ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Previous studies from the House Ear Institute have reported the possibility of sound sensation from the central electroauditory prosthesis (CEP) implanted in patients during removal of bilateral acoustic neuromas. This study describes histologic features of tissues formed around a CEP that was removed due to infection in the area of the electrical plug on the external surface of the skull. V\fe found a layer of compact collagen tissue around the CEP. The tissue penetrated spaces of the Dacron mesh matrix, preventing our determination of the precise place of the electrode-tissue interface. We also found a layer of connective tissue on the Silastic covering on the CEP leads. Histopathologic analysis showed no unusual pathologic changes around the CEP except for degeneration of the abdominal fat used for placement and stabilization of the CEP on the surface of the cochlear nuclei.

ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

An auditory test battery composed of seven behavioral and electrophysiologic measures, in addition to pure tone testing, was administered to 33 subjects with definite multiple sclerosis. More than 40% of the subjects with normal peripheral hearing presented with subjective complaints of hearing difficulties. Auditory brainstem response (ABR) was found to be the most sensitive individual test in detecting central auditory dysfunction. Further analyses suggested that the combination of ABR and masking level difference (MLD) tests was essentially as effective as the entire test battery in detecting dysfunction in these subjects. Dichotic speech measures, unlike other tests, showed a definite laterality effect with the left ear consistently poorer, possibly reflecting interhemispheric involvement.

ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The neural and vascular anatomy of the posterior fossa and bony skull base is of interest to both neurosurgeons and otologists charged with the evaluation and management of patients demonstrating lesions in this region. Despite well described approaches to pathology in this area, access to the lower basilar artery and clivus remains a significant challenge. This report highlights the pertinent anatomic details of the fossa, describes the bony dimensions relevant to surgical access, and reviews two unconventional approaches to the lower basilar upper vertebral artery union.

ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Thirty cases of congenital cholesteatomas of the cerebellopontine angle (CPA) treated over a period of 20 years are reviewed with regard to their clinical features, the pathophysiology of their symptoms, and their management. The predominant symptoms were related to cranial nerves VII and VIII and headaches. Signs and symptoms were divided into those caused by local involvement of the cholesteatoma, increased intracranial pressure, or both. Diagnostic procedures from invasive procedures such as ventriculography to more sophisticated noninvasive procedures including computed tomography and magnetic resonance imaging are discussed. The surgical management of 27 congential cholesteatomas was accomplished via a posterior cranial fossa approach. Total excision of the cholesteatoma was the aim but was carried out in only five (18%) patients because of concern regarding the preservation of nearby neurovascular structures. Partial excision was possible in 22 (82%) patients. To minimize re-formation, the residual cholesteatoma was carefully cauterized with the aid of the operating microscope and bipolar diathermy without damaging surrounding neurovascular structures. Follow-up has ranged from 2 to 15 years, with four (13%) cases of re-formation.

ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A review of the literature gives considerable evidence that there are manifestations of migraine involving the vestibular system starting in infancy and proceeding to late life. This paper deals with these manifestations in the first two decades of life There is evidence that vestibular symptoms are probably caused by involvement at different levels of the system in different cases. Paroxysmal vestibular symptoms may occur in association with headache, temporally independent of headache, or without headache, and may at times be the chief complaint causing the patient to seek help from the otolaryngologist in the latter two instances. Other neurologic symptoms may or may not be present. Meticulous family, past personal, and present history are the sources of information necessary to suspect the association of paroxysmal vestibular symptoms and a migraine diathesis. A prospective study of a large neurotologic population of this age group with recurrent paroxysmal vestibular symptoms seems indicated and may lead to diagnostic and therapeutic benefits.

ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Forty-five subjects with a rising, progressively improving (RPI) audiometric pattern were considered for a 5-hour oral glucose tolerance test. Results revealed that 2 nondiabetic subjects (4%) had a plasma glucose nadir of 49 mg/dl or lower and 7 nondiabetic subjects had a nadir between 50 and 57 mg/dl. A total of 21% of 42 subjects with data indicated abnormally low readings. An additional 7 subjects were found to be diabetic; 5 subjects had impaired glucose tolerance, and 9 other subjects had nondiagnostic glucose intolerance, totalling 47% of 45 subjects in the study with abnormally elevated plasma glucose levels. Therefore a total of approximately 68% of all subjects in our study indicated metabolic dysfunction based specifically on a RPI pattern.

ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Speech intelligibility in noise was tested pre- and postoperatively after 27 stapedectomy cases and 10 cases of reexploration after previous stapes surgery. We did not find a postoperative threshold shift (signal-to-noise ratio) for the intelligibility of sentences presented in noise. This finding corresponds well with the absence of postoperative high-frequency sensorineural loss in these patients. Using two types of prostheses we found a significant amelioration of speech intelligibility in quiet for the Schuknecht minihole prosthesis as compared to the House wire loop.

ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Immunolocalization of involucrin in human middle ear cholesteatoma was performed with specific rabbit anti-human involucrin antibody. Involucrin was noted prominently in the cytoplasm of the suprabasal cells, including spinous cells and granular cells. The pattern of distribution of involucrin in cholesteatoma shows its epidermal characteristics. Immunostaining of involucrin was also made in tympanic membrane and external ear canal skin. As for comparing its distribution, a larger amount of involucrin was present in cholesteatoma (60%) than in external ear canal skin (29%) in our study and in normal skin (25%) in another study. This suggests active differentiation of the epithelial cells in cholesteatoma. Further investigation on the inhibition of involucrin formation may have some effect in the treatment of cholesteatoma.

ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Interaural latency differences for wave V (IT) were measured for 406 patients having cochlear hearing loss and for 36 patients with Vlll th nerve tumors. The incidence of IT5 values exceeding 0.2, 03, and 0.4 msec was plotted as a function of the degree of asymmetry in hearing sensitivity for 2,000—4,000 Hz. In general, the patients with cochlear hearing loss and the greatest degree of hearing asymmetry yielded IT5 values that exceeded 0.2, 03, or 0.4 msec more frequently than patients with more symmetric hearing losses, and this trend was apparent for all degrees of hearing loss. For the Vlllth nerve tumor patients, IT5 data were scattered widely regardless of symmetry or asymmetry of hearing sensitivity. The falsenegative rate was 8% when IT5 was greater than 0.4 msec.

ISSN:0192-9763    

出版商:OVID    

年代:1989

数据来源: OVID