Summary--The Doppler ultrasonic flowmeter is presented as a method to help in flap outlining, transfer and return. When a directional flowmeter is added, this machine is extremely valuable for returning a flap at the earliest possible time. The Doppler is a safe, inexpensive, atraumatic, reliable instrument that can be learned in a very short time. We have found the Doppler to be very helpful in head and neck flaps.

Aged↗

PubMedDate not supplied

Late recurrence of a frontal sinus cholesteatoma.

The longest recorded recurrence of a frontal sinus cholesteatoma with involvement of the orbit, frontal bone, and floor of the anterior cranial fossa is presented. Radical surgery is required and often craniotomy is necessary. Bony reconstruction of defects should not be undertaken until recurrence has not been present for at least a year. A review of the literature and a discussion of the origin of cholesteatomas is given.

Adult↗

PubMedDate not supplied

Recurrent nerve locating system.

One recurring problem for otolaryngologists is the patient with vocal cord paralysis after thyroid surgery. We review the literature to assess the magnitude of this problem and to assess presently available techniques for sparing the recurrent laryngeal nerve. We present a new system for intraoperative recurrent laryngeal nerve location during thyroid surgery.

Adult↗

PubMedDate not supplied

Labyrinthectomy versus middle fossa vestibular nerve section in Menière's disease. A critical evaluation of relief of vertigo.

Labyrinthectomy has been used for years in the surgical management of Menière's disease for the control of vertigo. The effect of this procedure are predictable and satisfying but residual hearing is sacrificed. With the advent of the middle fossa section of the vestibular nerve, it soon became apparent that it was possible to obtain relief from vertigo and at the same time preserve residual hearing. How do the two procedures actually compare as far as relief of vertigo, postsurgical ataxia, and recovery periods? The purpose of this paper is to evaluate the two procedures in regard to these three parameters. A series of middle fossa operations is compared to one in which the patients received a labyrinthectomy. Results and complications in both groups are covered in detail.

Adult↗

PubMedDate not supplied

Medical management of Menière's disease.

The medical management of Menière's disease appears to be a misunderstood and controversial subject. There are those physicians who state that all cases can be controlled by medical means and that surgery is never indicated. Another group of investigators now emphasizes early surgical intervention without a medical trial. These conflicting views have led the authors to review all of their cases of Meniére's disease (almost 1,000) in relation to medical management. The medical regime and its rationale are presented in detail. The results of this therapy are discussed in the context of control of vertigo, relief of tinnitus and pressure, and the stabilization of hearing.

Adult↗

PubMedDate not supplied

Aspiration cytology for diagnosis of head and neck masses.

Most American clinicans have been relectant to utilize aspiration biopsy due to poor interpretive skills by the pathologists in the past and a fear of tumor spread by the needle. Voluminous European series and recent American series have proved aspiration to be safe and reliable. In our series of 78 cases, both thin-needle aspiration and conventional tissue biopsies were made. The diagnoses were compared and the overall agreement rate was 90%.

Biopsy↗

PubMedDate not supplied

Recurrent laryngeal nerve localization using a microlaryngeal electrode.

Damage to the recurrent laryngeal nerve is a frequently seen complication in head and neck surgery. A system for intraoperative monitoring of the recurrent laryngeal nerve is presented. The key to this system lies in the use of a microlaryngeal electrode and inserter. Application of this system to various situations is described.

Electric Stimulation↗

PubMedDate not supplied

ODWIN expansion program: a study in success.

Of 182 students who successfully completed an eight-week program for high school graduates with marginal credentials and who were admitted to schools of nursing, 125 (69 percent) subsequently received degrees or certificates. This success rate compares favorably with national and regional norms. This study documents the marginality of the students' credentials and evaluates their success rates. Of 11 academic variables correlated with successful completion of nursing programs, the two subjective evaluations of each student by the academic personnel teaching the eight-week program were the only variables to reach significance (p = .01).

Education, Nursing, Baccalaureate↗

PubMedDate not supplied

Where, how, and from whom do family practice residents learn? A multisite analysis.

This paper presents the results of a multisite study of 2,481 teacher-learner events reported by family practice residents in four separate training programs. Teacher-learner events were characterized by the location, activity, and teacher involved. Distinct patterns of teacher-learner interaction emerged across each of the three years of training. Hospital based direct patient care under the supervision of a non-family practice specialist was the most frequent type of educational experience in each of the three years. In contrast, family practice faculty influence throughout each of the three years is minimal. Learning in the outpatient setting with another specialist matched, or in some cases, exceeded that with a family physician. This study raises several important issues regarding the type and appropriate nature of educational influences on family practice physicians. Of greatest concern is the adequacy of role modeling and direct teaching by family practice specialists of family practice residents.

Family Practice↗

PubMedDate not supplied

High-frequency hearing loss in male farmers of Missouri.

Farmers are exposed to noise that is potentially hazardous to hearing. We measured the hearing of 161 male farmers and 75 male nonfarmers at the 1979 Missouri Farmers Association Agri-Fair and compared it with the hearing of 129 office workers from central Missouri. Fixed-level screening tests were conducted in both ears at three stimulus frequencies: 1000 and 2000 hertz at 20 decibels hearing level and 4000 hertz at 25 decibels hearing level. Audiometers were calibrated in accordance with the ANSI-1969 standard. The results show that farmers are at risk for hearing loss at 2000 and 4000 hertz when compared with office workers. The prevalence of hearing loss was greater for farmers at both frequencies in every decade age group from 25 to 64 years. Using screening failure at 2000 and 4000 hertz in both ears as a criterion for a loss that would affect communication ability, we found that the failure rate was 16.8 percent for farmers and 6.2 percent for office workers. As other investigators have found, the prevalence of high-frequency hearing loss in male nonfarmers who associate with farmers was nearly as great as for farmers.

Adult↗