摘要:

Abstract1. During rhinoplasty the surgeon can easily set in motion changes which produce soft‐tissue rounding of the supra‐tip area postoperatively.2. Preventive as well as therapeutic measures are discus

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00011

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractAn update of original data is presented. These data continue to confirm the physiological effect of adenotonsillectomy on the abnormal oropharyngeal and nasopharyngeal microflora of children with recurrent adenotonsillitis. A new concept suggesting a bacterial‐viral etiology of recurrent adenotonsillitis is presented. The advantages of such a concept are reviewe

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00012

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractA panel on contraindications to tympanoplasty connotes the need for self‐evaluation by the otologic surgeon. A polarity of opinion is developing among tympanoplastic surgeons. There are some who recognize few contraindications in these procedures in contrast to those who are very conservative. The panel has designated absolute and relative contraindications which must be determined according to the surgeon's dexterity and experience. A careful selection of patients in light of the relative contraindications is advocated.The contributors to this panel jointly enumerated the following contraindications, absolute and relative, to tympanoplasty:1. Extensive mucosal deficit (particularly with good hearing in opposite ear).2. Absence of middle ear bony framework (postoperative radical mastoidectomy).3. Non‐existence of stapedial superstructure (poor prognosis).4. Fixation of footplate (poor prognosis).5. Total eustachian tube obstruction.6. Extensive tympanosclerosis.7. Surgery on better hearing ear (except for compelling reason).8. Surgery on only serviceable ear (except for compelling reason).9. Minimum of discrimination is necessary (70–80 is borderline between good and bad prognosis).10. Patients with small air‐bone gap are usually non‐candidates (surgery could make them worse).11. Systemic diseases —i.e., tuberculosis, malignancy, diabetes, circulatory problems (obtain clearance from internist).12. Post irradiation base of skull (interferes with healing).13. Severe allergic disorders.14. Chronic sinusitis.15. Cleft palate.16. Extensive cholesteatoma (particularly with inexperienced aural surgeon).17. Avoid ear preferred by patient for hearing aid (a surgical accident might render ear useless).18. Ear in which previous surgery has been associated with serious complications (i.e., facial nerve paralysis, cerebrospinal fluid leak, lateral sinus rupture).19. Persistent wet ear after adequate local treatment (indicates eustachian tube problems and nasal pathology).20. Tympanoplasty in children not too successful. Eustachian tube does not achieve sufficient growth (until age 10–14 years) to prevent recurrent middle ear infection. There is a high probability of spontaneous healing.21. Age (under three or over 70).22. Fibrosis of middle ear and extensive tympanosclerosis (insufficient blood supply for good healing).23. Obliterative fibrosis of middle ear requiring space creating and adhesion preventing materials.24. Mumps exposure.25. Acute illness.26. Acute traumatic perforation.27. Perfect contralateral ear.28. Real benefit unlikely.29. Inability to remove epithelium at time of surgery.30. Acute or chronic external otitis.31. Unilateral congenital atresia.32. Bilateral congenital bony atresia b

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00013

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractA brief history of the surgical technique of tympanoplasty is provided, emphasizing the underlying principles and goals as defined by Wullstein.Based on clinical and surgical experience, a list of absolute and relative contraindications to tympanoplasty surgery is presented according to the presence or absence of active pathology.

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00014

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractThe two primary symptoms of chronic ear disease are otorrhea and hearing loss. The goal of any tympanoplasty is to eradicate disease and improve hearing. These are the primary indications for this procedure. The success or failure of the surgery is influenced by many factors such as the age and general health of the patient, the extent and type of disease present, and whether the upper airway is functioning properly. Contraindications to tympanoplasty will vary from one surgeon to another depending upon his training, philosophy, experience, and surgical skill.It is helpful to think of these contraindications as being either absolute or relative. Absolute contraindications consist of:1. uncontrolled cholesteatoma;2. malignant tumors;3. unusual infections and/or extenuating circumstances; and4. complications of chronic ear disease, such as meningitis, brain abscess, or lateral sinus thrombosis. Relative contraindications are less well defined:1. eustachian tube insufficiency or non‐function;2. the uncooperative patient;3. the dead ear;4. the better hearing or only hearing ear;5. the elderly patient;6. the young child; and7. the repeated failure case.The otologic surgeon must exercise good clinical judgment in selecting patients for tympanoplasty. This paper deals with some of the more common problems in decision makin

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00015

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractAbsolute and relative, systemic and regional contraindications are discussed under the topics of systemic illness, mumps, age, wet ear, traumatic perforation, only ear, perfect contralateral ear, and benefit unlikely.

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00016

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractAural and non‐aural disorders that are relative or are absolute contraindications to tympanoplasty surgery are discussed. Particular attention is focused on non‐aural convert general medical conditions that may escape the otologist's attention as he is not daily concerned in the management of such conditions. The aural contra‐indications are dealt with briefly because of the obvious and well known disorders that are familiar to all otolo

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00017

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractThis report describes the hereditary occurrence of severe laryngomalacia in three of five siblings of a Mexican‐American family. The mother, who experienced respiratory difficulties in the first year of life, may also have been affected. All three affected children required neonatal tracheostomy, and two died of pulmonary complications. Histological studies of tracheal cartilage revealed distinct hypercellularity and histochemical staining abnormalities of the cartilaginous matrix without defects in skeletal cartilage.Although laryngomalacia is not uncommon, this disorder previously has not been documented to occur as a familial trait, nor have distinct abnormalities of cartilage been associated with laryngomalacia. This report suggests that etiologic and pathophysiologic heterogeniety exists for the clinical syndrome of laryngomalaci

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00018

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractNumerous causes of peripheral facial nerve paralyses have been described; however, none has satisfactorily explained the genesis of the most common type of paralysis, Bell's palsy. Two patients undergoing an experimental embolization of vascular intracranial tumors suffered a total peripheral facial nerve paralysis when occlusion of the middle meningeal artery had been accomplished. It is speculated that this paralysis resulted from ischemia of the horizontal portion of the facial nerve, an observation that has not previously been described and that might be applicable as well to the etiology of Bell's palsy.

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00019

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractThe occurrence of a large pharyngeal rhabdomyoma in an otherwise healthy adult male is discussed in this paper. This lesion, except for local symptomatology, is established as benign. A differential diagnosis, as well as the specific surgical approach to its removal, are also presented.

ISSN:0023-852X    

DOI:10.1288/00005537-197601000-00020

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY