摘要:

AbstractStaging of tympanoplasty is important in the management of patients with chronic otitis media. It allows establishment of an air‐containing middle ear space and adequate postoperative hearing levels in a large proportion of patients with severely diseased ears.The results of 400 staged procedures performed over a 3‐year period at the House Ear Clinic, Los Angeles are reported. Staging was performed in 75% of tympanoplasty with mastoidectomy cases and in 15% of ears not requiring mastoid surgery. Closure of the air‐bone gap to 20 dB or less occurred in 68% of patients with intact stapes. Mucous membrane problems were the most common reason for staging. Almost one third of cases with middle ear choleste‐atoma at the first stage had residual disease on reexploration.Staging of tympanoplasty continues to be an important technique in management of severely diseas

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00001

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractThe uptake and distribution, skin phototoxicity, and direct tumor ablative potential of three porphyrin photosensitizers: hematoporphyrin derivative (HPD), dye hemato‐porphyrin ether (DHE), polyhematoporphyrin esters (PHE), and of Rhodamine‐123 (Rh‐123) have been studied in the AJ‐CR inbred albino female mouse implanted with C‐1300 neu‐roblastoma. Photosensitizer delivery was studied using saline and liposome carriers.The ratio of tumor uptake of the porphyrin compounds compared to the tumor‐bed musculature and skin was favorable with both saline and liposome delivery. Rhodamine‐123 precipitated in saline but was delivered effectively throughout the body in liposomes. There was no selective uptake by tumor cells of Rh‐123 in this tumor model.Skin phototoxicity with the porphyrin compounds was mildly decreased using liposomes carriers while Rh‐123 demonstrated no skin phototoxicity. DHE had the greatest tumoricidal effect among the porphyrin compounds. PHE has the potential of increased effect due to the ability to use higher light dosages in the activation of this porphyrin.Rhodamine‐123 had no tumor effect in this animal model. Clinical implications of phototherapy with these four co

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00002

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractCochlear implantation is an accepted medical treatment for profound bilateral postlinguistically acquired hearing loss. Because cochlear implants are still in the process of development, a detailed evaluation of the results of implantation is essential. However, the capability of predetermining the auditory benefit of a cochlear implant is limited and depends upon a number of factors. This report focuses upon the ability of computed tomography (CT) to predict surgical success and audiological results of multichannel cochlear implantation. It also addresses how the disease state might affect the functional benefit of the implant.After undergoing routine clinical and audiological evaluations, 28 cochlear implant candidates underwent CT scans in order to evaluate cochlear patency prior to surgery. Subsequently, 24 patients were implanted with either a single‐ or 22‐channel device. Surgical findings were noted and postoperative audiological assessments of sound detection and speech discrimination were made.The CT risk factors that diminish the likelihood of a successful cochlear implant result are discussed based upon a retrospective comparison of preoperative CT results, surgical findings, and postsurgical audiological evaluations of the 14 patients who received a 22‐channel implant. Analysis of the predictive capability of CT will allow clinicians to use that procedure more effectively in the presurgical assessment of cochlear implant candi

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00003

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractHearing results and extrusion rate for 89 consecutive patients receiving hydroxylapatite prostheses for hearing reconstruction were evaluated and compared to a control group of 75 patients who had received homograft bone or Plasti‐Pore® prostheses. At the 3‐month follow‐up, there were no cases of extrusion of the hydroxylapatite pros‐theses.Hearing success was defined as a postoperative air‐bone gap of≤ 15 dB for incus prostheses and partial ossicular replacement prostheses or ≤25 dB for incus‐stapes pros‐theses and total ossicular replacement prostheses. There was a statistically significant difference in the distribution‐of‐success rate by prosthesis type for the hydroxylapatite. Incus, incus‐stapes, and total ossicular replacement prosthesis results were similar, but partial ossicular replacement prosthesis results were poorer. The overall success rate in the hydroxylapatite group was 51.2%; in the control group, it was 60%. Hearing results tended to be better with the hydroxylapatite incus prosthesis than with the homo‐graft bone incus, but poorer with the hydroxylapatite partial ossicular replacement prosthesis than with the Plasti‐Pore. Several technical modifications of the prosthesis that may improve results with the hydroxylapatite partial ossicular replacement prosthesis are suggested.Hydroxylapatite middle ear prostheses appear to be a reasonable alternative to other more commonly used pros‐theses, which carry disadvantages rela

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00004

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractSince 1972, singular neurectomy has been performed on 58 patients who had classical benign positional vertigo. The procedure is done under general anesthesia; a wide post‐auricular exposure is made and the external auditory canal is maximally enlarged until the vertical portion of the facial nerve is identified. This gives an excellent view of the round window niche. Our results indicate vertigo was completely cured in 80% of the cases and improved in 17%. There has been no incidence of total hearing loss in the last 49 cases and only 3 of 49 patients (6%) had sensorineural loss. Although singular neurectomy can be mastered, it will remain a procedure done by few surgeons. The wide exposure technique is safer for preservation of cochlear function and the posterior ampullary nerve is easier to find than using the transmeatal approach as described by Gace

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00005

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractEleven temporal bones from eight patients who had clinical histories of sudden hearing loss (SHL) were studied to assess the possible etiopathogenesis. The origin of SHL in seven ears from five patients was obscure, but appeared to be due to multiple causes. Common histopathologic changes in the cochlea, although complex, included atrophy of the organ of Corti and loss of cochlear neurons. Loss of cochlear neurons was the main finding in ears of viral infection.Labyrinthine fibrosis and formation of new bone were seen in two ears associated with vascular insult and in two ears of autoimmune disease. Different histopathologic findings causing SHL were observed even in cases with the same etiology. A case of SHL showing endolymphatic hydrops as the main histopathologic finding is described.

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00006

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractTwo thousand thirteen patients with squamous cell carcinoma of oropharynx and pharyngolarynx were reviewed with regard to neck disease presentation and disease‐free survival after radical radiotherapy. All patients were staged according to both the AJCC1976 and the UICC1978 classifications. Causes of failure, disease‐free survival, and complication rates were assessed. Sixty percent had a clinically positive neck. The 3‐year disease‐free survival rates were 58%, 44%, 38%, and 25% for AJCC NO, Nl, N2, and N3 cases, respectively. Corresponding UICC figures were 58%, 46%, 26%, and 29%. Analyzed parameters were nodal stage, size, site and fixity, and location of primary. Complications attributed to neck disease did not exceed 3%. A critical appraisal of the nodal staging systems is derived from these sets

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00007

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractFifty‐four patients with metastatic cancer were followed audiometrically during high‐dose (100‐120 mg/m2) cisplatin chemotherapy. Eighty‐one percent of the patients showed significant changes in air‐conduction hearing thresholds after completion of therapy. Thirteen percent sustained a significant hearing handicap. An interindividual variation was found, ranging from severe hearing loss after the first course to unaffected hearing after three courses. The oto‐toxic effect was not increased by pre‐existing hearing loss, but was slightly increased by age. The risk was determined more by the amount of the single dose than by the cumulative dose. The further ototoxic effect could not be predicted on the basis of the audiogram after the first coursa Peak plasma concentration of platinum was measured in eight patients, and no ototoxic changes were noted below a concentrat

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00008

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractThe partial horizontal supracricoid laryngectomy with cricohyoidopexy consists of resection of the whole thyroid cartilage and paraglottic space, as well as the epiglottis and the whole preepiglottic space. The cricoid cartilage, the hyoid bone, and at least one arytenoid cartilage are spared.Sixty‐eight patients with squamous cell carcinoma of the supraglottis who underwent this procedure during the period from 1974 through 1986 are presented. Conventional horizontal supraglottic laryngectomy was contraindicated in all cases. All but three patients (95.4%) recovered physiologic deglutition, and none required a permanent tra‐cheostomy. The 3‐year actuarial survival rate was 71.4%. No local recurrences were encountered. The indications for the procedure are carcinomas of the supraglottis that 1. involve the glottis and anterior commissure,2. invade the ventricle,3. present with a marked limitation of true vocal cord mobility (transglottic lesions), and4. invade the thyroid cartilage. The procedure is presented as a useful alternative to radiation therapy, horizontal supraglottic laryngectomy, and total laryngectomy in select cases of supraglottic carc

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00009

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY

摘要:

AbstractSeventy‐four cases of nasopharyngeal malignant neoplasms were analyzed immunohistochemically and classified into 16 lymphomas and 58 carcinomas. Eight lymphomas were of T‐cell origin and eight were of B‐cell origin. Although there were no significant differences in prognoses between patients with carcinoma and those with lymphomn, T‐cell lymphomas resulted in a worse outcome.Five‐year survival rates of T‐cell and B‐cell Iymphoma were 12.5% and 75%, respectively. Polyclonal keratin and tissue polypeptide antigen were more sensitive and specific than other epithelial markers, and were positive in 97% (56 of 58) and 93% (54 of 58) of carcinomas, respectively. With regard to immunophenotypic analysis of malignant lymphomas, L26 to B‐cells (88%) and UCHL1 to T‐cells (100%) led to a satisfactory effect. Immunohistochemical investigations made possible differentiation of malignant lymphomas from a carcinoma and also aided in

ISSN:0023-852X    

DOI:10.1288/00005537-199007000-00010

出版商:John Wiley&Sons, Inc.    

年代:1990

数据来源: WILEY