摘要:

AbstractBrain stem electric response audiometry (BERA) is evaluated for early detection of hearing loss in high‐risk newborns selected from a general hospital population. They receive screening BERA in the nursery and detailed frequency‐specific BERA in the Audiology clinic, just before discharge. Three months later, testing is repeated and recommendations are made.From 1364 assessments, 321 at‐risk babies were identified; 234 received predischarge tests, and 200 had follow‐up tests. Screening BERA with 40 dB nHL clicks is appropriate in the nursery. Screening sensitivity is good, and only 8% of babies failed. Several of these had mild hearing loss, resolving in the first trimester. Follow‐up BERA confirmed hearing loss in 8 babies.Parental compliance is high, and the program is well‐accepted. In conjunction with the high‐risk register, BERA is useful both for screening and for quantitative audiometry

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00001

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractForty‐five patients were evaluated for reconstruction of the mandible. Thirty‐four patients had a particulate cancellous bone and marrow (PCM) crib graft placed. Thirty of 34 were successful at the primary operation producing a success rate of 88%. By using secondary procedures all 33 patients repaired to date have been rehabilitated. A dynamic bendable defect bridging plate with cancellous cortical graft (DBDB plate with CCG) was used in 7 patients, 4 of whom had tumor surgery and 3 of whom were operated on after trauma to the anterior mandible. All 7 cases were successfully rehabilitated in achieving a stable, functioning mandibular arch.An osteomyocutaneous flap was planned to reconstruct the anterior mandible in 4 cases; 1 in this group was not reconstructed. The PCM graft has been our first line approach to the mandibular non‐union but with experience we are beginning to rely on the DBDB plate with CCG for large bony defects after both trauma and secondarily after tumor surgery. When indicated, the osteomyocutaneous flap has been eminently successful in restoring function and form in the tumor pa

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00002

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractTwenty subjects with no vestibular complaints and normal otoscopic exams were stimulated with 44°C water for 5 minutes in one ear and their nystagmus was recorded by vertical and horizontal electro‐oculography. Changes in vertical eye position and nystagmus inhibition were correlated during periods of mental tasking, relaxation, and voluntary eye elevation. The results showed an average of 42° eye depression with mental tasking during irrigation. In addition, mental arithmetic had a “releasing” effect on horizontal nystagmus. Elevation of the eyes on command, however, produced marked irregularity in the horizontal tracings, simulating inhibition. Almost every subject had an apparent vertical deflection on ENG with eye closure. These findings suggest a mechanical component to the phenomenon of inhibition as well as an active central me

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00003

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe surgical plane between the VIIth nerve and acoustic tumor is often elusive. This histological relationship was reviewed in three patients who underwent VII‐VII neuroanastomosis at tumor removal disclosing an inseparable surgical plane in two. In the third patient, tissue sections did not accurately show the relationship. In all three, surgical planes were not apparent at tumor removal.Another patient had a second, isolated tumor in the same VIIIth nerve proximally at the brain stem root entry zone. This was seen only on permanent section.In considering “total” tumor removal by microsurgical standards, these histological findings should be kept in mind. We advocate removal of the entire VIIIth nerve to the brain stem root entry zone along with smaller t

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00004

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractTopographic study of congenital cholesteatomas revealed that the majority of these congenital epidermal cysts occur near the tympanic isthmus of the middle ear. Since this is the junction of the first and second brachial arch, the origin of the cholesteatoma could be linked to the migration of the external canal ectoderm into the middle ear at the early stage of development.Embryologic study showed that the tympanic ring plays an important role in limiting the medial extent of the external canal to the level of the tympanic annulus. Migration of the ectodermal tissue into the middle ear beyond the annulus is likely to be caused by the failure of this inhibitory function of the tympanic ring.Microscopic sections of human fetuses were studied to determine the developmental relationships between the external canal ectoderm and the tympanic ring. A section from a 16 1/2‐week fetus showed significant papillary ectodermal tissue projection into the mesenchyme near the tympanic isthmus, while the tympanic ring was absent in that site.Anatomical distance between the tympanic ring and the internal auditory canal is extremely short in these fetuses. This is suggestive of the source of petrous cholesteatomas from the canal ectodermal migration.These observations form the basis of the author's theory that the pathogenesis of congenital cholesteatomas is caused by migration of external canal tissue into the tympanic isthmus or into the petrous bone as a result of developmental error in which the advancing external canal ectoderm failed to receive stop signal of the tympanic ring that contains the ectoderm at the annular plan

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00005

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractThree unusual ossicular problems encountered in stapedectomy are: floating stapes footplate, partial absence of the incus long process, and otosclerosis combined with a fixed malleus. The surgical techniques advocated in solving these problems are: placing a Robinson prosthesis on the floating footplate, utilizing the Lippy modification of the Robinson prosthesis for the problem incus, and performing only a stapedectomy for malleus fixation and otosclerosis. The hearing results in 242 cases were quite satisfactory and no patient had a further sensorineural loss.

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00006

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractFour troublesome problems encountered in ossicular reconstruction are: low profile stapes, lateral tympanic membrane, remaining stapes crura, and absent stapes capitulum. The design advantages and modifications of the semibiological ossicle cup and ossicle columella prostheses ore given to solve these problems. The hearing results are completely satisfactory.

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00007

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractRotary subluxation of the atlantoaxial joint is an uncommon complication of head and neck surgery and infections. Reported sequelae of this disorder range from torticollis to death from compression of the spinal cord. Two cases of C1‐C2 rotary subluxation will be discussed. These complications occurred following otitis media, repair of choanal atresia, and an adenoidectomy. The literature is reviewe

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00008

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00009

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractProfessor Doctor F. H. Quix, of Utrecht, was a keen student of macular function, who published extensively at the beginning of this century. He described many useful tests for otolithic function, and one in particular has continued to be fairly widely used.The so‐called “Quix Test” is performed with the patient standing, feet slightly apart, arms outstretched, index fingers extended, and the examiner assumes a similar mirror‐image posture, such that the fingertips almost touch. The patient is then requested to close his eyes, and the index fingers are observed for drift. The lateralizing value of this sign of vestibular disease is di

ISSN:0023-852X    

DOI:10.1288/00005537-198309000-00010

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY