摘要:

AbstractAggressive medical management and surgical debridement is curative in most cases of malignant external otitis. Recently, four patients with this condition were treated at the University of California, San Francisco, who did not respond to conventional therapy. In each case, appropriate intravenous antibiotics, diabetic management, and extensive excision of involved tissue failed to eradicate the infection. Progression of the disease was evidenced by any one of the following: 1. Persistence of granulation tissue in the external auditory canal, 2. Development of cranial neuropathies during treatment, 3. Other signs or symptoms of active infection for more than two weeks after institution of therapy. Any one of these criteria was considered an indication for more radical surgical intervention. In three patients, the operative procedure consisted of a subtotal temporal bone resection to gain access to the primary focus of infection and provide adequate drainage. The common finding in each case was an abscess cavity in the soft tissues at the base of the skull. A description of the clinical course and surgical management of malignant external otitis forms the basis of this communication.

ISSN:0023-852X    

DOI:10.1002/lary.5540900301

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe benign eccrine cylindroma is one of a number of histologically different tumors of the external auditory canal that have been grouped by some as “ceruminomas.” The eccrine cylindroma, malignant apocrine gland tumors, and the adenoid cystic carcinomas of salivary gland origin are distinctly different histologically and in natural history and prognosis. Therapy should, therefore, be tailored to the specific tumor.A patient is presented who developed an asymptomatic external auditory canal mass that was initially incompletely excised. A recurrence five years later again proved to be a benign eccrine cylindroma of sweat gland origin. Successful and adequate treatment was local excision with a cuff of normal tissue.A variety of tumors originating from the adnexal skin structures may appear in the external auditory meatus and canal. Treatment must include biopsy and close consultation with the pathologist. The term cylindroma has been loosely applied to both benign and malignant glandular neoplasms but its usage should be restricted to the specific benign eccrine cylindroma herein described. A rationale of therapy is presen

ISSN:0023-852X    

DOI:10.1002/lary.5540900302

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractKeratosis obturans and external auditory canal cholesteatoma (EACC) have previously been considered to represent the same disease process. However, review of the literature and our cases reveal these to be two different clinical and pathological processes. Keratosis obturans presents as hearing loss and usually acute, severe pain secondary to the accumulation of large plugs of desquamated keratin in the ear canal. External auditory canal cholesteatoma presents as otorrhea with a chronic, dull pain secondary to an invasion of squamous tissue into a localized area of periosteitis in the canal wall.The treatment previously recommended for both of these conditions has been conservative debridement of the external canal and application of topical medication. While this remains the treatment of choice for keratosis obturans, surgery may be required to eradicate EACC.

ISSN:0023-852X    

DOI:10.1002/lary.5540900303

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractAlthough endolymphatic hydrops is generally considered to be the most prominent factor in the etiology and pathology of Ménière's disease, we have concluded that this condition more probably represents a polyganglionitis caused by the herpes simplex virus with secondary hydrops changes. The wide range of symptoms occurring in the Ménière's disease complex is illustrated in seven selected cases which support this conclusion. Vestibular nerve section can stabilize hearing and relieve episodic vertigo by removing the locus of viral infection and precluding recurrent activat

ISSN:0023-852X    

DOI:10.1002/lary.5540900304

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractNumerous flaps are available for reconstruction of the nose. However, most all of these utilize local or adjacent tissue which can result in moderate facial mutilation and scarring. The abdominal pedicle‐radial artery‐nose transfer flap has been previously described by Kilner and Chitrov. Both procedures somewhat compromise the final outcome and thus only portions of each were used in the design of this flap. The size of the flap was determined by doubling the width of the base of the nose and doubling the estimated length of the nose and tubing it. After staged transfer from abdomen to wrist to remaining nose, the distal end is defatted and cut into a three lobed flap for sculpturing the nasal tip and colume

ISSN:0023-852X    

DOI:10.1002/lary.5540900305

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1002/lary.5540900306

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractMore than 3000 workers referred by the Workmen's Compensation Board of Ontario have been evaluated for pension for industrial hearing loss. They include the normal proportion of otosclerotics, many of whom have had surgical therapy. The operations have been done by a wide variety of surgeons in the province of Ontario, and the results are representative of those which will be obtained in a large section of the Canadian community. The results are significantly worse than generally quoted, and some of the deficiencies are attributable to occupation. These include perilymph fistula from excessive straining and sensorineural hearing loss due to noise exposure. Detailed results will be presented.

ISSN:0023-852X    

DOI:10.1002/lary.5540900307

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractAs one of a series of investigations to evaluate the efficacy and safety of CO2lasers in otologic microsurgery, squirrel monkeys were subjected to tympanic neurectomies by means of vaporizing Jacobson's nerve in the promontory region. Air and bone conduction hearing acuity was measured by computer‐averaged pure tone evoked responses and behavioral audiometry before and after laser surgery. A moderate (avoidable) conductive loss was found as a consequence of the surgical approach selected, but no significant sensorineural loss was apparent. Thus, there would appear to be no adverse cochlear side effects as a result of using this instrument in the middle ear. The laser neurectomy procedure, however, was no more effective for the clinical purposes for which it was proposed than those techniques reported by several other investigator

ISSN:0023-852X    

DOI:10.1002/lary.5540900308

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractOur experience with anomalies of the first branchial cleft is reviewed. This includes 38 cases, the largest series collected to date. A new classification is proposed based on the anatomic findings – whether cyst, sinus, or fistula is present. The embryology and pathology of first cleft anomalies are discussed and an approach to the diagnosis and management of these lesions is given. In addition, a patient with a branchial cleft defect involving the middle ear space is reporte

ISSN:0023-852X    

DOI:10.1002/lary.5540900309

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractIn the past decade there has been a widespread renewal of interest in the clinical utilization of electroencephalic responses evoked by auditory stimulation. In particular, there has been considerable research conducted on the brain stem response, the frequency following response, and the middle latency response. An overview discussion of some of the latest findings from recent and ongoing investigations is presented. Discussion is centered initially on current ideas, findings, and controversies regarding the origins or site of generation of these responses.Clinical application of the responses is discussed from two perspectives, audiologic applications and neurologic applications. Essential parameters for evoking, recording and analyzing clinically these responses are summarized. Some of the problems resulting from a lack of standardized clinical testing protocols are also mentioned. Key findings from recent clinical studies of some investigators are cited. Also recent data concerning the developmental aspects of the responses on clinical testing are included.Finally, some directions for future research on these responses are discussed. One of the latest techniques for recording and analyzing the responses and its implications for site of lesion neurologic testing are described.

ISSN:0023-852X    

DOI:10.1002/lary.5540900310

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY