87 results on '"Spector GJ"'
Search Results
2. Management of stage IV glottic carcinoma: therapeutic outcomes.
- Author
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Spector GJ, Sessions DG, Lenox J, Newland D, Simpson J, and Haughey BH
- Published
- 2004
3. Analysis of treatment results for base of tongue cancer.
- Author
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Sessions DG, Lenox J, Spector GJ, Chao C, and Chaudry OA
- Published
- 2003
- Full Text
- View/download PDF
4. Management of T3N0M0 glottic carcinoma: therapeutic outcomes.
- Author
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Sessions DG, Lenox J, Spector GJ, Newland D, Simpson J, Haughey BH, and Chao KSC
- Published
- 2002
5. Analysis of treatment results for oral tongue cancer.
- Author
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Sessions DG, Spector GJ, Lenox J, Haughey B, Chao C, and Marks J
- Published
- 2002
6. Analysis of treatment results for floor-of-mouth cancer.
- Author
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Sessions DG, Spector GJ, Lenox J, Parriott S, Haughey B, Chao C, Marks J, and Perez C
- Published
- 2000
7. Fetal Respiratory Distress Causing CNS and Inner Ear Hemorrhage
- Author
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Spector Gj, Strauss M, Davis G, Rauchbach E, and Pettit Wj
- Subjects
Male ,Subarachnoid hemorrhage ,Labyrinth Diseases ,Hemorrhage ,Pregnancy ,otorhinolaryngologic diseases ,medicine ,Humans ,Inner ear ,Vein ,Lung ,Cerebral Hemorrhage ,Respiratory Distress Syndrome, Newborn ,Fetus ,Respiratory distress ,business.industry ,Infant, Newborn ,Infant ,Syndrome ,Subarachnoid Hemorrhage ,medicine.disease ,Bleeding diathesis ,Fetal Diseases ,medicine.anatomical_structure ,Otorhinolaryngology ,In utero ,Ear, Inner ,Anesthesia ,Cochlear aqueduct ,Female ,sense organs ,business - Abstract
Fifty-two consecutive temporal bones of infants who died neonatally, or in utero of natural causes, were studied. Complete autopsies were performed. Twenty-eight infants had a variety of pulmonary disorders which resulted in severe respiratory distress prior to their death. Of these, the majority had bleeding intracranially and into the inner ear. There were five major pathways of central nervous system and subarachnoid hemorrhage involvement of the inner ear: 1) the modiolus, 2) cochlear aqueduct, 3) retrograde via the cochlear vein, 4) episodes of spontaneous bleeding into various compartments of the inner ear, and 4) hemorrhage via the otic capsule. The remaining 24 infants died of other natural causes. Two had CNS bleeding with no extension to the inner ear. We propose that there is a syndrome which consists of 1) neonatal respiratory distress, 2) intracranial hemorrhage, and 3) bleeding into the inner ear--an extension of a subarachnoid or subependymal matrix bleeding diathesis.
- Published
- 1978
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8. LETTER TO THE EDITOR
- Author
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Spector Gj
- Subjects
medicine.medical_specialty ,Botulinum a toxin ,business.industry ,Blepharospasm ,Dermatology ,Facial muscles ,medicine.anatomical_structure ,Otorhinolaryngology ,Spastic ,medicine ,Eyelid Diseases ,medicine.symptom ,Head and neck ,business - Published
- 1986
- Full Text
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9. Carcinoma of paranasal sinuses: long-term outcomes with radiotherapy.
- Author
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Blanco AI, Chao KS, Ozyigit G, Adli M, Thorstad WL, Simpson JR, Spector GJ, Haughey B, and Perez CA
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- Adult, Aged, Aged, 80 and over, Analysis of Variance, Ethmoid Sinus, Female, Follow-Up Studies, Humans, Male, Maxillary Sinus Neoplasms radiotherapy, Middle Aged, Prognosis, Proportional Hazards Models, Radiation Injuries etiology, Adenocarcinoma radiotherapy, Carcinoma, Squamous Cell radiotherapy, Paranasal Sinus Neoplasms radiotherapy
- Abstract
Purpose: To assess the clinical features, prognostic factors, results, and complications of treatment of carcinomas of the paranasal sinus., Methods and Materials: The records of 106 patients (72 men and 34 women) with paranasal sinus carcinoma treated with curative intent at Washington University between January 1960 and August 1998 were analyzed. Patient age ranged from 29 to 91 years (median, 64 years). Most tumors originated in the maxillary (76%) or ethmoid (18%) sinus. Most tumors were locally advanced at presentation. All patients underwent radiotherapy (RT), combined with surgery in 65%; 2% received chemotherapy., Results: Follow-up ranged from 1.7 months to 24 years (median 5 years). The 5-year local tumor control, locoregional tumor control, disease-free survival (DFS), and overall survival rate was 58%, 39%, 33%, and 27%, respectively. A statistically significant improvement in DFS was noted with the addition of surgical resection to RT (35% vs. 29%, p = 0.05). Nodal status at presentation emerged as a statistically significant predictor for locoregional tumor control and DFS in multivariate analysis. Distant metastases occurred in 29% of patients., Conclusion: This review of a large, single-institution experience of paranasal sinus carcinoma patients who underwent RT showed that locoregional tumor progression and recurrence remain predominant patterns of failure despite aggressive local treatment with combined surgery and RT. DFS improved slightly with combined modality treatment. The overall survival rates remained suboptimal, suggesting a need for more accurate determination of tumor extent, as well as more effective locoregional and systemic therapies.
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- 2004
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10. Intensity-modulated radiation therapy for oropharyngeal carcinoma: impact of tumor volume.
- Author
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Chao KS, Ozyigit G, Blanco AI, Thorstad WL, Deasy JO, Haughey BH, Spector GJ, and Sessions DG
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- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Squamous Cell drug therapy, Disease-Free Survival, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Staging, Oropharyngeal Neoplasms drug therapy, Palate, Soft, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted, Statistics as Topic, Tongue Neoplasms pathology, Tongue Neoplasms radiotherapy, Tonsillar Neoplasms pathology, Tonsillar Neoplasms radiotherapy, Treatment Failure, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell radiotherapy, Oropharyngeal Neoplasms pathology, Oropharyngeal Neoplasms radiotherapy, Radiotherapy, Conformal methods
- Abstract
Purpose: To assess the therapeutic outcomes in oropharyngeal cancer patients treated with intensity-modulated radiotherapy (IMRT) and analyze the impact of primary gross tumor volume (GTV) and nodal GTV (nGTV) on survival and locoregional control rates., Methods and Materials: Between February 1997 and September 2001, 74 patients with squamous cell carcinoma of the oropharynx were treated with IMRT. Thirty-one patients received definitive IMRT; 17 also received platinum-based chemotherapy. Forty-three patients received combined surgery and postoperative IMRT. The median follow-up for all patients was 33 months (range, 9-60 months). Fifty-two patients (70.3%) had Stage IV disease, 17 patients (23%) had Stage III, 3 patients (4.1%) had Stage II, and 2 patients (2.7%) had Stage I tumors. The mean prescription dose was 70 and 66 Gy, respectively, for the definitive and postoperative cohorts. The daily fraction dose was either 1.9 or 2 Gy, five times weekly. The GTV and/or nGTV were determined and derived using the Computational Environment for Radiotherapy Research, a free software package developed at Washington University. The mean GTV was 30.5 +/- 22.3 cm(3), and the mean nGTV was 23.2 +/- 20.6 cm(3)., Results: Ten locoregional failures were observed. Six patients died of disease and three died of concurrent disease. Distant metastasis developed in 6 patients. The 4-year estimate of overall survival was 87%, and the 4-year estimate of disease-free survival was 81% (66% in the definitive vs. 92% in the postoperative RT group). The 4-year estimate of locoregional control was 87% (78% in the definitive vs. 95% in the postoperative RT group); the 4-year estimate of distant metastasis-free survival was 90% (84% in the definitive vs. 94% in the postoperative group). Multivariate analysis showed that GTV and nGTV were independent risk factors determining locoregional control and disease-free survival for definitive oropharyngeal IMRT patients. The worst late toxicities documented were as follows: 32 patients with Grade 1 and 9 with Grade 2 xerostomia; 2 with Grade 1 and 1 with Grade 2 skin toxicity; 3 with Grade 1 late mucositis; and 3 with Grade 1 trismus. Seventeen patients required gastrostomy tube placement., Conclusion: IMRT is an effective treatment modality for locally advanced oropharyngeal carcinoma. The GTV and nGTV are the most important factors predictive of therapeutic outcome.
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- 2004
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11. Esthesioneuroblastoma: the impact of treatment modality.
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Chao KS, Kaplan C, Simpson JR, Haughey B, Spector GJ, Sessions DG, and Arquette M
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- Adolescent, Adult, Aged, Antineoplastic Agents therapeutic use, Combined Modality Therapy, Esthesioneuroblastoma, Olfactory pathology, Female, Humans, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging methods, Nose Neoplasms pathology, Retrospective Studies, Treatment Outcome, Esthesioneuroblastoma, Olfactory therapy, Nasal Cavity pathology, Nose Neoplasms therapy
- Abstract
Background: We evaluated the impact of treatment modality on esthesioneuroblastoma., Methods: Between 1976 and 1996, 25 patients with esthesioneuroblastoma were treated at Mallinckrodt Institute of Radiology. There were 11 male and 14 female patients; their ages ranged from 16 to 73 years (median, 57 years). The tumors were Kadish stage A in 3, Stage B in 13, C in 8, and modified D in 1 (cervical nodal metastasis). Seventeen patients were treated with surgery and radiation therapy, six were treated with irradiation alone, and two were treated with surgery only. Eight patients received neoadjuvant chemotherapy. Median follow-up was 8 years (range, 2-24 years)., Results: The 5-year actuarial overall survival, disease-free survival, and local tumor control rates were 66.3%, 56.3%, and 73.0%, respectively. Kadish stage was not a significant prognosticator for local control or disease-free survival. Five-year local control rates were 87.4% for the combination of surgery and radiation therapy and 51.2% for irradiation alone. Two patients with Kadish stage A and B disease underwent surgical resection alone; both failed locally. In contrast, 33.3% of patients (three of nine) with Kadish stage A or B disease who received adjuvant radiation therapy had a local recurrence develop. With adjuvant radiation therapy, the surgical margin status did not influence local tumor control. Among the eight patients who received neoadjuvant chemotherapy, six patients showed no response, one had partial response, and one showed a complete response., Conclusions: Surgical resection plus adjuvant radiation therapy yielded the best treatment outcome. More effective chemotherapy agents with a reproducible effectiveness are needed for patients with locally advanced esthesioneuroblastoma., (Copyright 2001 John Wiley & Sons, Inc.)
- Published
- 2001
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12. Cancer of retromolar trigone: long-term radiation therapy outcome.
- Author
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Huang CJ, Chao KS, Tsai J, Simpson JR, Haughey B, Spector GJ, and Sessions DG
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell surgery, Disease-Free Survival, Female, Humans, Lymphatic Metastasis, Male, Middle Aged, Mouth Neoplasms pathology, Mouth Neoplasms surgery, Neoplasm Metastasis, Neoplasm Recurrence, Local, Neoplasms, Multiple Primary, Radiotherapy, Adjuvant adverse effects, Retrospective Studies, Time Factors, Treatment Outcome, Carcinoma, Squamous Cell radiotherapy, Mouth Neoplasms radiotherapy
- Abstract
Background: Cancer of the retromolar trigone is an uncommon head and neck cancer. In this retrospective study, we identified the prognostic factors and evaluated the therapeutic outcomes of patients treated with preoperative radiation therapy (RT), postoperative RT, and RT alone., Methods: Between 1971 and 1994, 65 patients with histologically proven epidermoid carcinoma of the retromolar trigone were treated at the Mallinckrodt Institute of Radiology; 10 patients received preoperative RT (30-55.2 Gy), 39 received postoperative RT (46-66.6 Gy), and 15 were treated with RT alone (63-74 Gy). Surgery included 44 composite resections and 7 wide excisions. The minimum follow-up was 5 years., Results: The 5-year disease-free survival rates were 90% with preoperative RT, 63% with postoperative RT, and 31% with RT alone. The 5-year disease-free survival rates were 76% for patients with T1 disease, 50% for T2, 72% for T3, and 54% for T4. The 5-year disease-free survival rates were 69% for patients with NO disease, 56% for N1, and 26% for N2. The locoregional recurrence rates were 10% (1 of 10) for preoperative RT, 23% (9 of 39) for postoperative RT, and 44% (7 of 16) for RT alone. On multivariate analysis, the significant factors for disease-free survival were treatment modality (p =.002) and N stage (p =.012); for locoregional control it was treatment modality (p =.046); and for distant metastasis it was N stage (p =.002). The incidence of bone necrosis, soft tissue necrosis, and severe trismus was 12% with postoperative RT, 11% with RT alone, and none with preoperative RT., Conclusions: Combination surgery with postoperative or preoperative RT offers better locoregional control and disease-free survival than RT alone for epidermoid carcinoma of the retromolar trigone. Lymph node status significantly influences the disease-free survival and distant metastasis rates., (Copyright 2001 John Wiley & Sons, Inc.)
- Published
- 2001
- Full Text
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13. Distant metastases from laryngeal and hypopharyngeal cancer.
