109-126.Crossref 14. Kileny P, Shea SL: Middle-latency and 40Hz auditory evoked responses in normal hearing subjects: Click and 500 Hz thresholds . J Speech Hear Res 1986;29:20-28. 15. Spelman FA, Clopton BM, Pfingst BE: Tissue impedance and current flow in the implanted ear: Implications for the cochlear prosthesis . Ann Otol Rhinol Laryngol 1982;91: 3-8. 16. Black FO, Lilly DJ, Fowler LP, et al: Surgical evaluation of candidates for cochlear implants . Ann Otol Rhinol Laryngol 1987;96:96-99.

FitzGerald, John E.;Green, Gary G. R.;Birchall, John P.;Pearson, Jeffrey P.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280060018pmid: 2923690

Abstract • The properties of pooled thick and thin middle ear effusions, from children with otitis media with effusion, were studied by viscometry. Mucus glycoproteins were responsible for effusion viscosity. Their percentage by weight in thick and thin effusions was 25% and 8.2%, respectively. N-acetylcysteine and 0.2 mol/L of mercaptoethanol caused a 39% viscosity drop in a 5-mg/mL glycoprotein solution, whereas S-carboxymethylcysteine had no effect. Treatment of thick effusions with 0.2 mol/L of mercaptoethanol initially caused a viscosity decrease followed by a gradual increase. Higher reducing agent concentrations (0.5 mol/L) caused a more rapid decrease followed by a rapid increase, presumably by causing nonspecific aggregation of reduced protein molecules. These results suggest that the concentration of and the time that a mucolytic is in the middle ear would be of prime importance in achieving the desired decrease in viscosity. (Arch Otolaryngol Head Neck Surg 1989;115:462-468) References 1. Sadé J: Pathology and pathogenesis of secretory otitis media . Arch Otolaryngol Head Neck Surg 1966;84:297-305.Crossref 2. Paradise JL: Otitis media in infants and children . Pediatrics 1980;65:917-943. 3. Harrison K, Watson TJ: Long-term follow up of chronic exudative otitis media (glue ear) . Proc R Soc Med 1969;62:455-460. 4. Hall DMB, Hill F: When does secretory otitis media affect language development . Arch Dis Child 1986;61:42-47.Crossref 5. Reichman J, Healey CH: Learning disabilities and conductive hearing loss involving otitis media . J Learn Disabil 1983;16:272-278.Crossref 6. McCall AL, Potsic WP, Shih CK, et al: Physicochemical properties of human middle ear effusions (mucus) and their relation to ciliary transport . Laryngoscope 1978;88:729-738. 7. Brown DT, Litt M, Marsh RR, et al: Mucociliary transport of human ear secretions in otitis media with effusion . Arch Otolaryngol Head Neck Surg 1985;93:18-21. 8. Goodhill V, Holcomb AL: The relation of auditory response to the viscosity of tympanic fluids . Acta Otolaryngol 1958;49:38-46.Crossref 9. Marsh RR, Baranak CC, Potsic WP: Hearing loss and viscoelasticity of middle ear fluid . Int J Pediatr Otorhinolaryngol 1985;9:115-120.Crossref 10. Wiederhold ML, Zajtchuk JT, Vap JG, et al: Hearing loss in relation to physical properties of middle ear effusions . Ann Otol 1980;89( (suppl 68) ):185-189. 11. Meyer FA: Comparison of structural glycoproteins from mucus of different sources . Biochim Biophys Acta 1977;493:272-282.Crossref 12. FitzGerald JE, Green GGR, Pearson JP: Characterization of middle ear mucus glycoprotein in chronic secretory otitis media . Biochem Soc Trans 1986;14:737-738. 13. Brown DT, Litt M, Potsic W: A study of mucus glycoproteins in secretory otitis media . Arch Otolaryngol Head Neck Surg 1985;111:688-695.Crossref 14. Pearson JP, Allen A, Parry S: A 70000 molecular weight protein isolated from purified pig gastric mucus glycoprotein by reduction of disulphide bridges and its implication in the polymeric structure . Biochem J 1981;197:155-162. 15. Carlstedt I, Sheehan JK: Macromolecular properties and polymeric structure of mucus glycoprotein , in Silberburg A (ed): Mucus and Mucosa . London, Pitman, 1984, vol 109, pp 157-172. 16. Gibbons RA: Mucus of the mammalian genital tract . Br Med Bull 1978;34:34-38. 17. Carlstedt I, Lindgen H, Sheehan JK: The macromolecular structure of human cervicalmucus glycoproteins . Biochem J 1983;213:427-435. 18. Roberts GP: The role of disulphide bonds in maintaining the gel structure of bronchial mucus . Arch Biochem Phys 1976;173:528-537.Crossref 19. Creeth JM, Bhaskar KR, Horton JR, et al: The separation and characterization of bronchial glycoproteins by density gradient methods . Biochem J 1977;167:557-569. 20. Pearson JP, Kaura R, Taylor W, et al: The composition and polymeric structure of mucus glycoprotein from human gallbladder bile . Biochim Biophys Acta 1982;706:221-228.Crossref 21. Pearson JP, Ward R, Allen A, et al: Mucus degradation by pepsin: Comparison of mucolytic activity of human pepsin 1 and pepsin 3 . Gut 1986;27:243-248.Crossref 22. Pearson JP, Mason RM: The stability of bovine nasal cartilage proteoglycans during isolation and storage . Biochim Biophys Acta 1977;498:176-188.Crossref 23. Mantle M, Allen A: A colorimetric assay for glycoproteins based on the periodic acid–Schiff stain . Biochem Soc Trans 1978;6:607-609. 24. Mantle M, Allen A: Isolation and characterization of the native glycoprotein from pig small-intestinal mucus . Biochem J 1981;195:267-275. 25. Pearson JP, FitzGerald JE, Green GGR, et al: Mucolytic agents for glue ear . Lancet 1985; 2:674-675.Crossref 26. Vered J, Eliezer N, Sadé J: Biochemical characterization of middle ear effusions . Ann Otol Rhinol Laryngol 1972;81:394-401. 27. Juhn SK, Hugg JG, Paparella MM: Biochemical analysis of middle ear effusions . Ann Otol Rhinol Laryngol 1971;80:347-353. 28. Martin R, Litt M, Marriott C: The effect of mucolytic agents on the rheologic and transport properties of canine tracheal mucus . Am Rev Respir Dis 1980;121:495-500. 29. Smyth GDL, Patterson CC, Hall S: Tympanostomy tubes: Do they significantly benefit the patient . Arch Otolaryngol Head Neck Surg 1982;90:783-786.

Wilkes, Clyde H.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280067019pmid: 2923691

Abstract • A retrospective analysis of 540 operated cases (740 joints) of internal derangements of the temporomandibular joint was carried out. Observations of this patient population provided the basis for describing pathological variations of internal derangements. Radiologic studies, including tomograms and arthrograms or magnetic resonance scans, and surgical/pathological findings were correlated with clinical data in each case. It was found that clinical manifestations varied in a characteristic way and were directly related to the degree of pathological change and time course. Various stages of internal derangements were identified. Pathophysiological mechanisms responsible for the observed changes, as well as clinical signs and symptoms and causal factors, were discussed. Internal derangements are organic lesions that appear to be progressive and are probably of traumatic origin. The view is given that internal derangements represent the basic pathological entity responsible for clinical manifestations of what has been known as the temporomandibular joint pain-dysfunction syndrome or similarly described conditions. Effective clinical management takes on new importance because progression to advanced degenerative states may occur. (Arch Otolaryngol Head Neck Surg 1989;115:469-477) References 1. Wilkes CH: Arthrography of the temporomandibular joint in patients with the TMJ pain-dysfunction syndrome . Minn Med 1978;61:645-652. 2. Wilkes CH: Structural and functional alterations of the temporomandibular joint . Northwest Dent 1978;57:287-294. 3. Farrar WB, McCarty WL Jr: Inferior joint space arthrography and characteristics of condylar paths in internal derangements of the TMJ . J Prosthet Dent 1979;41:548-555.Crossref 4. Katzberg RW, Dolwick MF, Bales DJ, et al: Arthrotomography of the temporomandibular joint: New technique and preliminary observations . AJR 1979;132:949-955.Crossref 5. Katzberg RW, Dolwick MF, Helms CA, et al: Arthrography of the temporomandibular joint . AJR 1980;134:995-1003.Crossref 6. Rasmussen OC: Semiopaque arthrography of the temporomandibular joint . Scand J Dent Res 1980;88:521-534. 7. Blaschke DD, Solberg WK, Sanders B: Arthrography of the temporomandibular joint: Review of current status . J Am Dent Assoc 1980;100:388-395. 8. Westesson P-L, Omnell KH, Rohlin M: Double-contrast tomography of the temporomandibular joint . Acta Radiol 1980;21:777-784.Crossref 9. Murphy WA: Arthrography of the temporomandibular joint . Radiol Clin North Am 1981; 19:365-378. 10. Bronstein SL, Tomasetti KJ, Ryan DE: Internal derangement of the temporomandibular joint: Correlation of arthrography with surgical findings . J Oral Maxillofac Surg 1981;39:572-584. 11. Eriksson C, Westesson P-L: Clinical and radiological study of patients with anterior disc displacement of the temporomandibular joint . Swed Dent J 1983;7:55-64. 12. Westesson P-L, Bronstein SL, Liedberg J: Internal derangement of the temporomandibular joint: Morphologic description with correlation to joint function . Oral Surg Oral Med Oral Pathol 1985;59:323-331.Crossref 13. Bessette R, Katzberg R, Natiella JR, et al: Diagnosis and reconstruction of the human TMJ after trauma or internal derangement . Plast Reconstr Surg 1985;75:192-203.Crossref 14. Schellhas KP, Wilkes CH, Heithoff KB, et al: Temporomandibular joint: Diagnosis of internal derangements using magnetic resonance imaging . Minn Med 1986;69:516-519. 15. Schellhas KP, Wilkes CH, Omlie MR, et al: Temporomandibular joint imaging: Practical application of available technology . Arch Otolaryngol Head Neck Surg 1987;113:744-748.Crossref 16. Schellhas KP, Wilkes CH, Fritts HM, et al: Temporomandibular joint: MR imaging of internal derangements and postoperative changes . AJNR 1987;8:1093-1101. 17. Schellhas KP, Wilkes CH, Omlie MR, et al: The diagnosis of temporomandibular joint disease: Two compartment arthrography and MR . AJNR 1988;9:579-588. 18. Katzberg RW, Schenck JF, Roberts D, et al: Magnetic resonance imaging of the temporomandibular joint meniscus . J Oral Maxillofac Surg 1985;59:332-335. 19. Katzberg RW, Bessette RW, Tallents RH, et al: Normal and abnormal temporomandibular joint: MR imaging with surface coil . Radiology 1986;158:183-189.Crossref 20. Farrar WB, McCarty WL: The TMJ dilemma . J Ala Dent Assoc 1979;63:19-26. 21. Rasmussen OC: Description and progress of symptoms in a longitudinal study of temporomandibular arthropathy . Scand J Dent Res 1981;89:196-203. 22. Katzberg RW, Keith DA, Guralnick WC, et al: Internal derangements and arthritis of the temporomandibular joint . Radiology 1983:146: 107-112.Crossref 23. Westesson P-L, Rohlin M: I nternal derangement related to osteoarthrosis in temporomandibular joint autopsy specimens . Oral Surg Oral Med Oral Pathol 1984;57:17-22.Crossref 24. Westesson P-L: Structural hard-tissue changes in temporomandibular joints with internal derangements . Oral Surg Oral Med Oral Pathol 1985;59:220-224.Crossref 25. Debont LGM, Boering G, Liem RSB, et al: Osteoarthritis and internal derangement of the temporomandibular joint: A light microscopic study . J Oral Maxillofac Surg 1986;44:634-643.Crossref 26. Schwartz L: A temporomandibular joint pain-dysfunction syndrome . J Chronic Dis 1956; 3:284-293.Crossref 27. Laskin DM: Etiology of the pain-dysfunction syndrome . J Am Dent Assoc 1969;79:147-153. 28. Guralnick W, Kaban LB, Merrill RG: TMJ afflictions . N Engl J Med 1978;299:123-129.Crossref 29. Roberts CA, Tallents RH, Katzberg RW, et al: Comparison of internal derangements of the TMJ with occlusal findings . Oral Surg Oral Med Oral Pathol 1987;63:645-650.Crossref 30. Stringert HG, Worms FW: Variation in skeletal and dental patterns in patients with structural and functional alterations of the temporomandibular joint: A preliminary report . Am J Orthod Dentofacial Orthop 1986;89:285-297.Crossref

Abemayor, Elliot;Sidell, Neil;Juillard, Guy

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280076020pmid: 2538133

Abstract • Medullary carcinoma of the thyroid (MCT), a tumor of calcitonin (CT)—secreting C cells, can display a variable malignant potential with poor prognosis linked to decreased cell differentiation. In vitro study of MCT has been hampered by the fact that few cell lines derived from this neoplasm have been available for study. Herein are reported the characteristics of two new lines derived from human MCT that are tumorigenic in athymic mice and do not secrete CT. After treatment with various concentrations of retinoic acid (a vitamin A derivative) and cyclic adenosine monophosphate, both lines exhibit the traits of more differentiated cells with a decrease in cellular proliferation and an increase in cytoplasmic CT content as shown by in situ immunoperoxidase staining. These cell lines should prove of great value in the study of the biology of MCT and the mechanisms underlying induced differentiation in this type of tumor. (Arch Otolaryngol Head Neck Surg 1989;115:478-483) References 1. Hazard JB, Hawk WA, Crile G Jr: Medullary (solid) carcinoma of the thyroid: A clinicopathologic entity . J Clin Endocrinol Metab 1959;19:152-161.Crossref 2. Sizemore GW: Medullary carcinoma of the thyroid . Semin Oncol 1987;14:306-314. 3. Saad MF, Ordonez NG, Rashid RK, et al: Medullary carcinoma of the thyroid: A study of the clinical features and prognostic factors in 161 patients . Medicine 1984;63:319-342.Crossref 4. Williams ED: Histogenesis of medullary carcinoma of the thyroid . J Clin Pathol 1966; 19:114-118.Crossref 5. Trump DL, Mendelsohn G, Baylin SB: Discordance between plasma calcitonin and tumor-cell mass in medullary thyroid carcinoma . N Engl J Med 1979;301:253-255.Crossref 6. Grimley PM, Deftos LJ, Weeks JR, et al: Growth in vitro and ultrastructure of cells from a medullary carcinoma of the human thyroid gland: Transformation by simian virus 40 and evidence of thyrocalcitonin and prostaglandins . JNCI 1969;42:663-680. 7. Roos BA, Bundy LL, Miller EA, et al: Calcitonin secretion by monolayer cultures of human C-cells derived from medullary thyroid carcinoma . Endocrinology 1975;67:39-45.Crossref 8. Tischler AS, DeLellis RA, Goldtzman D, et al: Medullary carcinoma of the human thyroid in monolayer culture: Morphological and cytochemical correlations . Cancer 1977;40:3004-3013.Crossref 9. Goretzki PE, Wahl RA, Becker R, et al: Nerve growth factor (NGF) sensitizes human medullary thyroid carcinoma (hMTC) cells for cytostatic therapy in vitro . Surgery 1987; 102:1035-1042. 10. Leong SS, Horoszewicz JS, Shimaoka K, et al: A new cell line for study of human medullary thyroid carcinoma , in Andreoli M, Monaco F, Robbins J (eds): Advances in Thyroid Neoplasia . Rome, Field Educational Italia, 1981, pp 95-108. 11. Berger CL, deBustros A, Roos BA, et al: Human medullary thyroid carcinoma in culture provides a model relating growth dynamics, endocrine cell differentiation and tumor progression . J Clin Endocrinol Metab 1984;59:338-343.Crossref 12. Niles RM: Chemical induction of tumor cell differentiation . Surv Synthesis Path Res 1985; 4:285-295. 13. Prasad KN: Differentiation of neuroblastoma cells in culture . Biol Rev 1975;50:129-265.Crossref 14. Sidell N, Altman A, Haussler M, et al: Effects of retinoic acid (RA) on the growth and phenotypic expression of several human neuroblastoma cell lines . Exp Cell Res 1983;148:21-30.Crossref 15. Povey S, Hopkinson DA, Harris H, et al: Characterization of human cell lines and differentiation from HeLa by enzyme typing . Nature 1976;264:60-63.Crossref 16. Harnden DG: Skin culture and solid tumor technique , in Yunis JJ (ed): Human Chromosome Methodology . Orlando, Fla, Academic Press Inc, 1974, pp 167-184. 17. Hazard JB: The C cells (parafollicular cells) of the thyroid gland and medullary thyroid carcinoma . Am J Pathol 1977;88:213-250. 18. Ulich T, Cheng L, Lewin KJ: Acinar-endocrine cell tumor of the pancreas: Report of a pancreatic tumor containing both zymogen and neuroendocrine granules . Cancer 1982;50:2099-2105.Crossref 19. Alitalo K, Koskinen P, Makela TP, et al: myc Oncogenes: Activation and amplification . Biochim Biophys Acta 1987;907:1-32. 20. Mathew CGP, Smith BA, Thorpe K, et al: Deletion of genes on chromosome 1 in endocrine neoplasia . Nature 1987;238:524-526.Crossref 21. Mathew CGP, Chin KS, Easton DF, et al: A linked genetic marker for multiple endocrine neoplasia type 2A on chromosome 10 . Nature 1987;238:527-530.Crossref 22. Wuster-Hill DH, Noll WW, Bircher LY, et al: Cytogenetics of medullary carcinoma of the thyroid . Cancer Genet Cytogenet 1986;20:247-253.Crossref 23. De Bustros A, Baylin SB, Berger CL, et al: Phorbol esters increase calcitonin gene transcription and decrease c-myc mRNA levels in cultured human medullary thyroid carcinoma . J Biol Chem 1985;260:98-104. 24. Nakagawa T, Mabry M, de Bustros A, et al: Introduction of v-Ha-ras oncogene induces differentiation of cultured human medullary thyroid carcinoma cells . Proc Natl Acad Sci USA 1987;84:5923-5927.Crossref 25. Slamon DJ, Clark GM, Wong SG, et al: Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene . Science 1987;235:177-182.Crossref 26. Seeger RC, Brodeur GM, Sather H, et al: Association of multiple copies of the N-myc oncogene with rapid progression of neuroblastoma . N Engl J Med 1985;313:1111-1146.Crossref 27. De Bustros A, Baylin SB, Levine MA, et al: Cyclic AMP and phorbol esters separately induce growth inhibition, calcitonin secretion, and calcitonin gene transcription in cultured human medullary thyroid carcinoma . J Biol Chem 1986; 261:8036-8041. 28. Rupniak HT, Rein G, Powell JF, et al: Characteristics of a new human neuroblastoma cell line which differentiates in response to cyclic adenosine 3′:5′-monophosphate . Cancer Res 1984;44:2600-2607. 29. Imashukii S, Sugano T, Fujiwara K, et al: Intra-aortic prostaglandin E, infusion in maturation of neuroblastoma . Experientia 1982;38: 932-933.Crossref 30. Abemayor E, Sidell N: Human neuroblastoma cell lines as models for the in vitro study of neoplastic and neuronal cell differentiation . Environ Health Perspect , in press.

Calhoun, Karen H.;Stanley, David;Stiernberg, Charles M.;Ahmed, Ahmed E.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280082021pmid: 2493794

Abstract • Tumorigenesis requires accelerated polyamine biosynthesis, and elevated levels of ornithine decarboxylase, the rate-limiting enzyme in this reaction chain. The primary goal of this study was to determine whether induction of oral cavity carcinoma by dimethylbenzanthracene was accompanied by increased ornithine decarboxylase. It has previously been demonstrated in an oral carcinogenesis model that cotreatment with vitamins A or E delayed tumor development. The second goal of this study was to determine whether this chemoprotective effect was associated with a decrease in ornithine decarboxylase activity. We found that dimethylbenzanthracene did stimulate ornithine decarboxylase. Vitamins A and E alone also stimulate ornithine decarboxylase, and this effect is additive with dimethylbenzanthracene. Use of both vitamins together prevents the additive effect of either, alone, and vitamin A inhibits the late-phase ornithine decarboxylase response to dimethylbenzanthracene in all animals. We conclude that pretreatment with vitamins A, or A and E together protects against the carcinogenic action of dimethylbenzanthracene, and that the mechanism of this protection is early truncation of the ornithine decarboxylase response to dimethylbenzanthracene. (Arch Otolaryngol Head Neck Surg 1989;115:484-488) References 1. Pegg AE: Polyamine metabolism and its importance in neoplastic growth and a target for chemotherapy . Cancer Res 1988;48:759-764. 2. Milano G, Viguier E, LaLanne CM, et al: The clinical value of urinary polyamine analysis in cancer patients . Oncodev Biol Med 1980;1:215-225. 3. Pastorini P, Milano G, Toubol J, et al: The diagnostic and prognostic value of urinary polyamine measurement in bladder cancer . Urol Res 1981;9:13-16.Crossref 4. Lundell L, Rosenbren E: Polyamine levels in human gastric carcinoma . Scand J Gastroenterol 1986;21:829-832.Crossref 5. Luk GD, Hamilton SR, Yang P, et al: Kinetic changes in mucosal ornithine decarboxylase activity during azoxymethane-induced colonic carcinogenesis in the rat . Cancer Res 1986; 46:4449-4452. 6. Garcia A, Benton T, Slanina P, et al: Changes in urine polyamines in childhood leukemias . Ann Clin Lab Sci 1981;11:109-114. 7. Hospattankar AV, Advani SH, Vaidya NR, et al: Elevation of serum polyamines in malignant lymphomas and acute myeloid leukemia . Int J Cancer 1980;15:463-466.Crossref 8. Grossie VB Jr, Nishioka K, Ota KM, et al: Relationship of erythrocyte polyamine levels and growth rate of transplantable tumors in rats . Cancer Res 1986;46:3464-3468. 9. Ota DM, Nishioka K, Grossie B, et al: Erythrocyte polyamine levels during intravenous feeding of patients with colorectal carcinoma . Eur J Cancer Clin Oncol 1986;22:837-842.Crossref 10. Dimery IW, Nishioka K, Grossie VB Jr, et al: Polyamine metabolism in carcinoma of the oral cavity compared with adjacent and normal oral mucosa . Am J Surg 1987;154:429-433.Crossref 11. Shideler CE, Johns ME, Cantrell RW, et al: Erythrocyte polyamine determinations in patients with head and neck cancer . Arch Otolaryngol Head Neck Surg 1981;107:752-754.Crossref 12. Verma AK, Shapas BG, Rice HM, et al: Correlation of the inhibition by retinoids of tumor promoter–induced mouse epidermal ornithine decarboxylase activity and of skin tumor promotion . Cancer Res 1979;39:419-425. 13. Lowe N, Verma AK, Boutwell RK: Ultraviolet light induces epidermal ornithine decarboxylase activity . J Invest Dermatol 1987;71:417-418.Crossref 14. Robinson DS, Ballesteros AF, Hellinger MD, et al: Antipromotional chemoprevention of lingual tumors by α-diflouromethylornithine . Surg Forum 1985;46:397-399. 15. Weerapradist W, Shklar G: Vitamin E inhibition of hamster buccal pouch carcinogenesis . Oral Surg 1982;54:304-312.Crossref 16. Shklar G: Oral mucosal carcinogenesis in hamsters: Inhibition by vitamin E . JNCI 1982; 68:791-797. 17. Shklar G, Marefat P, Kornhauser A, et al: Retinoid inhibition of lingual carcinogenesis . Oral Surg 1980;49:325-332.Crossref 18. Verma AL: Inhibition of tumor promoter 12-O-tetradecanolyphorbol-13-acetate–induced synthesis of epidermal ornithine decarboxylase messenger RNA and diacylglycerol-promoted mouse skin tumor formation by retinoic acid . Cancer Res 1988;48:2168-2173. 19. Clark-Lewis I, Murray AW: Tumor promotion and induction of epidermal ornithine decarboxylase activity in mechanically stimulated mouse skin . Cancer Res 1978;38:494-497. 20. O'Brien TG, Lewis MA, Diamond L: Ornithine decarboxylase activity and DNA synthesis after treatment of cells in culture with 12-O-tetradecanoylphorbol-13-acetate . Cancer Res 1979;39:4477-4480. 21. O'Brien TG, Diamond L: Ornithine decarboxylase induction and DNA synthesis in hamster embryo cell cultures treated with tumorpromoting phorbol diesters . Cancer Res 1977; 37:3895-3900. 22. Verma AK: Inhibition of both stage I and stage II mouse skin tumour promotion by retinoic acid and the dependence of inhibition of tumor promotion on the duration of retinoic acid treatment . Cancer Res 1987;47:5097-5101. 23. Wald N, Boreham J, Bailey A: Serum retinol and subsequent risk of cancer . Br J Cancer 1986;54:957-961.Crossref 24. Flaim E, Williford WO, Mullen J, et al: The relationship of serum cholesterol and vitamin A in hospitalized patients with and without cancer . Am J Clin Nutr 1986;44:370-378. 25. Watson RR, Leonard TK: Selenium and vitamins A, E, and C: Nutrients with cancer prevention properties . J Am Dietet Assoc 1986; 86:505-510.

Jacobs, John R.;Pajak, Thomas F.;Snow, James B.;Lowry, Louis D.;Kramer, Simon

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280087022pmid: 2647106

Abstract • The measurement of quality of medical care has always been a topic of concern to physicians and other health care professionals. During an age of increasing competitiveness in the health care environment, the ability to assess accurately the quality of the care delivered has become increasingly important. The head and neck surgeons within the Radiation Therapy Oncology Group have examined this problem and have developed an evaluation tool that was then applied retrospectively in an attempt to evaluate the quality of surgery performed in a randomized study. The analysis of the results suggested that the retrospective approach to surgical quality control is fraught with hazards and is unlikely to fulfill the goals set for it. (Arch Otolaryngol Head Neck Surg 1989;115:489-493) References 1. Bulpitt CJ: Randomized Controlled Clinical Trials . The Hague, Martinus Nijhoff Publishers, 1983. 2. Makuch R: Planning and execution of large scale multi-institutional cooperative trials , in Wittes R (ed): Head and Neck Cancer . New York, John Wiley & Sons Inc, 1985, pp 325-336. 3. Simon R: Design and conduct of clinical trials , in Devita V (ed): Principles and Practice of Oncology . Philadelphia, JB Lippincott, 1982. 4. Ingelfinger E: The randomized clinical trials . N Engl J Med 1972;287:100.Crossref 5. Kramer S, Gelber RD, Snow JB, et al: Combined radiation therapy and surgery in the management of advanced head and neck cancer: 73-03 of the Radiation Therapy Oncology Group . Head Neck Surg 1987;10:19-30.Crossref 6. Dixon WJ, Massey FJ: Introduction to Statistical Analysis , ed 3. New York, McGraw-Hill International Book Co, 1969, p 101. 7. Mantel N: Evaluation of survival data and two new rank order statistics arising in its consideration . Cancer Treat Rep 1966;50:163-170. 8. Cox DR: Regression models and life tables . J R Stat Soc , 1972, series B, vol 34, pp 187-220. 9. Kalbfleisch JD, Prentice RL: The Statistical Analysis of Failure Time Data . New York, John Wiley & Sons Inc, 1980. 10. Jacobs J, Spitznagel E, Sessions D: Staging parameters for cancers of the head and neck: A multifactorial analysis . Laryngoscope 1985; 95:1378-1381.Crossref 11. Sylvester R, Pinedo H, DePauw M, et al: Quality of institutional participation in multi-center clinical trials . N Engl J Med 1981;305:852-855.Crossref 12. Balch C, Burant J, Bartolucci A: The impact of surgical quality control in multi-institutional group trials involving adjuvant cancer treatments . Ann Surg 1983;198:164-167.Crossref 13. Wirtschafter D, Scalise M, Henke C, et al: Do information systems improve the quality of clinical research? Results of randomized trials in a cooperative multi-institutional cancer group . Comput Biomed Res 1981;14:78-90.Crossref 14. Glickman A, Reinsteine L, Brotman R, et al: Quality assurance programs in clinical trials . Cancer Treat Rep 1980;64:425-433.

Saito, Hitoshi;Yoshida, Sachio;Saito, Takehisa;Wakui, Shinya;Manabe, Yasuhiro;Tsuda, Gota

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280092023pmid: 2923692

Abstract • A newly devised simple primary tracheoesophageal shunt method, involving a mucodermal tunnel, was performed on 14 patients. Aspiration was prevented by percutaneous digital pressure on the shunt, with silicone or collagen injection around it, or the use of a voice prosthesis. The overall success rate was 79% (11/14). This method was an easy one-stage procedure that could be performed in about 15 minutes. (Arch Otolaryngol Head Neck Surg 1989;115:494-496) References 1. Conley JJ: Vocal rehabilitation by autogenous vein graft . Ann Otol 1959;68:990-995. 2. Asai R: Laryngoplasty after total laryngectomy . Arch Otolaryngol Head Neck Surg 1972;95:114-119.Crossref 3. Komorn RM: Vocal rehabilitation in the laryngectomized patient with a tracheoesophageal shunt . Ann Otol 1974;83:445-451. 4. Amatsu M: A one stage surgical technique for postlaryngectomy voice rehabilitation . Laryngoscope 1980;90:1378-1386.Crossref 5. Singer MI, Blom ED: An endoscopic technique for restoration of voice after laryngectomy . Ann Otol 1980;89:529-533. 6. Ford MD, Martin DW, Warner TF: Injectable collagen in laryngeal rehabilitation . Laryngoscope 1984;94:513-518.Crossref 7. Li SL: Functional tracheoesophageal shunt for vocal rehabilitation after laryngectomy . Laryngoscope 1985;95:1267-1271.Crossref 8. Amatsu M, Makino K, Kinishi M, et al: Primary tracheoesophageal shunt operation for postlaryngectomy speech with sphincter mechanism . Ann Otol 1986;95:373-376. 9. Strome M, Mustoe TA, Kelly JH: Voice rehabilitation following laryngectomy: Myomucosal tracheoesophageal shunt . Arch Otolaryngol Head Neck Surg 1986;112:1168-1171.Crossref 10. Hamaker RC, Singer MI, Blom ED, et al: Primary voice restoration at laryngectomy . Arch Otolaryngol Head Neck Surg 1985;111:182-186.Crossref 11. Stiernberg CM, Bailey BJ, Calhoun KH, et al: Primary tracheoesophageal fistula procedure for voice restoration: The University of Texas medical branch experience . Laryngoscope 1987;97:820-824.Crossref 12. Silver FM, Gluckman JL, Donegan JO: Operative complications of tracheoesophageal puncture . Laryngoscope 1985;95:1360-1362.Crossref 13. Saito H, Matsui T, Tachibana M, et al: Experiences with the tracheoesophageal shunt method for vocal rehabilitation after total laryngectomy . Arch Otorhinolaryngol 1977;218:135-142.Crossref

Davidson, Jean;Freeman, Jeremy;Birt, Derek

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280095024pmid: 2923693

Abstract • Though the "mandibular swing," as an approach to certain upper aerodigestive tract malignancies, has been gaining popularity in recent years, there has been little reported as to the feasibility of this procedure in subjects who have received radical preoperative radiotherapy. We have recently reported the results of 23 such patients, and we now present an update. The results presented are of a retrospective analysis of 44 patients, 50% of whom received radical preoperative radiotherapy to fields including the osteotomy site. As in the previous study, there were no statistically significant differences between the complication rates in the irradiated and nonirradiated patient populations. All the patients were orally rehabilitated. (Arch Otolaryngol Head Neck Surg 1989;115:497-499) References 1. Butlin HT: Diseases of the Tongue . London, Cassell, 1885, p 331. 2. Marchetta FC, Saro K, Murphy JB: The periosteum of the mandible and intraoral carcinoma . Am J Surg 1971;122:711-713.Crossref 3. Davidson J, Freeman J, Gullane P, et al: Mandibulotomy and radical radiotherapy: Compatible or not? J Otolaryngol 1988;17:279-281. 4. Harmer MH (ed): TNM Classification of Malignant Tumours , ed 3. Geneva, Union Internationale Contre le Cancer, 1982, pp 23-32. 5. Spiro RH, Gerold FP, Strong EW: Mandibular 'swing' approach for oral and oropharyngeal tumours . Head Neck Surg 1981;3:371-378.Crossref 6. McGregor IA, MacDonald DG: Mandibular osteotomy in the surgical approach to the oral cavity . Head Neck Surg 1983;5:457-462.Crossref 7. DeSanto LW, Whicker JH, Devine KD: Mandibular osteotomy and lingual flaps . Arch Otolaryngol Head Neck Surg 1975;101:652-655.Crossref 8. Spiro RH, Gerold FP, Shah JP, et al: Mandibulotomy approach to oropharyngeal tumours . Am J Surg 1985;150:466-469.Crossref

Ikeda, Katsuhisa;Morizono, Tetsuo

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280098025pmid: 2923694

Abstract • The effects of albumin-unbound furosemide and albumin-bound furosemide on the cochlear function were compared by the continuous observation of the endocochlear potential (EP) in the chinchilla using the microelectrode method. The EP depression following the intravenous injection of 50 mg/kg of furosemide was 108.5 ± 2.7 mV, while the addition of 1.0 and 1.3 g/kg of albumin induced the EP depression to be 35.0 ± 4.8 and 8.1 ± 1.9 mV, respectively, and both prolonged the time to attain the minimum EP. However, there was no difference in the recovery time of the EP between the two groups. The results indicate that access to the site of furosemide action in the cochlea is dependent on the unbound fraction of furosemide and that the albumin-bound furosemide alleviates the EP depression induced by furosemide alone with the augmentation of diuresis. (Arch Otolaryngol Head Neck Surg 1989;115:500-502) References 1. Schwarz GN, David DS, Riggio RR, et al: Ototoxicity induced by furosemide . N Engl J Med 1970;181:1413-1414.Crossref 2. Mathog RH, Thomas WG, Hudson WR: Ototoxicity of new and potent diuretics . Arch Otolaryngol Head Neck Surg 1970;92:7-13.Crossref 3. Kusakari J, Ise I, Comegys TH, et al: Effect of ethacrynic acid, furosemide, and ouabain upon the endolymphatic potential and upon high-energy phosphates of the stria vascularis . Laryngoscope 1978;88:12-37. 4. Rybak LP: Furosemide ototoxicity: Clinical and experimental aspects . Laryngoscope 1985; 95( (suppl 38) ):1-14.Crossref 5. Bowman RH: Renal secretion of [35S]furosemide and its depression by albumin binding . Am J Physiol 1975;229:93-98. 6. Prandota J, Pruitt AW: Furosemide binding to human albumin and plasma of nephrotic children . Clin Pharmacol Ther 1975;17:159-166. 7. Cohen MR, Hinsch E, Vergona R, et al: A comparative diuretic tissue distribution study of bumetanide and furosemide in the dog . J Pharmacol Exp Ther 1976;197:697-702. 8. Rane A, Villeneuve JP, Stone WJ, et al: Plasma binding and disposition of furosemide in the nephrotic syndrome and in uremia . Clin Pharmacol Ther 1978;24:199-207. 9. Deetjen P: Micropuncture studies on site and mode of diuretic action of furosemide . Ann NY Acad Sci 1966;139:408-415.Crossref 10. Hirsch G, Pakuts AP, Bayne AJ: Furosemide accumulation by renal tissue . Biochem Pharmacol 1975;24:1943-1946.Crossref 11. Odlind B: Relationship between tubular secretion of furosemide and its saluretic effect . J Pharmacol Exp Ther 1979;208:515-521. 12. Brater DC: Resistance to diuretics: Emphasis on a pharmacological perspective . Drugs 1981;22:477-494.Crossref 13. Rybak LP, Green TP, Juhn SK, et al: Probenecid reduces cochlear effects and perilymph penetration of furosemide in chinchilla . J Pharmacol Exp Ther 1984;230:706-709. 14. Andreasen F, Jakobsen P: Determination of furosemide in blood plasma and its binding to proteins in normal plasma and in plasma from patients with acute renal failure . Acta Pharmacol Toxicol 1974;35:49-57.Crossref 15. Hirashima N: Effect of radio-contrast media on cochlear depression . Ann Otol Rhinol Laryngol 1978;87:32-36. 16. Rybak LP, Santigo W, Whitworth C: An experimental study using sodium salicylate to reduce cochlear changes induced by furosemide . Arch Otorhinolaryngol 1986;243:180-182.Crossref 17. Inoue M, Okajima K, Itoh K, et al: Mechanism of furosemide resistance in analbuminemic rats and hypoalbuminemic patients . Kidney Int 1987;32:198-203.Crossref

Lee, Ya-Yen;Dimery, Isaiah W.;Van Tassel, Pamela;De Pena, Charles;Blacklock, J. Bob;Goepfert, Helmuth

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280101026pmid: 2466470

Abstract • Twenty-four patients with advanced paranasal sinus tumors were treated with combined superselective intra-arterial and systemic chemotherapy, yielding an immediate satisfactory tumor response rate of 91%, significantly better than previously reported. Eight patients had craniofacial surgery circumvented because of complete or near complete response. Repetitive uncomplicated catheterization of the pterygoid segment of the internal maxillary artery using a coaxial system is the cornerstone of successful induction chemotherapy. Strenuous screening of medical status is mandatory for this aggressive introduction chemotherapy. (Arch Otolaryngol Head Neck Surg 1989;115:503-511) References 1. Lee Y-Y, Wallace S, Dimery I, et al: Intra-arterial chemotherapy of head and neck tumors . AJNR 1986;7:343-348. 2. American Joint Committee for Cancer Staging and End-Results Reporting : Manual for Staging of Cancer . Chicago, American Joint Commission, 1978, pp 45-46. 3. Wolpert SM, Kwan ESK, Heros D, et al: Selective delivery of chemotherapeutic agents with a new catheter system . Radiology 1988; 166:547-549.Crossref 4. Baker SR, Wheeler RH, Esminger WD, et al: Intra-arterial infusion chemotherapy for head and neck cancer using a totally implantable infusion pump . Head Neck Surg 1981;4:118-124.Crossref 5. Carter SK: The chemotherapy of head and neck cancer . Semin Oncol 1977;4:413-424. 6. Smart CR, Rochlim DB, Nahum AM, et al: Clinical experience with vinblastine sulfate in squamous cell carcinoma and other malignancies . Cancer Treat Rep 1964;34:31-45. 7. Wittes RE, Cvitkovic E, Shah J, et al: Cisdichlorodiamineplatinum (II) in the treatment of epidermoid carcinoma of the head and neck . Cancer Treat Rep 1977;61:359-366. 8. Tapazolglon E, Kigh L, Ensley J, et al: The activity of a single-agent 5-fluorouracil infusion in advanced and recurrent head and neck cancer . Cancer 1986;57:1105-1109.Crossref 9. Kish JA, Weaver A, Jacobs J, et al: Cisplatin and 5-fluorouracil infusion in patients with recurrent and disseminated epidermoid cancer of the head and neck . Cancer 1984;53:1819-1824.Crossref 10. Shibuya H, Suzuki S, Horiuchi J, et al: Reappraisal of trimodal combination therapy for maxillary sinus carcinoma . Cancer 1982;50:270-274.Crossref 11. Jacobs C, Goffimet DR, Goffimet L, et al: Chemotherapy as a substitute for surgery in the treatment of advanced resectable head and neck cancer . Cancer 1987;60:1178-1183.Crossref 12. Benjamin RS, Chawla SP, Murray JA, et al: Preoperative chemotherapy for osteosarcoma: A treatment approach facilitating limb salvage with major prognostic implications , in Jones SE, Salmon SE (eds): Adjuvant Therapy of Cancer . New York, Grune & Stratton, 1984, vol 4, pp 601-610. 13. Raymond AK, Chawla SP, Carrasco CH, et al: Osteosarcoma chemotherapeutic effect: A prognostic factor . Semin Diagn Pathol 1987; 4:212-236. 14. Moseley HS, Thomas LR, Everts EC, et al: Advanced squamous cell carcinoma of the maxillary sinus . Am J Surg 1981;141:522-525.Crossref

April, Max M.;Burns, Jane C.;Newburger, Jane W.;Healy, Gerald B.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280110027pmid: 2923695

Abstract • Kawasaki disease (KD) is an acute illness of unknown cause that affects infants and children. The diagnosis is confirmed in patients with prolonged fever and four of the following clinical features: (1) nonexudative conjunctivitis; (2) oral cavity changes; (3) rash; (4) extremity changes; and (5) cervical adenopathy. Complications of KD include coronary artery aneurysms, which may lead to myocardial infarction, chronic coronary insufficiency, or death. We describe a series of 83 patients with KD in whom 43 (52%) of 83 developed cervical adenopathy during their acute illness. Eighteen (42%) of these 43 patients were initially misdiagnosed as having cervical adenitis and were treated with antibiotics. The otolaryngologist may see these patients in referral and should consider the diagnosis of KD in patients with cervical adenopathy, prolonged fever, signs of mucosal inflammation, or rash. Early diagnosis and intravenous treatment with high-dose γ-globulin is effective in reducing the prevalence of coronary artery abnormalities. (Arch Otolaryngol Head Neck Surg 1989;115:512-514) References 1. Kawasaki T: Acute febrile lymph node syndrome: Clinical observations of 50 cases . Jpn J Allergy 1967;16:178-222 (in Japanese). 2. Kato H, Koike S, Yokoyama T: Kawasaki disease: Effect of treatment on coronary artery involvement . Pediatrics 1979;63:175-179. 3. Yanagawa H, Kawasaki T, Shigematsu I: Nationwide survey on Kawasaki disease in Japan . Pediatrics 1987;80:58-62. 4. Bell DM, Morens DM, Holman RC, et al: Kawasaki syndrome in the United States . AJDC 1983;137:211-214. 5. Burns JC, Joffe L, Sargent RA, et al: Anterior uveitis in Kawasaki syndrome . Pediatr Infect Dis 1985;4:258-261.Crossref 6. Geisker DW, Krause PJ, Pastuszak WT, et al: Lymph node biopsy for early diagnosis in Kawasaki disease . Am J Surg Pathol 1982;6:493-501.Crossref 7. Kato H, Ichinose E, Yoshioka F, et al: Fate of coronary aneurysms in Kawasaki disease: Serial coronary angiography and long-term follow up study . Am J Cardiol 1982;49:1758-1766.Crossref 8. Newburger JW, Takahashi M, Burns JC, et al: Treatment of Kawasaki syndrome with intravenous gamma globulin . N Engl J Med 1986; 315:341-347.Crossref 9. Safety of therapeutic immune globulin preparations with respect to transmission of human T-lymphotropic virus type III lymphadenopathy-associated virus infection . MMWR 1986; 35:231-233. 10. Yanagihara R, Todd JK: Acute febrile mucocutaneous lymph node syndrome . AJDC 1980;134:603-614.

Fukuda, Katsunori;Yuasa, Kazumi;Uchizono, Akihiro;Matsuyama, Hirohumi;Shimada, Kaoru;Ohyama, Masaru

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280113028pmid: 2784319

Abstract • Sulfamethoxazole-trimethoprim, an antimicrobial agent, was used to treat three cases of cytotoxic agent-resistant Wegener's granulomatosis; one case was refractory to a regimen consisting of azathioprine and prednisolone, and in another two cases the therapy was insufficient to control the disease. By the introduction of sulfamethoxazole-trimethoprim, which has an advantage of fewer side effects compared with the conventional agents, into the regimen, the disease condition was markedly improved in all cases within four months. Sulfamethoxazole-trimethoprim is thus considered as one of the most promising drugs to treat, especially, cytotoxic agent-resistant Wegener's granulomatosis. The possible underlying mechanism of the effect of sulfamethoxazole-trimethoprim is also described. (Arch Otolaryngol Head Neck Surg 1989;115:515-518) References 1. McDonald TJ, DeRemee RA: Wegener's granulomatosis . Laryngoscope 1983;93:220-231.Crossref 2. Fahey JL, Leonard E, Churg J, et al: Wegener's granulomatosis . Am J Med 1954;17:168-179.Crossref 3. Fauci AS, Haynes BF, Katz P, et al: Wegener's granulomatosis: Prospective clinical and therapeutic experience with 85 patients for 21 years . Ann Intern Med 1983;98:76-85.Crossref 4. DeRemee RA, McDonald TJ, Weiland LH: Wegener's granulomatosis: Observations on treatment with antimicrobial agents . Mayo Clin Proc 1985;60:27-32.Crossref 5. Friedmann I, Bauer F: Wegener's granulomatosis causing deafness . J Laryngol 1973; 87:449-464.Crossref 6. Shilltoe EJ, Lehner T, Lessof MH, et al: Immunological features of Wegener's granulomatosis . Lancet 1974;1:281-284.Crossref 7. West BC, Todd JR, King JW: Wegener's granulomatosis and trimethoprim-sulfamethoxazole . Ann Intern Med 1987;106:840-842.Crossref 8. Yuasa K, Tokitsu M, Goto H, et al: Wegener's granulomatosis: Diagnosis by transbronchial lung biopsy, evaluation by gallium scintigram and treatment with sulfamethoxazole/trimethoprim . Am J Med 1988;84:371-372.Crossref 9. Kuroiwa Y, Okubo Y, Namushi NR, et al: A case of limited Wegener's granulomatosis in relapse following standard therapy treated effectively by anti-microbial agents . Jpn J Thorac Dis 1987;25:1135-1139. 10. Axelson JA, Clark RH, Ancerewicz S: Wegener's granulomatosis and trimethoprim-sulfamethoxazole . Ann Intern Med 1987;107:600.Crossref 11. Burchall JJ: Mechanism of action of trimethoprim-sulfamethoxazole . J Infect Dis 1973;128:S437-S441.Crossref

Ricciardelli, Edward;Hillel, Allen D.;Schwartz, Alan N.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280117029pmid: 2923696

Abstract • Three cases of an aberrant internal carotid artery presenting at or near the midline in the posterior part of the pharynx occurred. In all three cases, the anomalous finding was not correlated with the presenting symptoms of the patient. In two of the three cases intraoral pulsations were detected during initial examination. In the third case, pulsations were appreciated on reexamination after roentgenographic evaluation. Intraoral photographs, computed tomographic scan, magnetic resonance imaging, and arteriography of these findings are shown. A review of the literature and the embryology of the lateral pharyngeal carotid artery are presented along with the rare finding of the near midline carotid artery and the clinical implications of this anomaly. (Arch Otolaryngol Head Neck Surg 1989;115:519-522) References 1. Osguthorpe JD, Adkins WY, Putney FJ, et al: Internal carotid artery as a source of T & A hemorrhage . Otolaryngol Head Neck Surg 1981; 89:758-762. 2. Demme K: Über gefassanomeilien en pharynx . Wien Med Wochenschr 1901;51:2245. 3. Cioffi FA, Meduri M, Tomaselo F, et al: Kinking and coiling of the internal carotid artery: Clinical-statistical observations and surgical perspectives . J Neurosurg Sci 1975;19:15-22. 4. Metz H, Murray-Leslie RM, Bannister RG, et al: Kinking of the internal carotid artery in relation to cerebrovascular disease . Lancet 1961; 1:424-426.Crossref 5. Davis HJ: Case of abnormal artery on wall of pharynx . Proc R Soc Med 1914;7:104. 6. Schaeffer JP: Aberrant vessels in surgery of the palatine and pharyngeal tonsils . JAMA 1921; 77:14-19.Crossref 7. Carmack JW: Aberrant internal carotids and their relation to surgery of the pharynx . Laryngoscope 1929;39:707-720.Crossref 8. Sibileau: Paris letter . JAMA 1921;76:532. 9. Pratt LW: T & A: Incidence and mortality, 1968-1972 . Otolaryngol Head Neck Surg 1979; 87:159-166. 10. Fisher AG: Sigmoid tortuosity of the internal carotid artery and its relation to tonsil and pharynx . Lancet 1915;2:128-130.Crossref 11. Kelly AB: Tortuosity of the internal carotid artery in relation to the pharynx . J Laryngol Otol 1925;40:15-23.Crossref 12. Mukherjee D, Inahara T: Management of the tortuous internal carotid artery . Am J Surg 1985;149:651-655.Crossref 13. Weibel J, Fields WS: Tortuosity, coiling, and kinking of the internal carotid artery: II. Relationship of morphological variation to cerebrovascular insufficiency . Neurology 1965;15:462-468.Crossref 14. Cairney J: Tortuosity of the cervical segment of the internal carotid artery . J Anat 1924; 59:87-96. 15. McKenzie W, Woolf CI: Carotid abnormalities and adenoid surgery . J Laryngol Otol 1959; 73:596-602.Crossref 16. Bergqvist B: Anomalies in the course of arteria carotid interna in the upper region of the pharynx . Acta Otolaryngol 1946;34:246-255.Crossref 17. Skillern PG: Anomalous internal carotid artery and its clinical significance in operations on tonsils . JAMA 1913;60:172-173.Crossref

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280121030

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 the dissection of the temporal bone will be held in Barcelona, Spain, from November 6 through 11, 1989. Only limited seating is available. For further information, contact Instituto de Otologá-Ibáñez, 91 Dr Roux St, 08017 Barcelona, Spain; (3) 205.02.04; (3) 205.43.67 (fax). Seminar Announced.—The F. T. Hill Seminar in Otolaryngology will be held at Colby College-Mid-Maine Medical Center, Waterville, from July 31 through August 4, 1989. Topics include the surgery of cancer, the "near-total" laryngectomy, cancer of the tongue and floor of the mouth, the pericranial flap, and management of wounds of the anterior skull base. There will be 18 hours of Category 1 credit offered. For further information, contact R. H. Kany, Director, Special Programs, Colby College, Waterville, ME 04901; (207) 872-3386. Endoscopic Sinus Surgery Course.—The University of Chicago (Ill) will offer a hands-on course on adult and pediatric fiberoptic endoscopic sinus surgery

STRUNK, CHESTER L.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280121031

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 This monograph and atlas contains more than 1300 illustrations of neurootologic procedures from subtotal petrosectomy through three different infratemporal fossa approaches. The first eight chapters are concerned with these various procedures. Each chapter is comprehensive and begins with part 1 on general considerations that include rationale, indications, and complications followed by preoperative preparation, instrumentation, and, finally, postoperative care. Part 2 is concerned with surgical anatomy. For example, in chapter 4, on infratemporal fossa approaches, the bony landmarks, vessels, and nerves and the anatomy of the clivus are introduced. Not every chapter has a separate part for surgical anatomy. The surgical anatomy may be included under the surgical techniques portion. One section of each chapter on surgical approaches is concerned with the surgical technique that uses labeled, detailed line drawings for illustration. These line drawings are multiple as demonstrated in chapter 3 on "Infratemporal Fossa Approach Type A" in which more

