Vestibular projections to hypothalamic supraoptic and paraventricular nuclei.

The effects of electrical stimulation of the eighth nerve and caloric stimulation of the labyrinth were tested on the spontaneous or evoked electrical activity of single neurons located in the hypothalamic supraoptic (SON) and paraventricular (PVN) nuclei. It was found that these neurons responded to both kinds of stimulation. In particular, the neurons of the SON showed a predominant response pattern characterized by a sequence of excitation-inhibition, whereas the neurons of the PVN showed different patterns of response with various combinations of inhibition and excitation sequences.

Anatomic variations of surgical importance in ethmoid labyrinth and sphenoid sinus. A study of radiological anatomy.

The present study was performed on axial and coronal CT scans of 100 patients, most of whom were affected by nasal polyposis. Five observers had to analyse the radiograms and answer a questionnaire including the following items: presence of a supraorbital recess; identification of anterior and posterior ethmoidal canals; dehiscences in the lamina papyracea; pneumatized middle turbinate; presence of a sphenomaxillary plate; presence of Haller's cells; presence of Onodi's cells; relationships of the optic canal; relationships of the internal carotid artery; relationships of the maxillary nerve; relationships of the vidian nerve; level difference between the ethmoid roof and nasal vault; depth of the sphenoethmoidal recess. The data obtained were compared with those drawn from anatomical studies.

Transnasal sinusectomy with combined microscopic and endoscopic technique.

Severe, diffuse polyposis can be adequately treated through a transnasal approach which combines microscopic and endoscopic surgery. The operating microscope is used to perform ethmoidectomy, usually from the front to the back, and to open the sphenoid sinus and the antral window. The telescopes allow the sphenoid and maxillary sinuses to be cleaned under direct view control as well as enabling good drainage to be performed from the frontal sinuses.

Neoadjuvant chemotherapy with cisplatinum and 5-fluorouracil in advanced head and neck cancer.

Forty-one patients affected by solid tumors of the head and neck were treated with neoadjuvant therapy before radiotherapy or surgery. All patients received therapy with cisplatinum 100 mg/m2 day 1 and 5-fluorouracil 1000 mg/day for days 1-5 by continuous infusion with a portable chronoinfusor. After three cycles, we observed an objective response in 34/41 patients (82.

[The problem of the mandible in surgery of tonsillar tumors: proposal of a technique].

The Authors report a technique of a conservative transmandibular approach for the surgical treatment of tonsillar region malignancies. The procedure is based upon the preparation of a vascular mandibular flap through two osteotomies, which are performed, the first above the mandibular foramen and the second below the mental foramen. The main advantages of present technique are: lip-chin-splitting is avoided and, due to the preservation of mandibular vascular and nervous supply, it is possible to accomplish, without risk, postoperative radiotherapy.

[Post-operative recurrence of naso-sinus polyposis].

Maxipolyposis, i.e. severe, diffuse nasosinusal polyposis, is generally treated with an onerous surgery.

Volume receptors in guinea pig labyrinth: relevance with respect to ADH and Na control.

We tested the hypothesis that changes in extracellular fluid volume are reflected by pressure changes within structures of the inner ear and that through neural pathways, a control mechanism exerts an influence on antidiuretic hormone (ADH) release and Na excretion. The study was performed on 35 guinea pigs. In protocol 1, 13 animals were studied before and after decompression of the inner ear by bilateral fluid withdrawal in an experimental setting of sustained isotonic expansion that kept the osmoreceptor partially activated and the intrathoracic volume receptors suppressed.

Multiplanar reconstructions in the study of ethmoid anatomy.

Multiplanar and surface reconstructions are useful tools in anatomical studies. Details of ethmoid architecture which are hard to image in axial and coronal scans are well displayed by means of oblique sections. This paper addresses reformatted images of a) the nasal lateral wall; b) the middle meatus lateral wall; c) the lamina basilaris of the middle turbinate and d) the frontonasal duct.

Hematoporphyrin uptake by experimentally induced cholesteatomas in an animal model.

Photodynamic therapy is based on the production of a cytotoxic factor by porphyrins, particularly hematoporphyrin (HP), when exposed to light of a suitable wavelength and intensity. The uptake of HP is notably large in tissues with a high mitotic index. Although cholesteatomas are not malignant tumors, our working hypothesis was that their high lipid content might result in their exhibiting a remarkable affinity to HP, which is normally carried in the blood by lipoproteins.

Motor responses of the esophagus and lower esophageal sphincter (LES) to vestibular stimulation in man.

Pressure recordings in the esophageal body, LES and stomach were performed in 10 healthy subjects before and after caloric stimulation of the labyrinth. While esophageal and stomach responses varied or were absent, all subjects showed variations at the LES level. Duration of LES relaxation was increased and both time and amplitude of LES augmentation were significantly reduced.

Computed tomography of the ethmoid labyrinth and adjacent structures.

The architecture of ethmoid labyrinths as well as their relationships with adjacent structures are reviewed, giving special emphasis to the anatomic variants common in this area. The study was performed on six young normal subjects who were submitted to high resolution computed tomography. Approximately 25 axial scans, parallel to the floor of the anterior cranial fossa, were performed on each subject; four to five coronal CT scans were also added.

The vestibular cortical projection during spinal decompensation.

The removal of spinal afferents in rabbits submitted to unilateral lesion of the labyrinth and fully compensated greatly modified the field potentials as well as the single unit responses recorded from the cortical vestibular area during stimulation of the intact eighth nerve. In particular, an increase of contralateral and a decrease of ipsilateral potentials were observed. These asymmetrical responses indicate that the influence of the spinal cord in compensating the effects of unilateral lesion of the labyrinth is directed to balance not only the electrical activity of the brain-stem structures, but also that of the cerebral cortex.

Functional neck dissection. Anatomical grounds, surgical technique, clinical observations.

The anatomical grounds of and surgical technique for functional neck dissection are described in detail in order to demonstrate that the radicalism of this procedure, from the viewpoint of surgical anatomy, is by no means less than that of the classical (so-called radical) neck dissection. From 1972 to 1978, 476 operations were performed (211 patients treated bilaterally and 54 unilaterally). The percentage of false negatives (ie, histologically proven metastases in clinically unsuspected nodes) was 14%, while the percentage of false positives (histological negativity in clinically suspected nodes) reached 53%.

Horizontal glottectomy.

Horizontal glottectomy is a procedure which allows removal of the whole glottis, together with its cartilaginous framework. It is performed by means of two horizontal incisions, the lower through the cricothyroid membrane, and the upper one across the wings of the thyroid. The gap is then closed by approximating the cricoid to the thyroid remnants (cricothyropexy).