- Author
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Spector GJ
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell epidemiology, Carcinoma, Squamous Cell therapy, Female, Humans, Hypopharyngeal Neoplasms therapy, Laryngeal Neoplasms therapy, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Retrospective Studies, Carcinoma, Squamous Cell secondary, Hypopharyngeal Neoplasms pathology, Laryngeal Neoplasms pathology
- Abstract
A retrospective tumor registry analysis of patients with squamous cell carcinoma (SCC) of the larynx and hypopharynx who were treated with curative intent in the Department of Otolaryngology--Head and Neck Surgery at Washington University School of Medicine and Barnes Hospital between January 1971 and December 1991. In 2,550 patients, the mean age, sex and tumor differentiation did not affect the incidence of distant metastases. The overall incidence of distant metastases was 8.5% (217/2,550 patients) with the following distribution: glottis 4.4%, supraglottis 3.6%, subglottis 14%, aryepiglottic fold 16%, pyriform sinus 17% and posterior hypopharynx 17.6%. The overall 5-year disease-specific survival for distant metastases was 6.4%. Distant metastases were related to advanced local disease (T3 + T4), lymph node metastases at presentation (N+), tumor location (hypopharynx) and locoregional tumor recurrence (p < or = 0.028). A meta-analysis of variables which predispose to a higher incidence of distant metastases indicate that tumor location (hypopharynx > larynx), advanced primary disease (T3 + T4), regional disease (N+), locoregional recurrences, and advanced regional metastases (N2 + N3) are statistically significant., (Copyright 2001 S. Karger AG, Basel)
- Published
- 2001
- Full Text
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14. Carcinoma of the tonsillar fossa: prognostic factors and long-term therapy outcome.
- Author
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Perez CA, Patel MM, Chao KS, Simpson JR, Sessions D, Spector GJ, Haughey B, and Lockett MA
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- Analysis of Variance, Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell surgery, Combined Modality Therapy, Disease-Free Survival, Humans, Lymph Node Excision, Neoplasm Staging, Survival Rate, Tonsillar Neoplasms mortality, Tonsillar Neoplasms pathology, Tonsillar Neoplasms surgery, Tonsillectomy, Treatment Outcome, Carcinoma, Squamous Cell radiotherapy, Tonsillar Neoplasms radiotherapy
- Abstract
Purpose: To identify prognostic parameters and evaluate the therapeutic outcomes for patients with carcinoma of the tonsillar fossa treated with three treatment modalities., Methods and Materials: The results of therapy are reported in 384 patients with histologically proven epidermoid carcinoma of the tonsillar fossa; 154 were treated with irradiation alone (55-70 Gy), 144 with preoperative radiation therapy (20-40 Gy), and 86 with postoperative irradiation (50-60 Gy). The operation in all but four patients in the last two groups consisted of an en bloc radical tonsillectomy with ipsilateral lymph node dissection., Results: Treatment modality and total irradiation doses had no impact on survival. Actuarial 10-year disease-free survival rates were 65% for patients with T1 tumors, 60% for T2, 60% for T3, and 30% for T4 disease. Patients with no cervical lymphadenopathy or with a small metastatic lymph node (N1) had better disease-free survival (60% and 70%, respectively) at 5 years than those with large or fixed lymph nodes (30%). Primary tumor recurrence (local, marginal) rates in the T1, T2, and T3 groups were 20-25% in patients treated with irradiation and surgery and 31% for those treated with irradiation alone (difference not statistically significant). In patients with T4 disease treated with surgery and postoperative irradiation, the local failure rate was 32% compared with 86% with low-dose preoperative irradiation and 47% with irradiation alone (p = 0.03). The overall recurrence rates in the neck were 10% for N0 patients, 25% for N1 and N2, and 35-40% for patients with N3 cervical lymph nodes, without significant differences among the various treatment groups. The incidence of contralateral neck recurrences was 8% with the various treatment modalities. On multivariate analysis the only significant factors for local tumor control and disease-free survival were T and N stage (p = 0.04-0.001). Fatal complications were noted in 7 of 144 (5%) patients treated with preoperative irradiation and surgery, 2 of 86 (2%) of those receiving postoperative irradiation, and 2 of 154 (1.3%) patients treated with radiation therapy alone. Other moderate or severe nonfatal sequelae were noted in 30% of the patients treated with preoperative irradiation and surgery, in 53% treated with postoperative irradiation, and in 19% receiving radiation therapy alone., Conclusion: Primary tumor and neck node stage are the only significant prognostic factors influencing locoregional tumor control and disease-free survival. Treatment modality had no significant impact on outcome. Radiation therapy remains the treatment of choice for patients with stage T1-T2 carcinoma of the tonsillar fossa. In patients with T3-T4 tumors and good general condition, combination surgery and postoperative irradiation offers better tumor control than single-modality and preoperative irradiation procedures, but with greater morbidity.
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- 1998
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15. Giant intradiploic epidermoid cyst of greater sphenoid wing causing unilateral proptosis and optic nerve compression.
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Sargent EW, Garcia P, Paniello RC, and Spector GJ
- Abstract
Epidermoids are cystic tumors that arise from aberrant epidermal cells. Intradiploic epidermoids are relatively rare tumors that occur in all bones of the calvarium, temporal and sphenoid bones, paranasal sinuses, and maxilla. We report the case of an intradiploic epidermoid of the sphenoid wing causing severe proptosis and visual loss. Theories of embryogenesis and pathophysiology are discussed.
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- 1993
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16. Patulous eustachian tube syndrome. Preliminary report of the use of the tensor veli palatini transposition procedure.
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Stroud MH, Spector GJ, and Maisel RH
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- Adult, Aged, Anesthesia, Local, Body Weight, Boric Acids therapeutic use, Ear Diseases complications, Ear Diseases etiology, Ear Diseases therapy, Eustachian Tube anatomy & histology, Female, Hearing Disorders etiology, Humans, Middle Aged, Palate surgery, Posture, Pressure, Salicylates therapeutic use, Sphenoid Bone surgery, Therapeutic Irrigation, Tinnitus etiology, Ear Diseases surgery, Eustachian Tube surgery, Tendons surgery
- Published
- 1974
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17. Sialodochotomy and sialolithectomy for acute calculous submaxillary sialadenitis.
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Sobol S and Spector GJ
- Subjects
- Humans, Methods, Salivary Duct Calculi surgery, Submandibular Gland surgery
- Published
- 1979
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18. Liposarcoma of the larynx: a multicentric or a metastatic malignancy.
- Author
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Krausen AS, Gall AM, Garza R, Spector GJ, and Ansel DG
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- Aged, Child, Humans, Larynx pathology, Larynx ultrastructure, Leg, Male, Middle Aged, Neoplasm Metastasis, Laryngeal Neoplasms pathology, Liposarcoma pathology, Neoplasms, Multiple Primary
- Abstract
The third case of liposarcoma of the larynx, this one arising from the preepiglottic space, is presented. The report is unique in so far as the patient previously had been treated for a liposarcoma in another anatomic region. The diagnosis in this case was in doubt until electron microscopic studies were done. Since the histopathology of the laryngeal and the previous liposarcoma were different, the question of metastasis versus multicentricity was raised. Other discussions of liposarcomas over the past three decades have not resolved this aspect of their behavior completely. In this instance, after considering avenues of metastatic spread in conjuction with the histopathology, it would appear that the laryngeal lesion was a second primary and not a metastasis.
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- 1977
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19. Cytomegalovirus endolabyrinthitis.
- Author
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Davis GL, Spector GJ, Strauss M, and Middlekamp JN
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- Cytomegalovirus isolation & purification, Cytomegalovirus Infections complications, Ear, Inner microbiology, Ear, Inner ultrastructure, Humans, Hyaline Membrane Disease complications, Infant, Newborn, Infant, Premature, Labyrinthitis congenital, Labyrinthitis microbiology, Labyrinthitis pathology, Male, Temporal Bone pathology, Cytomegalovirus Infections congenital, Ear, Inner pathology, Endolymph microbiology, Labyrinth Diseases etiology, Labyrinthine Fluids microbiology, Labyrinthitis etiology
- Abstract
A premature male infant, who died 22 days after birth with hyaline membrane disease, was found to have had cytomegalic inclusion disease at autopsy. Histopathologic examination of the temporal bones showed cytomegalovirus (CMV) infection of the entire endolabyrinth without involvement of the neural and sensory structures. These findings support the thesis that late gestational or perinatal fetal CMV infection results in an endolymphatic labyrinthitis. We hypothesize that blood-borne virus passes from the stria vascularis into the endolymphatic spaces and infects the nonneurosensory epithelium. This pattern of infection differs from the perilabyrinthitis of human varicellazoster and experimentally produced mouse CMV.
- Published
- 1977
20. The effect of aerobic metabolism dissociation on the innervation of the guinea pig cochlea.
- Author
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Spector GJ and Carr CD
- Subjects
- Aconitate Hydratase metabolism, Aerobiosis, Animals, Chick Embryo, Citrates pharmacology, Citric Acid Cycle, Cochlea enzymology, Cochlea metabolism, Cochlea ultrastructure, Cochlear Nerve pathology, Electron Transport Complex IV metabolism, Guinea Pigs, Mitochondrial Swelling, Models, Biological, Neurons, Afferent ultrastructure, Neurons, Efferent ultrastructure, Quinone Reductases metabolism, Rats, Succinate Dehydrogenase metabolism, Cochlea innervation
- Published
- 1977
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21. Otologic clinical experience.
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Spector GJ
- Subjects
- Adult, Certification standards, Child, Fellowships and Scholarships, Humans, Otolaryngology standards, Otolaryngology trends, United States, Head surgery, Internship and Residency methods, Neck surgery, Otolaryngology education, Specialization trends
- Published
- 1983
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22. Laryngeal epidermoid carcinoma associated with juvenile laryngeal papillomatosis.
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Matsuba HM, Thawley SE, Spector GJ, Mauney M, and Pikul FJ
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- Humans, Laryngoscopy, Larynx pathology, Male, Middle Aged, Papilloma pathology, Smoking, Time Factors, Tracheotomy, Carcinoma, Squamous Cell complications, Carcinoma, Squamous Cell pathology, Laryngeal Neoplasms complications, Laryngeal Neoplasms pathology, Papilloma complications
- Abstract
The speculation whether juvenile laryngeal papillomatosis may transform into or be associated with epidermoid carcinoma is explored. We document a case of invasive laryngeal carcinoma arising in preexisting juvenile laryngeal papillomatosis. After multiple childhood laryngoscopies and a tracheotomy, a 54-year-old, 30-pack per year smoker, who had never received radiation therapy, developed a florid exophytic transglottic squamous cell carcinoma. Histologically, the invasive epidermoid carcinoma was surrounded by a field of papillomata with varying degrees of atypical changes. After total laryngectomy, isolated papillomata were found in the lower trachea. There were no cervical lymph node metastases. No postoperative radiation therapy was given. Persistent squamous papillomata in the tracheostomy site, the lower trachea, and the posterior pharynx were treated with the CO2 laser. We emphasize the need to maintain a high index of suspicion for malignancy. In addition, we review the problem of benign papillomata in the aerodigestive tract following laryngectomy.
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- 1985
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23. Malignant Glomus vagale: report of a case and review of the literature.
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Druck NS, Spector GJ, Ciralsky RH, and Ogura JH
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- Aged, Diagnostic Errors, Female, Humans, Lymph Nodes pathology, Lymphatic Metastasis, Pharyngeal Neoplasms pathology, Glomus Jugulare Tumor pathology, Paraganglioma, Extra-Adrenal pathology, Vagus Nerve pathology
- Abstract
Tumors of the chemoreceptor system are quite rare, and are usually considered to be benign, but locally invasive. We report a case of a glomus juxtavagale tumor with metastasis to cervical lymph nodes, lung, and bone. Review of the literature shows that 19% of similar cases reported also showed distant metastases, a rate significantly higher than for other chemodectomas. Clinically and histologically, benign and malignant tumors are identical, so only the demonstration of distant metastasis indicates malignant neoplasm. Primary treatment is surgical, but radiotherapy is useful for palliation.
- Published
- 1976
24. Auditory function in children with diabetes mellitus.
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Sieger A, White NH, Skinner MW, and Spector GJ
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- Adolescent, Adult, Audiometry, Audiometry, Evoked Response, Audiometry, Pure-Tone, Child, Diabetes Mellitus, Type 1 drug therapy, Diabetes Mellitus, Type 1 physiopathology, Diabetic Neuropathies complications, Diabetic Retinopathy complications, Hearing Disorders etiology, Humans, Insulin therapeutic use, Auditory Perception physiology, Diabetes Mellitus, Type 1 complications, Hearing
- Abstract
Fifty-one insulin-dependent diabetics and 13 nondiabetics between the ages of 8 and 21 years, without a history of exposure to noise, ototoxic drugs or ear disease, were evaluated to examine the relation between auditory function and diabetes, diabetic control and diabetic complications. Audiologic assessment included pure-tone audiometry, speech audiometry, impedance measures and brainstem evoked response audiometry. No statistically significant differences in auditory function were noted between insulin-dependent diabetics and normal controls, between the diabetics in good or poor control or between diabetics with or without neurologic or vascular complications.
- Published
- 1983
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25. External auditory canal stricture secondary to epidermolysis bullosa.
- Author
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Thawley SE, Black MJ, Dudek SE, and Spector GJ
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- Adult, Constriction, Pathologic etiology, Constriction, Pathologic surgery, Ear Diseases etiology, Ear Diseases surgery, Epidermolysis Bullosa pathology, Female, Humans, Ear Canal surgery, Epidermolysis Bullosa complications, Otitis etiology
- Abstract
A 24-year-old woman had epidermolysis bullosa simplex involving the external ear canal with resultant stricture that led to conductive hearing loss and repeated episodes of external otitis. Treatment consisted of scar excision, bony canal enlargement, and split-thickness skin grafting. A four-year follow-up has demonstrated no recurrence of disease. Mechanobullous diseases are characterized by blistering of the skin and mucous membrane following frictional trauma. In addition, the external ear may be deformed. Intraoral scarring may result in limitation of the mouth's opening. Dysphagia may occur secondarily to esophageal scarring. Endotracheal tubation may result in postoperative blisters necessitating tracheostomy. Even surgical scrubbing and use of skin tape may lead to blister formation. The otolaryngologist should be aware of the numerous problems these patients present.
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- 1977
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26. Later stages of development of the periotic duct and its adjacent area in the human fetus.
- Author
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Spector GJ, Lee D, Carr C, Davis G, Schnettgoecke V, Strauss M, and Rauchbach E
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- Cochlea blood supply, Cochlear Aqueduct embryology, Cochlear Duct embryology, Gestational Age, Humans, Petrous Bone embryology, Veins embryology, Ear, Inner embryology, Temporal Bone embryology
- Abstract
The later stages of development (16-40 weeks in utero) of the periotic duct and its adjacent areas in the human fetus indicate that the critical stages of development occur in four specific time related stages over a six-week period (20-26 weeks). First, the petrous apex ossifies to separate th inferior cochlear vein into the canal of Cotugno and forms the medial wall of the cochlear aqueduct (22 weeks); second, the canalicular otic capsule fuses with the cochlear otic capsule to obliterate Hyrtl fissure and forms of the lateral wall of the cochlear aqueduct (24 weeks); third, progressive bone deposition to the medial surface of the membranous labyrinth and cochlea at the petrous apex elongates the periotic duct and cochlear aqueduct (32 weeks in utero); and fourth, active arachnoid tissue ingrowth into the periotic duct occurs at 20-24 weeks and 34-40 weeks in utero. The terminal event is widening of the CNS opening of the periotic duct at 32 weeks in utero. The periotic duct and cochlear aqueduct length increase with gestation from 25 weeks until term. The periotic duct width remains the same throughout the gestation. The cochlear aqueduct width diminishes with gestational age. The periotic duct remains patent throughout 16-40 weeks in utero.
- Published
- 1980
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27. The salt loading provocative glycerol test for the early diagnosis of auditory endolymphatic hydrops (Ménière's disease) (a preliminary report).
- Author
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Arenberg IK, Stroud MH, Spector GJ, and Carver WF
- Subjects
- Audiometry, Edema diagnosis, Endolymph, Humans, Labyrinth Diseases diagnosis, Sodium Chloride, Glycerol, Meniere Disease diagnosis
- Published
- 1974
28. Neurologic manifestations of glomus tumors in the head and neck.
- Author
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Spector GJ, Druck NS, and Gado M
- Subjects
- Abducens Nerve, Adult, Brain Neoplasms diagnostic imaging, Brain Neoplasms etiology, Ear Diseases etiology, Facial Paralysis etiology, Female, Glomus Jugulare Tumor etiology, Glossopharyngeal Nerve, Horner Syndrome etiology, Humans, Hypoglossal Nerve, Labyrinth Diseases etiology, Male, Middle Aged, Neoplasm Metastasis, Radiography, Trigeminal Nerve, Glomus Tumor complications, Head and Neck Neoplasms complications, Neurologic Manifestations
- Abstract
In 75 patients with glomus tumors in the head and neck region, 57 tumors arose from the jugular bulb region, 11 from the middle ear, and seven from the vagus nerve. Thirty-seven percent (28 patients) had cranial nerve paralysis, and 14.6% (11) had intracranial tumor extension. The jugular foramen syndrome was associated with a 50% (two of four patients) incidence, and hypoglossal nerve paralysis with a 75% (three of four) incidence of posterior fossa tumor invasion. Horner syndrome and labyrinthine destruction had a 50% (two of four) incidence of a middle cranial fossa tumor invasion. The incidence of central nervous system (CNS) invasion with cranial nerve paralysis (excluding the seventh nerve) was 52% (11 of 21). Otologic findings and seventh nerve paralysis did not correlate with CNS tumor extension.
- Published
- 1976
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29. Developmental temporal bone anatomy and its clinical significance: variations on themes by H. F. Schuknecht.
- Author
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Spector GJ
- Subjects
- Adult, Cytomegalovirus Infections pathology, Ear Ossicles embryology, Ear, Middle blood supply, Ear, Middle embryology, Glomus Jugulare Tumor pathology, Humans, Infant, Newborn, Labyrinthitis etiology, Labyrinthitis pathology, Male, Maxillofacial Development, Meningitis, Haemophilus pathology, Skull Fractures pathology, Temporal Bone embryology, Temporal Bone growth & development, Temporal Bone injuries, Tympanic Membrane embryology, Ear, Middle anatomy & histology, Temporal Bone anatomy & histology
- Abstract
Fifty-eight fetal and neonatal temporal bones were studied to evaluate the mechanisms of development of the hiatus of the facial canal, hypotympanic fissures, periotic duct, tympanomeningeal fissures, and fetal inner ear vascularity. These were correlated with the clinical pathologic entities of temporal bone trauma, glomus jugulare tumor extension within the temporal bone, CNS-temporal septic conduits, and inner ear vascularity. Temporal bone developmental anatomy and histopathology provide rich sources of information on which to base the scientific and clinical study of otology.
- Published
- 1984
- Full Text
- View/download PDF
30. The ultrastructural cytochemistry of peroxisomes in the guinea pig cochlea: a metabolic hypothesis for the stria vascularis.
- Author
-
Spector GJ and Carr C
- Subjects
- Animals, Cochlea ultrastructure, Guinea Pigs, Histocytochemistry, Histological Techniques, Hydroxy Acids metabolism, Microbodies ultrastructure, Oxidative Phosphorylation, Staining and Labeling, Stria Vascularis ultrastructure, Alcohol Oxidoreductases metabolism, Catalase metabolism, Cochlea enzymology, Microbodies enzymology, Organoids enzymology, Stria Vascularis enzymology
- Abstract
The roles of catalase and alpha-hydroxyacid oxidase activities are studied in the peroxisomes of the guinea pig inner ear. The major activities are located primarily in the intermediate cells of the stria vascularis. The peroxisomes of the stria vascularis behave cytochemically in a similar fashion to those found in the proximal convoluted tubules of the kidney. This study indicates that the stria vascularis may behave as a compartmentalized metabolic system.
- Published
- 1979
- Full Text
- View/download PDF
31. Aerobic metabolism of the inner ear: results of a critical evaluation.
- Author
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Spector GJ and Lucente FE
- Subjects
- Animals, Arterial Occlusive Diseases physiopathology, Autoradiography, Carbohydrate Metabolism, Cochlea blood supply, Cochlea cytology, Cochlea enzymology, Cochlea metabolism, Cochlea physiopathology, Electrophysiology, Endolymph analysis, Energy Metabolism, Hypoxia physiopathology, Oxidation-Reduction, Potassium analysis, Sodium analysis, Aerobiosis, Ear, Inner metabolism, Metabolism
- Published
- 1974
- Full Text
- View/download PDF
32. A comparison of therapeutic modalities of glomus tumors in the temporal bone.
- Author
-
Spector GJ, Fierstein J, and Ogura JH
- Subjects
- Adult, Aged, Female, Follow-Up Studies, Glomus Jugulare Tumor radiotherapy, Glomus Jugulare Tumor surgery, Humans, Male, Middle Aged, Missouri, Paraganglioma, Extra-Adrenal radiotherapy, Patient Care Planning, Prognosis, Skull Neoplasms radiotherapy, Paraganglioma, Extra-Adrenal surgery, Skull Neoplasms surgery, Temporal Bone surgery
- Abstract
Seventy-seven patients with glomus tumors involving the temporal bone were treated by surgery, irradiation, and combined therapy. The therapeutic success rate for the surgery group was 91 percent for glomus tympanicum and 78 percent for glomus jugulare tumors. The success rate for radiation therapy was 30% in glomus jugulare tumors. Patients with extensive lesions treated by combined therapy had a therapeutic success rate of 60 percent. The clinical response of glomus jugulare tumors to radiation therapy was 65 percent. Surgery appears to be the best method for eradication of the tumors; however, with large extensive lesions, combined therapy offers a better prognosis than either modality alone.
- Published
- 1976
- Full Text
- View/download PDF
33. Roles and limitations of conservation surgical therapy for laryngeal cancer.
- Author
-
Ogura JH, Sessions DG, Spector GJ, and Alonso WA
- Subjects
- Glottis surgery, Humans, Laryngeal Cartilages surgery, Tongue Neoplasms surgery, Vocal Cords surgery, Carcinoma, Squamous Cell surgery, Laryngeal Neoplasms surgery, Laryngectomy methods
- Abstract
This paper deals with the limitations of conservation surgical therapy for cancer in various sites. The detailed techniques are not included in this paper, but rather its pathophysiological approach to partial surgery. The technique has been reported many times previously.
- Published
- 1975
34. Pre and post-glycerol special audiometric tests battery results in endolymphatic hydrops.
- Author
-
Swanson SN, Arenberg IK, Carver WF, Spector GJ, and Stroud MH
- Subjects
- Acoustic Stimulation, Administration, Oral, Adult, Aged, Auditory Perception drug effects, Auditory Threshold drug effects, Discrimination, Psychological, Female, Humans, Male, Meniere Disease diagnosis, Middle Aged, Recruitment, Neurophysiological drug effects, Speech, Audiometry methods, Edema diagnosis, Glycerol pharmacology, Labyrinth Diseases diagnosis
- Abstract
The glycerol test for endolymphatic hydrops was administered to 17 patients exhibiting classical symptoms of Meniere's disease. A complete battery of audiometric tests including the SISI, TTD (Rosenberg variation). ABLB, Sweep Frequency Bekesy, two tests of speech discrimination (Rush Hughes and Northwestern), and air and bone conduction thresholds were administered pre and post-glycerol ingestion in order to determine the effect of osmotic diuresis. Improvement in pure-tone sensitivity and speech discrimination scores were most often observed. Among the special audiometric tests only the SISI scores exhibited changes, however, these could be related to the threshold changes. There were no significant differences observed in the threshold tone decay tests nor in the ABLB. The sweep frequency Bekesy test revealed only the changes which were observed in pure-tone sensitivity.
- Published
- 1976
- Full Text
- View/download PDF
35. Histopathologic and experimental models for sensory and neural deafness.
- Author
-
Spector GJ
- Subjects
- Abnormalities, Multiple, Animals, Citrates, Cochlea abnormalities, Cochlea pathology, Cochlear Nerve pathology, Ear, Inner pathology, Female, Guinea Pigs, Humans, Infant, Newborn, Labyrinth Diseases chemically induced, Male, Organ of Corti pathology, Pregnancy, Subarachnoid Hemorrhage complications, Subarachnoid Hemorrhage pathology, Virus Diseases complications, Virus Diseases pathology, Deafness etiology, Disease Models, Animal, Labyrinth Diseases complications
- Abstract
Six selected cases with neonatal and fetal cochlear pathology are presented. Those denoting cochlear sepsis are: H. influenza purulent labyrinthitis, cytomegalovirus endolabyrinthitis, and aseptic meningitis and labyrinthitis. Those denoting cochlear neural aplasia are Goldenhar's syndrome, left-sided cardiac hypoplasia with partial basal turn neural aplasia, and cerebral cortical and ventricular hemorrhage with modiolar extension. These findings are compared to the fluorocitrate ototoxicity model for neural deafness in the guinea pig. This study suggests hypotheses for viral trophism in the inner ear and neural degeneration of the cochlea as mechanisms for sensorineural deafness.
- Published
- 1976
- Full Text
- View/download PDF
36. The electron transport system in the cochlear hair cell: the ultrastructural cytochemistry of respiratory enzymes in hair cell mitochondria of the guinea pig.
- Author
-
Spector GJ and Carr C
- Subjects
- Animals, Cochlea enzymology, Dihydrolipoamide Dehydrogenase analysis, Electron Transport, Electron Transport Complex IV analysis, Guinea Pigs, L-Lactate Dehydrogenase analysis, Microscopy, Electron, Oxidative Phosphorylation, Succinate Dehydrogenase analysis, Cochlea ultrastructure, Mitochondria enzymology
- Published
- 1974
- Full Text
- View/download PDF
37. Fascial pulley: cross-commissure lip reanimation for inferior division facial nerve paralysis.
- Author
-
Spector GJ, Matsuba HM, Killeen TE, and Griner NR
- Subjects
- Facial Muscles surgery, Humans, Surgery, Plastic methods, Suture Techniques, Time Factors, Facial Paralysis surgery, Fascia transplantation, Fascia Lata transplantation, Lip surgery
- Abstract
The risks of causing further harm to the facial nerve are greater in surgery for partial facial paralysis. We present a new active and passive reconstruction technique for paralysis of the buccal-mandibular divisions of the facial nerve. Our fascial pulley technique of reanimation and suspension of the oral commissure produces no further injury to the facial nerve and the eyelids. In addition, it adds a better technique to the armamentarium of the reconstructive surgeon dealing with partial lower facial nerve paralyses.
- Published
- 1986
- Full Text
- View/download PDF
38. Clinical application of Botulinum A toxin to spastic disorders of the eye and the head and neck region.
- Author
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Spector GJ
- Subjects
- Botulinum Toxins administration & dosage, Botulinum Toxins therapeutic use, Humans, Blepharospasm therapy, Eyelid Diseases therapy, Facial Muscles, Spasm therapy
- Published
- 1986
- Full Text
- View/download PDF
39. Conservation surgery for epidermoid carcinoma of the supraglottic larynx.
- Author
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Ogura JH, Sessions DG, and Spector GJ
- Subjects
- Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Follow-Up Studies, Humans, Laryngeal Neoplasms mortality, Laryngeal Neoplasms pathology, Laryngectomy, Larynx pathology, Methods, Neck Dissection, Neoplasm Recurrence, Local, Carcinoma, Squamous Cell surgery, Laryngeal Neoplasms surgery
- Published
- 1975
- Full Text
- View/download PDF
40. IV. Multiple glomus tumors in the head and neck.
- Author
-
Spector GJ, Ciralsky R, Maisel RH, and Ogura JH
- Subjects
- Adult, Aged, Carotid Body Tumor diagnostic imaging, Carotid Body Tumor epidemiology, Carotid Body Tumor surgery, Female, Follow-Up Studies, Glomus Jugulare Tumor diagnostic imaging, Glomus Jugulare Tumor epidemiology, Glomus Jugulare Tumor surgery, Humans, Male, Middle Aged, Missouri, Radiography, Neoplasms, Multiple Primary diagnostic imaging, Neoplasms, Multiple Primary epidemiology, Neoplasms, Multiple Primary surgery, Paraganglioma, Extra-Adrenal diagnostic imaging, Paraganglioma, Extra-Adrenal epidemiology, Paraganglioma, Extra-Adrenal surgery
- Abstract
Eight of 76 glomus tumors in the head and neck region are multiple. The most common association is with carotid body tumors; the most common pattern is an ipsilateral glomus tympanicum and carotid body tumor. The approach to clinical evaluation is based on a complete otolaryngologic, neurologic, and neuroradiologic evaluation of all patients with glomus tumors. The rationale for priorities in management is the resection of the most dangerous lesions first. This study confirms the previous observations that glomus tumors have a definite proclivity for multicentricity (10 percent) and a high incidence for other associated malignancies (8 percent).
- Published
- 1975
- Full Text
- View/download PDF
41. Surgical obliteration and silastic arthroplasty of the canine cricoarytenoid joint.
- Author
-
Miller DW and Spector GJ
- Subjects
- Animals, Ankylosis etiology, Dogs, Laryngeal Cartilages pathology, Larynx pathology, Silicone Elastomers, Laryngeal Cartilages surgery, Larynx surgery, Prostheses and Implants
- Abstract
The effects of surgical trauma on the cricoarytenoid joint were analyzed using canine models. The cricoarytenoid joints of seven dogs were surgically disrupted. In four of the dogs an arthroplasty with silastic implantation was simultaneously performed. The histologic findings and the unsuccessful functional results are presented and discussed.
- Published
- 1977
- Full Text
- View/download PDF
42. Neurologic implications of glomus tumors in the head and neck.
- Author
-
Spector GJ, Gado M, Ciralsky R, Ogura JH, and Maisel RH
- Subjects
- Ear Neoplasms diagnosis, Ear Neoplasms diagnostic imaging, Facial Paralysis diagnosis, Head and Neck Neoplasms diagnostic imaging, Horner Syndrome diagnosis, Humans, Papilledema diagnosis, Paraganglioma, Extra-Adrenal diagnostic imaging, Peripheral Nervous System Diseases diagnosis, Radiography, Trigeminal Neuralgia diagnosis, Vagus Nerve, Vocal Cord Paralysis diagnosis, Head and Neck Neoplasms diagnosis, Neurologic Manifestations, Paraganglioma, Extra-Adrenal diagnosis
- Abstract
Seventy-six patients with glomus tumors were evaluated. The incidenc- of cranial nerve paralysis in 37 percent and the incidence of intracranial extension is 14.6 percent. Jugular foramen syndrome is associated with 50 percent, and hypoglossal nerve involvement with 75 percent incidence of posterior fossa extension. Horner's syndrome is associated with 50 percent of middle cranial fossa invasion. The incidence of CNS tumor involvement with cranial nerve paralysis (not including VIIth nerve) is 52 percent.
- Published
- 1975
- Full Text
- View/download PDF
43. Malignant fibrous histiocytoma of the maxilla. A report of an unusual lesion.
- Author
-
Spector GJ and Ogura JH
- Subjects
- Diagnosis, Differential, Fibrosarcoma pathology, Follow-Up Studies, Humans, Male, Maxilla pathology, Maxillary Sinus pathology, Middle Aged, Histiocytoma, Benign Fibrous pathology, Maxillary Neoplasms pathology
- Published
- 1974
- Full Text
- View/download PDF
44. Leucine and alanine aminopeptidase activities in experimentally induced intradermal granulomas and late stages of wound healing in the rat.
- Author
-
Spector GJ
- Subjects
- Alanine, Animals, Carrageenan, Fibroblasts enzymology, Granuloma blood, Granuloma pathology, Leucyl Aminopeptidase blood, Macrophages enzymology, Male, Monocytes enzymology, Rats, Skin enzymology, Wounds and Injuries blood, Wounds and Injuries pathology, Aminopeptidases metabolism, Granuloma enzymology, Isoenzymes metabolism, Leucyl Aminopeptidase metabolism, Skin Diseases enzymology, Wound Healing, Wounds and Injuries enzymology
- Abstract
The role of leucine and alanine aminopeptidases is studied in two discrete biologic systems: experimental late stages of wound healing and carrageenan-induced intradermal granulomas in the rat. In the wound healing rats, the proliferating granulation tissue and serum have high quantities of aminopeptidase activity which correlate positively with the degree of fibroblastic activity. Starch gel electrophoresis demonstrates that in fibroblasts there are at least three groups of aminopeptidases: two isoenzymes are secreted or released into the blood serum and the third is membrane bound in the cytoplasm. The carrageenan intradermal granuloma is an inflammatory reaction rich in mononuclear phagocyte cells and macrophages. Elevated tissue levels of aminopeptidases are directly related to the degree of cellularity of the granuloma. Serum aminopeptidase levels remain normal. Starch gel electrophoretic studies of the granuloma demonstrate that the tissue-bound isoenzyme is the main component. This study indicates that fibroblasts and macrophages produce different quantities of aminopeptidase isoenzymes. In the former they are released or secreted into the serum and in the latter they are membrane bound.
- Published
- 1977
45. Glomus jugulare and vagale.
- Author
-
Ogura JH, Spector GJ, and Gado M
- Subjects
- Adolescent, Adult, Aged, Ear Neoplasms diagnosis, Ear Neoplasms surgery, Female, Glomus Jugulare Tumor diagnosis, Glomus Jugulare Tumor surgery, Glomus Tumor diagnosis, Glomus Tumor surgery, Humans, Male, Methods, Middle Aged, Postoperative Complications, Ear Neoplasms therapy, Glomus Jugulare Tumor therapy, Glomus Tumor therapy, Paraganglioma, Extra-Adrenal therapy, Vagus Nerve surgery
- Abstract
The therapeutic results in 72 patients with glomus jugulare and nine with glomus vagale have indicated a surgical cure rate of 80% in the former and 100% in the latter. Radiotherapy demonstrated a 65% tumor response rate and a 25% cure rate histologically and clinically. Embolization with Gelfoam beads in seven patients resulted in diminished tumor size and arterial circulation from the external carotid system. However, in all cases the tumor persisted. Embolization diminished intraoperative bleeding. Nevertheless, the use of embolization as a palliative modality demonstrated significant symptomatic relief in aged, debilitated patients and in all patients with large inoperable glomus jugulare tumors.
- Published
- 1978
- Full Text
- View/download PDF
46. Analysis of surgical therapy for epidermoid carcinoma of the laryngeal glottis.
- Author
-
Ogura JH, Sessions DG, and Spector GJ
- Subjects
- Carcinoma, Squamous Cell classification, Carcinoma, Squamous Cell mortality, Follow-Up Studies, Humans, Laryngeal Neoplasms classification, Laryngeal Neoplasms mortality, Laryngectomy, Missouri, Carcinoma, Squamous Cell surgery, Glottis, Laryngeal Neoplasms surgery
- Abstract
Four hundred sixty-three patients with glottic carcinoma were treated by surgical techniques with or without preoperative irradiation. Two hundred eighty-one had hemilaryngectomy and 182 total laryngectomy procedures. The overall cure rate for the hemilaryngectomy group was 91 percent and 80 percent for the total laryngectomy group, with an overall cure rate of 87 percent. Our observations support the fact that Stage I glottic carcinoma has slightly better prognosis when treated by hemilaryngectomy. Stage II and III lesions have a significant improvement in cure rate and survival when treated with combined preoperative irradiation and partiall vertical laryngectomy or total laryngectomy than by irradiation alone.
- Published
- 1975
- Full Text
- View/download PDF
47. Acalculous parotid sialadenopathy.
- Author
-
Fried MP, Spector GJ, Webber BL, and Ogura JH
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Clinical Trials as Topic, Diagnosis, Differential, Female, Humans, Infant, Male, Middle Aged, Parotid Neoplasms diagnostic imaging, Retrospective Studies, Sialography, Parotitis diagnostic imaging, Parotitis pathology
- Abstract
Acalculous inflammation of the parotid gland has been regarded by some as a specific disorder that can be staged as to the severity of the disease process. A review of the literature, however, indicates a divergence of opinion. It is the purpose of this study to test this hypothesis by a retrospective double-blind analysis of clinical, sialographic and histopathologic findings. Forty-two patients who were seen by the Department of Otolaryngology, Washington University School of Medicine from 1961 to 1970 were evaluated by two separate teams. There were 20 sialograms and 30 pathologic specimens, and all were re-examined. Eleven patients had both sialographic studies and histopathologic examination. The clinical presentations and sialographic findings were reviewed. These findings were then compared to each other. Our results indicate that we could not evaluate the severity of the clinical disease by sialography or histopathology. There was no consistent method of staging the sialographic and pathologic findings. In addition, there was no correlation between these two parameters. They reflect neither the patient's clinical syndrome pattern nor the extent of disease. It appears that the parotid gland responds variable to inflammation. These observations are exemplified by case histories.
- Published
- 1975
- Full Text
- View/download PDF
48. Endolymphatic sac surgery for Menière's disease.
- Author
-
Spector GJ and Smith PG
- Subjects
- Evaluation Studies as Topic, Follow-Up Studies, Hearing Disorders etiology, Humans, Mastoid surgery, Meniere Disease complications, Postoperative Complications, Sodium Chloride, Tinnitus etiology, Vertigo etiology, Ear, Inner surgery, Endolymphatic Sac surgery, Meniere Disease surgery
- Abstract
An endolymphatic-mastoid Silastic shunt procedure was performed in 122 cases of Menière's disease having a mean follow-up period of three years. In accordance with American Academy of Ophthalmology and Otolaryngology 1972 criteria, there were 43% class A, 20% class B, 21% class C, and 17% class D results. Analysis of 35 recent cases having a mean follow-up period of nine months revealed 57% class A, 25% class B, 9% class C, and 9% class D results. Sixteen percent of the patients who experienced classes A, B or C results complained of other fluctuating symptoms which were not relieved by surgery. Moreover, three new cases of otolithic crisis were found in the postoperative group. Seven of ten patients who experienced a class A or B result had either a recrudescence of their vertigo or a significant decrement in hearing in response to a postoperative salt-loading test. It is concluded that the surgical success rate decreases with time and that the procedure appears to alter the symptom complex but does not cure Menière's disease.
- Published
- 1983
- Full Text
- View/download PDF
49. Labyrinthine segment and geniculate ganglion of facial nerve in fetal and adult human temporal bones.
- Author
-
Ge XX and Spector GJ
- Subjects
- Adult, Age Factors, Body Height, Body Weight, Facial Nerve anatomy & histology, Geniculate Ganglion anatomy & histology, Geniculate Ganglion embryology, Gestational Age, Humans, Infant, Newborn, Temporal Bone anatomy & histology, Ear, Inner innervation, Facial Nerve embryology, Temporal Bone embryology
- Abstract
The later stages of development (15-40 weeks in utero) of the geniculate ganglion and labyrinthine segment of the facial nerve in the human fetus demonstrate minimal neuronal growth. The vascular supply is well established. The major changes occur in the perineural ossification pattern. The canal of the labyrinthine facial nerve segment ossifies first via the petrous apex and periotic capsule. The narrowest portion of the canal is at the geniculate ganglion in the earlier stages and at the fundus of the internal auditory canal at term. The geniculate ganglion area ossifies by means of two bony plates. The medial plate is a derivate of the periosteal growth of the petrous apex and the lateral plate is an extension of membranous bone from the squama. The major relationships to the middle ear do not change. The hiatus of the facial canal diminishes in size during gestation, but remains patent at birth.
- Published
- 1981
- Full Text
- View/download PDF
50. The role of aminopeptidases in inflammatory and neoplastic tissues.
- Author
-
Spector GJ
- Subjects
- Animals, Carrageenan, Granuloma chemically induced, Histocytochemistry, Humans, Male, Rats, Aminopeptidases metabolism, Carcinoma, Squamous Cell metabolism, Granuloma metabolism, Laryngeal Neoplasms metabolism, Wound Healing
- Abstract
The role of leucine andalanine aminopeptidases is stidued in three different biologic systems: experimental wound healing in the rat, experimental carrageenan induced intraderman granulomas in the rat, and human laryngeal carcinomas. The wound healing experiments indicate that the proliferating granulation tissue has high quantities of aminopeptidases activity which is residing primarily intracellularly in granulocytes, macrophages, mast cells fibroblasts, and new budding vessels. The quantititave levels of tissue aminopeptidases correlate positively with the degree of cellularity of the wound and fibroblastic activity. Some aminopeptidases (isoenzymes) are secreted or released by the fibroblasts in be blood serum. Starch gel electrophoretic analysis demonstrates thses with different concentrations and migration rates. Two are probably released or secreted into the serum, and th third is membranous bound in the cytoplasm (lysosomal). The carrageenan intradermal granuloma demonstrates a different inflammatory reaction which is rich in macrophages and produces a different pattern of aminopeptidases activity. Macrophages produce a high tissue level of aminopeptidase activity which is intracellular bound and not readily leached out into the serum. Gel electrophoresis studies of aminopeptidases produced by the granuloma demonstrate that the tissue bound enzyme is the main component. In addition, there appears to be a mechanism, which is not understood, for specific induction or activation of lysosomal proteolytic and carbohydrase enzymes. This mechanism is dependent on the nature of composition of the injuring agent. Laryngeal carcinomas demonstrate high tissue homogenate levels and normal serum levels of aminopeptidase activities. These enzymes are located in the tumor stroma. They are not directly related to tumor invasiveness but to the degree of stromal proliferation. The tumor stroma behaves as though it were a non-healing wound constantly secreted proteolytic enzymes (aminopeptidases). A major problem that needs to be resolved is to find the operating mechanism by which malignant cells interact with their constantly proliferating fibroblastic stroma.
- Published
- 1976
- Full Text
- View/download PDF
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