摘要:

ABSTRACTSoon after its discovery, streptomycin sulfate was found to be beneficial in the treatment of tuberculosis. However it also was found to have toxic effects, primarily vestibular and typically sparing the auditory nerve until higher doses were administered. The first reported use of streptomycin in the treatment of vertigo was in 1948. This was soon followed by its use for treating Meniere's disease. Although excellent control of vertigo was achieved significant post-treatment oscillopsia was experienced by these completely ablated patients. A protocol of titration streptomycin therapy was established that effectively controls vertigo while decreasing the incidence of oscillopsia. This report presents three patients with Meniere's disease treated with this protocol.

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ABSTRACTControversy exists surrounding the diagnosis of spontaneous perilymphatic fistula. In an effort to help resolve this controversy the author conducted a review of the literature as well as a review of 212 of his patients who underwent surgical exploration for suspected perilymphatic fistula. Interpretation of the literature reviewed was hampered by the lack of a uniformly accepted definition for the word spontaneous.Dorland's Medical Dictionarydefines spontaneous as that which occurs without external influence.Webster's Dictionary, on the other hand, provides a much more confining definition of the word by stating that a spontaneous event is one that occurs or is produced by its own energy. Only 58 percent of the author's 212 patients had an antecedent history of an external event that may have precipitated the suspected perilymphatic fistula (trauma, flying, diving) while almost 41 percent recalled an antecedent event of internal origin (lifting, straining, sneezing, nose blowing). If one were to support the definition of spontaneous provided byDorland's Medical Dictionary, then the 41 percent of patients who had no antecedent history of external event would have to be considered as having spontaneous perilymphatic fistula. If, on the other hand, one were to endorse the definition of spontaneous provided byWebster'sthen less than 2 percent of the author's patients would have to be considered as having spontaneous perilymphatic fistula.

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ABSTRACTAs a medical treatment for otospongiosis-otosclerosis, sodium fluoride influences the underlying bony changes in the labyrinth so as to arrest or prevent the onset of hearing loss. Sodium fluoride is an enzyme inhibitor and reduces osteoclastic bone resorption and, if the dosage is more than 60 mg a day, may rebuild pseudohaversian bone.

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ABSTRACTIncisional pain and headache have been reported following cerebellopontine angle surgery via the suboccipital approach. The high incidence and severity of pain determined in a retrospective study of acoustic tumor patients prompted the present prospective study. Various modifications of the suboccipital approach have been employed in an attempt to isolate a possible cause and potential method of minimizing this problem. The results of this study suggest that pain may be caused, in part, by adherence of healing nuchal soft tissue to underlying dura following suboccipital craniectomy. The substitution of a craniotomy with bone flap replacement, which prevents such adhesion, appears to have significantly reduced the postoperative pain associated with the suboccipital approach.

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ABSTRACTThe efficacy of hyaluronic acid when utilized in tympanoplasty was investigated in a multicenter, randomized, prospective patient blinded study. Of the 117 patients who completed the study, a majority (76) were treated with myringoplasty, 26 with myringoplasty combined with ossiculoplasty, and 15 with ossiculoplasty alone. The patients were evaluated by the operating surgeon up to 3 months following surgery, when the final assessment was made. The patients were divided into three groups: group 1 was treated with hyaluronic acid, 1 percent; group 2 with hyaluronic acid, 1.9 percent; and group 3 constituted the control where no hyaluronic acid was used at all. In the two test groups, utilizing hyaluronic acid, no gelatinous sponge was allowed to be left in the middle ear after surgery, whereas the control group was operated according to standard principles. The three groups were compared after the termination of the study as regards quality of healing and their hearing results. It could be concluded that the healing process within the middle ear and the tympanic membrane, as well as the hearing ability, was similar in all three groups. Thus no statistically significant differences could be obtained between the patient groups in which hyaluronic acid had been utilized in any concentration and the control group operated according to standard routine. This finding does not exclude, however, that hyaluronic acid might have a place in tympanoplastic surgery of today, since the long-term results were not evaluated here.

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ABSTRACTResults of surgical treatment in different types of cholesteatoma were analyzed in 431 chronic ears. Mean follow-up period was 6.9 years. The total recurrence rate (including both residual and recurrent cholesteatoma) was 8.6 percent. The recurrence rate was lowest (7.4%) in attic cholesteatoma and highest (10.0%) in pars tensa retraction cholesteatoma. The great majority (98%) of the operations were one-stage procedures. Canal wall down mastoidectomy was the procedure in 297 cases, with a recurrence rate of 7.7 percent; canal wall up mastoidectomy, in 86 cases, yielded a recurrence rate of 9.3 percent, and in 48 ears the cholesteatoma was removed by a transcanal procedure without mastoidectomy, giving a recurrence rate of 12.5 percent. Hearing results in attic and sinus cholesteatoma were significantly better than in pars tensa retraction cholesteatoma. Of the whole series, hearing improved in 36 percent and deteriorated in 28 percent. It is concluded that surgery should be individualized according to site and size of the cholesteatoma, but all large cholesteatomas require canal wall down procedure to avoid recurrence.

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

ABSTRACTSquamous cell carcinoma originating in the middle ear cleft is a rare tumor that tends to be diagnosed late in its course. The presenting symptoms mimic inflammatory disease of the middle ear space, and hence biopsy is often delayed. Herein we present a case of squamous cell carcinoma of the temporal bone arising 43 years after fenestration procedure. Operative findings were significant for complete dissolution of the tegmen tympani, tegmen mastoideum, and posterior fossa dura plate with dural exposure and sigmoid sinus exposure. Tumor was noted to invade the labyrinth at the horizontal semicircular canal. This case report highlights the aggressiveness of this particular tumor in a previously exenterated mastoid cavity and its proclivity to penetrate the otic capsule via pre-formed pathways. The treatment of choice is aggressive surgical resection followed by radiotherapy.

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1993

数据来源: OVID