摘要:

AbstractIn disorders of the auditory organ associated with hearing loss, a correlation of the anatomical, behavioral and electrophysiological studies furnishes the investigator several parameters of study to better comprehend the hearing mechanism and the various anatomical structural dysfunctions that relate to the hearing loss.Mice are interesting to study because they carry several types of genes for hereditary deafness. Until recently, it was very difficult to train mice for behavioral hearing threshold testing; however, having developed such a method, the next step was to study the normal mice in these three parameters and extend the studies to mice with hereditary hearing loss. The type of mouse studied in this research was the C57/b16 strain which carries such a gene.The results of the studies indicate that the results of the behavioral and electrophysiological studies relate well to each other, and that light microscopic studies (if taken alone) do not furnish us with the actual functional capability of the structures of the inner ear.It is recommended (and it would be most valuable) that efforts should be made to collect and study human temporal bones with all three parameters of study for a better understanding of the structures of the human inner ear. Reference is made and recommendations given as to the parameters of studies while performing human electrocochleography.

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00001

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractA 15 to 30 year follow‐up study has been made of radium therapy to the nasopharynx for Eustachian tube obstruction and serous otitis, with a review of the relevant literature. No malignancies or other complications have been seen or recorded. Objective evaluation leads to the conclusion that this is a safe, effective treatment modality. In spite of this it has been discontinued because of public fear and pressure. A judgement reached for this reason, ignoring scientific medical facts, contains the seeds of decline of quality and effectiveness of medical car

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00002

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractAn epidemiologic study was done comparing blacks versus whites with regard to the incidence of altered middle ear function or otitis media. Three separate groups were evaluated. All variables were controlled except for race. There appears to be statistically significant less otitis media or altered middle ear function in the black race than the white race.

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00003

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractA brief history of the advances made in acoustic tumor diagnosis and treatment is presented indicating the benefits derived therefrom over the past 15 years. The recent application of brain stem electric response audiometry (BERA) as related to tumors affecting the auditory nerve is reviewed. Patients were considered to have a positive test result for tumor detection (abnormal BER) when their responses showed one of three characteristics: 1. wave V latencies were significantly different from the normal mean, 2. the interaural latency difference (ILD) was greater than .3 msec. (.4 msecs when the hearing loss was greater than 65 db HL), or 3. no response could be recognized at suprathreshold levels. An abnormal BER result was observed in 92.6% of 27 surgically proven tumors in this study. Two patients with surgically proven tumors had a false‐negative test. In a series of 115 nontumor patients with asymmetric sensorineural hearing losses of multiple etiology, one in three had an abnormal BER result. All conductive losses increased wave V latency values. The authors have concluded that an abnormal ILD is far from pathogmonic for a tumor affecting the auditory nerve; interpretive caution is recommended with even small conductive hearing losses. False‐negative responses are few, false‐positive responses are common (relative to tumor diagnosis). BERA is the most efficient audiometric test available today in our search for tumors affecting the auditory nerve. As such, this test probably heralds a new era in diagnostic audi

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00004

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractClinical observation of patients with fluctuant sensorineural hearing loss following or occurring with chronic otitis media led to the hypothesis that endolymphatic hydrops can result from chronic otitis media. Illustrative case reports are described. This hypothesis resulted in a temporal bone study of 560 cases in which 109 temporal bones demonstrated the presence of hydrops and 194 evidenced otitis media. Seventy‐five cases demonstrated both otitis media and hydrops, of which 20 cases were selected for more detailed histo‐pathological study. An interesting finding was the presence of apical hydrops in every case of the latter group. Statistical interpretation of this data helped rule out a coincidental or chance occurrence. A discussion of this clinical relationship included the significance of subclinical (silent) otitis media as a possible cause of endolymphatic hydr

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00005

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractSome patients with sudden hearing loss actually have two membrane breaks, one at the oval or round window and one further inside the cochlea. One may heal spontaneously and the other not, or both, or neither. It is very likely impossible to detect this early from the threshold audiogram, because the intracochlear breaks allows endolymph and perilymph mixing which spreads over much of the anatomically normal cochlea causing diffuse loss of function. This theory is illustrated by three case histories.

