The management of vascular and tumorous lesions of the parasellar region still remains one of the most demanding tasks in neurosurgery. It is only a short time ago that the major concepts of the anatomy of the so-called cavernous sinus were described in detail. Surgical interventions in this region are very complex, they are time-consuming and require an extensive back ground of experience in surgery of the cranial base. Pioneer anatomical studies of the parasellar region done by Taptas, and the daring direct operative approach introduced by Parkinson pro moted the development of modern neuroradiological intervention proce dures, which were initiated by Serbinenko and further refined by Debrun, Vifiuela and others. The technique of the detachable balloon catheter stimulated surgeons to proceed with the direct operative approach to lesions of the parasellar region. Today, it is hard to imagine a successful man agement of vascular pathologies of this region without a complementary use of the two techniques."

I have attempted to prepare this volume in such a way as to provide a source of information on the normal physiology of speech and song as well as on the disorders of those functions. To the extent that I have succeeded it should be of interest to physiologists, physicians, and teachers and students of the VOlce. The book is by no means a text on laryngology, nor is it a treatise on the physiology of breathing mechanics, nor yet is it a manual telling how to teach or learn voice production. If none of these, what is it? It is a discussion of the application of breathing mechanics to phonation of interest to the respir- atory physiologist, of certain aspects of physiology and medicine of interest to the teacher or student of voice, and of the problems of voice production and its maladies of interest to the laryngologist. I have undergone a number of experiences during the past 50 years which I believe have qualified me to undertake this task with some special hope of success. In my youth I studied voice for twelve years with four outstanding teachers and performed publicly as a lieder singer, in oratorio, chorus, and opera. Later I trained for and entered the medical profession in the specialty of otolaryngology. Later still I engaged in research on the physiology of breath ing mechanics and phonation, especially singing."

This volume is one in a series of monographs being issued under the general title of "Disorders of Human Communication." Each monograph deals in detail with a particular aspect of vocal communication and its disorders, and is written by internationally distinguished experts. Therefore, the series will provide an authoritative source of up-to-date scientific and clinical informa tion relating to the whole field of normal and abnormal speech communication, and as such will succeed the earlier monumental work "Handbuch der Stimm und Sprachheilkunde" by R. Luchsinger and G. E. Arnold (last issued in 1970). This series will prove invaluable for clinicians, teachers and research workers in phoniatrics and logopaedics, phonetics and linguistics, speech pathology, otolaryngology, neurology and neurosurgery, psychology and psychiatry, paediatrics and audiology. Several of the monographs will also be useful to voice and singing teachers, and to their pupils. G. E. Arnold, Jackson, Miss. F. Wincke1, Berlin B. D. Wyke, London Since it was their chatter which prompted the question. this book is dedicated to Sarah and VickY; to Peter who provided some of the answers; to Dorothy in gratitude; and to Him who in the beginning was the Word. Preface These pages are the long-delayed product of questions prompted by the sponta neous chatter of my two daughters when they were little. It was only possible to begin to explore these unformed thoughts through the repeated kindness of medi cal friends who allowed me to record their new-born children."

Until recently, the contribution of immunological knowledge to the under standingand management ofENTdisorders was slight, being largely confined to the appreciation that many rhinitic patients were allergic. Happily, this situation is rapidly changing: the immunological basis of many disorders of the ears, nose and throat is becoming recognized and the mechanisms of the reactions involved are being elucidated. From this, rational therapy should evolve. This book aims to highlight some of the areas in which immunological mechanisms are involved in otorhinolaryngology. It is written by experts in their respective fields of immunology and allergy, otology, rhinology and pathology. It opens with an overview ofthe pathways ofthe immune response and the cells and molecules involved, leading to an appreciation of the normal defence mechanisms of the upper respiratory tract and possible areas offailure. There is then a chapter on HIV infection and how this may present to otorhinolaryngologists. The normal function of the tonsil and the immunological effects oftonsillectomy are then considered. The varying roles of fungi in ENT disorders ranging from commensal through allergen to invasive organisms is assessed by Professor R. J. Hay. Perhaps the most obvious immunological contribution to management thus far lies in the immunocytochemical diagnosis of pathological conditions of the ears, nose and throat and this is covered in a chapter by Professor Leslie Michaels."

Laryngotracheal Reconstruction: From Lab to Clinic lines for using the technique of tracheal autotra- presents the experimental and clinical aspects of plantation in conservation laryngectomy. The tissue reconstruction of the larynx and trachea. shortcomings and complications of tracheal auto- The book reflects the development and implemen- transplantation encountered in the initial patient tation of a research-based clinical program. The series led to a modification of the technique. The experimental work was started in 1989 with the modified autotransplantation technique proved to aim of improving the reconstructive possibilities be reliable from a reconstructive, functional and in the following two clinical situations: (1) extend- oncological viewpoint. ed hemilaryngectomy defects after tumour In a second part (Chap. VI), healing aspects after removal and (2) tracheal stenoses that are impos- repair of laryngotracheal defects are highlighted. sible to repair by segmental tracheal resection. The The healing mechanisms of the cartilage support, two problems differ in localization (larynx, tra- the mucosal lining and the blood supply were chea), etiology (oncology, traumatic), and treat- studied for each tissue component individually.

The cochlear implant is a device that bypasses a nonfunctional inner ear and stimulates the auditory nerve directly. Written by the "father" of the multi-electrode implant, this comprehensive text and reference gives an account of the principles underlying cochlear implants and their clinical application. For the clinician, the book will provide guidance in the treatment of patients; for the engineer and researcher it will provide the background for further research; and for the student, it will provide a through understanding of the subject.

This volume contains the papers presented at the 15th International Symposium on Hearing (ISH), which was held at the Hotel Regio, Santa Marta de Tormes, Salamanca, Spain, between 1st and 5th June 2009. Since its inception in 1969, this Symposium has been a forum of excellence for debating the neurophysiological basis of auditory perception, with computational models as tools to test and unify physiological and perceptual theories. Every paper in this symposium includes two of the following: auditory physiology, psychoph- ics or modeling. The topics range from cochlear physiology to auditory attention and learning. While the symposium is always hosted by European countries, p- ticipants come from all over the world and are among the leaders in their fields. The result is an outstanding symposium, which has been described by some as a "world summit of auditory research. " The current volume has a bottom-up structure from "simpler" physiological to more "complex" perceptual phenomena and follows the order of presentations at the meeting. Parts I to III are dedicated to information processing in the peripheral au- tory system and its implications for auditory masking, spectral processing, and c- ing. Part IV focuses on the physiological bases of pitch and timbre perception. Part V is dedicated to binaural hearing. Parts VI and VII cover recent advances in und- standing speech processing and perception and auditory scene analysis. Part VIII focuses on the neurophysiological bases of novelty detection, attention, and learning.

The Springer Handbook of Auditory Research presents a series of comp- hensive and synthetic reviews of the fundamental topics in modern au- tory research.The volumes are aimed at all individuals with interests in hearing research including advanced graduate students, post-doctoral researchers, and clinical investigators.The volumes are intended to int- duce new investigators to important aspects of hearing science and to help established investigators to better understand the fundamental theories and data in ?elds of hearing that they may not normally follow closely. Each volume is intended to present a particular topic comprehensively, and each chapter will serve as a synthetic overview and guide to the lit- ature.As such the chapters present neither exhaustive data reviews nor original research that has not yet appeared in peer-reviewed journals.The volumes focus on topics that have developed a solid data and conceptual foundation rather than on those for which a literature is only beginning to develop. New research areas will be covered on a timely basis in the series as they begin to mature.

"Phonosurgery: theory and practice" is a book that makes an impor tant contribution to the literature in laryngology. Professor Isshiki has been a driving force in the investigation and correction of certain conditions of the voice. His leadership in this field over two decades has proved to be an inspiration to those interested in the diagnosis and correction of the abnormal voice. His unique background and training in both otolaryngology and plastic surgery has provided him with fundamental knowledge and experience in the study of the voice and larynx and has given him an opportunity to utilize innovative surgical techniques in the correction of some of these problems. Professor Isshiki's name is indelibly linked with laryngeal framework surgery, and those who read this book will not be dis appointed. The book provides very adequate information on the phy siology and pathology of the voice. Emphasis is given to diagnostic aspects of abnormalities of the voice which have been made easier with the development of high technology, such as the use of the com puter and improved laryngoscopes, which include brighter lights, higher resolution lenses, and, when combined with stroboscopy and high-speed filming videolaryngoscopy, provide a valuable tool in faci litating communication between the patient, the physician, and the voice therapist.

This advanced book of rigid fixation describes the scientific principles and applied techniques primarily for the AO/ASIF hardware system.

Loudness is the primary psychological correlate of intensity. When the intensity of a sound increases, loudness increases. However, there exists no simple one-to-one correspondence between loudness and intensity; loudness can be changed by modifying the frequency or the duration of the sound, or by adding background sounds. Loudness also changes with the listener's cognitive state. Loudness provides a basic reference for graduate students, consultants, clinicians, and researchers with a focus on recent discoveries. The book begins with an overview of the conceptual thinking related to the study of loudness, addresses issues related to its measurement, and later discusses the physiological effects of loud sounds, reaction times and electrophysiological measures that correlate with loudness. Loudness in the laboratory, loudness of steady-state sounds and the loudness of time-varying sounds are also covered, as are hearing loss and models.

The third edition of ENT: An Introduction and Practical Guide provides an essential introduction to the clinical examination, treatment options and surgical procedures within ENT. It encompasses the most frequently encountered conditions in the emergency setting, on the ward and in the outpatient clinic. The text has been updated to include new content on implantation surgery for hearing loss. It also includes significant changes in the indications for surgery, patient assessment, management, and surgical techniques. The subject of dizziness and vertigo have also been updated to include novel interventions. With its highly practical step-by-step approach, this book will be invaluable to all surgical trainees studying for higher postgraduate examinations in ENT, and an essential guide for otorhinolaryngologists, primary care practitioners and specialist ENT nurses in their early years of training.

This volume is one in a series of monographs being issued under the general title of "Disorders of Human Communication." Each monograph deals in detail with a particular aspect of vocal communication and its disorders, and is written by internationally distinguished experts. Therefore, the series will provide an authoritative source of up-to-date scientific and clinical informa tion relating to the whole field of normal and abnormal speech communication, and as such will succeed the earlier monumental work "Handbuch der Stimm und Sprachheilkunde" by R. Luchsinger and G. E. Arnold (last issued in 1970). This series will prove invaluable for clinicians, teachers and research workers in phoniatrics and logopaedics, phonetics and linguistics, speech pathology, otolaryngology, neurology and neurosurgery, psychology and psychiatry, paediatrics and audiology. Several of the monographs will also be useful to voice and singing teachers, and to their pupils. G. E. Arnold, Jackson, Miss. August 1980 F. Wincke1, Berlin B. D. Wyke, London Preface Despite years of interest and research in the hearing process, much of the exact detail of auditory processing remains in the realm of conjecture. We do have some rudimentary understanding of the way the system records changes in frequency and intensity and of the relations between the ear's spectrum analysis and our identification of sound quality. Some of these operations we can duplicate with auditory models of our own, or with laboratory analyzers that can serve as auditory analogs."

Twenty five years ago, Bill Stebbins presented the principles of animal psychophysics in an edited volume (Stebbins, 1970) describing an array of modem, creative methodologies for investigating the range of sensory systems in a variety of vertebrate species. These principles included precise stimulus control, a well defined behavioral response, and a rigorous behavioral procedure appropriate to the organism under study. As a generation of comparative sensory scientists applied these principles, our knowledge of sensory and perceptual function in a wide range of animal species has grown dramatically, especially in the field of hearing. Comparative psychoacoustics, i. e. , the study of the hearing capabilities in animals using behavioral methods, is an area of animal psychophysics that has seen remarkable advances in methodology over the past 25 years. Acoustic stimuli are now routinely generated using digital methods providing the researcher with unprecedented possibilities for stimulus control and experimental design. The strategies and paradigms for data collection and analysis are becoming more refined as well, again due in large part to the widespread use of computers. In this volume, the reader will find a modem array of strategies designed to measure detection and discrimination of both simple and complex acoustic stimuli as well experimental designs to assess how organisms perceive, identify and classify acoustic stimuli. Refinements in modem methodologies now make it possible to compare diverse species tested under similar, if not identical, experimental conditions.

Liposuction began as a contouring procedure but has evolved into the treatment of obese patients, gynecomastia, ptosis, macromastia, and even patients who have complications from heart disease or diabetes. Other disorders such as axillary sweat hypersecretion, lipomas, and angiomas are also potential disorders that may be treated with liposuction.

Physicians performing liposuction must be adequately trained and experienced in the potential and actual complications before attempting to perform liposuction. Patient safety is the most important aspect of all surgeries, but especially of cosmetic surgery, which is an elective procedure.

New technology helps improve results but experience, care, and skill of the cosmetic surgeon is necessary to obtain optimal results that satisfy the patient.

The contributors to this book have spent time and effort presenting the cosmetic and plastic surgeon as much information as possible on the techniques and uses of liposuction for cosmetic and non-cosmetic surgery purposes.

The question about the function ofsleep remains one ofthe major challenges scientists are faced with. Wherein lies the fascination with sleep? I am convinced that it is the necessity for sleep. No one has failed to experience the overpowering urge to fall asleep after a disturbed night's sleep or after sleep was curtailed or deprived, especially when our daily activities impose restrictions on motor activity. The demand ofour body and brain to sleep challenges our understanding ofwhy this is the case, and which are the benefits ofa night ofprofound sleep. Also in animals prolongation of waking consistently increases their attempts to fall asleep. It has been stated that sleep is more necessary to animals than even food! The need for sleep and some insight into the consequences of the preceding daily waking activities on subsequent sleep was wonderfully formulated by Shakespeare in Othello: Not poppy nor mandragora, Nor all the drowsy syrups ofthe world, Shall ever medicine thee to that sweet sleep Which thou owed'st yesterday It is interesting that the most powerful single intervention which invariably influences sleep in a positive and predictable manner is the prolongation of waking. The activities which people or animals engage in during the wakefulness episode are secondary in the magnitude oftheir effects on sleep.

MRI is assuming a dominant role in imaging of the larynx. Its superior soft tissue contrast resolution makes it ideal for differentiating invasion of tumors of the larynx from normal or more sharply circumscribed configuration of most of the benign lesions. Over ten years ago CT made a major impact on laryngeal examination because it was the first time that Radiologists were beginning to look at submucosal disease. All of the previous examinations duplicated the infor mation that was available to the clinician via direct and in-direct laryngo scopy. With the advent of rigid and flexible endoscopes, clinical examination became sufficiently precise that there was little need to perform studies such as laryngography which merely showed surface anatomy. The status of deep structures by these techniques was implied based on function. Fortunately laryngography is now behind us together with all of the gagging and contrast reactions which we would all like to forget. CT is still an excellent method of examining the larynx but it is unfortunately limited to the axial plane. With presently available CT techniques motion deteriorates any reformatting in sagittal or coronal projections. The latter two planes are extremely helpful in delineating the vertical extent of submucosal spreads. MRI has proven extremely valuable by producing all three basic projections, plus superior soft tissue contrast. Although motion artifacts still degrade the images in some patients, newer pulsing sequences that permit faster scanning are elimi nating most of these problems."

Thirty years of research into the development of hearing have produced a decent description of age-related changes in hearing as well as some understanding of the mechanisms underlying those changes. The number of potential applications of this knowledge has increased tremendously in recent years. Universal hearing screening programs make it likely that a child with a hearing loss will be identified at birth. Infants may receive hearing aids before they are six months old, and one-year-olds are receiving cochlear implants. The optimal design of device fitting strategies and habilitation techniques must be based on knowledge of auditory development and the effects of abnormal experience with sound. Moreover, there is a growing recognition of the contributions of auditory processing deficits to speech and language disorders. Again, the nature of the relationship between perception and language development must provide the basis for attempts to remediate such problems. Although recent volumes have addressed auditory development, they have focused on development in nonhuman species. Although this work is certainly informative to workers in the field of human development, it is often difficult to generalize findings from nonhumans to humans. The goal of the proposed book is to provide a basic reference for graduate students, clinicians, and researchers on fundamental principles of human auditory development, with an emphasis on the effects of auditory experience on development.

This volume will provide an important contemporary reference on hearing development and will lead to new ways of thinking about hearing in children and about remediation for children with hearing loss. Much of the material in this volume will document that a different model of hearing is needed to understand hearing during development. The book is expected to spur research in auditory development and in its application to pediatric audiology.

Throughout the world, head and neck cancer is a major threat to public health and a significant challenge to both clinicians and basic scientists. Despite extensive efforts in primary prevention, screening, early detection, and therapy, long-term survival rates have not improved substantially in the last three decades. This book covers a wide range of exciting new findings in both clinical and basic sciences as they are relevant to head and neck cancer. These findings have recently enhanced our understanding of head and neck carcinogenesis at the genetic and molecular levels, offering the promise of improved preventive and therapeutic strategies. This book will also present information on the important clinical advances that have been made in chemoprevention, organ preservation, and the simultaneous use of chemo therapy and radiotherapy. The first part provides an overview of the etiology and biology of head and neck cancer, including an examination of human papillomaviruses in both benign and malignant lesions. This section also discusses the carcinogenic process at the genetic and molecular levels, as well as aberrant squamous differentiation; increased understanding of these areas has great potential to translate into new strategies for cancer prevention. The second part describes recent advances in developing a risk model for head and neck cancer, as well as the application of genetic susceptibility data in chemoprevention. This section also includes overviews of the status of chemoprevention trials and of the process of invasion and metastasis in head and neck cancer."

Exposure to loud noise continues to be the largest cause of hearing loss in the adult population. The problem of NIHL impacts a number of disciplines. US standards for permissible noise exposure were originally published in 1968 and remain largely unchanged today. Indeed, permissible noise exposure for US personnel is significantly greater than that allowed in numerous other countries, including for example, Canada, China, Brazil, Mexico, and the European Union. However, there have been a number of discoveries and advances that have increased our understanding of the mechanisms of NIHL. These advances have the potential to impact how NIHL can be prevented and how our noise standards can be made more appropriate.

Phonological Processes and Brain Mechanisms reviews selective neurolinguistic research relating brain structures to phonology. The studies in the volume report on a number of timely and important topics, such as a neuronal model for processing segmental phonology, the role of the thalamus and basal ganglia in language processing, and oral reading in dyslexia. Increasingly, phonology is considered a cognitive module whose brain correlates may be independently investigated. Given the modular nature of the phonological system and its direct linkage with peripheral components of the nervous system, research on phonology and the brain will undoubtedly flourish in the future. The chapters in this volume give substance to this future.

In this text atlas of neuroimaging the author provides a review of the pathologies and diseases that affect the head, brain, skull base, face, spine, and cord. The case presentation format of this handbook covers the important clinical and neuropathological aspects of the disease process. The book contains 350 selected pathologies, represented in 750 high resolution MR images. It also covers the aspects of neurological disorders and the fundamental aspects of the physics of magnetic resonance, spectroscopy, as well as a review of MR techniques. Given its scope, this book is of interest to radiologists involved in MR interpretation, neuroradiologists seeking an up-to-date review, and all workers in the field of diagnostic and therapeutic neurology.

If we possessed a true, well established and undoubted theory concerning the function of the nerves in the human body, the principles of smell would be much easier to understand. So far, we do not know for certain whether the action of nerves takes place by means of a subtle fluid, which is instantaneously conveyed from the beginning of the nerves to their ends, or whether, as some think, some sort of vibratory movements is produced in them, or whether the stimulation should be considered as the only sufficient cause, to say nothing of the new opinion concerning the electrical force. Linnaeus Although much has been learned since the time of Linnaeus, it is still true that we do not yet possess "a true, well established and undoubted" theory of olfaction. The literature of the subject, however, has long been rather voluminous - the frequent assertions to the contrary are simply untrue - and is now growing rapidly. Moreover, quite a number of symposia on olfaction (or olfaction and taste) have been held during recent years. For example, in the U. S. A.

The endoscope with magnifying lens systems and retrotympanic sub-regions. During microsurgical pro angled view has, in all oto-rhino-laryngology, been cedures, the recognition of pathologic changes in developed from a basically diagnostical tool into a sur niches, recesses or occluded tunnels is considerably gical instrument. Earlier, it served to see what exists. facilitated. The disadvantages of the operating micro Nowadays, it is continuously changing what one does. scope -reduced brightness and bad focus with higher Jean-Marc Thomassin's book "Otoendoscopically magnifieations, no angled view- can be compensated guided surgey" appears as the first guide into this new by additional endoscopy with the instrument's tip field of otoendoscopic control of microsurgery of the close to the target and with the view "around the cor ear. The author has achieved to compile and codify ner". what, during recent years, was already looked at by While thus visualizing remote areas or hidden him and by a "happy few" of otological pilots. But, he spots by a rigid magnifying endoscope with an angled has also added new insights into this matter. One may view direction apparently no patho-anatomical secret say that he has provided a solid basis for both the remains undiscovered. What can be inspected can be scholars and the experts who want to enrich their cleaned, there are adequate instruments. This fact arsenal of otosurgical techniques. makes the analysis of surgical failures more plausible.

This volume brings together noted scientists who study presbycusis from the perspective of complementary disciplines, for a review of the current state of knowledge on the aging auditory system. Age-related hearing loss (ARHL) is one of the top three most common chronic health conditions affecting individuals aged 65 years and older. The high prevalence of age-related hearing loss compels audiologists, otolaryngologists, and auditory neuroscientists alike to understand the neural, genetic and molecular mechanisms underlying this disorder. A comprehensive understanding of these factors is needed so that effective prevention, intervention, and rehabilitative strategies can be developed to ameliorate the myriad of behavioral manifestations.