摘要:

AbstractThe Lempert one stage horizontal semicircular canal fenestration was the surgical procedure of choice for otosclerosis from 1939 to 1954. Subsequently, mobilization and stapedectomy replaced fenestration.In the offices of Drs. Day, Jordan, and Caparosa, the horizontal semicircular canal fenestration was performed from 1940 to 1955; the mobilization, two years; and, thereafter, the stapedectomy. A significant number of patients have had fenestration on one side and stapedectomy on the opposite ear.Fifty patients seen consecutively were reviewed. Reliable office audiological testing has been available only in the more recent years; and, therefore, audiological statistical comparison has limited reliability. It is felt, however, that a review of these patients and the study of their surviving hearing results is a worthwhile inferential comparison.

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00001

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractThousands of individuals fly commercial airlines and private aircraft daily. One airline boasts of serving more than 100,000 passengers each day. Of these individuals exposed to barometric alterations, an undocumented number will develop significant barotrauma and may seek help from an otolaryngologist. Although many otolaryngologists learn the mechanics and management of barotrauma as military flight surgeons, residents in otolaryngology usually receive no specific training in this area. Because private and commercial aviation are so common today, we believe that a basic knowledge of barometric changes experienced while flying is essential for the practicing otolaryngologist.These basic principles are covered in this presentation. Case histories will also be discussed. One patient, who presented with signs of perilymph fistula, including sensorineural deafness and abnormal ENG, recovered spontaneously.

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00002

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractIn the past there has been a general reluctance among rhinologists to remove the entire lateral nasal wall for fear of causing drastic disturbances of nasal physiology. It has been our observation that the physiological disturbances are fairly minimal if the patient, following surgery, uses nasal saline irrigations daily. Sometimes a nasal siphon or water pik is required to prevent crusting. It has also been noted that when the septum is removed, a chronic antritis on the contralateral side will usually occur. It has been our practice to do an antrostomy on the uninvolved side when the septum has been removed for any reason.Ophthalmologists have shown some reticence to having the entire bony support of the medial wall of the orbit and half the floor removed. This does necessitate transecting the lacrimal duct at its neck. We have, however, seen no trouble with epiphora following this provided the sac was allowed to drain into the open nasal cavity. The trochlea is by necessity deprived of its support; however, the periostium seems to provide adequate support here and we have noticed no troublesome permanent problems with function of this muscle. The periorbita, which has been robbed of its osseous support, quickly epithelializes with nasal mucosa and becomes a part of the nasal cavity. Requirements for intranasal douching with saline have varied; however, we have had no problems with bothersome crusting following b.i.d. nasal irrigations. In cases where a small portion of the inferior turbinate could be preserved, there was always extreme hypertrophy of this remnant which usually brings the nasal physiology back to a nearly normal state which seldom requires any special care whatever.This paper presents primarily a method of approaching tumors of the sinonasal area, especially when there is difficulty in determining whether the lesion arises from the septum or lateral wall of the nose.

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00003

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractA modified American Optical (Model 100) CO2laser was used to produce lesions in the tympanic membranes, ossicles, and cochlear capsules of guinea pigs. Even with the lowest available intensities and durations (0.4 watts, 50 msec), there was damage to the inner ear. Although laser surgery of the ear can avoid mechanical trauma and bleeding as well as increase accuracy, the use of commercial lasers in ear surgery should be avoided until a proven unit is avaliable.

