摘要:

In recent years the number of stapedectomies performed by residents in training programs has drastically decreased, raising the question of competency. With the lowered incidence of otosclerotic patients requiring surgery, who should perform a stapedectomy when it is indicated? Is the otolaryngologist who has the experience of 10 stapes procedures as competent as one who has performed 300? These are obviously difficult questions to answer. A recent paper presented at a national meeting suggested that the occasional operator should not attempt stapedectomy.While the Editors of The American journal of Otology do not take sides in this controversy, we felt it would be important to offer an opposing view. For this reason, the following comment was solicited from Dr. James L. Sheehy of The Otologic Medical Group.

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The authors consider the consequences and treatment of any error during and after stapedectomy, and present the usually less developed complications of stapedec-tomies: postoperative cochlear drops, tinnitus, vertigo. They also mention the other complications of stapedial surgery, and they particularly advocate the half-posterior stapedectomy technique, associated with a sufficiently large venous interposition.The authors had no cases of severe permanent cochlear loss during the first postoperative month in a series of more than 4000 stapedectomies.

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

A group of site-of-lesion tests are reviewed in reference to their clinical capability for eighth nerve lesion detection. The tests selected by the authors are analyzed not only in regard to their validity for defining eighth nerve disorders, but also for their overall clinical feasibility. It is hoped that the information in this article will provide a basis for developing a test battery that is keenly sensitive to eighth nerve disorders.

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

An incidence of postoperative infection of up to 15 percent has been reported following middle ear ventilation tube surgery. This rate of complication would be considered unacceptable following most other operative procedures. A controlled prospective study of 107 children undergoing tympanostomy and tube surgery over a 1-year period was undertaken. Subjects were randomly assigned to receive antibiotic-steroid otic drops at the time of surgery and for 1 week afterward, oral ampicillin for 24 hours preceding and 3 days following surgery, or no prophylactic treatment.The overall infection rate within four weeks of surgery was 12 percent. Purulent otorrhea occurred in 18 percent of those receiving no prophylactic treatment, in 13 percent receiving ampicillin, and in 6 percent receiving antibiotic-steroid otic drops. Postoperative infection was related to preoperative history of status otitis media and to previous placement of ventilation tubes.

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

In the evaluation of patients with pseudohypoacusis, a test that gives at least a suggestion of the patient's true auditory sensitivity is of great value. This report is an evaluation of the application and contribution of auditory brain stem response (ABR) measurement in pseudohypoacusis through a case study approach. Four patients suspected of having pseudohypoacusis on the basis of their histories and initial audiometric results were tested with the ABR procedure. In all cases the auditory sensitivity suggested by ABR was considerably better than the voluntary thresholds obtained on the initial audiograms. Following ABR measurement, all four patients showed marked improvement in voluntary threshold responses, and two gave responses that were within normal limits. Although auditory brain stem response measurement is not a test of hearing, it can be a powerful tool in the identification and quantification of nonorganic hearing loss.

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

A fresh brain-slice preparation that allows simultaneous characterization of the anatomic localization of radioactively labeled substances in a variety of different auditory brain stem areas has been used to examine localization patterns for a number of putative neurotransmitter amino acids in the anteroventral and dorsal cochlear nuclei of the cat. Following incubation of fresh brain sections in oxygenated salt solutions containing micromolar amounts of the tritiated amino acids, differences in the pattern of label localization are revealed by light microscopic autoradiography. Electron microscopic autoradiography of the same material demonstrates that the label is restricted to different synaptic terminal populations. In the dorsal cochlear nucleus, gamma aminobutyric acid (GABA) and glutamic acid incubations label two different terminal populations in the molecular layer. Glycine incubation labels a population more uniformly distributed among the molecular, fusiform cell, and deep layers. In the anteroventral cochlear nucleus the pattern after GABA and glycine incubations is similar, with multiple endings on all spherical cells labeled. Studies are underway to characterize fully the different labeling patterns and the conditions under which they occur.

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

By using the energy dispersive x-ray microanalysis technique the elemental composition of otoconia was analyzed in the normal fetal and normal adult, Shaker-1 and Shaker-2 mouse. There are no statistically significant differences in Ca concentration between otoconia seen in normal nineteenth gestational day (CBA/CBA) fetuses and that seen in 2-month-old animals. However, the standard deviation is almost three times larger in fetal than in adult otoconia. In all analyses, in both normal and mutant species, the following elements were identified: Na, Mg, P, S, Cl, K, and Ca. The present findings strongly indicate a calcite composition of otoconia in both normal and mutant species. Significant differences in Ca concentration (p < 0.05) occurred between the central and peripheral parts of large otoconia in normal mice. No difference in the elemental composition of otoconia in adult normal and Sh-2 mutants was detected. Differences occurred between adult normal and Sh-1 otoconia (Na — p < 0.05; Mg — p < 0.001; K — p < 0.001; Ca — p < 0.02). It is, however, unlikely that the shaking-waltzing behavior of Sh-1 and Sh-2 mutants derives from a minimal derangement of the elemental composition of otoconia.

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

A comprehensive endocrinologic evaluation of water electrolyte balance system was performed on 25 patients with Meniere's disease, 6 persons with sudden deafness, and 20 normal persons. In the controlled environment, the following studies were performed: (1) plasma and urine Na+K+and Cl−, (2) plasma 17-ketosteroid and 17-hydroxysteroids, (3) plasma cortisol and ACTH, (4) urine steroids, (5) urinary excretion of aldosterone, (6) plasma activity of the renin (PRA) in clinostatism and in orthostatism, (7) plasma aldosterone in clinostatism and orthostatism.In patients with Meniere's disease and sudden deafness, the water-electrolyte balance results were normal, as were the hormonal system directly (renin-aldosterone) or indirectly (cortisol-ACTH) involved. A further confirmation of the integrity of the explored enzymatic-endocrinologic complex derived from the normal response observed in all patients when they were subjected to a physiologic stimulus as represented by the orthostatism. The results of the present study do not confirm previous findings by Arenberg and Goodfriend.1

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Benign osteoblastoma is an uncommon tumor in the skull and particularly rare in the temporal bone. This article presents the clinical, radiologic, and pathologic findings of the fifth case known to involve the temporal bone, and only the second case limited to the temporal bone itself. Subtotal removal was performed following embolization of the tumor. The patient currently has no evidence of disease eighteen months following therapy.Benign osteoblastoma is rarely synchronously or metachronously associated with its malignant counterpart, osteosarcoma. Treatment should be conservative. Subtotal curettage is acceptable and often results in long-term resolution. Radiotherapy is not recommended unless the removal is incomplete and the consequences of local recurrence are serious, as in vertebral lesions. This lesion may be highly vascular, and preoperative embolization should be considered to minimize blood loss at surgery.

ISSN:0192-9763    

出版商:OVID    

年代:1983

数据来源: OVID