摘要:

AbstractThe purpose of this study was to develop a high‐risk clinical profile of patients with autoimmune (immune‐mediated) inner‐ear disease. The records of 52 patients diagnosed over the past 5 years were reviewed. Age, sex, bilateral versus unilateral involvement, otologic symptoms, concomitant systemic immune disease, and presenting clinical diagnoses were recorded.The presenting diagnoses were Cogan's syndrome, Meniere's syndrome, Dandy's syndrome without hearing loss, or progressive sensorineural hearing loss without dizziness. Because Cogan's and Dandy's syndromes were relatively uncommon, the typical high‐risk clinical profile was a middle‐aged patient (often female) with bilateral, asymmetric, progressive sensorineural hearing loss, with or without dizziness, and occasional systemic immune disease such as rheumatoid arthritis.When a more common clinical diagnosis cannot be reached in suspicious patients, immune laboratory tests should be obtained and a trial of immunotherapy offered. Positive test results and beneficial response to therapy support a presumptive diagnosis of immune inner‐

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00001

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractRadical surgery for congenital cholesteatoma leaves the patient, usually a child, with an ear that requires care for life. At the Otologic Medical Group, the intact canal wall technique has been used for many patients with cholesteatoma. To determine results of this management in the treatment of congenital cholesteatoma, we reviewed records of all patients treated between 1974 and 1985.Forty‐two ears were studied in 41 patients. A closed middle‐ear space was achieved in all cases, and an intact canal wall was maintained in 41 (98%). Follow‐up averaged 4.3 years.Of the 41 cases with serviceable hearing before surgery, 28 (68%) had postoperative hearing within 10 dB of the best preoperative bone conduction threshold. Thirty‐eight of the 41 achieved a final hearing result within 20 dB of the best bone conduction th

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00002

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractTo determine the effect of retrolabyrinthine vestibular nerve section (RVNS) on hearing, vertigo, and associated symptoms, we reviewed our experience in 48 patients. Of the 48, 39 responded to a questionnaire. Although RVNS appeared to have little effect on hearing in Meniere's patients, 91% of non‐Meniere's patients had significant and often delayed postoperative sensorineural hearing loss. Our results for vertigo control compared favorably to previous reports with 96% of Meniere's patients and 69% of non‐Meniere's patients reporting improvement.Presently, we more frequently recommend RVNS as the primary procedure for the control of severe vertigo in Meniere's patients. Patients with vertigo from other causes must be carefully selec

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00003

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe Utah‐design multichannel cochlear Implant consists of six intracochlear monopolar electrodes, one promontory electrode, and an indifferent electrode. Connection of the intracochlear system to the external sound processor is via a percutaneous pedestal system. Four of the intracochlear electrodes receive simultaneous stimulation. Twenty patients implanted at the University of Utah with more than 1 year of sound processor use were evaluated for the study. All patients wear their sound processors on a daily basis. Seven of the 20 are able to use the telephone without special devices. Nineteen patients were tested with open set CID sentences with an average 42.2% response. A comparison was made between live voice and taped voice open‐set spondee word list performance, showing slightly better overall performance with live vo

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00004

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractSix patients with parapharyngeal space tumors presenting intraorally over the past 16 years were managed by transoral excision. All had benign tumors of salivary gland origin (1 monomorphic and 5 pleomorphic adenomas) and 3 of 6 patients were asymptomatic. There were no surgical complications and blood loss was minor in all cases. One patient, who had refused treatment for more than 40 years, presented with dyspnea and dysphagia, and required a tracheotomy for safe induction of anesthesia. Only one patient was hospitalized for more than 3 days and only one tumor recurred — as a malignant pleomorphic adenoma 3 years late

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00005

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractMetastatic lesions to the mandible are rare, comprising less than 1% of all malignancies.Twenty‐two cases of metastatic disease to the mandible were seen from 1938 to 1985. The records of 17 cases were available for detailed review.The age range was from 27 to 80 years with a female to male ratio of 12 to 5. A mandibular or paramandibular mass or swelling was the most common presenting sign. Three patients presented with mandibular metastasis prior to the discovery of the primary tumor. In the other 14 patients, the mandibular lesion appeared from 2 months to 20 years following discovery of the primary tumor. The mandibular lesion was the initial sign of distant metastatic disease in 11 of the 17 patients. Breast, lung, and colon cancer were the most common primary tumors.When presented with an isolated mandibular mass, a high index of suspicion is necessary to make the diagnosis of metastatic disease. Since plain x‐rays may initially be normal, technetium or CT scan may be necessary to demonstrate osseous destruction.Inferior alveolar nerve anesthesia should be considered an indication of tumor until proven otherwise.Treatment is often of a palliative nature because of the presence of widespread metastatic disease; however, surgical resection may be considered in the rare patient with a well‐documented, solitary mandibular metas

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00006

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractEpitympanic cholesteatoma may involve the facial nerve at several anatomic locations resulting in functional impairment. The most common site of nerve compression is the middle‐ear segment where the nerve is frequently devoid of bony covering. In five patients with facial palsy due to epitympanic cholesteatoma, a characteristic pattern of growth was recognized in which the cholesteatoma traversed the anterior epitympanum rather than taking the more common posterior route. Extension anteromedial to the head of the malleus leads to compression of the facial nerve in the region of the geniculate ganglion at the level of the middle cranial fossa floor. The most probable pathogenesis of this lesion is extension of disease along the embryologic course of either the saccus anticus or the anterior saccule of the saccus medius. Management of these lesions is surgical and may require, in addition to mastoidectomy with anterior and/or posterior atticotomy, middle fossa craniotomy and/or partial removal of the labyrinth for complete excisio

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00007

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractSubjective tinnitus remains obscure, widespread, and without apparent cure. In the absence of a suitable animal model, past investigations took place in humans, resulting in studies that were understandably restricted by the nature of human investigation. Within this context, the development of a valid animal model would be considered a major breakthrough in this field of investigation. Our results showed changes in the spontaneous activity of single neurons in the inferior colliculus, consistent with abnormally increased neuronal activity within the auditory pathways after manipulations known to produce tinnitus in man. A procedure based on a Pavlovian conditioned suppression paradigm was recently developed that allows us to measure tinnitus behaviorally in conscious animals. Accordingly, an animal model of tinnitus is proposed that permits tests of hypotheses relating to tinnitus generation, allowing the accommodation of interventional strategies for the treatment of this widespread auditory disorder.

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00008

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractOtologists may be reluctant to perform labyrinthectomy in unilateral Meniere's disease, fearing the later development of bilateral disease and severe hearing loss in the previously normal ear. To illuminate this issue, we reviewed audiologic records for 85 patients diagnosed as having bilateral Meniere's disease at the University of Washington Hospital from 1969 to 1986. The progression of hearing loss in each ear was noted, as well as inter/aural relationships. Nine patients experienced a significant reversal, in which the initially better ear surpassed the other ear in hearing deficit, but only one of these patients could at any time have been considered a labyrinthectomy candidate, according to hypothetically liberal audiometric criteria.

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00009

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe exposure obtained using the degloving approach is superb and the absence of resultant facial scar or deformity provides a dramatic new addition to the otolaryngologist's surgical repertoire. The advantages of the degloving technique in exposure of the midface, nasal cavities, paranasal sinuses, nasopharynx, skull base, and clivus have led to its increasing importance in the otolaryngology literature. Within 2 years of the technique's introduction in our department, it had been used 48 times for a wide variety of problems, including inverting papilloma, juvenile angiofibroma, chordoma and selected cases of fungal disease of the sinuses.This article describes the procedure, reports the results from a panel of 48 patients, and discusses potential complications.The authors' experience with this procedure indicates that it should become a procedure of choice for management of inverting papilloma and juvenile angiofibroma, as well as a major alternative method in many other circumstances.

ISSN:0023-852X    

DOI:10.1288/00005537-198803000-00010

出版商:John Wiley&Sons, Inc.    

年代:1988

数据来源: WILEY