Otolaryngology最新文献

A cost-benefit analysis of biopsy techniques for deep cervical lesions reveals that the aspiration biopsy is superior in terms of cost, speed, and morbidity but inferior in accuracy. Aspiration is most accurate for the diagnosis of metastatic carcinoma in cervical lymph nodes. An early diagnosis of malignancy by needle aspiration can be of benefit in several stages of patients management.

A review of the literature on basilar artery migraine as well as a brief overview of classic migraine is given. Diagnosis and management are also discussed as well as six case histories.

The microscopic and ultrastructural anatomy of the spiral ganglia and osseous spiral laminae (OSL) of the guinea pig were studied using the transmission and scanning electron microscopes. The nerve and vascular elements within the spiral ganglia and OSL are surrounded by distinct perineural and perivascular spaces maintained by a loose meshwork of cells and connective tissue fibers. The connective tissue cells are fibers within the OSL and spiral ganglia are distinctly different from the arachnoid-like reticular cells and elastin fibers of the modiolus described in an earlier study. The present experiment demonstrates a pathway between the perineural spaces of the modiolus, spiral ganglia, and OSL. The perineural spaces of the modiolus were previously shown to communicate with the subarachnoid space; therefore, perineural communication from the cerebrospinal fluid to the perilymph via this route is likely. Using mircosphere tracers injected intrathecally, this communication route between the subarachnoid space and scala tympani was further defined. The tracer experiment suggests that the perineural spaces within the internal acoustic meatus, modiolus, spiral ganglia, and OSL are normally patent and do not represent artifacts induced during tissue processing.

Controversy rages in the literature over the possibility of denervation and atrophy of the palate that may occur secondary to severance of the greater palatine neurovascular bundles during palatoplasty. A pilot study was undertaken to assess palatal bulk, mobility, sensation, and mucous gland population, as well as speech, in a group of cleft palate patients, some of whom had severance of the bundles during their palatal repair and some who did not. These same parameters were tested in a group of patients who had juvenile nasopharyngeal angiofibromata, in whom one bundle was tied and the other was not during the transpalatal exposure of the tumor. Severing the neurovascular bundle produced no appreciable differences between the two cleft groups except they all had depressed mucous gland counts. The procedure produced no problems in the angiofibroma patients.

Rising hospital costs have prompted many surgeons to develop office surgical facilities. This can be particularly useful in the type of practice seen by the otolaryngologist. This paper deals with the requirements for an office surgical setup, the scope of surgery that can be carried out in the office, as well as the advantages and disadvantages of operating in the office. Of particular importance is the fact that one must be prepared for the emergency situation when operating in his office.

Augmentation of deficient soft tissue contours accounts for a large part of facial plastic and reconstructive surgery. An attempt to use homograft sclera in the feline animal model is presented. Augmentation of nasal dorsum and the chin contours was carried out in the cat model with preserved homograft sclera. Serial soft tissue radiographs and histologic study of the homografts demonstrated complete resorption of the grafts by six months. Further physical and chemical alterations of homograft sclera appear to be necessary prior to its implantation for the purpose of soft tissue augmentation.