Pub Date : 1984-03-01DOI: 10.1097/00006534-198512000-00086
L. Bernstein, R. Nelson
The peripheral, extraparotid distribution of the clinically important branches of the facial nerve is described, with common variations, based on the anatomical dissection of 35 cadaver half heads. Methods are suggested for avoiding, isolating, and protecting the facial nerve branches during surgical procedures.
{"title":"Surgical anatomy of the extraparotid distribution of the facial nerve.","authors":"L. Bernstein, R. Nelson","doi":"10.1097/00006534-198512000-00086","DOIUrl":"https://doi.org/10.1097/00006534-198512000-00086","url":null,"abstract":"The peripheral, extraparotid distribution of the clinically important branches of the facial nerve is described, with common variations, based on the anatomical dissection of 35 cadaver half heads. Methods are suggested for avoiding, isolating, and protecting the facial nerve branches during surgical procedures.","PeriodicalId":8315,"journal":{"name":"Archives of otolaryngology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1984-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83646941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1983-09-01DOI: 10.1001/ARCHOTOL.1983.00800230004002
J. Loré
Of the nine practical anatomical considerations relative to thyroidectomy, the relationship of the recurrent laryngeal nerve to the posterior suspensory ligament of the thyroid rather than the nerve relationship to the inferior thyroid artery is believed to be the most important. Thus, the surgeon is admonished first to locate the nerve at or just above the superior thoracic inlet as one of the initial steps in thyroidectomy. The other more important considerations are the surgical anatomy of the external branch of the superior laryngeal nerve and the fact that often the parathyroid glands can be retrieved from the surgical specimen while still in the sterile surgical field and then can be reimplanted.
{"title":"Practical anatomical considerations in thyroid tumor surgery.","authors":"J. Loré","doi":"10.1001/ARCHOTOL.1983.00800230004002","DOIUrl":"https://doi.org/10.1001/ARCHOTOL.1983.00800230004002","url":null,"abstract":"Of the nine practical anatomical considerations relative to thyroidectomy, the relationship of the recurrent laryngeal nerve to the posterior suspensory ligament of the thyroid rather than the nerve relationship to the inferior thyroid artery is believed to be the most important. Thus, the surgeon is admonished first to locate the nerve at or just above the superior thoracic inlet as one of the initial steps in thyroidectomy. The other more important considerations are the surgical anatomy of the external branch of the superior laryngeal nerve and the fact that often the parathyroid glands can be retrieved from the surgical specimen while still in the sterile surgical field and then can be reimplanted.","PeriodicalId":8315,"journal":{"name":"Archives of otolaryngology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78454953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1983-02-01DOI: 10.1097/00004728-198312000-00062
M. Friedman, M. Mafee, V. Shelton, F. Berlinger, E. Skolnik
Increased accuracy of parathyroid hormone assays has yielded an earlier diagnosis of primary hyperparathyroidism, often in an asymptomatic stage. Non-invasive modalities used to localize parathyroid abnormalities have not been accurate for small adenomas. Although arteriography has been shown to be accurate in detection of adenomas, the invasive nature of the study, as well as possible complications, minimizes its use in preoperative localization of parathyroid abnormalities. The computed tomographic (CT) scan was used preoperatively in eight patients to assess its accuracy in localizing parathyroid abnormalities. The radiographic findings were correlated with surgical and pathologic findings. The conditions of seven patients were correctly diagnosed preoperatively by the CT scan, including that of one patient with diffuse hyperplasia. With the increased accuracy attained by this noninvasive examination, we believe that CT scanning should be a routine part of the preoperative examination of patients with primary hyperparathyroidism.
{"title":"Parathyroid localization by computed tomographic scanning.","authors":"M. Friedman, M. Mafee, V. Shelton, F. Berlinger, E. Skolnik","doi":"10.1097/00004728-198312000-00062","DOIUrl":"https://doi.org/10.1097/00004728-198312000-00062","url":null,"abstract":"Increased accuracy of parathyroid hormone assays has yielded an earlier diagnosis of primary hyperparathyroidism, often in an asymptomatic stage. Non-invasive modalities used to localize parathyroid abnormalities have not been accurate for small adenomas. Although arteriography has been shown to be accurate in detection of adenomas, the invasive nature of the study, as well as possible complications, minimizes its use in preoperative localization of parathyroid abnormalities. The computed tomographic (CT) scan was used preoperatively in eight patients to assess its accuracy in localizing parathyroid abnormalities. The radiographic findings were correlated with surgical and pathologic findings. The conditions of seven patients were correctly diagnosed preoperatively by the CT scan, including that of one patient with diffuse hyperplasia. With the increased accuracy attained by this noninvasive examination, we believe that CT scanning should be a routine part of the preoperative examination of patients with primary hyperparathyroidism.","PeriodicalId":8315,"journal":{"name":"Archives of otolaryngology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1983-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89823633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1982-11-01DOI: 10.1001/ARCHOTOL.1982.00790590019006
S. Edström, K. Bennegȧrd, E. Edén, K. Lundholm
The present study evaluates the energy and skeletal muscle metabolism in malnourished patients, with and without cancer, in response to nutrition. The energy balance was positive in all patients receiving nutritional support. This led to an increase in body weight and body potassium levels. Glucose turnover increased in all patients. In patients with cancer, elevated glucose turnover reflected increased utilization of glucose preferentially for synthetic pathways rather than for oxidation. Protein synthesis and RNA content in skeletal muscles increased during nutrition. Nutritional support improved energy balance and protein synthesis capacity in skeletal muscles in patients with cancer to the same extent as in malnourished patients without cancer. Malignant cachexia seems to be a consequence of a relative lack of energy and not of impaired energy utilization in host tissues, at least early in the disease.
{"title":"Energy and tissue metabolism in patients with cancer during nutritional support.","authors":"S. Edström, K. Bennegȧrd, E. Edén, K. Lundholm","doi":"10.1001/ARCHOTOL.1982.00790590019006","DOIUrl":"https://doi.org/10.1001/ARCHOTOL.1982.00790590019006","url":null,"abstract":"The present study evaluates the energy and skeletal muscle metabolism in malnourished patients, with and without cancer, in response to nutrition. The energy balance was positive in all patients receiving nutritional support. This led to an increase in body weight and body potassium levels. Glucose turnover increased in all patients. In patients with cancer, elevated glucose turnover reflected increased utilization of glucose preferentially for synthetic pathways rather than for oxidation. Protein synthesis and RNA content in skeletal muscles increased during nutrition. Nutritional support improved energy balance and protein synthesis capacity in skeletal muscles in patients with cancer to the same extent as in malnourished patients without cancer. Malignant cachexia seems to be a consequence of a relative lack of energy and not of impaired energy utilization in host tissues, at least early in the disease.","PeriodicalId":8315,"journal":{"name":"Archives of otolaryngology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1982-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82288827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1982-06-01DOI: 10.1001/ARCHOTOL.1982.00790540045013
P. Lavie, J. Zomer, I. Eliaschar, Z. Joachim, E. Halpern, A. Rubin, G. Alroy
Twenty-five adults with a deviated nasal septum, who complained about excessive daytime sleepiness, chronic fatigue, and nocturnal insomnia, were studied for one to two nights in a sleep laboratory. Recordings disclosed disordered breathing during sleep in the form of pronounced periodic breathing of alternating hypopneas and hyperpneas, isolated hypopneic episodes and central apneas and periodic sighs, all combined with electrophysiologic "microarousals," and a mixture of alpha and delta EEG wave activities. Surgical treatment of the deviated septum in 14 patients resulted in a subjective improvement in the level of diurnal alertness and in the quality of nocturnal sleep in 12 patients. Follow-up sleep recordings in seven of the patients who reported subjective improvement in sleep disclosed notably less waking and abnormal breathing during sleep. These results suggest that increased upper airway resistance can cause nonapneic breathing disorders in sleep and, consequently, sleep disturbances.
{"title":"Excessive daytime sleepiness and insomnia.","authors":"P. Lavie, J. Zomer, I. Eliaschar, Z. Joachim, E. Halpern, A. Rubin, G. Alroy","doi":"10.1001/ARCHOTOL.1982.00790540045013","DOIUrl":"https://doi.org/10.1001/ARCHOTOL.1982.00790540045013","url":null,"abstract":"Twenty-five adults with a deviated nasal septum, who complained about excessive daytime sleepiness, chronic fatigue, and nocturnal insomnia, were studied for one to two nights in a sleep laboratory. Recordings disclosed disordered breathing during sleep in the form of pronounced periodic breathing of alternating hypopneas and hyperpneas, isolated hypopneic episodes and central apneas and periodic sighs, all combined with electrophysiologic \"microarousals,\" and a mixture of alpha and delta EEG wave activities. Surgical treatment of the deviated septum in 14 patients resulted in a subjective improvement in the level of diurnal alertness and in the quality of nocturnal sleep in 12 patients. Follow-up sleep recordings in seven of the patients who reported subjective improvement in sleep disclosed notably less waking and abnormal breathing during sleep. These results suggest that increased upper airway resistance can cause nonapneic breathing disorders in sleep and, consequently, sleep disturbances.","PeriodicalId":8315,"journal":{"name":"Archives of otolaryngology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1982-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81802600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1982-04-01DOI: 10.1001/ARCHOTOL.1982.00790520062018
M. Nuwer
To the Editor .—I would like to question respectfully the article entitled "Auditory Function in Friedreich's Ataxia: Electrophysiologic Study of a Family" by Shanon et al published in the AprilArchives(1981;107:254-256). First, the inherited ataxias are a large, diverse, heterogeneous group of disorders. 1 Friedreich's ataxia forms a subgroup with rather specific symptoms. 2 Scientifically, it is important to separate patients with Friedreich's ataxia from others with inherited ataxias. However, Shanon et al do not describe in this family the typical scoliosis, cardiomyopathy, diabetes, corticospinal tract dysfunction, and other characteristics. Without the usual recessive inheritance pattern, these other features are important for making a diagnosis. As suggested by Barbeau, 2 the eponym "Friedreich's" should be avoided in atypical families. The second difficulty I have is with the latencies of their auditory brainstem potentials (ABPs). On close inspection, the latencies seem to be within generally accepted normal limits 3 in
{"title":"Dispute diagnosis of Friedreich's ataxia.","authors":"M. Nuwer","doi":"10.1001/ARCHOTOL.1982.00790520062018","DOIUrl":"https://doi.org/10.1001/ARCHOTOL.1982.00790520062018","url":null,"abstract":"To the Editor .—I would like to question respectfully the article entitled \"Auditory Function in Friedreich's Ataxia: Electrophysiologic Study of a Family\" by Shanon et al published in the AprilArchives(1981;107:254-256). First, the inherited ataxias are a large, diverse, heterogeneous group of disorders. 1 Friedreich's ataxia forms a subgroup with rather specific symptoms. 2 Scientifically, it is important to separate patients with Friedreich's ataxia from others with inherited ataxias. However, Shanon et al do not describe in this family the typical scoliosis, cardiomyopathy, diabetes, corticospinal tract dysfunction, and other characteristics. Without the usual recessive inheritance pattern, these other features are important for making a diagnosis. As suggested by Barbeau, 2 the eponym \"Friedreich's\" should be avoided in atypical families. The second difficulty I have is with the latencies of their auditory brainstem potentials (ABPs). On close inspection, the latencies seem to be within generally accepted normal limits 3 in","PeriodicalId":8315,"journal":{"name":"Archives of otolaryngology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1982-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80716427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1982-01-01DOI: 10.1007/springerreference_123173
L. Storrs, R. Caparosa
{"title":"Pain threshold.","authors":"L. Storrs, R. Caparosa","doi":"10.1007/springerreference_123173","DOIUrl":"https://doi.org/10.1007/springerreference_123173","url":null,"abstract":"","PeriodicalId":8315,"journal":{"name":"Archives of otolaryngology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1982-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88571229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1981-12-01DOI: 10.1001/ARCHOTOL.1981.00790480051017
C. Whittaker
To the Editor .—As a recent investigator and author of a double-blind crossover clinical study, I have great appreciation for the difficulties in the study of the surgical therapy for Meniere's disease published in theArchives(1981;107:271-277) by Thomsen and co-workers. Their pride in this well-executed study is apparent and, in my opinion, justified. I offer a few small criticisms that may be only quibbling in terms of the overall impact of this work. First, like all authors who can be proud of their work, they have implied in the "Comment" section of their article that all surgical procedures for Meniere's disease are now suspect as proved by their study, whereas a proper conclusion from their article is that placement of a Silastic foreign body from the endolymphatic sac into the mastoid cavity gives no better results than mastoidectomy. Surgeons experienced with Silastic know that the body tends to allow
{"title":"Therapy for Ménière's disease.","authors":"C. Whittaker","doi":"10.1001/ARCHOTOL.1981.00790480051017","DOIUrl":"https://doi.org/10.1001/ARCHOTOL.1981.00790480051017","url":null,"abstract":"To the Editor .—As a recent investigator and author of a double-blind crossover clinical study, I have great appreciation for the difficulties in the study of the surgical therapy for Meniere's disease published in theArchives(1981;107:271-277) by Thomsen and co-workers. Their pride in this well-executed study is apparent and, in my opinion, justified. I offer a few small criticisms that may be only quibbling in terms of the overall impact of this work. First, like all authors who can be proud of their work, they have implied in the \"Comment\" section of their article that all surgical procedures for Meniere's disease are now suspect as proved by their study, whereas a proper conclusion from their article is that placement of a Silastic foreign body from the endolymphatic sac into the mastoid cavity gives no better results than mastoidectomy. Surgeons experienced with Silastic know that the body tends to allow","PeriodicalId":8315,"journal":{"name":"Archives of otolaryngology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1981-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77986236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1981-09-01DOI: 10.1001/ARCHOTOL.1981.00790450016005
O. Herbild, P. Bonding
In 161 patients treated for a peritonsillar abscess by stab incision as the only surgical procedure, a follow-up study was conducted after 3 1/2 to eight years. Of all the patients examined, 51% had experienced no throat symptoms, 22% had had recurrent peritonsillar abscesses, 20% had had recurrent episodes of tonsillitis with fever, and 7% had had symptoms resembling episodic pharyngitis in varying degrees. The age of the patient and the patient's history of previous throat infections were found to have prognostic value. Older patients (older than 40 years) had a lower incidence of new throat infections (peritonsillar abscess, tonsillitis, or both) than younger patients. Patients without previous throat symptoms had a lower incidence of new throat infections than patients with a history of throat infection before the peritonsillar abscess, which in itself might indicate the need for tonsillectomy.
{"title":"Peritonsillar abscess.","authors":"O. Herbild, P. Bonding","doi":"10.1001/ARCHOTOL.1981.00790450016005","DOIUrl":"https://doi.org/10.1001/ARCHOTOL.1981.00790450016005","url":null,"abstract":"In 161 patients treated for a peritonsillar abscess by stab incision as the only surgical procedure, a follow-up study was conducted after 3 1/2 to eight years. Of all the patients examined, 51% had experienced no throat symptoms, 22% had had recurrent peritonsillar abscesses, 20% had had recurrent episodes of tonsillitis with fever, and 7% had had symptoms resembling episodic pharyngitis in varying degrees. The age of the patient and the patient's history of previous throat infections were found to have prognostic value. Older patients (older than 40 years) had a lower incidence of new throat infections (peritonsillar abscess, tonsillitis, or both) than younger patients. Patients without previous throat symptoms had a lower incidence of new throat infections than patients with a history of throat infection before the peritonsillar abscess, which in itself might indicate the need for tonsillectomy.","PeriodicalId":8315,"journal":{"name":"Archives of otolaryngology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1981-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78375935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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