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00004

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractOtomycosis represents a small percentage of clinical external otitis. This well documented entity is often a stubborn clinical problem and, in contrast to bacterial external otitis, there is no otic preparation with specific antifungal activity. In response to this lack of otic preparations, we have surveyed in vitro a variety of available preparations to determine the general spectrum of activity against appropriate bacterial and fungal species. An agar‐disc diffusion system was used testing the drugs against (1.) bacteria common in external otitis, and (2.) a variety of yeast and filamentous fungi.Aqueous Merthiolate and Cresylate demonstrated good non‐specific antimicrobial activity, while nystatin and clotrimazole demonstrated specific antifungal activity. Otic preparations can now be used which have demonstrated in vitro effectiveness and give an alternate means of therapy to the now empirically selected otic preparation used for otomyco

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00005

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractThe Temporal Bone Laboratory of Northwestern University Medical School has three sets of temporal bones from patients who had antemortem polytomographic examinations resulting in a diagnosis of otospongiotic involvement of the cochlea. One of these cases was thought to have been an example of pure cochlear otospongiosis. The other two cases were patients with clinical (stapedial) otospongiosis, and their polytomograms were interpreted as unilateral otospongiosis with involvement of the basal turn of the cochlea.In the first set of temporal bones, no otospongiosis was present. In the other two sets, the otospongiotic lesion did not involve the cochlea, and a contralateral otospongiotic lesion was present that had not been seen on the polytomograms.Caution must be exercised in the interpretation of subtle polytomographic changes noted in the cochlear capsule and restraint used in the X‐ray diagnosis of pure cochlear otospongiosis until there is evidence of correlation with pathological materia

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00006

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractThe angiographic features of various lesions of the head and neck are presented. Angiographically, cavernous hemangiomas display large venous lakes with calcified phleboliths. Arteriovenous malformations reveal massive tumor stain with well delineated feeding vessels from multiple systems. Chemodectomas and juvenile nasopharyngeal angiofibromas are clearly vascular with homogenous tumor staining in the capillary phase. Angiography of cavernous hemangioma, AVM, chemodectoma, and angiofibroma is diagnostic and may preclude the need for tissue biopsy.Angiographically neurilemmomas are less vascular with non‐homogenous tumor stain. Carcinomas are typically avascular.The use and benefits of arterial embolization in the management of these lesions is presente

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00007

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractIn an attempt to find a better technique for immediate control of CSF rhinorrhea following transsphenoidal hypophysectomy, a tissue adhesive, ethyl 2‐cyanoacrylate, has been used in 28 consecutive operations. The physical properties of the adhesive, its theoretical advantages, and our results are discusse

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00008

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractSophisticated virological techniques are described for isolating whole virus, free viral DNA, or integrated viral DNA. Based upon preliminary results, it is suggested that the virus responsible for laryngeal papillomatosis is not the same as the virus responsible for cutaneous papillomatosis lesions and, for the most part, it exists in the integrated DNA form.

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00009

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractThe symptom complex of localized facial gustatory sweating and flushing during mastication (The Frey syndrome) is a common sequela of parotidectomy with facial nerve dissection.A thorough review of the literature concerning the Frey syndrome is reported. The procedure of tympanic neurectomy has received special emphasis with a review of 73 cases of tympanic neurectomy. The treatment modalities available, if tympanic neurectomy fails, are discussed. Important guidelines for the safe use of topical therapy to control gustatory sweating are presented as an alternative to surgical therapy.The author studied 129 post parotidectomy patients in whom 60% noted symptomatic gustatory sweating, and approximately one‐fourth of these symptomatic patients requested topical anticholinergic therapy, with one patient electing tympanic neurectomy.The only form of medical treatment presently available utilizes the topical application of scopolamine, a drug having potentially significant central nervous system side effects if systemically absorbed. In an effort to find an effective drug for topical application with a more favorable therapeutic index than scopolamine, glycopyrrolate was investigated. Glycopyrrolate was compared in varying concentrations to topical scopolamine in a personally conducted double blind clinical trial involving 16 patients.Initial results of this investigation suggest that topical glycopyrrolate in concentrations of 0.5% and 1.0% provide complete effective control of gustatory sweating for at least several days duration after a single application. There have been no significant side effects with the use of topical glycopyrrolate to date. Commercial topical antiperspirants were also investigated and found to be of limited benefi

ISSN:0023-852X    

DOI:10.1288/00005537-197811000-00010

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY