The sellar region and paranasal sinuses constitute the anatomical sections of the skull base in which pathological entities warrant interdisciplinary management. Processes originating in the paranasal sinuses can reach and involve the skull base in and around the sella, sometimes not respecting the natural dural boundary. On the other hand, lesions involving the sellar block, such as pituitary adenomas and meningiomas, can also extend downwards into the paranasal sinuses. The orbit and cavernous sinus may be subject to involvement and infiltration by both paranasal and sellar pathology. The advancement and new achievements of modern diagnostic procedures, such as high-resolution CT, three-dimensional reconstruc tion, MRI, and MRI angiography, as well as the detailed selective angiographic protocols and endovascular techniques, have increased the possibilities for surgical management of this type of pathology with extra- and intracranial involvement. Long-standing and intense inter disciplinary work has led to sophisticated operative approaches which for benign tumors allow total excision with preservation of structures and function, and for some malignant lesions permit an en bloc resec tion via a combined intracranial-extracranial approach. This volume reflects the work and scientific exchange which took place during the IV International Congress of the Skull Base Study Group, held in Hanover. Leading authorities in the basic sciences including anatomy joined with diagnosticians, clinicians, and surgeons from different fields to evaluate the state of the art of this topic in skull base surgery."

For more than three decades the methods for assessing cell pro liferation have been largely the preserve of experimental biologists, and in their hands such techniques have contributed greatly to our understanding of the dynamic organisation of normal and patho logical tissues. In recent years, with the advent of novel method ologies, there has been increased interest among both pathologists and clinicians, particularly oncologists and others interested in neoplasia, in assessing cell proliferation. This interest has been stimulated by the possibility that indices of cell proliferation may have direct clinical relevance, for example in being useful predictors of outcome in patients with certain forms of malignancy. In addi tion, interest in assessing cell proliferation has been fuelled by the tremendous advances in our understanding of the mechanisms of cell proliferation and their deregulation in pathological processes. Consequently, the time is ripe for a monograph critically reviewing the available methods for assessing cell proliferation, their potential and their problems. We have been particularly concerned to present a balanced view of the advantages and disadvantages of different methods currently available for assessing cell proliferation. The assessment of cell proliferation often requires some familiarity with mathematical methods, but in this book we have attempted to keep detailed mathematical analyses to a minimum. We have asked exponents of each of the well-recognised methods to critically review the tech niques and the ways in which they may be applied to clinical mate rial."

Acquired aural cholesteatoma poses a unique procedural dilemma with regard to pathogenetic research and theory building. Because cholesteatoma spontane ously occurs only in the poorly pneumatized human ear, its pathogenesis is specific to humans. Nonetheless, because of the ethical questions surrounding human experimentation, pathogenetic study has almost exclusively involved nonhuman subjects. Indeed, attempts have failed in almost all animal expe riments except with the gerbil, and even here experimental designs have been improbable compared with human cholesteatoma. Cholesteatoma in the gerbil is useful, therefore, only for the study of pathology and not for human pathogenesis. I hold that the pathogenesis of cholesteatoma will be understood by studying the cholesteatomatous ear, that is, the malpneumatized ear of the human. The anatomical difference between the normal and malpneumatized ear is a probable cause of cholesteatoma. This difference may be found clinically in facial nerve decompression and cholesteatoma surgery, as, for example, facial nerve palsy occurs usually in the normal, well-pneumatized ear. Of course, conventional animal experimentation will not confirm this clinical difference since there is no ideal animal model for the poorly pneumatized human ear. Present surgical techniques for cholesteatoma vary greatly according to indi vidual otosurgeon's opinion. The most extreme difference of opinion is focused on whether to remove the external ear canal wall. Normally, the best option would be not to remove the canal wall if cholesteatoma recurrence can be prevented. Simply put, recurrence of cholesteatoma comes about when its cause has not been removed during primary surgery."

Often being vastly underrated the human sense of smell plays an essential role in our life, e.g. in food acceptance, fragrance appreciation, and as a warning device for spoiled food, toxic gases and the presence of fire. The book provides a multidisciplinary up-to-date review of the structure and function of the sense of smell and of how it is influenced by the environment and diseases. It is divided into the following 5 sections: - Anatomy, Physiology and Chemistry - Measurement of OlfactoryResponses - Development and Senescense - Basic Characteristics of Human Olfaction - Clinical and Health Aspects of Olfaction.

This book contains a series of articles and summaries regarding surgical voice restoration after or during a total laryngectomy. Most readers will recall the pleasure patients feel when they are able to speak again after years of mute existence. A few simple questions are relevant to the articles contained herein. Firstly, how important is a person's voice? Is it for example as important to man as the dances bees use to convey essential information? Even the most superficial consideration must tell us that the function of the human voice is still more important as we already have a detailed body language of our own, e.g., when we feel pain, joy, love, fear, etc. Without doubt, speech is the basis of knowledge and surely it is the capacity to learn which characterizes the human intellect. Secondly, one may ask whether man was always intended to have a voice? A few every-day observations can provide us with an answer. When little children play together, for instance, they all speak at once and seldom listen to what their neighbors are saying. Obviously, this is b cause it is not so important what they are actually saying as that something is being said at all.

The esophagus, ostensibly a simple tubular structure whose functional role often is minimized and even ignored, is, in re- ality, a highly complex viscus. The problems associated with disorders of the esophagus are not only related to the usual en- tities which may be anticipated in any portion of the gastroin- testinal tract, but include in a major fashion the functional mechanisms indigenous to the pharyngoesophageal and eso- phagogastric junctions. A number of disorders, representative of the classical cate- gories of disease, affect the esophagus. These include the various congenital and developmental abnormalities, of which some are complex. Trauma to the esophagus is not un- common, and infective and inflammatory lesions of this struc- ture are encountered relatively frequently. The different types of neoplasms of the esophagus are relatively few in number, but are commonly observed-the most serious, from the point of view of survival, being carcinoma. The collagen disorders, particularly scleroderma and dermatomyositis, affect the eso- phagus all too often. A miscellaneous group includes such en- tities as achalasia and varices, occurring in varying degrees of frequency. Functional abnormalities of the oropharynx, hypo- pharynx and esophagus, particularly relating to swallowing and the frequently encountered instances of spasm of the pharyngoesophageal and the esophagogastric junctions, consti- tute an important and common source of difficulty in the pa- tient population at large. In this regard, anatomic, radiologic, and physiologic studies of these structures have provided through the years vital data which has proved of considerable VII ...

Vestibular physiology has acquired new interest in the past few years. The development of fast aircraft, beginning during the Second World War and continuing through modern supersonic jets and space travel, has increased dramatically the acceleration range to which man is subjected, from prolonged weightlessness to several gs. The labyrinth measures all kinds of acceleration, including gravity. and therefore has taken on particular impor tance in the study of human health in the Space Age. It is understandable. then, that NASA sponsored the Symposium on Vestibular Function and Morphology. a satellite of the Eighth Annual Meeting of the Society of Neuroscience. held October 30-November 1. 1978, at the University of Pittsburgh, which also supported the symposium. The present volume was developed from papers originally presented there. My strategy in editing this book has been to focus upon the vestibular end organ and its direct connections. both peripheral and central, in order to as sure a coherent discussion of the basics of vestibular function, structure, and ultrastructure. Fortunately, it was possible to secure the contributions of a number of outstanding investigators from both the United States and abroad, including functionally oriented morphologists. ultrastructuralists, biophysicists, and vestibular physiologists. The result is a comprehensive discussion of the main mechanisms of the labyrinth: the transduction pro cess at the receptor level, in the semicircular canals, and in the utricular and saccular maculae; the information transfer through neuronal pathways to the nuclei and the cerebellum; and the general organization of the system."

Language and Speech has been selected for the Fifth Convention of the Academia Eurasiana Neurochirurgica as a topic closely related to neurosurgery but also to philosophy, art, culture and humanity and treated by various experts of the field of this interdisciplinary subject. The volume has a certain structure: Language is evaluated as a tool of the Homo Artis in the introduction, which is followed by chapters focusing the language in history, in linguistics, as well as in music and that of the animals. In the next part speech is dealt with as a physiological process. It is followed by papers on three different but uniformly neurosurgical representation of speech in gliomas, AVMs, and focal epilepsies. Neurologists compiled papers on clinical forms of aphasia, and that among bilinguists as well as on lateralisation of speech centres in relation of handedness followed by rehabilitation of speech disorders. Two papers on language and computers complete the volume.

Many pathologists have little acquaintance with ear, nose concomitant biopsy have become commonplace in the and throat pathology. Some receive few specimens from management of throat disorders. It is hoped that. by ENT tissues; others are deterred from deeper study of the publication of this Atlas, pathologists receiving only material that emanates from regions the normal anatomy occasional specimens will be guided in their provision of of which is so forbidding in its complexity and holds no a report helpful to the clinician and those who are involved familiarity through autopsy investigation, for, apart from with a larger ENT service may be providec with a guide the larynx, there is usually no compelling indication for to the deeper understanding of the subject. examination of the ear, nose or throat at postmortem. Yet. The modern tendency in publication of ristopatholog equally with biopsy specimens from other parts of the ical microphotographs is to omit any statement of their body, the pathologist's report is consequential for the magnification, since it will usually be clear to the reader efficient handling of ear, nose and throat illnesses and what order of enlargement is involved. I n this Atlas, sometimes even for the patient's survival."

Contents: The Neck and Thorax.- The Larynx and the Thyroid Gland.- The Face.- The Oral Cavity and the Oropharynx.- The Nose.- The Paranasal Sinus and the Retromaxillary Space.- The Eye and its Orbital Adnexa.- The Ear.- The Middle and Posterior Cranial Fossae.- The Skull and the Gross Anatomy of the Central Nervous System.- The Topography and Variations of the Extra- and Intracranial Vessels.- The Paraganglia.- References.- Index of Operations and Surgically Important Anatomic Relationships.- Subject Index.

The cochlea does not just pick up sound, it also produces sounds of low intensity called Otoacoustic Emissions (OAEs). Sounds produced by healthy ears - either spontaneously or in response to stimuli - allow researchers and clinicians to study hearing and cochlear function noninvasively in both animals and humans. This book presents the first serious review of the biological basis of these otoacoustic emissions.

A book such as this one necessarily entails the effort of many individuals. Its first seed was a workshop in 1988 that one of us (K. L. C. ) designed and directed at the City University of New York Graduate Center as part of a series of conferences and workshops on topics in neuropsychology spon sored by the Institute for Research in Behavioral Neuroscience (IRBN). At that time, studies in the efficacy of olfaction as an alternative modality of stimulation in brain-injured adults were taking place at IRBN. The work shop helped to spark many new ideas among IRBN's staff, leading to various projects in clinical intervention, some of which are discussed in this volume. We soon discovered that clinical interest in olfaction was steadily increasing, and that this modality was in many ways on a par with the rest. Along with progress in the clinical investigation of olfaction, an abundance of work has been published in the basic science of the field. Ideas such as the regeneration of olfactory neurons and the use of these neurons in trans plantation took hold and were proved to be viable ones. These develop ments along with a profusion of techniques that allow a closer look at the anatomy and physiology of olfaction, have contributed to the accelerated pace with which this field is now advancing. Dr."

The title of this book may at first appear to be somewhat restrictive in its use of terminology. However, this is far from the intention of the writer; on the contrary, the following chapters seek to reflect a departure from the traditional segmentally orientated approach to this type of disability. Indeed one reason why the book has been written is the sense of frustration arising out of the largely ineffectual static and structural methodology of remedial work. Alternative titles could have been Disorders of Speech Production, or Neurogenic Speech Disorders, but neither would have encapsulated the essence of the book. Much of the recent research in the neurophysiology of motor control and also in the field of neurolinguistics has been concerned with ways in which intention and planning of movement is effected. Such models are still in their infancy, but it seems the potential value of their application to speech is considerable. In the case of verbal dysp'taxia, for example, we have long since in rather vague terms described it as a disorder of organization and programming without ever stating exactly what may be disorganized or not properly planned. This book does not provide the answer for as yet there is insufficient data on which to work so that formulated theories may be tested and further defined. But as we move from speculative guess-work towards established fact so the likelihood grows of providing more positive help for those who suffer these drastic limitations in communication.

