ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Recurrent otorrhea, pain, and a conductive hearing deficit are common indicators of possible recurrent disease following mastoidectomy for chronic otitis media. High-resolution computed tomography (CT) provides an excellent method for examination of the surgically altered mastoid. Areas of residual infected air cells, cholesteatoma, cholesterol granuloma, and other surgical conditions within the mastoid are localized by this technique prior to reexploration. The technique provides information regarding the extent of disease as well as possible anatomic variations and potential complications that may be avoided during surgery. The imaging modality illustrates the detailed nature and extent of the prior mastoid surgery. CT of the temporal bone is therefore a useful guide to the surgeon in managing patients after unsuccessful surgery. Nine illustrative case examples are presented in which CT results prior to reoperation are directly compared to the surgical findings. The causes of recurrent disease and the utility of CT scanning prior to reexploration of the mastoid are discussed. High-resolution CT scanning should be performed on all patients presenting with signs or symptoms of possible recurrent disease following mastoid surgery for chronic otitis media.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

In an attempt to destroy selectively the affected peripheral vestibular labyrinth in patients with intractable vertigo as a result of Meniere's disease, a known quantity of streptomycin was introduced within the bony labyrinth following fenestration of the horizontal semicircular canal. Initial laboratory results in animal models proved that near total ablation of the vestibular end-organs (including the hair cell population of the cristae ampularis, utricle, and to some extent the saccule) could be achieved chemically without involvement of the cochlear hair cell population. The exact dose required to accomplish this in the animal model was 250 μg of streptomycin. However, this dose proved excessive in initial human application possibly because the animals had excellent hearing in nondiseased ears while our patients uniformly had long standing inner ear disease with marked decrease in auditory thresholds. The current dose of streptomycin utilized is 125 μg, and patients treated thus far have maintained (or improved) their preoperative audiologic pure tone average.The aim of this preliminary report is to detail our developmental animal research and subsequent clinical application of selective chemical vestibulectomy (SCV) in 15 patients with intractable vertigo as a result of Meniere's disease, which have failed conventional medical management.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Knowledge of the microsurgical anatomy of the lower skullbase is needed in order to resect tumors involving this region. We have dissected 10 formalin-preserved skull-base specimens and identified the structures that would be encountered during the course of surgery using the lateral approach. A morphometric analysis was performed on the jugular foramen, the hypoglossal canal, the condylar emissary vein, and the foramen magnum. By identifying the relationships of the lower skull base, we hope to minimize the morbidity associated with removing lesions in the region. A representative case is presented and discussed.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Several efforts have been made to treat patients with Meniere's disease with ototoxic drugs. Lately the aminoglycoside antibiotic, gentamicin, has been favored. Several reports have proved its efficacy. In a series of 12 patients treated at the Karolinska Hospital in Stockholm, two patients failed to show improvement regarding their vertigo in spite of repeated courses of treatment. These patients both underwent labyrinthectomy where their vestibular sensory epithelia as well as portions of the cochlea were removed. The findings in these two cases were quite unanimous in that the vestibular sensory epithelia were retained showing advanced signs of degeneration. The organ of Corti in the cochlea was totally absent in all specimens examined. These findings indicate that gentamicin seems to affect the cochlea more than the vestibular sensory epithelia that also was clinically proven since both patients totally lost their hearing in the affected ear. Possible routes and actions of the drug in the inner ear are discussed.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Posterior canal wall reconstruction using porous hydroxylapatite (HA), Grote canal wall prosthesis (Richards), has been recommended for obliteration of troublesome “canal-wall-down” procedures. The same method has been utilized during the management of diverse otologic problems. The results obtained encourage the further utilization of this technique in the management of various otologic dilemmas. Indications for reconstruction of the posterior canal wall using HA are suggested.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Relatively few complications have been reported for cochlear implant surgery in spite of a recent report detailing a complication rate of 11.8 percent. This report highlights both the surgical and nonsurgical complications we have encountered that have resulted in either replacement of the implanted prosthesis or compromise of the sound processing strategy employed by the external unit. These complications make a strong argument for the use preoperative, intraoperative, and postoperative radiologic examinations. Since the complications reported herein have not been attributed to the implant device proper, we feel cochlear implantation remains a safe and effective procedure for those patients who are untreatable by traditional methods.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Cochlear implant surgery was performed in four Cantonese-speaking postlingually deaf Chinese adults, using the House/3M single channel device. This article outlines the methodology, including preoperative assessment and postoperative rehabilitation; and explains the necessary modifications in speech and audiologic work-up in Cantonese-speaking patients. Salient features of Cantonese phonetics, especially its tonal characteristics, are described.The findings of the study are presented. The results of the cochlear implant would suggest a performance superior to that of the hearing aid. Furthermore, the cochlear implant is able to detect tonal cues. This quality of the cochlear implant may prove to be a valuable asset to a tonal language-speaking cochlear implantee.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The purpose of this paper is to introduce a simple and reliable method to close traumatic tympanic membrane ruptures. Traumatic eardrum perforations without ossicular discontinuity were treated by patching with a piece of micropore tape (3M Micropore Strip Tape). A retrospective study of 108 cases treated by this method over a 7-year period revealed that 107 (99.1%) of the perforations were healed completely by the procedure. The authors stress that this is a simple and reliable method for treating fresh traumatic eardrum perforation. This method does not require anesthesia or any averting manipulation of the perforation.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Tone-on-tone masking patterns were measured in the chinchilla using the auditory evoked response from the inferior colliculus. The masker was a 2 kHz continuous tone presented at one of five levels from 20 to 70 dB SPL. The evoked response was elicited with tone bursts presented over a wide range of frequencies. Masking was defined as the difference between evoked response thresholds measured in the presence of the masker versus quiet. At low masker levels, the masking profile was symmetrical and centered around 2 kHz. However, as masker level increased, masking spread toward the high frequencies. Furthermore, at masker levels above 50 dB SPL, a low-threshold notch occurred above the masker. The masking profiles obtained with the evoked response are in good agreement with those obtained psychophysically.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID