Otolaryngology Basic Science and Clinical Review This page intentionally left blank Otolaryngology Basic Science and Clinical Review EDITOR Thomas R.Van De Water, Ph.D Director Cochlear Implant Research Program University of Miami Ear Institute Professor Department of Otolaryngology Miller School of Medicine University of Miami Miami, Florida ASSOCIATE EDITOR Hinrich Staecker, M.D., Ph.D Director Otology and Neurotology Program Associate Professor Department of Otolaryngology–Head and Neck Surgery University of Maryland School of Medicine Baltimore, Maryland Thieme New York • Stuttgart Thieme Medical Publishers, Inc 333 Seventh Ave New York, NY 10001 Editor: Esther Gumpert Associate Editor: Birgitta Brandenburg Vice President, Production and Electronic Publishing: Anne T.Vinnicombe Production Editor: Print Matters, Inc Sales Director: Ross Lumpkin Associate Marketing Director:Verena Diem Chief Financial Officer: Peter van Woerden President: Brian D Scanlan Compositor: Compset Printer: Maple-Vail Book Manufacturing Group Library of Congress Cataloging-in-Publication Data Otolaryngology : basic science and clinical review / [edited by] Thomas R.Van De Water, Hinrich Staecker p ; cm Includes bibliographical references and index ISBN 0-86577-901-5 (US)—ISBN 3-13-124651-0 (GTV) Otolaryngology Ear—Physiology Respiratory organs—Physiology [DNLM: Otorhinolaryngologic Diseases Ear—physiology Otorhinolaryngologic Surgical Procedures Respiratory Physiology WV 150 088 2005] I Van De Water, Thomas R II Staecker, Hinrich RF46.07525 2005 616.5'1—dc22 2005050640 Copyright ©2006 by Thieme Medical Publishers, Inc This book, including all parts thereof, is legally protected by copyright Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher’s consent is illegal and liable to prosecution This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating, preparation of microfilms, and electronic data processing and storage Important note: Medical knowledge is ever-changing.As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may be required.The authors and editors of the material herein have consulted sources believed to be reliable in their efforts to provide information that is complete and in accord with the standards accepted at the time of publication However, in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors, editors, or publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such information Readers are encouraged to confirm the information contained herein with other sources For example, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for administration.This recommendation is of particular importance in connection with new or infrequently used drugs Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text.Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain Printed in the United States of America 54321 TMP ISBN 0-86577-901-5 GTV ISBN 13 124651 Maxwell Abramson, M.D (1935–1991) This book is dedicated to the memory of Maxwell Abramson, M.D., husband, father, physician, educator, researcher, scholar, and friend Max was an extraordinary human being whose life reflected his core humanitarian values He was a gifted healer, creative scientist, and talented teacher in the discipline of otolaryngology He possessed both a strong desire and an unbridled enthusiasm to pass along his knowledge of the basic science and clinical foundations of otolaryngology to the fellows, residents, and medical students at the Columbia University College of Physicians and Surgeons, where he was chair- man of the otolaryngology department from 1977 until his untimely death in 1991 Max greatly loved both his family and his chosen profession He was a valued friend to many of us in the otolaryngology community, and his absence is felt by all of us I know that Max would be pleased to have this book dedicated to his memory because it continues the dissemination of basic and clinical sciences knowledge of otolaryngology Thomas R.Van DeWater, Ph.D Thispageintentionallyleftblank Contents PREFACE FOREWORD Thomas J Balkany, M.D., F.A.C.S., F.A.A.P CONTRIBUTORS PART I CHAPTER THE BASIC PRINCIPLES SURGICAL HEMOSTASIS Christopher Hartnick and Hinrich Staecker WOUND HEALING CHAPTER Jane A Petro, Mark D Suski, and Howard D Stupak BASIC PRINCIPLES OF ALLERGIC DISEASES CHAPTER David Rosenstreich, Ashok Vaghjimal, and Golda Hudes HEAD AND NECK MANIFESTATIONS OF RHEUMATOLOGICAL DISEASES CHAPTER Derek D Sloan and Jeffrey P Harris PULMONARY PHYSIOLOGY AND MECHANICAL VENTILATION CHAPTER Karen B Zur and Gregory J Schilero BIOLOGY AND TREATMENT OF SLEEP APNEA CHAPTER Hector P Rodriguez and Diana V.-A Berggren MICROBIOLOGY, VIROLOGY, AND MECHANISMS OF INFECTION CHAPTER Ruy Soeiro and Bettie Steinberg PRINCIPLES OF PHARMACOLOGY CHAPTER Christopher J Hartnick, Alexander W Gotta, and Ira M Leviton OTOTOXICITY CHAPTER Leonard P Rybak, John S.Touliatos, and Kathleen Campbell CHAPTER 10A ONCOLOGY OF HEAD AND NECK TUMORS Elizabeth Franzmann, Scott Lilly, David Huang, Giovana Thomas CHAPTER 10B IMMUNOBIOLOGY AND IMMUNOTHERAPY OF HEAD AND NECK SQUAMOUS CARCINOMA Giovana Thomas,William J Richtsmeier, and Hari Nadiminti xi xiii xv 32 43 59 71 83 98 129 137 150 viii CONTENTS CHAPTER 11 CHAPTER 12 CHAPTER 13 CHAPTER 14 CHAPTER 15 CHAPTER 16 CHAPTER 17 CHAPTER 18 CHAPTER 19 PART II CHAPTER 20 CHAPTER 21 CHAPTER 22 CHAPTER 23 CHAPTER 24 CHAPTER 25 CHAPTER 26 CHAPTER 27 CHAPTER 28 CLINICAL RADIATION BIOLOGY AND RADIOTHERAPY Steven R Isaacson and Lanny Garth Close ENVIRONMENTAL EFFECTS ON THE UPPER AIRWAY Andrew Blitzer HOW TO CONDUCT CLINICAL RESEARCH Steven D Rauch BASIC PRINCIPLES AND CURRENT APPLICATIONS OF LASERS IN HEAD AND NECK SURGERY Daniel B Kuriloff MOLECULAR BIOLOGY FOR THE OTOLARYNGOLOGIST Jeffrey Wolfe, Hinrich Staecker, and Thomas R.Van De Water PHYSIOLOGY OF THE PEDIATRIC PATIENT Lewis P Singer BRANCHIAL CLEFT ANATOMY AND CONGENITAL NECK MASSES Gerald B Healy PATHOPHYSIOLOGY OF STRIDOR AND AIRWAY DISEASE John H Greinwald and Robin T Cotton CLINICAL GENETICS IN OTOLARYNGOLOGY Simon I Angeli, Nancy Sculerati, and Thomas R.Van De Water THE EAR, HEARING, AND BALANCE EMBRYOLOGY OF THE OUTER, MIDDLE, AND INNER EAR Thomas R.Van De Water and Hinrich Staecker ACOUSTICS AND MIDDLE EAR MECHANICS FOR OTOLARYNGOLOGY John J Rosowski and Saumil N Merchant SURGICAL ANATOMY OF THE TEMPORAL BONE Hinrich Staecker and Adrien A Eshraghi HISTOLOGY AND HISTOPATHOLOGY OF THE TEMPORAL BONE Joseph B Nadol, Jr ULTRASTRUCTURAL ANATOMY OF THE COCHLEA David J Lim HAIR CELL FUNCTION Peter G Gillespie AUDITORY PROCESSING IN SENSORINEURAL HEARING LOSS M Charles Liberman PATHWAYS OF HEARING AND BALANCE Alan D Legatt ASSESSMENT OF CENTRAL AUDITORY FUNCTION Philippe P Lefebvre and Alan D Legatt 158 164 168 178 192 199 207 212 225 251 259 275 283 313 332 340 350 361 CONTENTS CHAPTER 29 CHAPTER 30 CHAPTER 31 CHAPTER 32 CHAPTER 33 CHAPTER 34 CHAPTER 35 CHAPTER 36 PART III CHAPTER 37 CHAPTER 38 CHAPTER 39 CHAPTER 40 PART IV CHAPTER 41 CHAPTER 42 CHAPTER 43 LANGUAGE AND THE PLASTIC BRAIN Robert J Ruben PRINCIPLES OF AUDIOMETRY Jackson Roush and John Grose HEARING AIDS, BONE-ANCHORED HEARING AIDS, AND COCHLEAR IMPLANTS Adrien A Eshraghi, Susan B.Waltzman, Joseph G Feghali, Thomas R.Van De Water, and Noel L Cohen MECHANISM OF NOISE-INDUCED HEARING LOSS AND OTOPROTECTIVE STRATEGIES Richard D Kopke, John K.M Coleman, Jianzhong Liu, Ronald L Jackson, and Thomas R.Van De Water VESTIBULAR SYSTEM PHYSIOLOGY John Carey TESTING BALANCE AND THE VESTIBULAR SYSTEM Hinrich Staecker MORPHOPHYSIOLOGY OF THE FACIAL NERVE K Paul Boyev and Adrien A Eshraghi RADIOLOGY OF THE TEMPORAL BONE Barbara Zeifer THE NOSE, OLFACTION, AND THE SINUSES DEVELOPMENT OF THE NOSE Bradley J Goldstein and Thomas R.Van De Water SURGICAL ANATOMY OF THE NOSE AND PARANASAL SINUSES Dinesh Mehta and Walter M Ralph Jr NASAL AND PARANASAL SINUS PHYSIOLOGY Erich P.Voigt and David R Edelstein THE BIOLOGY AND TESTING OF OLFACTORY DYSFUNCTION James E Schwob, Daniel B Kurtz, and Bradley J Goldstein ix 368 374 385 395 409 415 421 431 449 455 472 485 THE LARYNX, VOICE, AND NECK THE BRANCHIAL ARCHES AND THEIR DERIVATIVES Jeffrey T Laitman, Joy S Reidenberg, Armand Balboni, Andrew Bergemann, and Peter Som MORPHOPHYSIOLOGY OF THE LARYNX Joy S Reidenberg and Jeffrey T Laitman NEUROLOGICAL DISORDERS OF THE LARYNX Abigail Arad-Cohen and Andrew Blitzer 499 505 516 INDEX normal, 530 passive F0 control in, 528 physiology of, 537–541 pressed, 530 pressure equilibration in, 527 respiratory dynamics in, 538–539 source in, 538 subsystems of, 538, 538f vocal fold oscillation/vibration in, 531, 537, 539–543 voice register in, 541–542, 542f Phonatory adductory range, 526 Phonatory threshold pressure, 526 Phonemes, 369 Phonology, 369–370 Phonomicrosurgery, 537t, 549–550 Phonosurgery anatomical considerations in, 548–549 definition of, 536 laryngoplastic, 537t neuromotor, 537t principles of, 536–551 types of procedures in, 536, 537t Photoaging, 26 Photodynamic therapy, 189–190 for HPV infection, 221 Photoreceptors, 611 Phrenic nerve, 603f, 604, 607 Phrenic nerve palsy, 202 Pickwickian syndrome, 71 Pierre Robin sequence, 235 Pigmentation, facial resurfacing and, 687 Pillar cells, 319 inner, 315f, 319 outer, 315f, 319 Pilocarpine, for xerostomia, 143 Pilosebaceous units, 682 Pinna congenital malformations of, 256–257 in craniofacial disorders, 257, 257f in Down syndrome, 256, 257f in fetal alcohol syndrome, 256–257, 257f microtia, 256, 256f development of, 251, 252f musculature of, 251 “railroad track,” 256–257, 257f vascular supply of, 280 Piperacillin, 113 Piperacillin-tazobactam, 113 Pipracil (piperacillin), 113 Piriform fossae, 556 Piriform recess, 553f Piriform sinuses, 507–509 tumors of, 580–581 Pitch control, 528–529 Pitch perception, inner hair cell loss and, 346–347, 348f Placenta transfer of drugs, 100–101 Plain radiography dental studies with, 667–668 of neck, 667–668 of temporal bone, 431 