ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The brain and the brain stem were investigated by magnetic resonance (MR) in 19 patients with complete acute peripheral facial palsy, diagnosed as Bell's palsy. Five patients with a median age of 57 years had changes on T2 weighted MR: One patient showed transient signal changes with increased signal intensity in the ipsilateral brain stem. Another patient had persisting abnormal signals both in the brain and the brain stem. Two patients presented regions of high signal intensity in the subcortical cerebral white matter and still another patient had increased signal intensity in the periventricular white matter. MR abnormalities anatomically related to the facial nerve or its nucleus were not demonstrated. The significance of the MR findings is not quite certain but the MR pattern in conjunction with the patients' high median age most likely indicate vascular disease.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Allograft tympanoplasties on 68 ears done between October, 1980 and December, 1986 were analyzed from the viewpoint of graft take rate and hearing improvement, and also the results were compared between draining and nondraining ears as well as among three stabilizing methods of the transplanted tympanic membrane (Type I: allograft tympanic membrane (ATM) covered with reflected epithelium; Type II: entirely covered ATM with fascia; and Type III: ATM reinforced with thin crescent fascia) and four groups of allograft materials (Group I: ATM with attached malleus and incus en bloc; Group II: ATM with attached malleus; Group III: ATM attached malleus and incus columella; and Group IV: two stage surgery with Group III material). Among the three types of stabilization in draining ears, the anatomic success rate of the tympanic membrane transplant was 27% in Type I, 56% in Type II and 90% in Type HI, while in nondraining ears it was 81%, 88%, and 100%, respectively. The success rate for hearing improvement in draining ears was 40% in Group A, 44% in Group B, 33% in Group C, and in nondraining ears, it was 82%, 100%, and 82%, respectively.Our results show that allograft tympanoplasty can be successful for a wellcontrolled middle ear with good utility of the areolar fascia in stabilization.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Endoneurial fluid pressure (EFP) was measured in the facial nerve in rabbits and guinea pigs using a servo-controlled micropipette system. EFP in the tympanic segment was 5.3 ± 1.2 cm H2O in rabbits and 4.1 ±0.9 and 4.2 ± 0.9 cm H2O in the tympanic and mastoid segment respectively in guinea pigs, while EFP in the sciatic nerve was around 2 cm H2O. The higher pressure in the facial nerve may be related to the proximo-distal flow of the endoneurial fluid in peripheral nerves.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The open technique in cholesteatoma surgery has, besides a higher security concerning the recurrence of disease, some disadvantages: lifelong care for the cavity, often discharging granulations, and vestibular vertigo due to the lack of labyrinthine protection. Most of the disadvantages can be avoided by the obliteration of the mastoid cavity, for which many different techniques have been described in literature.The authors recommend a new method: the reconstruction of the posterior canal wall using autograft conchal cartilage and the obliteration of the mastoid cavity with hydroxyapatite granulate. The technique can be used for the treatment of old cavities as well as for one-stage surgery.The results of 25 cases are reported. Due to the elevation of the tympanic membrane on a nearly physiologic level and suitable tympanoplastic procedures an air-bone gap of less than 30 dB can be reached in more than 70%.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Tuberculous otitis media can present with very nonspecific clinical features. Five cases of tuberculous otitis media are reviewed over a period of 5 years. Significant clinical findings included the presence of abundant granulation tissue in mastoids with good pneumatization, cervical lymphadenopathy, profound hearing loss, facial palsy, and foci of tuberculous infection at other sites. Histologic examination of granulation tissue showed tuberculoid granulomata in all cases. The mycobacteria could be identified in two of the biopsies but not on cultures. Other conditions that give rise to tuberculoid granulomata should be searched for in cases where the mycobacteria cannot be identified. In one case, diagnosis was delayed because the operative specimen was neither histologically examined nor sent for culture. Persistent otorrhea and recurring granulomata after mastoidectomy provided other important clinical features. All cases responded well to antituberculous chemotherapy. Surgery is indicated nowadays for facial palsy, subperiosteal abscess, fistula formation, labyrinthitis, intracranial complication, or infrequency for resistant mycobacterial infection caused by the nontuberculous mycobacteria.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The retrosigmoid approach is currently used in the resection of small acoustic schwannomas or the vestibular nerve in selected patients with recurrent vertigo. Cerebrospinal fluid otorhinorrhea associated with the approach is often due to a failure to completely obliterate exposed air cells of the posteromedial and posterosuperior tracts of the temporal bone.A therapeutic protocol for managing a postoperative spinal fluid leak is outlined on the basis of these anatomic features and the status of the patient's hearing. If serviceable hearing has been preserved, the operative site is explored and incompletely obliterated or exposed cells are sealed with bone wax. If a leak persists, or if hearing is lost with the initial procedure, the mastoid cavity and middle ear cleft are obliterated with abdominal fat and the eustachian tube orifice occluded with Proplast through a facial recess approach.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

This report represents the second of two providing a consumer-oriented comparison of commercially available auditory evoked potential units. The units compared here were those whose basic price was between $10,000-$30,000 (“midpriced”), and greater than $30,000 (“luxury”). The midpriced group included the Amplaid MK15, Bio-Logic Navigator and Traveler LT, Cadwell 5200A and Quantum 84, GSI-50, Nicolet CA-2000 and Compact Auditory, Nihon-Kohden Neuropak IV Mini, Madsen ERA2250, Siegen (Dantec) Neuroscope, and Tracor Nomad. The luxury units comprised the Bio-Logic Brain Atlas, Cadwell Spectrum 32 and Nicolet Pathfinder.Descriptive information and the names and addresses of users were solicited from the manufacturers for each of the above units. Questionnaires were sent to the users asking them for information on how their unit was used and to rate some of its features.The midpriced and luxury units offer more flexibility and options than less expensive (i.e., “economy”) units. However, the basis for a given unit's price versus another's was not always apparent by a comparison of features or options. In general, users of the midpriced and luxury units rated the majority of their instruments' features highly. The lowest ratings were received for some aspect of the printer or print-out, and portability.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Müchausen syndrome is uncommon in otolaryngology. Self-induced otitis externa has rarely been reported, and nothing is known concerning the true incidence of feigned vertigo. We present a patient who has been hospitalized several times and who has undergone ear surgery and treatment at different institutions along the eastern seaboard. She has suffered complications of therapy, including a profound sensorineural hearing loss, and was referred to us for surgical treatment of bizarre intractable otitis externa. The infection failed to respond to medical treatment and was ultimately found to be self-inflicted. Despite psychotherapy, the patient continues to seek further treatment at still other hospitals. This entity must be considered whenever a thorough evaluation fails to yield a reasonable organic diagnosis.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

This study aimed to demonstrate that new bone formation in the scala tympani of patients deaf from otosclerosis does not preclude cochlear implant surgery. In seven temporal bones from patients with otosclerosis, we measured the extent of new bone from the round window to the distal part of the new growth. We compared results to surgical data on the extent of drilling and depth and ease of placement of the electrode in 20 patients deaf from otosclerosis. We also examined clinical performance and voltage requirements for long-term implant use in patients with and patients without ossification of the scala tympani. Findings in our limited sample of patients and bones show that obstruction of the basal turn, which occurs in some otosclerotic patients, does not preclude implant surgery. The dynamic range in the studied sample was relatively stable long-term and clinical performance did not differ between groups with and without an ossified scala tympani.

ISSN:0192-9763    

出版商:OVID    

年代:1990

数据来源: OVID