The rate of nerve regeneration is a critical determinant of the degree of functional recovery after injury. Here, we sought to determine whether treatment with the neuroprotective compound, agmatine, with or without nerve reconstruction utilizing a regional autogenous vein graft would accelerate the rate of facial nerve regeneration. Experiments compared the following seven groups of adult male rats: (A) Intact untreated controls. (B) Sham operation with interruption of the nerve blood supply (controls). (C) Transection of the mandibular branch of the facial nerve (generating a gap of 3 mm) followed by saline treatment. (D) Nerve transection with unsutured autogenous vein (external jugular) graft reconstruction plus saline treatment. (E) Nerve transection with sutured vein graft approximation (coaptation of the proximal and distal nerve stumps) plus saline. (F) Nerve transection with sutured vein graft followed by agmatine treatment (four daily intraperitoneal injections of 100 mg/kg agmatine sulfate). (G) Nerve transection with unsutured vein graft followed by agmatine treatment. Functional recovery, as assessed by grading vibrissae movements and by recording nerve conduction velocity and numbers of regenerated axons, indicated that either vein reconstruction or agmatine treatment resulted in accelerated and more complete recovery as compared with controls. But best results were observed in animals that underwent combined treatment, i.e., vein reconstruction plus agmatine injection. We conclude that agmatine treatment can accelerate facial nerve regeneration and that agmatine treatment together with autogenous vein graft offers an advantageous alternative to other facial nerve reconstruction procedures.

Background Inferior turbinectomy on patients of all ages is a controversial procedure. Its effect on children has been reported little in the literature and the few studies that are available involved relatively older children, i.e., >10 years old. Nasal obstruction caused by extensive hypertrophy of the inferior turbinates is not an uncommon observation in the pediatric population. The clinical manifestations might present as snoring, noisy breathing, mouth breathing, and, possibly, sleep apnea. Methods In this study, we followed 227 children >10 years of age who underwent inferior turbinectomy (27 children also underwent a revision of an earlier adenoidectomy), of whom 179 children had significant relief of nasal obstruction at the 1-year follow-up. Results Nocturnal breathing was reported to be more regular and otherwise improved in the 36 children with a suspected history of sleep apnea. Forty-two of 47 children who had thick nasal secretions and did not respond to antibiotic therapy before the operation had significant relief postoperatively. Postoperative complications were few and their number did not exceed that of adults. Conclusions A complete inferior turbinectomy should be considered in children >10 years of age who have hypertrophied inferior turbinates that cause major interference with nasal breathing.

Objective: To explore whether acute acoustic trauma or noise-induced hearing loss may cause the later development of Meniere's Disease.Study Design: Retrospective search of a military medical data bank.Setting: Medical records of 17,245 Israel Defense Force veterans who were recognized as being disabled as a result of acoustic trauma or noise-induced hearing loss.Patients: Eleven cases of late-onset Meniere's Disease were retrieved from these files.Main Outcome Measures: Documented symptoms and audiograms.Results: Eleven of the 17,425 veterans appeared to have typical Meniere's Disease. Their symptoms included attacks of vertigo, lasting between half an hour and a few hours and no more than 24 hours; the sensation of aural fullness; and tinnitus accompanied by a fluctuating or permanent low-tone hearing loss. Four of the 11 patients had a documented previous noise-induced hearing loss, and the remaining 7 had experienced acute acoustic trauma. The Meniere's Disease was bilateral in three cases. The average period between the first documented hearing loss and the onset of Meniere's Disease was 15.8 years (standard deviation, +/-6.6 years). This yielded a prevalence of 1.9:100,000 of Meniere's Disease in a population with acoustic trauma or noise-induced hearing loss-a figure comparable to that in the general population.Conclusions: No support was found for the hypothesis that Meniere's Disease may be causally related to previous acoustic trauma or noise-induced hearing loss.

Objective: To report for the first time hearing impairment resulting from blunt neck trauma.Study Design: Retrospective chart review of clinical, pure tone, and speech audiometric findings. The first obtained within 3 months and the follow-up ones between 6 and 12 months after injury. Three representative examples are given.Patients: Eighty-three patients (166 ears) who reported hearing impairment after blunt neck trauma.Results: Twenty of the 166 ears (12%) had normal hearing and 137 ears (81.3%) showed an acoustic trauma-like hearing impairment. Eight ears (4.8%) had a hearing loss of at least 30 dB in the speech frequencies (500-2,000 Hz) and two ears (1.2%) had additional impairment in the higher frequencies. Only one ear (0.8%) had a conductive hearing loss. No speech discrimination score was poorer than 80%. Forty-six subjects (55.4%) reported tinnitus.Conclusions: Blunt neck trauma, like whiplash injury, may cause objectively measurable hearing impairment.

Objective To explore whether acute acoustic trauma or noise-induced hearing loss may cause the later development of Ménière's Disease. Study Design Retrospective search of a military medical data bank. Setting Medical records of 17,245 Israel Defense Force veterans who were recognized as being disabled as a result of acoustic trauma or noise-induced hearing loss. Patients Eleven cases of late-onset Ménière's Disease were retrieved from these files. Main Outcome Measures Documented symptoms and audiograms. Results Eleven of the 17,425 veterans appeared to have typical Ménière's Disease. Their symptoms included attacks of vertigo, lasting between half an hour and a few hours and no more than 24 hours; the sensation of aural fullness; and tinnitus accompanied by a fluctuating or permanent low-tone hearing loss. Four of the 11 patients had a documented previous noise-induced hearing loss, and the remaining 7 had experienced acute acoustic trauma. The Ménière's Disease was bilateral in three cases. The average period between the first documented hearing loss and the onset of Ménière's Disease was 15.8 years (standard deviation, ± 6.6 years). This yielded a prevalence of 1.9:100,000 of Ménière's Disease in a population with acoustic trauma or noise-induced hearing loss—a figure comparable to that in the general population. Conclusions No support was found for the hypothesis that Ménière's Disease may be causally related to previous acoustic trauma or noise-induced hearing loss.

Objective To explore whether acute acoustic trauma or noise-induced hearing loss may cause the later development of Ménière's Disease. Study Design Retrospective search of a military medical data bank. Setting Medical records of 17,245 Israel Defense Force veterans who were recognized as being disabled as a result of acoustic trauma or noise-induced hearing loss. Patients Eleven cases of late-onset Ménière's Disease were retrieved from these files. Main Outcome Measures Documented symptoms and audiograms. Results Eleven of the 17,425 veterans appeared to have typical Ménière's Disease. Their symptoms included attacks of vertigo, lasting between half an hour and a few hours and no more than 24 hours; the sensation of aural fullness; and tinnitus accompanied by a fluctuating or permanent low-tone hearing loss. Four of the 11 patients had a documented previous noise-induced hearing loss, and the remaining 7 had experienced acute acoustic trauma. The Ménière's Disease was bilateral in three cases. The average period between the first documented hearing loss and the onset of Ménière's Disease was 15.8 years (standard deviation, ± 6.6 years). This yielded a prevalence of 1.9:100,000 of Ménière's Disease in a population with acoustic trauma or noise-induced hearing loss—a figure comparable to that in the general population. Conclusions No support was found for the hypothesis that Ménière's Disease may be causally related to previous acoustic trauma or noise-induced hearing loss.

Objective: To estimate the temporal endpoint of permanent sensorineural hearing loss after head trauma.Study Design: Retrospective observational case study.Patients: In patients with sensorineural hearing loss caused by head trauma, 1,741 ears were studied.Main Outcome Measure: A follow-up survey of audiograms in patients with sensorineural hearing loss after head trauma was performed for up to 4 years from the date of injury. Each patient's audiograms were compared according to a severity score that specifically classified hearing loss that was associated with acoustic trauma.Results: Either improvement or deterioration of the early post-trauma hearing loss occurred during the first year after head trauma. Thereafter, hearing levels could be expected to remain stationary.Conclusion: Fluctuation in hearing after head trauma may take place within the first year after trauma, after which the associated hearing loss should be considered to be stabilized.

Objective: To determine whether CT (computerized tomography) scan of the paranasal sinuses is essential in the diagnosis and medical/surgical management of nasal obstruction. Design: One hundred thirteen adult patients with nasal obstruction but without signs of sinusitis who underwent CT examination prior to surgery, were included in the study. Results: Fifty seven percent of the CI scans revealed a variety of abnormal findings. Of the patients with an abnormal CT scan, surgical planning had to be altered in 16 patients due to significant abnormalities found on the CT scans. Conclusions: We conclude that CT scan of the nose and paranasal sinuses is an effective presurgical planning tool in patients with nasal obstruction.

The platysma myocutaneous flap is an infrequently used flap in head and neck reconstruction. This flap should be considered for reconstruction of small and medium-sized defects of the oral cavity. We present two cases demonstrating the utility of this local flap in reconstruction. Advantages, contraindications and limitations of the platysma myocutaneous flap are discussed.

Complaints of nasal obstruction following nasal trauma without any deformation have been noticed by rhinologists For many years. However, neither an epidemiologic nor a pathophysiologic connection has ever been established. The complaints and physical examination findings of these patients resemble those of vasomotor rhinitis. Only very few articles suggesting nasal trauma as a possible cause for vasomotor rhinitis have ever been published. We present a retrospective study that found 87 of 802 patients to suffer from vasomotor rhinitis following nasal trauma. No other factors known to cause vasomotor rhinitis were present in these patients. None had any previous nasal problems. We therefore suggest that nasal trauma was the causative factor in their vasomotor rhinitis

Solitary fibrous tumor (SFT) belongs to a group of mesenchymal tumors,(1) first described as a primary spindle cell tumor of the pleura in 1931.(2) Recently SFT has been reported in various locations with no relation to serosal surfaces. Sites such as the lung,(3) liver,(4) thyroid,(5) sublingual gland,(6) and parapharyngeal space(7) have been reported, SFTs of the upper respiratory tract, including the nasal cavity, paranasal sinuses, and nasopharynx, are extremely rare, with only 9 previously reported cases.(8-11) Most of the tumors involved the nasal cavity with or without extension to the nasopharynx or the paranasal sinuses. We report the tenth case of SFT of the nasal cavity with extension to the maxillary and ethmoid sinuses.

Complications of rhinosinusitis are fortunately rare. The progression from the initial stage of cellulitis to orbital abscess, cavernous sinus thrombosis, or meningitis may at times be quite rapid. Prompt treatment with intravenous antibiotics and a high index of suspicion are critical in the management of these cases. Computed tomography (CT) is the standard radiographic examination performed initially and subsequently to diagnose complications. Thickening of the superior ophthalmic vein should be looked for as an important radiologic marker of impending orbital complications, such as cavernous sinus thrombosis. We describe a patient with superior ophthalmic vein thrombosis seen early on CT scan.

A case of pleomorphic adenoma of the maxillary sinus in a 78-year-old man with associated mucocele is reported. The diagnosis and treatment of this rare lesion is discussed.

Inferior turbinectomy has generated a great deal of controversy among rhinologic surgeons. Proponents of partial and total inferior turbinectomy cite numerous studies of large numbers of patients with subjective relief of nasal obstruction after turbinectomy. Clinical studies critical of turbinectomy have focused on complications such as hemorrhage, crusting, adhesions, and atrophic rhinitis. Our study was undertaken to evaluate the incidence of chronic sinusitis post inferior turbinectomy. Postoperative evaluation by history, physical examination, and computerized tomography of the paranasal sinuses revealed that a significant number of patients who underwent inferior turbinectomy developed sinusitis. Patients evaluated in our clinic for nasal obstruction underwent a detailed history, physical examination along with nasal endoscopy and coronal computerized tomography of the paranasal sinuses. Those patients with nasal obstruction not responsive to medical treatment and without evidence of sinusitis underwent submucous resection and inferior turbinectomy. The incidence, cause, and possible prevention of post inferior turbinectomy sinusitis is discussed in this article.

Otolaryngology–Head and Neck SurgeryVolume 117, Issue 4 p. 412-414 International Case Report Liposarcoma of the Scalp: A Case Report and Review of the Literature Alex Kessler MD, Corresponding Author Alex Kessler MD n/[email protected] Department of Otolaryngology, Assaf Harofeh Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Zerifin, IsraelReprint requests: A. Kessler, MD, Department of Otolaryngology, Assaf Harofeh Medical Center, Zerifin 70300, IsraelSearch for more papers by this authorLeonard Berenholz MD, Leonard Berenholz MD Department of Otolaryngology, Assaf Harofeh Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Zerifin, IsraelSearch for more papers by this authorEphraim Eviatar MD, Ephraim Eviatar MD Department of Otolaryngology, Assaf Harofeh Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Zerifin, IsraelSearch for more papers by this authorSamuel Segal MD, Samuel Segal MD Department of Otolaryngology, Assaf Harofeh Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Zerifin, IsraelSearch for more papers by this author Alex Kessler MD, Corresponding Author Alex Kessler MD n/[email protected] Department of Otolaryngology, Assaf Harofeh Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Zerifin, IsraelReprint requests: A. Kessler, MD, Department of Otolaryngology, Assaf Harofeh Medical Center, Zerifin 70300, IsraelSearch for more papers by this authorLeonard Berenholz MD, Leonard Berenholz MD Department of Otolaryngology, Assaf Harofeh Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Zerifin, IsraelSearch for more papers by this authorEphraim Eviatar MD, Ephraim Eviatar MD Department of Otolaryngology, Assaf Harofeh Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Zerifin, IsraelSearch for more papers by this authorSamuel Segal MD, Samuel Segal MD Department of Otolaryngology, Assaf Harofeh Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Zerifin, IsraelSearch for more papers by this author First published: 21 November 2016 https://doi.org/10.1016/S0194-5998(97)70136-0Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCES 1Orson GG, Sim FH, Reiman HM, Taylor WF Liposarcoma of the musculoskeletal system. Cancer 1987; 60: 1362–70. 2McCulloch TM, Makielski KH, McNutt MA Head and neck liposarcoma. Arch Otolaryngol Head Neck Surg 1992; 118: 1045–9. 3Saunders JR, Jaques DA, Casterline PF, Percurpio B, Booloe S. Liposarcomas of the head and neck. Cancer 1979; 43: 162–8. 4Dahl EC, Hammond HL, Sequeira E. Liposarcomas of the head and neck. J Oral Maxillofac Surg 1982; 40: 674–7. 5Stout AP Liposarcoma: The malignant tumor of lipoblasts. Ann Surg 1944; 119: 86–107. 6Srivastava KP, Chaundra H, Sharma RD, Agarwal BM Primary liposarcoma of the skull. Int Surg 1976; 61: 234. 7Slullitel I. Osseous liposarcoma involving cranium. Rev Assoc Med Argent 1949; 63: 368–71. 8Enterline HT, Culberson JD, Rochlin DB, Brady LW Liposarcoma: A clinical and pathological study of 53 cases. Cancer 1960; 3: 932–50. 9Georgiades DE, Alcalais CB, Karabela VG Multicentric well-differentiated liposarcomas: A case report and a brief review of the literature. Cancer 1969; 24: 1091–7. 10Hemmer R, Haensel G, Fredrick H. Development of liposarcoma out of the capsules of a hygroma. Childs Brain 1976; 2: 73–80. 11Sima A, Kindblom LG, Pellettieri L. Liposarcoma of the meninges: A case report. Acta Pathol Microbiol Scand 1976; 84: 306–10. 12Rossouw DJ, Cinti S, Dickersin GR Liposarcoma—an ultra-structural study of 15 cases. Am J Clin Pathol 1986; 85: 649–67. 13Gertner R, Podoshin L, Fradio M, Misselevitch I, Boss J. Liposarcoma of the larynx. J Laryngol Otol 1988; 102: 838–41. Volume117, Issue4October 1997Pages 412-414 ReferencesRelatedInformation