Plasma protein binding, of local anesthetics, 108 Plasticity, and language development, 371–372 Plastic surgery, facial, 688–691 patient motivation for, 683 preoperative evaluation for, 683–685 skin type classification for, 683, 683t Platelet(s) disorders of, evaluation of, tests for, in flap dynamics, 706 in hemostasis, 3, 7f in wound healing, 12–13 Platelet activating factor (PAF) in immune response, 481 in wound healing, 12, 13t Platelet-derived factors, in wound healing, 12–13, 13t Platelet-derived growth factor (PDGF), in wound healing, 12, 14t, 15 Platysma muscle, 600, 696f aging and, 685 Play audiometry, 376 Plica mallearis, 277 Pneumocystis carinii, 205 Pneumolabyrinth, 439 Pneumolysin, 86 Pneumonia causative agents of parainfluenza virus, 92–93 Streptococcus pneumoniae, 85–86 in pediatric patients, 205 PO2, 66 Pollens allergy to, 38 seasonal prevalence of, 38, 39f Pollutants, chemical, 164–165 Polyamide mesh, 711–712 Polyarteritis nodosa, 54–55 clinical presentation of, 54 epidemiology of, 54 head and neck manifestations of, 54–55 laboratory findings in, 54 otologic findings in, 54–55 treatment of, 54 Polyenes, 126 Polyethylene terephthalate, 712 Polymerase chain reaction (PCR), 195–196 Polymer implants, 711–712 Polymethyl methacrylate, 688, 711 Polymorphonuclear leukocytes, 44 Polymyalgia rheumatica, 53–54 clinical presentation of, 53 epidemiology of, 53 gelling phenomenon in, 53 head and neck manifestations of, 53–54 Polymyositis, 49 epidemiology of, 49 head and neck manifestations in, 49 treatment of, 49 Polysomnograph (PSG), 76 definitions and classifications in, 76t in sleep apnea syndromes, 76–78 in snoring, 76–77 749 in stridor evaluation, 216 in upper airway resistance syndrome, 76–77 Polytetrafluoroethylene (Gore-Tex), 711 Ponticulus, 278 Pontine perforating branches, of vertebral artery, 694 Poorly differentiated neuroendocrine carcinoma (PDNEC), 583–585 Porosity, of implants, 710 Porphyria, acute, 522 Port wine stains, 701–702 Porus acusticus, computed tomography of, 433f–434f, 435 Positive end-expiratory pressure (PEEP), 69 auto-, 69 extrinsic, 69 Positron emission tomography, in head and neck cancer, 149 Postcricoid area, 556 Posterior auricular artery, 280, 603f, 696f, 698f, 699–700 Posterior auricular muscle, 251, 696f Posterior auricular vein, 601f, 635f Posterior cerebellar artery, 694 Posterior cerebral artery, right and left, 694 Posterior cervical space imaging of, 673t, 676 pathology of, 673t, 676 Posterior cricoarytenoid ligament, 526 Posterior cricoarytenoid muscle, 509f, 511–512, 517 Posterior cricopharyngeus muscle, 555f Posterior facial vein, 636, 636f Posterior incudal ligament, 277 Posterior triangle, of neck, 598–600, 599f lymphatics of, 607–608 nerve supply of, 603–604 Posterior tympanum, 276 Posteroinferior cerebellar artery (PICA), 522, 694 aneurysms of, 616–617 Posterolateral neck dissection, 609 Posthumous Papers of the Pickwick Club, 71 Postobstructive pulmonary edema (POPE), 205 Poststyloid space, 560 Posturing, 357–358 Posturography, 415, 419–420 Potassium in cochlear amplification, 337, 337f in hair cell transduction, 335–336, 341 in salivary regulation, 638–640 Potassium recycling, in inner ear, 313–314, 322f, 325–327 gap junctions in, 326, 327f–328f, 329 ion channels in, 322f, 326, 328f pathways from inner hair cells, 327, 327f pathways from outer hair cells, 322f, 326–327, 327f Potassium titanyl phosphate (KTP/532) laser, 179, 181t, 189 Power (statistical), 175 Preacher’s nodes, 574 Prechordal mesoderm, 592 750 INDEX Precision, in research, 173 Prednisone dosage of, 103, 103t for polyarteritis nodosa, 54 for polymyositis, 49 for systemic lupus erythematosus, 48 for Wegener’s granulomatosis, 53 Pregnancy, pharmacokinetics in, 100–101 Premaxilla, 450, 457–458, 467 Premolars, 628 Presbycusis, 302–305 indeterminate, 305, 307f neural, 304f–305f, 305 sensory, 303f, 304–305 P300 response, 382 Pressed phonation, 530 Pressure, for bleeding control, Pressure-flow-adduction, in phonation, 531–532, 532f Pressure support ventilation (PSV), 69 Prestin, 318, 337 Prestyloid space, 560 Pretibial myxedema, in Graves’ disease, 644, 653 Prevacid (lansoprazole), 101 Prevertebral fascia, 554f, 556 Prevertebral space, 560f imaging of, 672t, 675 pathology of, 672t, 675 Prevotella, 88–89 Prilosec (omeprazole), 101 Primary auditory cortex, 354 Primary motor cortex, and swallowing, 567–568, 569f, 571 Primary palate, 450 Primaxin (imipenem), 117 Probability methods, of sampling, 174 Procaine chemistry of, 106, 106f duration of action, 108 Procerus muscle, 460, 460f Professional antigen-processing cells, 151 Progressive bulbar palsy (PBP), 521 Progressive sensorineural hearing loss (PSNHL), autoimmune, 46 Progressive spinal muscular atrophy (PSMA), 521 Progressive systemic sclerosis (PSS), 48–49 esophageal dysfunction in, 48–49 female to male ratio in, 48 head and neck manifestations in, 48–49 incidence of, 48 prevalence, 48 treatment of, 48–49 Prokinetic drugs, for reflux disease, 101–102 Prolene, 711 Proliferative phase, of wound healing, 2, 11–12, 12f, 12t, 15–17 Promoter sequences, 194 Prontosil (sulfanilamide), 110–111 Proprioreceptors, laryngeal, 517 Propulsid See Cisapride Propylthiouracil, for hyperthyroidism, 56, 645 Prostacyclin for flap survival enhancement, 707 for progressive systemic sclerosis, 48 Prostaglandins in allergic diseases, 36, 481 in head and neck cancer, 146, 153 in immune response, 481 in wound healing, 12 Protease(s), neutral, in allergic diseases, 37 Protease inhibitors, 91t Protein(s) dietary, and wound healing, 22 in nasal secretions, 476 salivary secretion of, 638–640, 639f Protein energy malnutrition (PEM), 22 Proteoglycans in allergic diseases, 37 in bone, 28 in cartilage, 27 in wound healing, 16–17 Proteus infection, ␤-lactam-␤-lactamase inhibitor combinations for, 113 Prothrombin, 3, 6f–7f vitamin K and, 24 Prothrombin time (PT), 4–5 Proton pump inhibitors, for reflux disease, 101 Proto-oncogenes, 194, 228 Protympanum, 276 Proud flesh, 15 Prussak’s space, 276 computed tomography of, 435, 436f Psammetichus (pharaoh), 368 Pseudomonas aeruginosa, 88 infection, 88 in cystic fibrosis, 233 penicillins for, 113 Psoriatic arthritis, 55 Pterygoid muscles development of, 593f external, 629 internal, 629 medial, 555f, 636f Pterygoid nerve lateral, 616 medial, 616 Pterygoid plexus, 699 Pterygomandibular space, 561 Pterygopalatine fossa, 471 Pterygopalatine ganglion, 468–469, 469f, 629 Pterygopalatine nerve, 468–469, 615–616 Ptosis, 56, 613 aging and, 683–685 surgical treatment of, 688–691 p53 tumor suppressor gene, 143, 194–195, 229 Puberphonia, 548 Pulmonary circulation, in pediatric patients, 203 Pulmonary edema, postobstructive, 205 Pulmonary function tests, 62–63 flow-volume loops in, 62–63, 62f patterns of impairment in, 62–63 in stridor evaluation, 216 Pulmonary reserve, 60 Pulp, tooth, 628 Pulsed delivery mode, for lasers, 183 Pulse oximetry, in stridor evaluation, 215 Pulse register, 541 Pure-tone audiometry, 362, 374–376 in conductive hearing loss, 375f, 376 detection thresholds in, 375, 375f in mixed hearing loss, 375f, 376 pediatric modifications in, 376 in sensorineural hearing loss, 375f, 376 Purkinje cells, 357 Pursuit eye movement, in electronystagmogram, 415, 417t Pus, 11 Pyramidal eminence, 277–278 computed tomography of, 433f–434f, 434 Pyridostigmine, for myasthenia gravis, 56 Pyridoxine, and wound healing, 23 Pyriform aperture, 457, 457f, 458 Q Q-switched lasers, 179, 183, 188 Quadrangular membrane, 509, 509f, 516, 581 Quadratus menti muscle, 695f–696f Quadrilateral plate, 459 Quasi-experimental research design, 172 Questionnaires, 173 Quinidine, myasthenic syndrome with, 522 Quinine, ototoxicity of, 132–133 Quinolones, 125–126 chemistry of, 125 mechanism of action, 125 pharmacokinetics of, 125 resistance to, 125 side effects of, 125–126 spectrum of activity, 125 Quota sampling, 174–175 R Rad, 161 Radial tunnel nerve bundle, 315f Radiation exposure, and papillary thyroid cancer, 656 Radiation therapy, 158–163 accelerated, 161–162, 162t accelerated hyperfractionated, 162 concomitant boost, 162t fractionation in, 160–162, 161t biologic basis for, 160, 161t fraction number in, 161, 162t fraction size in, 161, 162t overall time in, 161, 162t rationale for, 161–162 total dose in, 161, 162t and gustatory dysfunction, 631 for head and neck cancer, 141–143, 158–163 adjuvant, 141, 143, 159 with chemotherapy, 142–144 clinical applications of, 158 definitive (curative), 141–142 postoperative, 141, 143, 159 reirradiation, 143 side effects of, management of, 143 single modality, 142 INDEX hyperfractionated, 142, 144, 161–162, 162t intensity modulated, 142–143 for keloids, 21 radiobiology of, 159–160 reproductive effects of, 159–160 Radical neck dissection, 608, 608f imaging findings of, 679–680 Radioactive iodine, 644 for hyperthyroidism, 56, 645 Radioallergosorbent test (RAST), in allergic diseases, 40 Radiofrequency (RF) coils, in cochlear implant, 389–390, 389f Radiofrequency tissue volume reduction, for obstructive sleep apnea, 80 Radix, 456 “Railroad track” pinna, 256–257, 257f Rales, 213 Random pattern flaps, 694, 700, 705 Random sampling, 174 Ranitidine, for reflux disease, 101 RANTES, in allergic diseases, 37 Ranulas, 589, 630, 677 plunging, 589, 630 simple, 589 sublingual, 630 Rapid eye movement (REM) sleep, 73–74 Rasmussen’s syndrome, 372 Rathke’s pouch cysts of, 453 development of, 451 Ratio variables, 175 Raynaud’s phenomenon in polymyositis, 49 in progressive systemic sclerosis, 48 Reactive oxygen species (ROS) See Free radicals Reconstructive flaps, 705–706 See also Surgical flaps Rectus muscles dorsal, 593f inferior, 612–613 lateral, 593f, 616 medial, 593f, 612–613 superior, 612–613 ventral, 593f Recurrent laryngeal nerve, 513, 513f, 517, 555f, 606, 622 esophageal innervation by, 562–563, 563f, 564 paralysis of, 518–520 goiter and, 650 management of, 519–520 Recurrent respiratory papillomatosis (RRP), 221 adult or benign-type, 221 clinical presentation of, 221 diagnosis of, 221 juvenile or aggressive-type, 221 stridor with, 221 treatment of, 221 “Red man” or “red neck” syndrome, 118 Reepithelialization, in wound healing, 17 Reflection, of laser energy, 181, 181f Regeneration, Register, voice, 541–542, 542f, 545 Reglan See Metoclopramide Regression analysis, 176 Reichert’s cartilage, 253, 501–502, 501t Reinke’s edema, 532–533, 574 Reinke’s space, 532, 574 Reissner’s membrane, 279, 279f, 314f, 321–322 epithelial cells of, 321–322 in Meniere’s syndrome, 321 mesothelial cells of, 321 Reiter’s disease, 55–56 Relapsing polychondritis (RP), 51–52 audiovestibular manifestations of, 51–52 epidemiology of, 51 head and neck manifestations of, 51–52 Relaxed skin tension lines (RSTLs), 18–19 Reliability, in research, 172–173, 172t Remodeling in bone healing, 28–29 in wound healing, 17–18 cellular and biochemical components of, 12t Renal failure, and surgical hemostasis/coagulation, 4t Research, 168–177 control and validity in, 173–174 data analysis and statistical methods in, 175–177 data collection in, 173–175 design of, 171–173 categories of, 172–173 experimental, 172 ex post facto, 172 quasi-experimental, 172 interpreting and reporting, 177 population of interest in, 171 power and sample size in, 175 project criteria in, 170 reliability of, 172–173, 172t resident training in, 168–169 sampling methods in, 174–175 statistician’s role in, 175 written proposal for, 169–171, 171t Reserpine, for flap survival enhancement, 707 Residual volume (RV), 60, 60f, 62 Resonance, vocal, 544–545 Respiration, in pediatric patients, 199–203 Respiratory distress syndrome (RDS), 200–201 Respiratory syncytial virus (RSV), 93 croup with, 204 pneumonia with, 205 treatment of, 91t vaccine against, 93 Resting ventilation, 63 Restriction endonucleases, 195 Restriction fragment length polymorphisms (RFLPs), 196 Resurfacing, facial, 686–688 chemical, 687 laser, 687–688 Retention cysts, 588–589, 677 751 Reticulospinal tract, 358 Retinoic acid for aged skin, 26 for HPV infection, 221 Retinoid(s), in head and neck cancer, 146 RET oncogene, 228–229 RET/PTC gene, 652–653, 656 Retrocochlear dysfunction, BAER studies of, 383 Retrocuspid papilla, 589 Retrofacial nucleus (RN), 517 Retrohyoid depression, 500 Retromandibular vein, 601f–602f, 636, 699 Retromolar trigone, 554 Retropharyngeal abscess, 203–204, 560 Retropharyngeal space, 554f, 559–560, 560f–561f imaging of, 673t, 676 pathology of, 673t, 676 Retrosigmoid cells, 279 Reye’s syndrome, aspirin and, 103 Rhabdomyosarcoma alveolar, 230 embryonal, 230 genetics of, 230 Rheometer, 482 Rheumatic fever, 45 Rheumatoid arthritis, 46–47 head and neck manifestations of, 46–47 laboratory findings in, 46 laryngeal manifestations of, 46–47 onset of, 46 otological manifestations of, 46–47 prevalence of, 46 treatment of, 47 Rheumatoid factor (RF), 46 Rheumatoid nodule, 46 Rheumatological diseases, head and neck manifestations of, 43–58 Rhinion, 456, 457f Rhinomanometry, 482, 483f Rhinophyma, laser treatment of, 188 Rhinoplasty, 457 Rhinorrhea, in Wegener’s granulomatosis, 52–53 Rhinostereometry, 483 Rhinovirus, 92, 205 Rhizopus, 38 Rhonchi, 213 Rhytid(s), 685 chemodenervation of, 685–686, 686f surgical treatment of, 691 Rhytidectomy, 691 Ribavirin, 91t, 221 Ribonucleic acid See RNA Ribosomal RNA (rRNA), 193 Riedel’s thyroiditis, 654 Right posterior cerebral artery, 694 Rima glottidis, 510–512 Rima vestibuli, 509 Rivinus, ducts of, 637 RNA, 226 messenger (mRNA), 193, 194f ribosomal (rRNA), 193 transfer (tRNA), 193 752 INDEX RNA virus, 90–91 Rocephin (ceftriaxone), 115t, 116 Rods (eye), 611 Root cells (external sulcus cells), 314f, 319, 321 in pH regulation, 329 in potassium recycling, 326, 327f Ropivacaine, 107–108 duration of action, 108 maximum dose of, 108t Rosenmüller, fossa of, 553, 560, 561f Rosenthal’s canal, 280 Rotational testing, 417–419 findings in, summary of, 419t gain in, 418–419, 418f, 419t phase in, 418–419, 418f, 419t symmetry in, 418–419, 418f Round window, 276f, 278 Rouvière, nodes of, 676 RSVF mnemonic, 213, 215–216 Rubella vaccine, 93 Rubella virus, 93–94 Rubrospinal tract, 358 Rumination, pharyngeal function in, 557 RYR gene, 232 S Saccade, 356f, 358 in electronystagmogram, 415, 417t Saccular cysts, laryngeal, 576 Saccule anatomy of, 279–280 anomalies of, 256–258 development of, 254 fluid spaces of, 279 testing of, 420 vestibular function of, 355, 410–411 Saddle nose deformity, 52–53, 459 Sagittal sinuses, superior and inferior, 699 Salicylates ototoxicity of, 132 and wound healing, 25 Saliva, 629, 637–641 composition of, 629, 640–641 electrolyte concentrations in, 641 flow rate of, 629, 640 mucins in, 640–641 viscosity of, 641 Salivary gland(s), 628–629, 634–642 acinus of, 637–638, 638f anatomy of, 628–629, 634–637 atrophy of, in Sjögren’s syndrome, 50 cancer of, 630 ductal system of, 637–638, 638f, 640 intercalated duct of, 637, 640 interlobular duct of, 637, 640 masses of, 630 minor, 628, 637 morphophysiology of, 634–642 mucinous, 629, 637–638 mucoceles of, 588–589 neuroeffector arrangements in, 637 epilemmal, 637 hypolemmal, 637 physiology of, 637–641 secretions of, 629, 637–641 acinar cell, mechanism of, 638–640, 639f autonomic control of, 637 composition of, 629, 640–641 flow rate of, 629, 640 mucins in, 640–641 regulation of, 629, 637 viscosity of, 641 secretory unit of, 637–638, 638f serous, 629, 637–638 striated duct of, 637, 640 tumors of, 585 Salpingopalatine membrane, 553 Salpingopharyngeal fold, 553f Salpingopharyngeal muscle, 278 Salpingopharyngeus muscle, 555f, 556, 558–559 in swallowing, 570 Salty taste, 631 Sample size, 175 Sampling methods, 174–175 nonprobability, 174–175 probability, 174–175 The Sanford Guide to Antimicrobial Therapy, 110 Santorini’s fissure, 281 Sarcoidosis laryngeal neuropathy in, 521 oral masses in, 630 Scala media, 279–280, 314f floor of, cells covering, 319–321 homeostasis in, 325–326 in potassium recycling, 326–327, 327f Scala tympani, 279, 314f homeostasis in, 325–326 Scala vestibuli, 279–280, 314f homeostasis in, 325–326 in potassium recycling, 327f Scalene muscles, 600, 695f, 697f–698f middle, innervation of, 603 Scalp lymphatics of, 702 vascular supply of, 701 Scapular artery, transverse, 695f Scar(s), 18–21 excessive, 18t in fetal surgery, 30 formation of, 9, 18 pathological, by tissue types, 18t hypertrophic, 15, 19–21, 20f insufficient, 18t keloid, 15, 19–21, 19f minimization of, methods for, 19 relaxed skin tension lines (RSTLs) and, 18–19 satisfactory, 18–19 unsatisfactory, 18–21 widened, 19 Scarpa’s ganglion, 254, 355, 620 Scattering, of laser energy, 181, 181f Scheibe’s anomaly, 257–258 Scheibe’s dysplasia of membranous labyrinth, 287, 288f Scheie’s syndrome, 233 Schirmer’s test, 426 Schwannoma, vestibular See Acoustic neuroma Science, culture of, 168–169 Scintigraphy for parathyroid localization, 648–649 peptide receptor, 670 in thyroiditis, 654 Screamer’s nodes, 574 Scroll region, nasal, 458–459 Scurvy, 23 Scutum, 278 computed tomography of, 435, 436f SDHD gene, 230 Secondary intention, in wound healing, 17 Secondary palate, 450 Second messengers, and salivary secretion, 629, 638 Seizure disorders, auditory processing in, 366 Selection bias, 173–174 Selective neck dissection, 608–609 Self versus nonself, 45–46, 150–151 Sella turcica, 593f Semantics, 369–370 Semicircular canals afferent physiology of, 411–413 anatomy of, 279–280 directional sensitivity of, 410–411 in electronystagmogram, 415–416, 418t excitatory pathways of, 412 horizontal, 411 inhibitory pathways of, 412 integrative function of, 411–413, 412f lateral, computed tomography of, 433f–434f, 435–436, 436f planes of, 410–411 posterior, computed tomography of, 433f–434f, 435–436, 436f “push-pull” pairs of, 411 in rotational testing, 417–419 superior, computed tomography of, 433f–434f, 435–436, 436f torsional pendulum model of, 411 vertical, 411 vestibular function of, 355, 356f, 409–412 Semicircular ducts anatomy of, 279–280 development of, 254 fluid spaces of, 279 Sensitization, in allergic disease, 33, 33f, 479–480 Sensorineural hearing loss aging and, 302–305 indeterminate presbycusis, 305, 307f neural presbycusis, 304f–305f, 305 sensory presbycusis, 303f, 304–305 strial atrophy, 305, 306f in Alport’s syndrome, 239, 290, 290f auditory processing in, 340349 in Behỗets syndrome, 51 in branchi-oto-renal syndrome, 238 cochlear implants for, 388–393 in Cogan’s syndrome, 53, 299, 300f complete hair loss and, 344–345, 345f INDEX in DiGeorge syndrome, 235 etiology of, evaluation by age of onset, 237t in giant cell arteritis, 53–54 in Hashimoto’s thyroiditis, 56 hereditary, 236–240 in HIV/AIDS, 94 idiopathic, 309, 310f immune-mediated, 299 with systemic disease, 299, 300f without systemic disease, 299, 300f inner hair cell loss and, 344–347, 345f, 347f in Jervell and Lange-Nielsen syndrome, 239 in Meniere’s syndrome, 309–311, 311f noise-induced, 295–297, 298f nonsyndromic, 238, 242–244, 243f, 245, 328–329 in Norrie’s disease, 239 outer hair cell loss and, 344–346, 345f–348f in Pendred’s syndrome, 238–239 in polyarteritis nodosa, 54 progressive autoimmune, 46 pure-tone audiometry in, 375f, 376 in relapsing polychondritis, 51–52 in rheumatoid arthritis, 46–47 sickle cell anemia and, 232 in Sjögren’s syndrome, 50 syndromic, 236–240, 245 in systemic lupus erythematosus, 47–48 in Usher’s syndrome, 239–240, 287–290 in Waardenburg’s syndrome, 240, 290–291, 291f in Wegener’s granulomatosis, 52–53 Sensorineural olfactory dysfunction, 491, 493t, 494 disease processes in, 495–496 Sensory cortex, and swallowing, 567–568, 569f, 571 Sensory organization test (SOT), 420 Sensory presbycusis, 303f, 304–305 Sentinel node biopsy, 702 Septra (trimethoprim-sulfamethoxazole), 111 Serial analysis of gene expression (SAGE), 197–198 Seronegative spondyloarthropathies, 55–56 Serotonin in flap dynamics, 706 in wound healing, 12, 13t Serous otitis media in polyarteritis nodosa, 54 in Wegener’s granulomatosis, 52–53 Serturner, Friedrich, 104 Sesamoid cartilage, 457f Sestamibi imaging, for parathyroid localization, 648–649 Sex chromosomes, 226–228 Shakespeare,William, on analgesics, 104 Shearing forces, and vestibular function, 410 Shprintzen’s syndrome, 235 Sick building syndrome, 166 Sickle cell anemia, 232 genetics of, 232 hearing loss in, 232 Sigmoid sinus, 276, 280, 699 Signal-to-noise ratio, 176 Signal transducer and activator of transcription (STAT6), 35 Silica, in ceramic implants, 711 Silicone, topical, for keloids, 21 Silicone implants, 709, 711 Silktouch, 188 Sill, nasal, 456f, 457 Silverman technique, 520 Simple random sampling, 174 Simultaneous analog system, for cochlear implants, 391 Singer(s), vocal folds of, 533 Singer’s formant, 545 Singer’s nodes, 574 Single nucleotide polymorphisms (SNPs), 196 Single photon emission computed tomography (SPECT), for parathyroid localization, 648–649 Sinodural cells, 279 Sinus cholesteatoma, 438, 438f Sinusitis in AIDS patients, 57, 84 antibiotics for, 110 causative agents of anaerobic, 88–89 Haemophilus influenzae, 86–87 Moraxella catarrhalis, 87 Pseudomonas aeruginosa, 88 Streptococcus pneumoniae, 85–86 cilia dyskinesia in, 477 in cystic fibrosis, 233 inherited syndromes associated with, 233 in Kartagener’s syndrome, 233 nosocomial, 84 olfactory dysfunction in, 495 in Wegener’s granulomatosis, 53 Sinusoidal rotations, 411 Sinus tympani, 278 computed tomography of, 433f–434f, 434 Site-directed mutagenesis, 196 Sjögren’s syndrome, 50, 630 diagnosis of, 50 epidemiology of, 50 gustatory dysfunction in, 632 head and neck manifestations of, 50 otologic involvement in, 50 with polymyositis, 49 Skin aging, 26–27, 682–683 laser applications for, 187–188, 687–688 tensions lines of, 18–19 Skin grafts commercial products for, 27 healing of, 27 imbibition of, 27 thin, split-thickness, or full-thickness, 27 Skin protection, from lasers, 186–187 Skin resurfacing, 686–688 chemical, 687 laser, 687–688 Skin testing, in allergic diseases, 40 Skin types, classification of, 683, 683t 753 Skull base fracture of, nerve damage in, 617 pharyngeal attachment at, 560, 561f surgical anatomy of, 610–624 SLC26A4 (pendrin), 321, 326 Sleep delta, 74 EEG studies of, 73–74, 76 in infants, 201 non-rapid eye movement (N-REM), 73–74 physiologic effects of, 74 rapid eye movement (REM), 73–74 stage II of, 73–74 stage I of, 73 Sleep apnea body mass index and, 71–72, 77 central, 78 mild, 72f, 76t, 78 mixed, 76t, 77–78 moderate, 72f, 76t, 78 morbidity and mortality in, 71 obstructive classification of, 71, 72f, 77–78 clinical signs and symptoms of, 74, 74t continuous positive airway pressure for, 78 daytime sleepiness with, 74, 74t differential diagnosis of, 76t laboratory evaluation in, 76–77 laser-assisted uvulopalatoplasty for, 80, 188 mandibular advancement device for, 78–79 maxillofacial surgery for, 80–81 mild, 72f, 78 moderate, 72f, 78 pathophysiological features of, 72–73, 73f physical examination in, 74–76, 75f polysomnogram in, 76, 76t radiofrequency tissue volume reduction for, 80 radiological examination in, 77 severe, 72f, 78 sickle cell anemia and, 232 Snap test in, 76–77 snoring in, 74, 74t tongue base and hyoid bone suspension for, 80 tracheostomy for, 79 treatment of, 78–81 goals of, 81 medical, 78–79 surgical, 79–81, 79t upper airway collapse in, 65, 67, 72 uvulopalatopharyngoplasty for, 79–80 weight control for, 78 pathogenesis of, 72–73 prevalence of, 71 risk factors for, 72–73 severe, 72f, 76t, 78 syndromes of, classification of, 77–78 Sleep architecture, 73–74 Sleep disordered breathing (SDB) syndromes, 71, 72f See also Sleep apnea 754 INDEX “Slow” viruses, 91 Sluder’s sphenopalatine neuralgia, 630 Small cell carcinoma, laryngeal, 583–585 SMAS See Superficial musculoaponeurotic system Smell, sense of, 485 See also Olfactory apparatus; Olfactory dysfunction Smell Identification Test (SIT), 492 Smoking chemical pollutants from, 164–165 and flap dynamics, 707 and head and neck cancer, 138 and laryngeal cancer, 580 and skin damage, 685 as surgical contradiction, 25 and wound healing, 25 Snap test, in sleep apnea, 76–77 Sneeze reflex, 478 Snoring, 67, 71–72, 74, 74t acoustic analysis of (Snap test), 76–77 habitual, 72f, 77 polysomnogram in, 76, 76t, 77 surgical procedures for, 79–81, 79t Sodium in inner ear homeostasis, 326 in salivary regulation, 638–640 Sodium channel blockers, 107 Sodium-hydrogen exchange, 329 Soft callus, in bone healing, 28–29 Soft palate, 553f, 554, 555f, 628 development of, 450–451 Soft tissue fillers, injectable, 688, 712 Soft triangle, nasal, 456, 456f Somatic cell mutations, 228 Somatic motor oculomotor nucleus, 612–613 Somatostatin receptor scintigraphy, 670 Sound(s), 259–268 complex, 261f, 262 definition and description of, 260, 260f diffraction and scattering of, 264–265, 264f fetal reaction to, 369 hair cell excitation by, 333–335, 334f–335f human sensitivity to, 261–263, 263f influences on, 264–265 processing of, 265–268, 322–323, 333–336, 340–342 simple or pure, 261f, 262 Sound C, speed of, 264, 264t Sound frequency, 262 Fourier spectra of, 262, 262f human sensitivity to, 262–263, 263f Sound pressure, 260–262 auditory nerve fiber response to, 343–344 of common sounds, 261, 262t definition of, 260, 260f free field description of, 262–263 international unit of (pascal), 260 quantification of, 260–262, 261f temporal variation in, 260–261, 261f, 262 variations, with distance from source, 265 Sound pressure level (SPL), 261–262, 530 Sound propagation, 264–265 velocity of, 264, 264t Sound wave(s), in phonation, 537–538 Sound wavelength, 264–265, 264f, 265t Sour taste, 631 Spasmodic croup, 204 Spasmodic dysphonia, 520 abductor, 520 adductor, 520 treatment of, 520, 548 tremors in, 521 Spearman’s rho, 177 Spectinomycin, 120 Spectral peak (SPEAK) coding, for cochlear implants, 391 Speech audiometry, 362, 376–377 masked, 362–363 Speech detection threshold (SDT), 362 Speech processor, of cochlear implant, 389–391, 389f Speech production See Voice disorder(s);Voice production Speech reception threshold (SRT), 362, 376–377 Sphenoethmoid recess, 466f, 467 Sphenoid bone, 467 Sphenoid sinus, 462f–463f, 467–468, 468f intracranial anatomical relations of, 468 Sphenomandibular ligament, development of, 501, 501t Sphenopalatine artery, 470–471, 470f, 701 Sphenopalatine fossa, 471 Sphenopalatine vein, 469 Spinal accessory nerve (CN XI), 623 clinical considerations of, 623 in fifth-sixth branchial arch, 501t, 502, 513 innervation by neck, 600f, 603f, 605–606, 605f pharyngeal, 560–561 sparing, in neck dissection, 609 Spinal artery, anterior, 694 Spindle squamous cell carcinoma, laryngeal, 583 Spine of Henle, 275, 276f Spiral ganglion, 279f, 280, 314f development of, 254 type I cells of, 280 type II cells of, 280 in Usher’s syndrome, 289f, 290 in Waardenburg’s syndrome, 291 Spiral ligament, 279f, 280, 314f, 323–324 cellular composition of, 324, 324t, 325f function of, 324 in potassium recycling, 326, 328f Spiral limbus, 314f cellular composition of, 324–325, 324t, 325f Spiral modiolar vein (SMV), 46 Spiral prominence, 314f, 323 Spiral prominence cells, 324 Spiral tunnel nerve bundle, 315f Spirometer, 60, 62 Splenius capitis muscle, 600, 696f Splenius colli muscle, 696f Spondyloarthropathies, seronegative, 55–56 Sporanox (itraconazole), 126–127 Squamous cell carcinoma head and neck, 137–149, 229 See also Head and neck cancer laryngeal, 579–583 histology of, 581–582, 582f localization of, 580–581 variants of, 582–583, 582f oral cavity, 630 spindle, 583 of temporal bone, 305, 308f thyroid, 661 CASTLE variant of, 661 epidemiology of, 661 gross appearance of, 661 histology of, 661 prognosis of, 661 Staggered spondaic test, 363 Stainless steel implants, 709, 711 Standard deviation, 176 Standard error of the mean (SE), 176 Stapedial artery persistent, 287, 289f, 502 in second branchial arch, 502 Stapedius muscle, 253, 277–278, 355 development of, 501t, 502 Stapedius reflex, 355, 426 Stapedotomy, 273 Stapes acoustic function of, 266–267, 267f anatomy of, 277, 278f computed tomography of, 433f–434f, 434–435, 436f development of, 253, 501, 501t Stapes fixation, 269 Stapes footplate, 277 Staphylococcal infection croup/stridor with, 204 supraglottitis with, 218 Staphylococcus aureus, 87–88 colonization, 85, 87–88 infection, 87–88 penicillin-resistant, 112 tracheitis with, 204 vancomycin-resistant, 118 Static admittance, 377–378, 377f Static pressure-volume curve, of lung, 65, 65f Statistic(s), 175–177 descriptive, 175–176 inferential, 176–177, 176t nonparametric, 175–177 parametric, 175–176 power in, 175 variables in, 175 Statistical regression, 174 Statistical significance, 176 Statistician, research role of, 175 Statoacoustic ganglion complex, 254 Steatoblepharon, 684 Steeple sign, in croup, 202, 202f, 219 Stensen’s (parotid) duct, 628, 634, 635f Stereocilia, 279, 316–317, 332–333, 333f arrangement of, 316, 316f–317f, 333 beveled needle (vestibular), 333 pipe organ (cochlear), 333 INDEX composition of, 316 development of, 254–255 excitation of, 334–335 genetic mutations of, 316–318 structure of, 332–333 tip links of, 316, 316f–317f, 333, 333f, 336, 341, 341f transduction by, 316, 335–336, 340–342, 341f vestibular function of, 355, 410–411 Sternocleidomastoid muscle, 600, 635f, 695f–698f in delineation of neck triangles, 598–600, 599f–600f innervation of, 605, 605f, 623 Sternohyoid muscle, 511, 511f, 516–517, 600, 695f–698f Sternothyroid muscle, 510, 511f, 516–517, 600 Steroids See Corticosteroids Stertor, 213 Stickler’s syndrome, 235, 453 Stimulus-frequency otoacoustic emissions (SFOAEs), 364 Stomodeum, 449, 450f Strabismus, 613 Strap muscles, 511, 516–517, 599f, 600 Stratified random sampling, 174 Streptococcal infection croup/stridor with, 204 group A, abscess with, 204 Streptococcus pneumoniae colonization, 85 capsulated, 85 opaque variant of, 85 transparent variant of, 85 infection, 85–86 inflammation in, 85–86 pathogenesis of, 85–86 penicillin-resistant, 114 sulfonamides for, 111 tracheitis with, 204 penicillin-resistant, 112 tissue penetration by, 85 Streptococcus pyogenes, 85 Streptokinase, and surgical hemostasis/ coagulation, 4t Streptomycin, 119–120 chemistry of, 119, 119f ototoxicity of, 118, 128, 295 resistance to, 119 spectrum of activity, 119–120 vestibular toxicity of, 128, 295 Strial atrophy, 305, 306f Striated duct of salivary gland, 637, 640 Stria vascularis, 255, 279f, 280, 314f, 323–324, 341 basal cells of, 323 epithelial cells of, 323 function of, 313–314 intermediate cells of, 323 marginal cells of, 323 in potassium recycling, 326–327, 327f–328f Stridor, 66, 212–224 airway anomalies and, 216–223, 217t at birth, 214 with choanal stenosis/atresia, 216 with croup, 202, 219 definition of, 212 diagnostic approach to, 214–215 differential diagnosis in, 216 endoscopic findings in, 215 etiology of, 216–223, 217t expiratory, 212 with foreign-body obstruction, 223 glottic/subglottic causes of, 217t, 219–222 with hemangiomas, 221–222, 222f high- or low-pitched, 212 inspiratory, 212 in croup, 204 in laryngitis, 204 with laryngomalacia, 215–216, 218, 218f localization of, 213–214, 214t nasal/pharyngeal causes of, 216–218, 217t with oral synechiae, 216–218 versus other airway noise, 213 in pediatric patients, 212–224 with persistent buccopharyngeal membrane, 216–218 physiology of, 212–213 positional changes to, 215 progressive, 214 radiographic findings in, 215–216 with recurrent respiratory papillomatosis, 221 with reflux disease, 216 with rheumatoid arthritis, 47 RSVF mnemonic in, 213, 215–216 with subglottic stenosis, 220 supraglottic causes of, 217t, 218–219, 218f with supraglottitis, 218–219 tracheal causes of, 222–223 with tracheal stenosis, 222 with tracheomalacia, 215, 222 with true vocal cord paralysis, 220–221 String model, for phonation, 528 Stroke, laryngeal disorders in, 522–523 Sturge-Weber sequence, 702 Stuttering, 521 Styloglossus muscle, 628, 697f–698f in swallowing, 568–570 Stylohyoid ligament, development of, 501–502, 501t Stylohyoid muscle, 511, 517, 555f, 635f development of, 501t, 502, 593f in swallowing, 570 Styloid process, 275, 276f, 555f, 560, 697f–698f development of, 501–502, 501t Stylomastoid foramen, 275, 276f Stylopharyngeus muscle, 511, 517, 555f, 556, 558, 558f development of, 501t, 502, 593f innervation of, 562, 621 in swallowing, 570 755 Subacute sclerosing panencephalitis (SSPE), 94 Subarachnoid hemorrhage, 297–299, 299f Subclavian artery, 693–694, 695f, 697f esophageal supply by, 564 Subclavian vein, 602f, 698f, 699 Subglottic hemangioma, 221–222, 222f Subglottic space, 510 Subglottic stenosis, 220 acquired, 220, 220f congenital, 220 etiology of, 220 intubation and, 220, 220f stages of, 220, 220t stridor with, 220 Subglottis, 580 obstruction of examination for, 213–214, 214t stridor with, 213–214, 217t, 219–222 size, by age, 213, 213t tumors of, 580, 585 Subharmonics, 529 Subiculum, 278 Sublingual gland, 628–629, 636f anatomy of, 628–629, 637 innervation of, 637 vascular supply of, 637 Sublingual space imaging of, 672t, 673–674 pathology of, 672t, 673–674 Submandibular (Wharton’s) duct, 629, 636, 636f obstruction of, 673, 673f Submandibular ganglion, 600f, 629, 636f Submandibular gland, 599, 606, 628–629 aging and, 685 anatomy of, 628–629, 636–637, 636f dissection of, 604 imaging of, 672t, 673, 673f innervation of, 636–637 saliva composition in, 641 vascular supply of, 637 Submandibular space, 560 imaging of, 671–673, 672t pathology of, 672t, 673 Submandibular triangle, 599, 599f–600f, 636 lymphatics of, 606–607 nerve supply of, 604–605 Submental artery, 696f–697f Submental triangle, 599, 599f Submucous fibrosis, 589 Subnasale, 456f, 457 Subperichondral hematoma, with cartilage injury, 28 Substance P, 706 Substernal thyroid, 656 Subsurface cisternae (SSC), 318 Subtotal neck dissection, 609 Sudden infant death syndrome (SIDS), 201 Sufentanil, 105 Sulcus vocalis, 533 Sulfamethoxazole, 111 chemistry of, 111, 111f with trimethoprim, 111112 756 INDEX Sulfanilamide, 110111 Sulfasalazine for Behỗets syndrome, 51 for rheumatoid arthritis, 47 Sulfisoxazole, 111 Sulfonamides, 110–112 chemistry of, 111, 111f history of, 110–111 mechanism of action, 111 pharmacokinetics of, 111 resistance to, 111 side effects of, 111 spectrum of activity, 111 Summating potential (SP), 382–383 Sunderland classification, of neural injury, 425–426, 426f Sun exposure, 683, 685 Superficial musculoaponeurotic system (SMAS), 460, 682 Superficial musculoaponeurotic system lift, 690f, 691 Superficial temporal artery, 603f, 635f, 636, 695f–697f, 699–700 Superficial temporal vein, 635f, 699 Superinfection, 110 Superior auricular muscle, 251 Superior conchae, 462–463, 465–466 Superior labial artery, 460, 461f, 470, 470f Superior laryngeal artery, 602f Superior laryngeal nerve, 511f, 513, 513f, 517, 555f, 622 paralysis of, 518–520 management of, 519–520 Superior meatus, 465 Superior oblique muscle, 614 Superior olivary complex, 352f, 353–354 Superior petrosal sinus, 280, 699 Superior pharyngeal constrictor muscle, 555f, 556, 558–559, 558f in swallowing, 570 Superior rectus muscle, 612–613 Superior sagittal sinus, 699 Superior suspensory ligament, 277 Superior thyroid artery, 512–513, 602, 602f–603f, 694, 695f, 698f Superior thyroid vein, 602, 602f, 644, 699 Superior vena cava, 698f Superior vena cava syndrome, 650–651 Superior vestibular nerve, 280 Superior vestibular nucleus, 357, 357t Superoxide dismutase (SOD), 26 for flap survival enhancement, 707 Supplementary motor area (SMA), and swallowing, 567–568, 569f, 571 Suppressive therapy, for hyperthyroidism, 645 Suppurative labyrinthitis, 293, 293f Suppurative otitis media, chronic, 292f, 293, 293f Supraclavicular nerve, 603, 603f Supraclavicular nodes, 607 Supraglottic region, 510 Supraglottis, 580 obstruction of examination for, 213–214, 214t and stridor, 213–214, 217t, 218–219 tumors of, 580–581, 585 Supraglottis tumors See also Head and neck cancer staging of, 139, 139t Supraglottitis, 204 acute, 218–219 causative agents of, 218 clinical presentation of, 219 radiographic findings in, 219, 219f stridor with, 218–219 treatment of, 219 Supraglottoplasty, 218 Suprahyoid muscles, in swallowing, 570 Supramid, 711–712 Supraomohyoid neck dissection, 609 Supraorbital artery, 695f, 700–701 Suprascapular artery, 694 Supratip breakpoint, nasal, 456–457 Supratip lobule, nasal, 456–457 Supratrochlear artery, 461, 701 Suprax (cefixime), 115t, 116 Supreme conchae, 463 Surfactant, 65, 200 Surgical flaps, 704–708 axial pattern, 694, 700, 705 delay phenomenon with, 705 diseases affecting, 707 dynamics of, 706–707 fasciocutaneous, 706, 706t imaging findings with, 680 musculocutaneous, 705–706, 706t random pattern, 694, 700, 705 for reconstructing defects, 705–706 survival of, enhancement of, 707 tension and elasticity of, 707 vascular architecture and, 694, 699–701, 704–705 Surgical hemostasis, 3–8, 6f description of, disorders of, 4t, 5–7 acquired, 4t clinical evaluation for, 3–4 commonly seen, 5–7 drug-induced, 4t, laboratory evaluation for, 4–5 management of, 7–8 initiation of, 3, 7f lasers and, 181, 181t, 185 process of, 3, 7f Surgicel, Surveys, 173 Suspensory ligaments, 277, 643–644 Swallowing, 556–557, 566–573 airway protection in, 567, 567t anatomy and physiology of, 566–568 basic mechanisms in, 568–571 bolus preparation in, 567t, 568 bolus transport in, 567, 567t central nervous system components of, 567–568, 569f clinical evaluation of, 571–572 difficulty in See Dysphagia esophageal function in, clinical evaluation of, 572 esophageal phase of, 571 musculoskeletal components of, 567, 567t neural control of, 571 oral function in, evaluation of, 572 oral phase of, 568–569 oral preparatory phase of, 568 peripheral nervous system components of, 567, 568t pharyngeal function in, evaluation of, 572 pharyngeal phase of, 570–571 phases of, 568–571 Sweet taste, 631 Synapse(s) of cochlear nucleus, 351 of hair cells, 333, 333f Synaptic transmission, by hair cells, 338 Synchronized intermittent mandatory ventilation (SIMV), 69 Syndromic hearing loss, 236–240, 245 Syntax, 369–370 Synthesis (S) phase, of cell cycle, 193, 193f Syphilis, of inner ear, 294, 294f Systematic sampling, 174 Systemic lupus erythematosus (SLE), 47–48 head and neck manifestations of, 47–48 laryngeal manifestations of, 48 otologic manifestations of, 47–48 treatment of, 48 T Tagamet (cimetidine), 101 Tagliacozzi, Gaspard, 11 Tall-cell papillary thyroid carcinoma, 657, 661 Tapazole, for hyperthyroidism, 645 Taste (gustation), 631–632 anatomy and physiology of, 631 disorders of, treatment of, 632 evaluation of, 631 laboratory analysis of, 632 pathology of, 631–632 psychophysical testing of, 632 qualities of, 631 Taste buds, 628, 631 Taste receptors, 631 TATA box sequence, 194 Taxanes, for head and neck cancer, 145 Tazicef (ceftazidime), 115t, 116 Tazidime (ceftazidime), 115t, 116 Technetium 99m labeled sestamibi, for parathyroid localization, 648–649 TECTA gene, in hearing loss, 243f, 244 Tectorial membrane, 279f, 313, 314f–315f, 322–323 biochemistry of, 322–323 fibrils of, 322 interdental cells of, 324–325 structure of, 322 Tectorin, 323 Teeth, 628, 641 plain film studies of, 667–668 Teflon injection, for vocal fold paralysis or paresis, 519, 711 INDEX Tegmental cells, 279 Tegmen tympani, 278 Telangiectasias, in progressive systemic sclerosis, 48–49 Telithromycin, 123 mechanism of action, 123 pharmacokinetics of, 123 side effects of, 123 spectrum of activity, 123 Telomerase, in head and neck cancer, 145–146 Telopharyngeal bodies, development of, 503 Temperature, and flap dynamics, 706 Temporal (giant cell) arteritis, 53–54 Temporal artery, 693, 695f, 698f forehead supply by, 700 superficial, 603f, 635f, 636, 695f–697f, 699–700 Temporal bone aging and (presbycusis), 302–305 bone disorders of, 301–302 in Cogan’s syndrome, 55 computed tomography of, 431–438, 433f–434f, 436f–437f developmental defects of, 284–287 imaging of, 443–444 development of, 253, 256 eponyms and anatomical pearls for, 281 external anatomy of, 275–276, 275f facial nerve course in, 276, 277f, 278, 280–281, 422–424, 423f fracture of imaging of, 439–440, 439f longitudinal, 439, 439f mixed, 439 nerve damage in, 618 transverse, 439, 439f genetic disorders of, 287–293 histology of, normal, 284, 285f–286f histopathology of, 283–287 infections of, 293–295 inferior view of, 275, 276f inflammatory disease of, imaging of, 438–439 lateral view of, 275, 276f light microscopy of, 284 magnetic resonance imaging of, 432 neoplasia of, 305–309 nerves running through, 280–281, 422–424 noise trauma to, 295–297, 298f plain radiography of, 431 plane of section, 284 in polyarteritis nodosa, 54 posterior view of, 275–276, 276f radiology of, 431–445 comparison of modalities, 444, 444t imaging techniques in, 431–432 normal anatomy in, 432–438, 433f–434f, 436f–437f pathology in, 439–444 retrieval and study of, techniques for, 284 squamous cell carcinoma of, 305, 308f surgical anatomy of, 275–282 in systemic lupus erythematosus, 47 transverse fracture of, 295, 297f trauma to, 295–297 imaging of, 439–440, 439f vascular disorders of, 297–299 imaging of, 440 vascular supply of, 280 Temporalis free flap, imaging findings with, 680 Temporalis muscle, 629 development of, 593f Temporal line, 275 Temporal nerve, 616, 635 Temporal tenderness, in giant cell arteritis, 53–54 Temporal vein, 696f superficial, 635f, 699 Temporomandibular joint (TMJ), 629 in rheumatoid arthritis, 47 in systemic lupus erythematosus, 48 Temporomandibular joint syndrome, 629 Tensile strength, in wound healing, 16–17 Tensor tympani muscle, 253, 355 computed tomography of, 435, 436f development of, 501, 501t Tensor tympani tendon, 277 Tensor veli palati muscle, 278–279, 628 development of, 501, 501t Tequin (gatifloxacin), 125–126 Teratoma, nasopharyngeal, 453 Terminal sulcus, 503 Testing, and research validity, 174 Tetracaine, chemistry of, 106 Tetracycline(s), 120–121 and black thyroid, 652 chemistry of, 121, 121f history of, 120 mechanism of action, 121 pharmacokinetics of, 121 side effects of, 121 spectrum of activity, 121 Thiopental, for local anesthetic toxicity, 109 35delG mutation, 242, 328 Thoracic duct, 563, 563f Thrombin, 3, 6f–7f, 13 Thrombocytopenia, Thromboxane(s) A2 in flap dynamics, 706–707 in surgical hemostasis, in wound healing, 13t in immune response, 481–482 Thymic cysts, 677 Thymidine, 193 Thymidylate synthetase, in head and neck cancer, 148 Thymoxamine, for flap survival enhancement, 707 Thymus gland, development of, 503 Thyroarytenoid muscle, 511–512, 517 in phonation, 525 Thyrocervical arterial trunk, 644, 694, 697f Thyroepiglottic muscle, 511–512 Thyroglobulin, 644 Thyroglossal duct, persistent, 643 757 Thyroglossal duct cyst, 210, 210f, 590, 655, 676 Thyroglossal fistula, 643 Thyrohyal ligament, 507 Thyrohyoid membrane, 516 Thyrohyoid muscle, 510, 511f, 600, 697f–698f Thyroid acropachy, 644 Thyroid adenoma, 651–652 hyperfunctioning, versus GravesЈ disease, 662 Thyroid artery inferior, 512–513, 693–694, 695f, 697f–698f superior, 512–513, 602, 602f–603f, 694, 695f, 698f Thyroid cancer, 656–662 anaplastic, 660–661 clinical presentation of, 660 diagnosis of, 660 epidemiology of, 660 histology of, 660–661, 661f prognosis of, 661 follicular, 658–659 epidemiology of, 658 invasive, 658–659, 659f minimally invasive encapsulated, 658, 662 frozen section analysis of, 657, 657f, 661–662 hormone levels in, 644 imaging of, 676 lymphoma, Hashimoto’s thyroiditis and, 652–653 medullary, 644, 659–660 diagnosis of, 660 epidemiology of, 659–660 familial, 659–660 genetics of, 229 gross appearance of, 660 histology of, 660 prognosis of, 660 sporadic, 659–660 papillary, 656–659 versus cervical lymph node inclusions, 654–655 clinical presentation of, 656 columnar cell, 657 diagnosis of, 657, 657f epidemiology of, 656 familial, 229 follicular, 657, 657f frozen section analysis of, 657, 657f, 662 genetics of, 656 versus Graves’ disease, 653–654 gross appearance of, 656, 656f Hashimoto’s thyroiditis and, 653 versus hyalinizing trabecular tumor, 651–652 incidental findings of, 657 metastatic, 658 microscopic features of, 657, 657f prognosis in, 657–658 radiation exposure and, 656 758 INDEX Thyroid cancer (Continued) tall-cell, 657, 661 variants of, 657 squamous cell, 661 CASTLE variant of, 661 epidemiology of, 661 gross appearance of, 661 histology of, 661 prognosis of, 661 Thyroid cartilage, 506–507, 506f–508f, 516, 556 development of, 513 superior horn of, 555f Thyroidectomy, 646 for medullary carcinoma, 660 Thyroid gland, 643–646, 697f–698f anatomy of, 643–644 benign lesions of, 650–652, 676 black, 652 blood supply of, 644 cervical lymph node inclusions in, 654–655 ectopic, 589–590, 643, 654–656 embryology of, 503, 643 enlargement, in Pendred’s syndrome, 238–239 imaging of, 673t, 676 innervation of, 644 intratracheal, 655 lateral aberrant, 654–655 lingual, 589–590, 655 lymphatic drainage of, 644, 703 malignant neoplasia of See Thyroid cancer mediastinal, 656 metastatic disease to, 661 pathobiology of, 650–662 physiology of, 644 abnormal, 56, 644–646 Thyroid hormone(s), 644 assays of, 644 deficient (hypothyroidism), 56, 644 excessive (hyperthyroidism), 56, 644–646 in thyroid cancer, 644 Thyroid hormone therapy, 644–645 Thyroiditis, 644, 652–654 autoimmune, 56 De Quervain’s, 654 giant cell, 654 granulomatous, 654 Graves’ disease, 56, 644–646, 653 diagnosis of, 56, 653 ophthalmopathy of, 56, 653 versus papillary thyroid carcinoma, 653–654 pathobiology of, 653 symptoms and signs of, 56, 644–645, 653 treatment of, 56, 645–646 Hashimoto’s, 56, 644, 652–653 complications of, 652 diagnosis of, 652 neoplasia in, incidence of, 652–653 pathobiology of, 652 symptoms of, 56 invasive fibrous, 654 lymphocytic, 644 Riedel’s, 654 subacute, 654 Thyroid lamina tumors, 586 Thyroid muscle, 695f Thyroid notch, 507, 512f Thyroid-stimulating hormone (TSH), 644 Thyroid storm, 645 Thyroid vein(s) inferior, 699 middle, 602, 644 superior, 602, 602f, 644, 699 Thyropharyngeus part of inferior constrictor muscle, 558f, 559 Thyroplasty type I, 548 type II, 548 type III, 548 type IV, 548 window for, placement of, 549, 549f Thyroxine (T4), 644 Ticar (ticarcillin), 113 Ticarcillin, 113 Ticarcillin-clavulanic acid, 113 Tic disorders, laryngeal effects of, 521 Tic douloureux, 616 Tidal volume (TV), 60, 60f Timentin (ticarcillin-clavulanic acid), 113 Tinnitus aspirin and, 103 cisplatin and, 131 in Cogan’s syndrome, 55 in Hashimoto’s thyroiditis, 56 imaging in, 440 inner hair cell loss and, 346–347 loop diuretics and, 130 in mumps, 94 quinine and, 132–133 in relapsing polychondritis, 51 salicylates and, 132 Tip, nasal, 456–458 Tip cells, 279 Tip-defining points, nasal, 456, 456f, 458 Tip links, of stereocilia, 316, 316f–317f, 333, 333f, 336, 341, 341f Tip projection, nasal, 456–457 Tissue plasminogen activator, and surgical hemostasis/coagulation, 4t Titanium implants, 709–711 T lymphocytes, 44 in allergic diseases, 33–35, 479 in autoimmunity, 45–46 CD4ϩ, 34–35, 45, 153 CD8ϩ, 34–35, 153 cytotoxic, 35, 44, 153 helper, 35, 44–45, 153, 479 in Hashimoto’s thyroiditis, 652 Th1, 35, 45 Th2, 35, 45 in immune response, 44–45, 151 in head and neck cancer, 152–156 suppressor, 44 TNM staging, of cancer, 139, 139t Tobramycin, 119–120 ototoxicity of, 120, 120t, 130 vestibular toxicity of, 120, 120t Toluidine blue, in cancer detection, 148 Tongue, 628 base of, 554, 556, 556f dexterity of, 628 embryology of, 503, 593 gustatory function of, 631 innervation of, 503, 624, 628 masses of, 630 muscles of, 628 embryology of, 593, 593f in swallowing, 568–570 paralysis of, 624 root of, 553f, 555f Tongue base and hyoid bone suspension, for obstructive sleep apnea, 80 Tongue buds, 503 Tongue claudication, in giant cell arteritis, 53–54 Tonsil(s) Gerlach’s, 557 lingual, 557 hypertrophy, in sleep apnea, 76 Luschka’s, 554 palatine, 553f, 554–556, 555f–556f, 557, 628 development of, 503 pharyngeal, 554f–555f tubal, 557 Tonsillar artery, 562 Tonsillar carcinoma human papillomavirus and, 96 polymyositis and, 49 Tonsillar crypts, deep, 628 Tonsillar cysts, 575 Tonsillar fossa, 554–556 Tonsillar pillar, anterior, 554 Tonsillectomy, coagulation studies for, 4–5 Tonsil surface ablation, 188 Tornwaldt’s bursa, 453 Torsional pendulum model, of vestibular function, 411 Torus tubarius, 553, 553f Total lung capacity (TLC), 60, 60f impaired, in pulmonary function tests, 62 Toxicity See also Ototoxicity environmental, 164 Toxic nodular goiter, 645–646 Trabecular-insular thyroid carcinoma, 658–659 Trachea, 695f, 697f–698f dynamic compression of, 68 ectopic thyroid tissue in, 655 extrathoracic, 213–214 flaccidity of, 67–68 intrathoracic, 213–214, 214t lumen of, changing dimensions of, 68 obstruction of, 67–68 examination for, 213–214, 214t flow-volume curves of, 67–68, 67f foreign-body, 223 stridor with, 213–214, 222–223 INDEX patency of, 68 physiology of, 67–68 Tracheal homograft transplant, 222 Tracheal rings, destruction in relapsing polychondritis, 52 Tracheal stenosis, 65, 222 clinical presentation of, 222 diagnosis of, 222 segmental or funnel-type, 222 stridor with, 222 treatment of, 222 Tracheitis bacterial causative agents of, 204 in pediatric patients, 204–205 in systemic lupus erythematosus, 48 Tracheobronchitis, 87 Tracheomalacia, 65–66, 222 clinical presentation of, 222 diagnosis of, 222 primary, 222 secondary, 222 stridor in, 215, 222 treatment of, 222 Tracheostomy, for obstructive sleep apnea, 79 Tracheotomy in pediatric patients, 205 in subglottic stenosis, 220 in true vocal cord paralysis, 221 for vocal fold paralysis or paresis, 519 Tragal pointer, 635 Transcapillary fluid exchange, in flap dynamics, 706–707 Transcription, 193, 194f Transcription factors, 194 Transduction (genetic), 195 Transfection, 195 Transfer RNA (tRNA), 193 Transforming growth factor ␣ in head and neck cancer, 145 in wound healing, 12, 14t, 17 Transforming growth factor ␤ in keloid formation, 20–21 in wound healing, 13, 14t, 15, 17 Transiently evoked otoacoustic emissions (TEOAEs), 134, 364, 379, 380f Translation, genetic, 193, 194f Transmission, of laser energy, 181, 181f, 183–184 Transverse arytenoid muscle, 509f, 511–512, 555f Transverse cervical artery, 695f, 697f–698f Transverse crest, 620 Transverse facial artery, 603f, 635f, 636, 696f, 700 Transverse facial vein, 635f Transverse nasalis muscle, 460, 460f Transverse process, 697f–698f Transverse scapular artery, 695f Transverse sinus, 276, 699 Trapezius muscle, 695f–696f innervation of, 605f, 606, 623 Trapezoid body, 351–353, 352f Trautmann’s triangle, 281 Treacher Collins syndrome, 236 aural atresia in, 287 cleft lip/palate in, 453 pinna malformation in, 257, 257f The Treatment of InfectedWounds, 11 The Treatment ofWounds Caused by Firearms, 11 Tremors, 520–521 essential, 520 vocal or laryngeal, 520–521 Triamcinolone acetonide dosage of, 103t for keloids, 21 Triangles of neck, 598–600, 599f anterior, 598–599, 599f carotid, 599, 599f posterior, 598–600, 599f submandibular, 599, 599f–600f submental, 599, 599f Triangularis menti muscle, 695f–696f Triangular ligament, 516 Trichloroacetic (TCA) acid, for chemical peel, 687 Trichophytic browlift, 688–689 Trigeminal nerve (CN V), 615–616 clinical considerations of, 616 damage to, 616 in eustachian tube control, 278–279 in first branchial arch, 501, 501t general somatic afferent of, 615 innervation by laryngeal, 511 nasal, 461, 468–469, 469f, 477, 486 tensor tympani muscle, 355 tongue, 503 magnetic resonance imaging of, 617f mandibular branch of (V3), 615–616, 617f maxillary branch of (V2), 615–616, 617f olfactory function of, 489, 491, 494 ophthalmic branch of (V1), 615, 617f special visceral efferent of, 615 in systemic lupus erythematosus, 48 Trigeminal neuralgia, 630 Triiodothyronine (T3), 644 Trimethoprim, 110–112 chemistry of, 111–112 pharmacokinetics of, 111–112 Trimethoprim-sulfamethoxazole, 111 Trisomy 13 inner ear anomalies in, 258 pinna malformation in, 256 Trisomy 15, pinna malformation in, 256 Trisomy 18, inner ear anomalies in, 258 Trisomy 21 (Down syndrome), 234, 256, 257f Triticeal cartilage, 506 Trochlear artery, 700 Trochlear nerve (CN IV), 358, 614–615 clinical considerations of, 614–615 paralysis of, 614–615 susceptibility to injury, 615, 615f True vocal cord, 502, 510, 516 See alsoVocal cords/folds 759 Tryptase, 34, 37 t-test, 176 Tubal tonsil, 557 Tuberculosis laryngeal neuropathy in, 521 in ventilation systems, 166 Tuberculum impar, 503 Tubotympanic recess, 502 Tumor(s) See specific anatomic sites and types head and neck See Head and neck cancer Tumor, node, metastasis (TNM) staging, 139, 139t Tumor-associated antigens (TAAs), 152–153 Tumor bioassays, 197 Tumor necrosis factor ␣ in immune response, 45 in rheumatoid arthritis, 47 in wound healing, 13, 15, 17 Tumor necrosis factor ␤, in immune response, 45 Tumor suppressor genes, 143, 193–195, 228 Tumor viruses, 95–96 Tunica muscularis, 564 Tuning fork, 260, 260f Turbinates (conchae), 462–465, 463f development of, 451 inferior, 462–463, 463f, 473, 554f middle, 462–465, 463f–464f, 466, 554f superior, 462–463, 463f–464f, 465–466, 554f supreme, 463, 466 Turner syndrome, 234 22q11 deletion syndrome, 235 Two-tailed test, 176 Tympanic annulus, 252–253 Tympanic cavity, development of, 502 Tympanic membrane acoustic function of, 266–267, 267f anatomy of, 276–279 computed tomography of, 433f–434f, 434 development of, 252–253, 500, 502 epithelial generation in, 29 healing of, 29–30 histologic layers of, 29 layers of, 252 loss of, 269, 269f perforation of, 270 chronic, 29–30 healing of, 29 surgical reconstruction of, 270–272 Tympanic nerve, 621 Tympanic plexus, 281, 621, 629 Tympanic ring, 278 Tympanic striae, anterior and posterior, 276 Tympanomastoid fissure, 275 Tympanometric peak, 377–378, 377f–378f Tympanometric shape (width), 377–378, 377f Tympanometry, 377–378, 377f–378f Tympano-ossicular system, 266–267, 267f Tympanoplasty middle ear aeration in, 272 without ossicular linkage, 270–271 760 INDEX Tympanoplasty (Continued) with ossicular linkage preservation, 271 ossiculoplasty with, 271–272 static pressure in, 272 type I, 271 type II, 271 type III, 271 type IV, 270–271, 270f type V, 270–271 Tympanosquamous ssure, 275 U Ulcers aphthous, 630 in Behỗets syndrome, 50–51 contact, vocal cord, 574 oral cavity, 630 Ultimobranchial bodies, development of, 503 Ultrafast computed tomography, 669 Ultrapulse, 188 Ultrasound disadvantages of, 668 of neck, 668 in parathyroid disease, 676 in stridor, 215 in thyroiditis, 654 Ultraviolet radiation, 683, 685 Umami, 631 Unasyn (ampicillin-sulbactam), 113 Uncinate process, 464–465, 464f development of, 451 Uniparental disomy, 228 Upper aerodigestive tract anatomic relationships of, 566–567 pathology of, 574 Upper airway collapse, during sleep, 67, 72 congenital abnormalities of, 67 environmental effects on, 164–167 obstruction of, 67–68 flow-volume curves of, 67–68, 67f physiology of, 67–68 Upper airway resistance syndrome, 72f, 76–77 Upper esophageal sphincter (UES), 563, 567, 570–571 Upper lateral cartilage, 457f, 458, 467, 473 Upper respiratory infections bacterial, 85–89 defense mechanisms against, 83–85 fungal, 85 and olfactory dysfunction, 493t, 494 viral, 85, 92–96 Ureidopenicillins, 113 Urokinase, and surgical hemostasis/coagulation, 4t Usher’s syndrome, 239–240, 244, 287–290 type I, 239–240, 289f, 290 type II, 240, 290 type III, 240, 290 Utricle anatomy of, 279–280 development of, 254 fluid spaces of, 279 testing of, 420 vestibular function of, 355, 410–411 Uvula, 553f, 555f development of, 450–451 Uvular muscle, 628 Uvulopalatopharyngoplasty (UPPP) complications of, 80 for obstructive sleep apnea, 79–80 success rates in, 79–80 Uvulopalatoplasty, laser-assisted, 179 for obstructive sleep apnea, 80, 188 V Vagus nerve (CN X), 621–622 versus ansa cervicalis, 604 auricular branch of, 281 clinical considerations of, 622 components of, 621 damage to, 622 in eustachian tube control, 279 in fourth branchial arch, 501t, 502, 513 general somatic afferent of, 621–622 general visceral efferent of, 621–622 innervation by, 621–622 esophageal, 563f, 564–565 laryngeal, 513, 513f, 517–518 neck, 605f, 606 pharyngeal, 560, 562, 606 special visceral efferent of, 621–622 tumor of, 622f–623f visceral afferent of, 621–622 Validity, 173–174 external, 173–174 internal, 174 Valleculae, 554, 556, 556f Vancomycin, 118 chemistry of, 118 mechanism of action, 118 ototoxicity of, 133 pharmacokinetics of, 118 resistance to, 118 side effects of, 118 spectrum of activity, 118 van der Hoeve’s syndrome, 257 Vantin (cefpodoxime), 115t, 116 Variable(s), 175 continuous, 175 definition of, 175 dependent, 175 discrete, 175 independent, 175 interval, 175 nominal, 175 ordinal, 175 ratio, 175 Varicella pneumonia, 205 Vascular anatomy, 693–703 See also specific anatomic structures and vessels direct cutaneous, 704 fasciocutaneous, 704 and flap design, 694, 699–701, 704–705 musculocutaneous, 704 surgical considerations of, 699–701 Vascular endothelial growth factor (VEGF), in head and neck cancer, 149 Vascular malformations, 210–211, 701–702 classification of, 701 combined, 701 high-flow, 701–702 low-flow, 701–702 surgical treatment of, 701–702 syndromes associated with, 702 Vascular territory, 694, 704–705 Vasoactive intestinal polypeptide, 706 Vasoconstriction in flap dynamics, 706 in hemostasis, in wound healing, 12–13 hypoxic, 64 Vasodilating agents, for flap survival enhancement, 707 Vasopressin, in inner ear homeostasis, 330 Vein(s), 696f, 698f See also specific veins adult pattern of, 698f, 699 Velocardiofacial syndrome, 235 Velocity storage, 413 Velosef (cephradine), 115t Vena comitans, 605 Venous malformations, 701 Venous thrombosis, due to factor V Leiden deficiency, 232 Ventilation alveolar, 63 dead space, 63 in infants and children, 202–203 measurements of, 63 mechanical See Mechanical ventilation minute, 63 resting, 63 Ventilation/perfusion (V/Q), 64 Ventilation system contamination, 165–166 Ventral acoustic stria, 353–354, 353t Ventral oblique muscle, 593f Ventral rectus muscle, 593f Verapamil, for flap survival enhancement, 707 Vergeture, 533 Vermilion border, 627, 700 Verrucous carcinoma, laryngeal, 582–583, 582f Vertebral artery, 693–694 Vertebrobasilar infarct, 297, 298f Vertical crest (Bill’s bar), 280, 422, 620 computed tomography of, 433f–434f, 435, 619f Vertigo, 358–359 augmentation, in fast phase, 413 benign paroxysmal positional, 311, 311f, 411, 415 in Cogan’s syndrome, 55 in Hashimoto’s thyroiditis, 56 loop diuretics and, 130 in Meniere’s syndrome, 309–311, 311f quinine and, 132–133 in relapsing polychondritis, 51–52 INDEX in Sjögren’s syndrome, 50 testing for, 415–420 Vestibular aqueduct, computed tomography of, 433f–434f, 435 Vestibular fold, 509–510, 509f Vestibular ganglion, development of, 254 Vestibular hair cells, 409–411 Vestibular ligament, 509 Vestibular nerve, 276, 277f, 280, 355–357, 619–620 firing rate of, 410 projections of, 355–357, 357t Vestibular nucleus, 356–357 projections to and from, 357, 357t Vestibular pathways, 356f afferent, 355–359 efferent, 359 Vestibular periphery, 409–410 Vestibular receptor(s), 355 Vestibular receptor epithelium, adequate stimuli for, 410 Vestibular schwannoma See Acoustic neuroma Vestibular system adjustment in, 413 anatomy of, 279–280 asymmetrical responses of, 410 bidirectional responses of, 410 cellular composition of, 324t cerebellar regulation of, 413 directional sensitivity in, 410–411 dysfunction of, 358–359 aminoglycosides and, 118, 118t, 128, 295 antineoplastic agents and, 131–132 aspirin and, 103 in benign paroxysmal positional vertigo, 311, 311f, 411, 415 cisplatin and, 131 in Cogan’s syndrome, 55 in Hashimoto’s thyroiditis, 56 inner hair cell loss and, 346–347 loop diuretics and, 130 in Meniere’s syndrome, 309–311, 311f in mumps, 94 quinine and, 132–133 in relapsing polychondritis, 51–52 salicylates and, 132 in Sjögren’s syndrome, 50 in eye movement control, 356f, 358–359 functions of, 409 head acceleration in, 410–411, 412f head velocity in, 410–411, 412f neuronal firing rate in, 410, 412f nonlinearity in, 410 physiology of, 409–414 testing of, 415–420 caloric test in, 356f, 358, 416–417 electronystagmogram in, 415–416, 417f, 417t posturography in, 419–420 rotational tests in, 417–419, 418f, 419t tests under development, 420 vestibulo-ocular reflex in, 415, 416f visual-vestibular interaction in, 419 torsional pendulum model of, 411 velocity storage in, 413 Vestibule ear, 279 laryngeal, 509f, 510 nasal, 461, 467 Vestibulocerebellum, 357, 357t Vestibulocochlear nerve (CN VIII), 619–620 See also Cochlear nerve; Vestibular nerve clinical considerations of, 620 Vestibulocolic reflex, 409, 413 Vestibulo-ocular reflex, 356f, 358–359, 409, 412–413 cerebellar control of, 413 testing of, 415, 416f caloric test in, 356f, 358, 416–417 electronystagmogram in, 415–416 rotational tests in, 417–419, 418f, 419t tests under development, 420 visual-vestibular interaction in, 419 Vestibulospinal reflexes, 409, 413 Vestibulospinal tract, 357–358 Vfend (voriconazole), 126–127 Vibramycin (doxycycline), 120–121 Vibrissae, 461 Vicryl, 711 Videofluoroscopy, in stridor, 215 Vidian nerve, 562, 629 Vinca alkaloids, neurotoxicity of, 522 Vinorelbine, for head and neck cancer, 145 Viral infection(s), 85 host resistance to, 89–90, 89f latency of, 91 and otologic disorders, 93–95 pathogenesis of, 91 persistent, 91 respiratory, 92–96 treatment of, 91–92, 91t Viral vectors, for gene therapy, 195 Virus(es), 90–91 DNA, 90–91 life cycle of, 90–91, 90f replication of, 90–91 RNA, 90–91 “slow,” 91 structure of, 90 tumor, 95–96 Visceral motor oculomotor nucleus, 612–613 Visceral space imaging of, 672t–673t, 675–676 pathology of, 672t–673t, 675–676 Viscometer, 482 Visual reinforcement audiometry, 376 Visual-vestibular interaction, 419 Vital capacity, 60, 60f Vitamin A for aged skin, 26 deficiency of, 22–23 physiological roles of, 22 supplemental, 22–23 and wound healing, 22–23 761 Vitamin B complex deficiency of, 23 supplemental, 23 and wound healing, 23 Vitamin C deficiency of, 23 excess doses of, 23 and wound healing, 23 Vitamin D deficiency of, 23 functions of, 23 and wound healing, 23 Vitamin E, and wound healing, 24 Vitamin K in coagulation, 6f, 7, 24 and wound healing, 24 Vocal cords/folds, 502, 509f, 510 abnormalities of, 532–533 carcinoma of, 532–533 contact ulcers of, 574 false, 509, 509f granular cell tumor of, 577–578, 577f histology of, 543, 543f laser treatment of, 188 layered structure of, 543, 543f, 549–550, 550f length, mass, and tension of, 546 muscular action on, 517 nodules of, 533, 574 oscillation/vibration of, 531, 537, 539–543 elliptical nature of, 542 and voice register, 541–542, 542f paralysis or paresis of, 220–221, 518–520 acquired, 220 bilateral versus unilateral, 220 congenital, 220 diagnosis of, 221 Gelfoam injections for, 519 management of, 221, 519–520 nerve-muscle pedicle reinnervation for, 519–520 posterior cordotomy for, 519 reinnervation for, 519 stridor with, 220–221 in stroke patients, 522–523 surgical lateralization for, 519 surgical medialization for, 519 Teflon injections for, 519, 711 tracheotomy for, 519 in Parkinson’s disease, 520 in phonation, 524–537 See also Phonation polyps of, 533, 574 in rheumatoid arthritis, 47 in singers, 533 surgical anatomy of, 548–550 true, 502, 510, 516 Vocal fry register, 541 Vocalis ligament, in laryngeal cancer, 581 Vocalis muscle, 511–512 in laryngeal cancer, 581 in phonation, 525 in swallowing, 570 762 INDEX Vocal ligament, 510, 516 biomechanics of, 526 Vocal process gap, 531 Vocal process of arytenoid, 507–508, 507f Vogt-Koyanagi-Harada (VKH) syndrome, 55 Voice disorder(s), 547–551 in dystonia/dysphonia, 520 in laryngeal hypofunction, 518–520 laryngeal innervation in, 517–518 in Parkinson’s disease, 520 phonation in, 524–535 phonosurgery for, 536–537, 548–550 in stroke patients, 522–523 in vocal fold paralysis or paresis, 518–520 in vocal or laryngeal tremors, 520–521 Voice production, 524–535 laryngeal biomechanics in, 525–526, 536–537 laryngeal position and, 514–515, 537 pathology of, 547–550 See alsoVoice disorder(s) phonation in, 524–537 abnormal, 532–533 phonosurgery for, 536–537, 548–550 active F0 control in, 528–529 breathy, normal, and pressed, 530 cessation of, adduction and, 526 DC-to-AC conversion in, 537–538, 538f fundamental frequency of, string model for, 528 glottal flow in, 527–528, 527f skewing of, 529–530, 529f spectral aspects of, 530 instabilities in, 529 intraglottal pressures in, 531, 531f laryngeal biomechanics in, 525–526 laryngeal flow resistance in, 531–532, 532f in men versus women, 530 passive F0 control in, 528 physiology of, 537–541 pressure equilibration in, 527 vocal fold oscillation/vibration in, 531, 538 Voice quality, 530, 545–546 epiglottic tumors and, 580 Voice register, 541–542, 542f, 545 Volatile compounds, 164–165 Volume of distribution, 99–100 Vomer, 461–462, 462f Vomeronasal organ of Jacobson, 450 Vomiting, pharyngeal function in, 557 von Eber glands, 556–557 von Hippel-Lindau disease, 307–309, 310f, 702 von Recklinghausen disease, 231 von Willebrand factor (vWF), von Willebrand’s disease, 2t, 3, 231 genetics of, 231 treatment of, 231 type 1, 231 type 2, 231 type 3, 231 Voriconazole, 126–127 mechanism of action, 126 pharmacokinetics of, 127 side effects of, 127 spectrum of activity, 126–127 W Waardenburg-Shah syndrome, 291 Waardenburg’s syndrome, 240, 290–291, 291f cleft lip/palate in, 453 type I, 240, 290 type II, 240, 290–291 type III, 291 type IV, 291 Waldeyer’s ring, 557, 576 Wallenberg’s syndrome, 522 Warfarin and surgical hemostasis/coagulation, 4t, vitamin K therapy with, 24 Warthin’s tumor, 674 Water balance, in inner ear, 325–326 Water transporters (aquaporins), in inner ear, 319–322, 322f, 324, 329–330 Weak triangle, nasal, 457f, 458 Wegener’s granulomatosis, 52–53 clinical characteristics of, 52 epidemiology of, 52 head and neck manifestations of, 52–53 laboratory findings in, 52 nasal findings in, 52–53 otologic findings in, 52–53 treatment of, 53 Weight control, for obstructive sleep apnea, 78 Well-differentiated neuroendocrine carcinoma (WDNEC), 583–585 Wernicke’s aphasia, 354 Wernicke’s area, 354 Wharton’s (submandibular) duct, 629, 636, 636f obstruction of, 673, 673f Wheezing, 213 Whirlin, 318 White line, nasal, 461 Whole-body plethysmography, of lung volumes, 60–62, 61f Whole-nerve action potential (WNAP), 382–383 WHRN gene mutation, 318 Widened scars, 19 Willis, circle of, 693–694 Winklekarzinom, 580 Wolff’s law, of bone healing, 29 Word recognition testing, for ototoxicity, 133 Work of breathing, 65–66 Wound debridement, macrophages in, 14, 14t Wound healing, 9–31 aging and, 26–27 alcohol and, 25 amino acids, dietary, and, 22 anti-inflammatory drugs and, 25 in bone, 28–29 in bone grafts, 29 calcium and, 17, 24 in cartilage, 27–28 cellular and biochemical components of, 12t cellular basis of, 11–12, 12t cellular proliferation in, 9, 11–12, 12f cellular and biochemical components of, 12t duration of, 15 clotting disorders and, 13 failures of, 21–22 extrinsic factors in, 21 intrinsic factors in, 21–22 reduction of risk for, 21–22 in fetus, 30 fibroplasia in, 10 growth factors in, 12–13, 13t–14t, 17 hemostasis in, 9–13, 12f, 12t history and progress of, 10–11 inflammation in, 9–11, 12f, 12t, 13–15 injury type and, 10 integrity of, 16–17, 16f iron and, 24 lathyrogens and, 25–26 macrophages in, 12t, 14–15, 14t magnesium and, 24 maturation in, 9–11, 12f nutritional factors in, 22–23 oxygen and, 24–25 oxygen-derived free radicals and, 26 perioperative preparation for, 30 postoperative care in, 30 primary closure in, 16–17 remodeling in, 12t, 17–18 scar formation in, 9, 18–21 secondary intention in, 17 in skin grafts, 27 smoking and, 25 in specialized circumstances, 27–30 stages of, 9–11, 12f steroids and, 25 surgical, ideal goal of, 9–10 tensile strength in, 16–17 in tympanic membrane, 29–30 via contracture, 17 vitamin A and, 22–23 vitamin B complex and, 23 vitamin C and, 23 vitamin D and, 23 vitamin E and, 24 vitamin K and, 24 wound-breaking strength in, 16–18, 16f Wound infection, 11, 21 vitamin C deficiency and, 23 Wrinkling See also Facial aging Glogau scale of, 683t Wrisberg, intermediate nerve of, 422 X X chromosome, 226–228 X chromosome deficiency (XO), 234 Xerostomia, 630 gustatory dysfunction in, 631 in progressive systemic sclerosis, 48 radiation therapy-induced, management of, 143 INDEX secondary disorders with, 630 in Sjögren’s syndrome, 50, 630 treatment of, 50 X-linked disorders, 227–228 Y Y chromosome, 226–228 Z Zantac (ranitidine), 101 Zefazone (cefmetazole), 116 Zell-ballen pattern, 578–579, 579f, 651 Zenker’s diverticulum, 557, 675 Zidovudine (AZT), ototoxicity of, 94 Zinacef (cefuroxime), 115t, 116 Zinc deficiency of, 24 inhalation of, 165 supplemental, 24 and wound healing, 17, 24 Zinc finger proteins, 194 Zithromax (azithromycin), 122–123 Zona accuata, 315f Zona pecta, 315f Zosyn (piperacillin-tazobactam), 113 Zyderm, 712 Zygoma, 276f Zygomatic muscle, 635f major, 695f–696f minor, 695f–696f Zygomatic nerve, 615–616, 635 Zyplast, 712 Zyvox (linezolid), 124–125 763 .. .Otolaryngology Basic Science and Clinical Review This page intentionally left blank Otolaryngology Basic Science and Clinical Review EDITOR Thomas R.Van De Water,... this basic sciences course on Tuesday evenings at the New York Academy of Medicine.The course became very comprehensive and covered almost all of the basic and clinical science aspects of otolaryngology? ??head... 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