ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

ABSTRACTWe performed quantitative assays for estrogen, progesterone, and testosterone receptors in 19 acoustic neuroma specimens from ten men and nine women. No patient received preoperative or intraoperative glucocorticoids, mineralocorticoids, or sex hormones. All tumors were unilateral and removed by the translabyrinthine approach. No tumor specimen was positive for estrogen or testosterone receptors. Three of ten men and seven of nine women had tumors positive for progesterone receptors (10 fmol/mg cytosol protein or greater). This between-sex difference was of borderline significance by the Mann-Whitney U test (p=0.08). This finding indicates the need for further investigations of endocrinologic therapy as a possible treatment of acoustic neuromas.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

ABSTRACTMany systems for reporting results of facial function tests have been proposed, but after five International Facial Nerve Symposia, a perfect system for reporting has yet to be developed. In 1985 the American Academy of Otolaryngology-Head and Neck Surgery adopted the House-Brackmann (H-B) six-point subjective grading scale as a universal standard. This decision was based on the recommendation of the Facial Nerve Disorders Committee. The next year, 1986, Burres and Fisch proposed the Linear Measurement Index (B-F LMI) as an alternative, objective grading system. To determine the ability of each system to grade the facial function of patients with facial palsy, and the relative merits of each system, 41 patients with facial weakness and one normal patient were studied. The H-B grading system is easy to use and provides simple, concise criteria for each separate grade of facial function. The B-F LMI grading system is time-consuming and labor-intensive, and requires a complex calculation to derive a percentage value that represents facial function. The most important finding of this study was the high degree of correlation between the two systems, in spite of the fact that the H-B system is subjective and qualitative while the B-F LMI system is objective and quantitative. Until the perfect grading system is developed, the authors favor combining the H-B and B-F LMI systems as the best method available at the moment to evaluate facial function.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

ABSTRACTThe debate regarding the surgical technique for the management of cholesteatoma still continues. The resolution of this issue will only come with the study of the long term results of well controlled series. In this paper long term follow-up on three groups of patients is reported. The groups underwent combined approach tympanoplasty (CAT), mastoid tympanoplasty with obliteration (MOT), and modified radical mastoidectomy (MRM) respectively for cholesteatoma. The factors studied included frequency of required review, condition of the external canal/cavity, and hearing status. The meatal cross-sectional areas and cavity volumes were also measured for the MRM and MOT groups. Analysis of the data showed no significant difference between the groups in either frequency of review or cavity status. The hearing results showed an initial improvement in all groups, however, over the prolonged follow-up period the air conduction threshold gradually increased.In conclusion this data supports the view that a one-stage canal wall down procedure provides maximum long term patient benefit.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

ABSTRACTAn implantable hearing aid (IHA), in which the direct driving of the stapes by a ceramic vibrator is a fundamental mechanism, was applied to 24 patients with mixed hearing loss of varying degree due to chronic otitis media. The instrument used in the present study was a partial IHA, in which only the vibrator and secondary coil were implanted and the remaining components were packed in a unit to be located behind the auricle. All the patients reported that quality of sound provided by the IHA was natural, clear, and intelligible without causing fatigue with long use. Speech discrimination tests conducted under conditions with background noise demonstrated that speech perception with the partial IHA was superior to that with a conventional hearing aid. These advantages may be ascribed to the direct oscillation of the stapes by the piezoelectric element.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

ABSTRACTThe resection of skull base neoplasms requires an intimate knowledge of basicranial vascular anatomy. Tumor distortion of surgical landmarks may increase the potential for inadvertent vascular injury with life-threatening intraoperative bleeding or delayed neurologic sequelae. Moreover, massive transfusion therapy may significantly alter the hemostatic mechanism in the perioperative period. On the basis of a review of hemorrhagic complications encountered in 154 consecutive skull base procedures, we describe techniques that are designed to avoid or efficiently control venous and arterial bleeding in extended skull base surgery. The management of complications resulting from blood replacement are reviewed.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

ABSTRACTRecently, electrocochleography (ECochG) has enjoyed a resurgence in clinical use, particularly in the preoperative and intraoperative evaluation of Meniere's disease patients. With a transtympanic electrode, large amplitude, repeatable waveforms can be easily recorded. Despite this fact, transtympanic ECochG has not been widely adopted in the United States, primarily because of the technical difficulties in securing the electrode and then delivering a stimulus. We have developed a simplified transtympanic electrode placement, using a standard subdermal needle held in place by a foam plug earphone. The foam plug earphone not only secures the electrode, but also delivers the stimulus. We have used this technique in a series of cases, both intraoperatively as well as in the outpatient clinic. The advantages of this approach are discussed and illustrated with individual and group data.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

ABSTRACTThe successful healing of the tympanic membrane (TM) following myringotomy or tympanoplasty is dependent upon the maintenance of the blood supply to the injured area of the TM. The blood supply of the TM is derived from the manubrial plexus and the peripheral plexus of vessels. This study concentrated on measuring blood flow derived from the manubrial vessels.The TM of the guinea pig was used as an in vivo model. Ten Outbred Hartley guinea pigs were anesthetized with Inactin 100 mg/kg, the common carotid artery cannulated, and FITC-dextran 150 injected intra-arterially. Blood pressures (mean 66.0 mmHg ± 5.0 mmHg) and heart rates (330 bpm ± 12.0 bpm) remained relatively constant throughout the experiment. Following injection of FITC-dextran 150, the TM was visualized under fluorescence microscopy and images recorded by video recorder; measurements of vessel diameter, blood velocity, and blood flow were made.Analysis of the in vivo studies revealed blood flow in the tympanic membrane to travel in two directions: down the manubrial artery towards the periphery and up the manubrial veins from vessels in the periphery. The manubrial artery divides and branches into a series of arcading vessels that extend towards the periphery of the TM. Manubrial artery diameter was measured (mean 0.0521 mm ± 0.0004 mm) and blood flow calculated (mean 0.0439 mm3/min ± 0.0007 mm3/min). Blood flow from the manubrial artery supplying the superior quadrants (0.18 mm3/min ± 0.01) was statistically greater when compared to the blood flow in the inferior quadrants (0.08 mm3/ min ± 0.007) (p<.001).

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

ABSTRACTReports on the effectiveness of myringotomy and tube for treatment of symptoms of the patulous eustachian tube are discouraging, even though there are no large series substantiating its ineffectiveness. To further investigate this problem, we have reviewed the charts of all patients at the Otologic Medical Group (OMC) from 1974 to 1981 with the diagnosis of patulous eustachian tube who underwent myringotomy and tube for their symptoms. We identified 60 ears of 46 patients with complaints consistent with patulous eustachian tube symptoms. The treatment either eliminated or substantially reduced symptoms in 32 ears (53%). For the other 28 ears, myringotomy and tube were of no benefit. Nine of 13 (70%) ears with a definitive diagnosis based on movement of the tympanic membrane with respiration or tympanometry showed relief of symptoms with myringotomy and tube. Myringotomy and tube will remain part of the treatment regimen because it is relatively simple to perform, reversible, and effective in the majority of patients.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

ABSTRACTThe surface architecture of dried temporalis fascia autografts and preserved tympanic allografts was investigated by scanning electronmicroscopy. During the storage in formaldehyde-cialit solutions the outer epithelial as well as the inner mucosal layer of tympanic allografts are progressively detached, and finally the lamina propria with outer radial and inner circular fiber arrangement remains. Due to dehydration phenomena irregular “crater-like” defects, surrounded by an amorphous structure, appear in dried fascia autografts. While a real lamina propria graft may induce migration and differentiation of the host's canal wall epithelium into a specific tympanic epithelium, one may imagine epithelial spreading toward the middle ear along the observed defects in dried fascia grafts. This latter observation gives new evidence for the immigration cholesteatoma theory.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID