Faculty Bibliography

The relationships between vocal intensity (sound pressure level) and intrapulmonic pressure, mean flow rate, and aerodynamic powere were investigated in ten normal subjects. The intrapulmonic pressure was measured noninvasively and simultaneously with sound pressure level and mean flow rate during sustained phonation of the vowel/a/by means of plethysmographic and pneumotachographic methods. The aerodynamic power was calculated as intrapulmonic pressure times mean flow rate. The averaged values for the normal subjects represented (sound power) alpha (intrapulmonic pressure), (sound power) alpha (mean flow rate), and (sound power) alpha (aerodynamic power), where sound power at the open end of the pneumotachograph was estimated from sound pressure level. Vocal efficiency was defined as the ratio of sound power to aerodynamic power. Individual variation of coal efficiency (in dB) was satisfactorily small in the normal subjects, and was determined by the simple addition of individual variations of intrapulmonic pressure and mean flow rate (in dB) from the averaged values. These findings strongly suggested that the comparison of those three measurements against normative data for normal subjects such as provided by this study is useful in evaluating and clarifying the ineffective voice production of the pathological larynx.

Infiltrating lipomata are unusual benign tumors that have been rarely associated with the head and neck areas. We present the only known documented case of an infiltrating lipoma of the sternocleidomastoid muscle. The literature is reviewed and the characteristics of these lesions are discussed. The head and neck surgeon should include these interesting tumors in the differential diagnosis of head and neck masses and be aware that, because of a known propensity for recurrence, total surgical excision is the treatment of choice.

Previously it has been very difficult or impossible for radiologists to delineate accurately the size and extent of glomus tympanicum tumors. By utilizing axial transverse and coronal computed tomography detailed enlargement techniques we have been able to accurately demonstrate four such lesions. We believe that this mode of investigation is now the method of choice for glomus tympanicum tumors

In 17 cases of sinusitis-induced subdural empyema, all but 5 occurred in boys or men aged 13 to 33 years. Clinical features were headaches and fever (14 patients), nuchal rigidity (10), and seizures (8). Seven patients had periorbital cellulitis, and 15 had radiographic clouding of at least one sinus. Only five patients had a history of sinusitis. CT identified the empyema accurately in seven patients but failed in two patients who developed subdural empyema while being treated for sinusitis-induced cerebritis. Ten patients had specific bacteriologic etiologies determined by culture of empyema, blood, or sinuses.

This study investigates the controversy regarding the influence of age on the acoustic reflex threshold for broadband noise, 500-, 1000-, 2000-, and 4000-Hz activators between Jerger et al. [Mono. Contemp. Audiol. 1 (1978)] and Jerger [J. Acoust. Soc. Am. 66 (1979)] on the one hand and Silman [J. Acoust. Soc. Am. 66 (1979)] and others on the other. The acoustic reflex thresholds for broadband noise, 500-, 1000-, 2000-, and 4000-Hz activators were evaluated under two measurement conditions. Seventy-two normal-hearing ears were drawn from 72 subjects ranging in age from 20-69 years. The results revealed that age was correlated with the acoustic reflex threshold for BBN activator but not for any of the tonal activators; the correlation was stronger under the 1-dB than under the 5-dB measurement condition. Also, the mean acoustic reflex thresholds for broadband noise activator were essentially similar to those reported by Jerger et al. (1978) but differed from those obtained in this study under the 1-dB measurement condition.

A retrospective study of patients intubated for more than 24 hours was undertaken to assess the possibility of predicting the length of intubation. Patients requiring intubation for injuries secondary to motor vehicle accidents were scored according to a well-documented grading system which enables a numerical assessment of the severity of injury. There appears to be a significant relationship between this score and the length of intubation. It also appears possible to estimate the duration of intubation within the first 24 hours after injury in this group of patients. This information could provide an objective criterion for the clinician who must choose between prolonged intubation or tracheotomy in the management of severely injured patients.