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Background and Objectives: Dysphagia and vocal cord palsy (VCP) are common otolaryngological complications after revision anterior cervical discectomy and fusion (rACDF) procedures. Our objective was to determine the early incidence and risk factors of VCP and dysphagia after rACDF using a 2-team approach., Methods: Single-institution, retrospective analysis of a prospectively collected database of patients undergoing rACDF was enrolled from September 2010 to July 2021. Of 222 patients enrolled, 109 patients were included in the final analysis. All patients had prior ACDF surgery with planned revision using a single otolaryngologist and single neurosurgeon. MD Anderson Dysphagia Inventory and fiberoptic endoscopic evaluation of swallowing (FEES) were used to assess dysphagia. VCP was assessed using videolaryngostroboscopy., Results: Seven patients (6.7%) developed new postoperative VCP after rACDF. Most cases of VCP resolved by 3 months postoperatively (mean time-to-resolution 79 ± 17.6 days). One patient maintained a permanent deficit. Forty-one patients (37.6%) reached minimum clinically important difference (MCID) in their MD Anderson Dysphagia Inventory composite scores at the 2-week follow-up (MCID decline of ≥6), indicating new clinically relevant swallowing disturbance. Forty-nine patients (45.0%) had functional FEES Performance Score decline. On univariate analysis, there was an association between new VCPs and the number of cervical levels treated at revision ( P = .020) with long-segment rACDF (≥4 levels) being an independent risk factor ( P = .010). On linear regression, there was an association between the number of levels treated previously and at revision for FEES Performance Score decline ( P = .045 and P = .002, respectively). However, on univariate analysis, sex, age, body mass index, operative time, alcohol use, smoking, and individual levels revised were not risk factors for reaching FEES Performance Score decline nor MCID at 2 weeks postoperatively., Conclusion: VCP is more likely to occur in long-segment rACDF but is often temporary. Clinically relevant and functional rates of dysphagia approach 37% and 45%, respectively, at 2 weeks postoperatively after rACDF., (Copyright © Congress of Neurological Surgeons 2023. All rights reserved.)

Bismuth(III) salicylate, [Bi(Hsal)(3)](n), reacts readily with the trivalent metal beta-diketonate compounds M(acac)(3) (acac = acetylacetonate; M = Al, V, Cr, Fe, Co) to produce trinuclear coordination complexes of the general formula Bi(2)(Hsal)(6).M(acac)(3) (M = Al, V, Cr, Fe, Co) in 60-90% yields. Spectroscopic and single crystal X-ray diffraction experiments indicate that these complexes possess an unusual asymmetric nested structure in both solution and solid state. Upon standing in dichloromethane solution, Bi(2)(Hsal)(6).Co(acac)(3) eliminates Bi(Hsal)(3) to give the 1:1 adduct Bi(Hsal)(3).Co(acac)(3). The 2:1 heterobimetallic molecular compounds undergo facile thermal decomposition on heating in air to 475 degrees C to produce heterometallic oxide materials, which upon annealing for 2 h at 700 degrees C form crystalline oxide materials. The synthetic approach detailed here represents a unique, general approach to the formation of heterobimetallic bismuth-based coordination complexes via the coordination of M(acac)(3) complexes to bismuth(III) salicylate.

Normative data for 267 neurologically normal adults (age range 18-91) are provided for a six-trial administration of Form I of the Verbal Selective Reminding Test (VSRT; Hannay & Levin, 1985). Gender corrections were generated by age- and education-matched pair analyses of the VSRT performance of 82 males and 82 females. Normative data are grouped by seven age cohorts: 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-91. A regression-based procedure is provided, so that existing delayed recall norms, based on a 12-trial administration, can be utilized, following a 6-trial administration.

This study examined the relationship between visual neglect and ability to judge the angular orientation of lines in patients with unilateral cerebrovascualar lesions. Participants were 75 patients with right-hemisphere cerebrovascular lesions (RCVA) and 39 patients with left-hemisphere cerebrovascular lesions (LCVA). All were administered the Judgment of Line Orientation test (JLO). Results revealed that twice as many RCVA patients (56%) exhibited impairment on the JLO as did LCVA patients (26%). In RCVA patients, much lower performance was seen in patients with left visual neglect. Among LCVA patients, no relationship was found between JLO performance and the presence of visual neglect. Correlations between JLO scores and WAIS-R variables suggested that JLO performance may be related in part to general cognitive factors, as well as to other perceptual and spatial abilities.

Visual recognition memory was examined in 310 normal adults (age range 18-91) and 60 patients with unilateral vascular lesions (30 right, 30 left) using the Continuous Visual Memory Test (CVMT). Significant age-related differences were found for both acquisition and delayed phases of the CVMT, with older subjects performing lower on all variables. Data from clinical groups revealed that both patients with left-hemisphere (LCVA) and right-hemisphere (RCVA) lesions performed below age-matched controls. However, RCVA patients performed significantly worse than LCVA patients. Data generally supported the double-dissociation hypothesis, with a majority of RCVA patients exhibiting impaired visual memory but preserved verbal memory, and vice versa for LCVA patients. Results also suggested that the CVMT Delayed task was less susceptible to potentially confounding effects of visual-spatial and verbal ability than was the acquisition phase.

This study provided a normative data base for the Continuous Recognition Memory Test and also investigated age-related differences in recognition memory for pictures in a sample of 299 normal subjects (age range 10-89). Data analysis revealed that older subjects consistently set a lower response criterion (Cx), resulting in a significantly higher number of within-class false alarms. Older subjects also displayed significantly lower sensitivity (d'). Changes in sensitivity were attributed to both an increase in false alarms and a concurrent decrease in hits in subjects over 65. Analysis of the likelihood ratio (beta) revealed no significant change across age groups.

This study was designed to investigate the relationship between 15 emotional indicators on the Bender-Gestalt Test and acting-out behavior in young children. The subjects were 93 children ranging in age from five to 12 years. Each was administered the Bender. A measure of each subject's overt acting-out behavior was then obtained by having teachers rate each student on a Behavioral Rating Scale. Subjects' records were then divided into groups on the basis of both sex and age. Results indicated that neither the total number of Bender indicators nor any of the individual Bender indicators were correlated significantly with total scores on the rating scale. Use of the Bender as a projective device to measure acting-out behavior was seriously questioned.