Contemporary laryngology had its beginnings near the close of the 19th century and is probably best exemplified in the work of Morel McKenzie and of Czermak. Subsequent to their pioneering efforts, another surge of interest could be said to have centered about the efforts of the Chevalier Jacksons in the 1920's. After those bold steps, and for almost 40 years, research in laryngology and interest in laryngology continued, but at considerably and increasingly less intense levels, certainly so far as the otolaryngologist population was concerned. In the 1940's Julius Lempert sparked a renaissance in otologic research, deVelopment, and surgery, and exciting new frontiers opened in otology. In our own time, otology remains a large basic and fundamental segment of the otolaryngologic purview, but the flood of new discoveries which followed Lempert, like those which had followed the Jacksons in the 1920's in laryngology, appears to have diminished. When the authors of this publication made acquaintance in the late 1960's, there were approximately 10 centers in the United States for laryngologic research which could be truly designated as voice research facilities. The senior author was at that time instrumental in formulating the major criteria for laboratories to be so designated. In the early 1980's interest in laryngology has revived. At a recent meeting it was possible to list over 40 such laboratories which now were known to the authors over a broad geographic sweep, covering the entire United States.

Hearing From Sensory Processing to Perception presents the papers of the latest International Symposium on Hearing, a meeting held every three years focusing on psychoacoustics and the research of the physiological mechanisms underlying auditory perception. The proceedings provide an up-to-date report on the status of the field of research into hearing and auditory functions.

The 59 chapters treat topics such as: the physiological representation of temporal and spectral stimulus properties as a basis for the perception of modulation patterns, pitch and signal intensity; spatial hearing and the physiological mechanisms of binaural processing in mammals; integration of the different stimulus features into auditory scene analysis; physiological mechanisms related to the formation of auditory objects; speech perception; and limitations of auditory perception resulting from hearing disorders."

Cochlear implants have instigated a popular but controversial revolution in the treatment of deafness. This book discusses the physiological bases of using artificial devices to electrically stimulate the brain to interpret sounds. As the first successful device to restore neural function, the cochlear implant serves as a model for research in neuroscience and biomedical engineering. These and other auditory prostheses are discussed in the context of historical treatments, engineering, psychophysics and clinical issues as well as implications for speech, behavior, cognition and long-term effects on people.

In spite of great advance made by ENT and maxillofacial surgeons as well as radiotherapists to improve therapy of cancer of the oral cavity and oropharynx, it has not been possible in the past 4 decades to raise the chances of patient survival above 40%-45%. However, recent studies with different combination therapies indicate that better results can be expected in the future. In this volume, the current status and results of therapeutic studies are presented by distinguished clinicians in the three disciplines. The book provides up-to-date information and encourages interdisciplinary cooperation.

The Springer Handbook of Auditory Research presents a series of compreh- sive and synthetic reviews of the fundamental topics in modern auditory - search. The volumes are aimed at all individuals with interests in hearing research including advanced graduate students, postdoctoral researchers, and clinical investigators. The volumes are intended to introduce 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 presents a particular topic comprehensively, and each serves as a synthetic overview and guide to the literature. 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.

Addressing disease of the frontal sinus successfully remains, perhaps, one of the most technically challenging issues encountered by otolaryngologists. The intricate anatomy, combined with a narrow aperture and relatively acute angle of approach, leads to complexity not encountered elsewhere in surgery of the sinuses. This comprehensive volume with contributions by over 30 of the world's leading rhinologists will help to shed light on this difficult topic. Thorough discussions of anatomy and pathophysiology of a variety of frontal sinus diseases provide a background for in-depth chapters on aspects of both medical and surgical management. A variety of surgical approaches are discussed, including the latest endoscopic techniques, as well as more traditional open and microscopic approaches. Heavily illustrated, this volume will be a "must have" for the rhinologist managing disease in the frontal sinus.

Simplified Facial Rejuvenation is divided into sections that include anatomy and anesthesia, classifications, dermatologic procedures, suture lifts, surgical variations of the face, surgical variations of the eyes, brow, neck, lips, nose ear, and scalp, and medical legal aspects. The book presents multiple variations of suture lift procedures to allow the physician to decide which is best. Unique surgical procedures of the face are presented, many of which are techniques of minimal incision facelift. The book brings together the more popular procedures for patients that include simpler methods of facial rejuvenation with less pain, shorter recovery time, lower cost, and fewer complications.

Both the major and minor salivary glands can be the site of a wide variety of diseases and functional disturbances. This monograph covers both the common lesions and conditions of the salivary glands as well as the rare ones. Much attention is given to the problematic complaint of dry mouth and the even more cumbersome diagnostic aspects of Sjogren's syndrome. Emphasis is on the clinical aspects and the management of the various disorders. The vast experience of the authors is reflected in their clear and concise style. The illustrations are well chosen and updated references are provided, where appropriate."

Our common interest in surgery of the vertebral artery was born in 1976, when as residents in the same hospital, we attended an attempt by two senior surgeons to treat an aneurysm of the vertebral artery at the C 3 level. Long discussions had preceded this unsuccessful trial, to decide if surgery was indicated and to choose the surgical route. Finally a direct lateral approach was performed, but access was difficult and correct treatment was impossible, resulting in only partial reduction of the aneurysmal pouch. Following this experience, we decided to seek a regular and well defined approach for exposition of the vertebral artery. Review of the literature indicated some surgical attempts, but the descriptions did not give the impression of safety and reproducibility. No landmark on the described surgical route appeared sufficiently reliable. Henry's anatomical work (1917) gave the only accurate description on vertebral artery anatomy, and it became the basis for our work. When the same patient was referred again one year later, after a new stroke in the vertebro-basilar system, we had behind us repetitive experience on cadavers of an original approach to the distal vertebral artery.

In Videofluorscopic Studies of Speech in Patients with Cleft Palate, Drs. M.L. Skolnick and E.R. Cohn present multiview videofluoroscopy as a technique for the radiological evaluation of speech defects in patients with cleft palate. Dr. Skolnick's invaluable contributions as both the originator and leading authority on the subject are discussed in a concise, clinical fashion. Topics examined include the anatomy and imaging of the velopharyngeal portal; the equipment and techniques of multiview videofluoroscopy; the interpretation of results and various patterns of velopharyngeal closure; Passavant's Ridge and patterns of velopharyngeal closure; normal and abnormal speech production; and the evaluation of test results. This book is the only source which concisely and completely describes the technique and its interpretations for those who need a description of the clinical procedure.

Many books from symposia describe the current status in well established fields of research, where much is known and where the loose ends are only details in the picture. The topic dealt with here does not fall into this pattern. The study of time as a parameter in its own right is difficult, and the loose ends tend to do minate the present picture. Although the book does provide the reader with an overview of the field, its main value is probably to act as a source of "food for thought" for those interested in the function of sense organs and nervous systems as substrates for behaviour. The Introduction is intended to provide the readers of the book with a short guide to the topiCS discussed in the different chapters. The rather detailed Index may help those looking for information on specific topiCS. The Index also explains most of the abbreviations used in the book. The basic idea of the Danavox symposia is to invite a small group of experts to discuss a rather narrow theme in sound communication. The small number of active par tiCipants has the advantage of encouraging intense dis cussions and of avoiding overloading the program. On the other hand, selecting the partiCipants is difficult."

The cerebello-pontine angle has always posed a challenge to the neurosurgeon, the otoneurosurgeon, and the neuroradiologist. Angle masses which are very small and difficult to detect frequently produce symptoms, but may remain silent while growing to exceptional size. The neuroradiologist must have firm knowl edge of the clinical manifestations of the diverse angle lesions in order to tailor his studies to the patients' needs. The majority of angle lesions are benign; thus successful surgery has the potential for complete cure. Angle lesions typically arise in conjunction with vital neurovascular structures, and often displace these away from their expected positions. Large lesions may attenuate the vestibulocochlear and facial nerves and thin them over their dome. Since the nerves often remain functional, the surgeon then faces the need to separate the tumor from the contiguous nerve, with preservation of neurological function. Depending on the exact location and extension of the lesion, resection may best be attempted via otologic or neurosurgical approaches. The neuroradiologist must determine - precisely -the presence, site, size, and extension( s) of the lesion and the displacement of vital neurovascular structures as a guide to selecting the line of surgical attack. Since the arteries, veins, and nerves that traverse the angle are fine structures, the neuroradiologist must perform studies of the highest quality to do his job effectively."