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00006

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractData of 27 signs, symptoms or findings were collected on 125 confirmed cases of Meniere's disease. Statistical association, plus the percentage prevalence of these findings were studied to perform a cluster analysis. These findings were used to obtain a statistical picture of the disease in terms of the recorded variable (signs, symptoms and findings).The major finding was the existence of a group of variables (a central core) of high percentage occurrence. They consisted of intermittent rotational vertigo, intermittent to constant nerve hearing impairment, tinnitus, pressure in the ears, positional vertigo, nausea, abnormal caloric nystagmus, headache and normal laterotorsion. The first four are the classic criteria of Meniere's disease, the remainder are additions. The average patient had 8 of the 9 conditions; 44% had all 9.A graphic multi‐factor analysis of the signs, symptoms and findings suggests that these patients had a disease of a specific central origin. An alternative suggestion is that of several closely related diseases arising from adjacent central locations.No indication was found that influenza, hypertension, arteriosclerosis or diabetes were consistent precursors of Meniere's disease.Spontaneous, positional, gaze and optokinetic (tracking) nystagmus showed no demonstrable relationship to the Meniere's signs and symptoms. They showed the ordinary population prevalence except for spontaneous nystagmus which was slightly higher.The possibility of using these associations as a guide for correlation of the disease manifestations with neuroatomic tracts and areas is suggeste

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00007

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractPreoperative, operative and postoperative findings in 97 cases of labyrinthine fistula are presented.Most of these patients had had symptoms of chronic otitis media for 20 years or more and manifested some degree of sensorineural hearing impairment. Two‐thirds had experienced dizziness.The fistula was limited to the lateral semicircular canal in 83 cases and involved the labyrinth more extensively in 14 instances. The intact canal wall technique was used in less than 60% and an open cavity technique in 25% of the cases.Severe or total sensorineural hearing impairment developed postoperatively in 8% of the lateral canal cases and in over half of the extensive fistula cases. Five percent had incapacitating dizziness for up to six months postoperatively.When a labyrinthine fistula is encountered in an only hearing ear we usually recommend a classical modified radical mastoidectomy. In other instances the procedure performed will vary with the status of the opposite ear, the extent of the fistula, the sensorineural function of the involved ear and the size of the mastoi

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00008

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractSince Portmann suggested surgical drainage of the endolymphatic sac in 1927, several similar procedures have been described. These procedures all share a common problem: the endolymphatic sac must be identified without injuring the labyrinthine structures or the facial nerve.Anson and Donaldson have provided the otologist with a detailed and accurate description of the anatomy of the endolymphatic sac but did not provide the surgeon a convenient and reliable way of safely locating this structure through Trautmann's triangle via a mastoidectomy approach.Forty normal temporal bones were examined and measurements obtained. In 20 temporal bones, the vestibular portion of the endolymphatic duct was injected with dye, and a complete mastoidectomy was performed. Accurate measurements were obtained. In addition, 20 normal temporal bones were sectioned down to the inferior‐most extent of the endolymphatic sac, and measurements from local landmarks were obtained.The distance between the short process of the incus and the bottom of the otic capsule of the posterior semicircular canal is 10.4 mm (range 9.5 to 11.5 mm), and the distance from the tip of the short process of the incus to the inferior‐most point of the endolymphatic sac is 16.9 mm (range 13.0 to 19.0 mm). Hence, the distance from the otic capsule of the posterior canal to the bottom of the sac is 4.3 mm (range 1.9 to 6.6 mm). Therefore, the conservative surgeon can approach the endolymphatic sac below the level of the posterior semicircular canal and minimize risk of injury to that struct

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00009

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractMeniere's disease is a well recognized clinical entity, yet the etiology and pathophysiology of the disease is not fully understood. Impaired endolymphatic sac function resulting in faulty reabsorption of endolymph has been implicated in the production of the disease. The histopathological findings from biopsied sac specimens and observed by transmission (TEM) and scanning (SEM) electronmicroscopy in two patients with early Meniere's disease are presented and discussed. Extensive subepithelial fibrosis with loss of vascularity and obliteration of portions of the lumen of the endolymphatic sac by an ingrowth of collagen is noted in both specimens. The implications of these findings are discussed and the need for more TEM and SEM studies of inner ear disorders is stressed.

ISSN:0023-852X    

DOI:10.1288/00005537-197901000-00010

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY