Faculty Bibliography

Otologic disease often extends into the hypotympanum, posterior mesotympanum, and infralabyrinthine compartments. Surgical access to these areas can be difficult because of the proximity of the facial nerve. In patients with a normal bone anatomy, these regions can be accessed by a retrofacial approach, which spares the posterior canal wall and avoids transposition of the facial nerve. The anatomy of the hypotympanum, posterior mesotympanum, and infralabyrinthine compartments will be reviewed emphasizing gross anatomic documentation. We will detail the surgical approach to these areas along the retrofacial air cell tract, and will present an appropriate case history

The aim of this study was to determine whether postnatal mammalian central neurons retain the capacity for axonal regeneration across a lesion site in organotypic cultures of the auditory midbrain. Brain slices from the gerbil inferior colliculus (IC) were obtained from postnatal 6-8 d old animal and cultured for 6-15 d in vitro. IC explants containing an intact commissural projection exhibited robust axonal and dendritic morphologies as assessed with biocytin labelling. In transected explants, the two lobes of the inferior colliculus were cut at the midline and then reapposed to one another in vitro. There was a robust regeneration of commissural fibers across the lesion site in 78% of the biocytin-labeled explants. Massive axonal regeneration was also revealed by immunostaining explants for Tau (100% of sections), an axon-specific microtubule-associated protein. Ultrastructural analyses demonstrated that biocytin-labeled regenerating fibers established de novo synaptic profiles in the contralateral lobe of the inferior colliculus. Finally, the distribution of astrocytes and oligodendrocytes were assessed by staining for glial fibrillary acidic protein (GFAP) and myelin-associated glycoprotein (MAG), respectively. GFAP-positive astrocytes were more widely distributed than in vivo, and oligodendrocytes remained immature, and evenly distributed in all explants. Taken together, these data demonstrate that the postnatal mammalian auditory midbrain can be maintained in vitro, and that central axons are capable of regenerating across the site of injury without the aid of an artificial substrate

A theoretical framework for the segmental component of speech production is outlined and some preliminary supporting data are reviewed. According to the framework, articulatory movements are programmed to achieve sequences of goals that are defined in terms of articulatory and acoustic parameters. The goals are correlates of distinctive features. Some feature correlates are determined by quantal (non-linear) relations between articulation and sound. Goals may also be influenced by other principles, such as a compromise between sufficient perceptual contrast and economy of articulatory effort, which leads to the prediction that the goal definitions correspond to regions (as opposed to points) in acoustic and articulatory space. Thus the goals are characterized by some parameter variation, which is possible partly because listeners can understand variable speech. Before utterances are produced, goal specifications are modified by prosodic influences and reduction. The sequence of modified goal specifications is converted to smooth, appropriately-timed articulatory movements by the speech motor control system. This control and the resulting kinematics are constrained in part by the biomechanical properties of the articulators. To help keep acoustic variability within perceptually-acceptable limits, speech motor control mechanisms may include a strategy by which different parts of the vocal-tract area function are adjusted in a complementary (''motor equivalent'') manner. The strategy takes advantage of the fact that for some sounds, a similar acoustic transfer function can be achieved with somewhat different area functions. The existence of such a strategy and the idea that speech motor programming is based in part on acoustic goals are supported by data that show trading relations between lip rounding and tongue-body raising in production of the vowel /u/. $$:

BACKGROUND. Not every patient with Kaposi's sarcoma (KS) has acquired immunodeficiency syndrome (AIDS). The 'classic' form of KS is rare, and is associated with an indolent course. It is very distinct from AIDS-associated KS in which oral involvement is common and may be the initial presenting feature of this disease. Two other types of KS are recognized, the African and renal transplant-associated, which also are rarely associated with oral involvement. METHODS. We present the case of a 76-year-old man of Mediterranean ancestry who was found to have a biopsy-proven classical KS lesion of the hard palate. The patient was followed by the Radiation Therapy and Otolaryngology Services during and after his treatment. A review of the literature was also conducted. RESULTS. Radiotherapy was ineffective at a dose considered 'standard' for KS in AIDS patients (1,500 cGy), but was effective when continued to 4,800 cGy. A 24-month follow-up showed no evidence of recurrence in the oral cavity. CONCLUSIONS. KS of the oral cavity, is almost always associated with AIDS in the United States, However, it can occur in any of the four types of KS. Although this neoplasm is typically highly radiosensitive, the treatment for each patient needs to be individualized