FECHNER, ROBERT E.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280122032

Abstract PATHOLOGIC QUIZ CASE 1 Jed A. Kwartler, MD, Anjali Limaye, MD, Newark, NJA 36-year-old man presented with a nontender, indurated, nondraining mass in the left submandibular area of three weeks' duration. His history was significant for cigarette smoking and intravenous drug abuse. He denied any history of blunt trauma to the area, but did admit to attempted drug injections in the region of the mass. He denied any recent dental work.Physical examination revealed a 6 × 4-cm firm, nontender, left submandibular mass. Oral examination did not demonstrate any mucosal lesions, and the dentition appeared intact. Clear saliva could be milked from Wharton's duct. An aspiration biopsy was performed and revealed the mass to be cystic. A large amount of foul-smelling purulent material was evacuated and was sent for culture and cytologic examination.What is your diagnosis? PATHOLOGIC QUIZ CASE 2 Howard K. Nam, MD; Miriam L. Christ, MD; References 1. Mandell GL, Douglas RG Jr, Bennett JE (eds): Principles and Practice of Infectious Diseases . New York, John Wiley & Sons Inc, 1979, pp 273, 332, 1969-1977. 2. Rippon JW: Medical Mycology . Philadelphia, WB Saunders Co, 1974, pp 13-28. 3. Dubos R, Hirsch J (eds): Bacterial and Mycotic Infections of Man , ed 4. Philadelphia, JB Lippincott, 1965, pp 329-341, 490, 825. 4. Weese WC, Smith IM: A study of 57 cases of actinomycosis over a 36-year period . Arch Intern Med 1975;135:1562-1568.Crossref 5. Bennhoff DF: Actinomycosis: Diagnostic and therapeutic considerations and a review of 32 cases . Laryngoscope 1984;94:1198-1217.Crossref 6. Brown JB: Human actinomycosis: A study of 181 subjects . Hum Pathol 1973;4:319-330.Crossref 7. Youmans G, Paterson P, Sommers H: The Biologic and Clinical Basis of Infectious Disease , ed 2. Philadelphia, WB Saunders Co, 1980, pp 13, 89, 286-298. 8. Yeager BA, Hoxie J, Weisman RA, et al: Actinomycosis in the acquired immunodeficiency syndrome-related complex . Arch Otolaryngol Head Neck Surg 1986;112:1293-1295.Crossref 9. Silverman PM, Farmer JC, Korobkin M, et al: CT diagnosis of actinomycosis of the neck . J Comput Assist Tomogr 1984;8:793-794.Crossref 10. Dehner LP, Enzinger FM, Font RL: Fetal rhabdomyoma: An analysis of nine cases . Cancer 1972;30:160-166.Crossref 11. DiSant'Agnese PA, Knowles DM: Extracardiac rhabdomyoma: A clinicopathologic study and review of the literature . Cancer 1980; 46:780-789.Crossref 12. Neville BW, McConnel FMS: Multifocal adult rhabdomyoma: A report of a case and review of the literature . Arch Otolaryngol Head Neck Surg 1981;107:175-178.Crossref 13. Modlin B: Rhabdomyoma of the larynx . Laryngoscope 1982;92:580-582.Crossref 14. Anderson CB, Elling F: Adult rhabdomyoma of the oropharynx recurring three times within 35 years . Acta Pathol Microbiol Immunol Scand A 1986;94:281-284.

DEDIO, ROBERT M.;Tom, LAWRENCE W. C.;MCGOWAN, KARIN L.;WETMORE, RALPH F.;HANDLER, STEVEN D.;POTSIC, WILLIAM P.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280126034

Abstract In Reply.—As stated clearly in our introduction, the purpose of our study was to "investigate the nature of the aerobic and anaerobic flora of core tonsil and adenoid tissue."1 We are well aware that anaerobic bacteria can be easily overlooked and misidentified unless appropriate procedures for transport, isolation, and identification are used. Our laboratory is fully equipped for the isolation, identification, and susceptibility testing of anaerobic organisms. Brook and Foote claim that anaerobic bacteria have been found in the core of the tonsils by all previous investigators who "employed proper methodology for the isolation of these organisms." The reader should note carefully that seven of ten of the supplied references are from the primary author. In addition, the authors have neglected to mention that other reputable investigators have demonstrated the absence2 or paucity3,4 of anaerobes in core tonsil tissue. In the course of our investigation, we followed highly References 1. DeDio RM, Tom LWC, McGowan KL, et al: Microbiology of the tonsils and adenoids in a pediatric population . Arch Otolaryngol Head Neck Surg 1988;114:763-765.Crossref 2. Pillsbury HC, Kveton JF, Sasaki CT, et al: Quantitative bacteriology in adenoid tissue . Otolaryngol Head Neck Surg 1981;89:355-363. 3. Surow JB, Handler SD, Telian SA, et al: Bacteriology of tonsil surface and core in children . Laryngoscope , in press. 4. Ruokonen J, Sandelin K, Makinen J: Adenoids and otitis media with effusion . Ann Otol Rhinol Laryngol 1979;88:166-171. 5. Allen SD, Siders JA, Marier LM: Isolation and examination of anaerobic bacteria , in Lennette EH, Balows A, Hausler WJ Jr, et al (eds): Manual of Clinical Microbiology . Washington, DC, American Society for Microbiology, 1985, pp 413-433. 6. Becton Dickinson Co: Dept of Research and Development Technical Data Report M009 . Rutherford, NJ, Beckon Dickinson Co, 1977. 7. Becton Dickinson Co: Dept of Research and Development Technical Data Report M104 . Rutherford, NJ, Becton Dickinson Co, 1981. 8. Brook I, Yocum P, Friedman EM: Aerobic and anaerobic bacteria in tonsils of children with recurrent tonsillitis . Ann Otol Rhinol Laryngol 1981;90:261-263. 9. Brook I, Foote PA: Comparison of the microbiology of recurrent tonsillitis between children and adults . Laryngoscope 1986;96:1385-1388.Crossref 10. Brook I: Aerobic and anaerobic bacteriology of adenoids in children: A comparison between patients with chronic adenotonsillitis and adenoid hypertrophy . Laryngoscope 1981;91:377-382.

BROOK, ITZHAK;FOOTE, PERRY

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280126033pmid: 2923699

Abstract To the Editor.—We have read with interest the article by DeDio et al1 that was recently published in the Archives. In their study, DeDio et al evaluated the microbiology of 50 tonsils and adenoids of children who had a tosillectomy or an adenoidectomy. Although they have recovered aerobic bacteria from all their patients, in frequency similar to ours,2-8 as well as other investigators,9-11 they failed to isolate any anaerobic bacteria, as we and others did. In the "Comment" section of their article, they brought out several hypotheses that attempt to explain their inability to recover anaerobic bacteria from these sites. We believe that the issues they raised deserve specific comments. Although anaerobic bacteria colonize the oropharynx, they have been found in the core of the tonsils by all previous investigators who employed proper methodologies for the isolation of these organisms.2-11 The inability of DeDio et References 1. DeDio RM, Tom LWC, McGowan KL, et al: Microbiology of the tonsils and adenoids in a pediatric population . Arch Otolaryngol Head Neck Surg 1988;114:763-765.Crossref 2. Brook I, Yocum P, Friedman EM: Aerobic and anaerobic bacteria in tonsils of children with recurrent tonsillitis . Ann Otol Rhinol Laryngol 1981;90:261-263. 3. Brook I, Hirokawa R: Treatment of patients with a history of recurrent tonsillitis due to group A beta-hemolytic streptococci . Clin Pediatr 1985;24:331-336.Crossref 4. Brook I, Yocum P, Shah K: Surface vs core tonsillar aerobic and anaerobic flora in recurrent tonsillitis . JAMA 1980;244:1695-1698.Crossref 5. Brook I, Foote PA: Comparison of the microbiology of recurrent tonsillitis between children and adults . Laryngoscope 1986;96:1385-1388.Crossref 6. Brook I, Yocum P: Bacteriology of chronic tonsillitis in young adults . Arch Otolaryngol Head Neck Surg 1984;110:803-805.Crossref 7. Brook I, Yocum P: Comparison of the microbiology of group A and non–group A streptococcal tonsillitis . Ann Otol Rhinol Laryngol 1988; 97:243-246. 8. Brook I: Aerobic and anaerobic bacteriology of adenoids in children: A comparison between patients with chronic adenotonsillitis and adenoid hypertrophy . Laryngoscope 1981;91:377-382. 9. Reilly S, Timmis P, Beeden AG, et al: Possible role of the anaerobe in tonsillitis . J Clin Pathol 1981;34:542-547.Crossref 10. Chagollan JRR, Macias JR, Gil JS: Flora indigena de las amigdalas . Invest Med Int 1984; 11:36-39. 11. Turner K, Nord CE: Beta-lactamase-producing anaerobic bacteria in recurrent tonsillitis . J Antimicrob Chemother 1982;10( (suppl A) ):153-156. 12. Brook I: Comparison of two transport systems for recovery of aerobic and anaerobic bacteria from abscesses . J Clin Microbiol 1987;25:2020-2022.

1989 Archives of Otolaryngology - Head & Neck Surgery

doi: 10.1001/archotol.1989.01860280142035

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