摘要:

AbstractThe histologic findings in the temporal bones of three patients who died from viral encephalopathy are presented. Pathology was restricted to the scala media, vestibular labyrinth, and internal auditory canal and was considered to be expressions of viral labyrinthitis. The changes were different degrees of degeneration of the organ of Corti, early encapsulation of the tectorial membrane, degeneration of the stria vascularis, and round cell infiltration of the modiolus and contents of the internal auditory canal. A new finding in the organ of Corti and early stages of cystic degeneration of the stria vascularis are documented. In all cases, the saccule was degenerated with sloughing of the otolithic membrane and vestibular labyrinth was involved in varying degrees.

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00001

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractPulsatile tinnitus is a rare presenting symptom in patients with enlarged jugular bulbs. We will describe three young women presenting with right pulsatile tinnitus associated with a megabulb deformity of the temporal bone. After extensive radiologic and audiologic evaluation, no vascular or bony abnormalities could be identified. All three patients demonstrated pulsatile bruits over the right temple. Pulsatile tinnitus disappeared with ipsilateral jugular compression suggestingflowrather thanpressureto be responsible for abnormal auditory symptoms. This observation formed the basis of our treatment recommendations.Because of progressively debilitating pulsatile tinnitus, two patients elected right internal jugular vein ligations under local anesthesia. Both patients were relieved of tinnitus.We conclude that jugular vein ligation can be a safe and effective surgical treatment for pulsatile tinnitus resulting from a jugular megabulb deformity, provided two criteria are met:1, The presence of an expanding tumor is ruled out.2. The presence of contralateral venous drainage is established by angiography or brain scan. Anatomic and functional hemodynamic considerations of brain circulation will be emphasized in the discussion of our treatment rationale.

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00002

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractAcquired and congenital syphilis are both known causes of potentially reversible sensorineural hearing loss. Various therapeutic regimens, including penicillin and/or corticosteroids have been used in the past as treatment for otosyphilis. Response rates have varied from 15% to 80%. In this retrospective study, 13 patients with otosyphilis were treated with a combined course of long‐term penicillin and prednisone. A significant response was defined as a 15% improvement in the discrimination score and/or the pure tone average. Initial response rates were 35% with a lasting response rate of 15%. Discrimination scores improved more commonly than pure tone averages. No patient with congenital syphilis or profound deafness had a lasting response. An analysis of possible reasons for failure of therapy is discusse

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00003

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractA prospective study was undertaken to investigate the incidence of sensorineural hearing loss in bullous myringitis. Fifteen patients with 21 ears diagnosed as bullous myringitis were seen over a 24‐month period. Pure tone and speech audiometry were performed as early in the clinical course as possible; 7 ears demonstrated a sensorineural hearing loss and 7 ears a mixed loss. There were no purely conductive hearing losses. Recovery of hearing was complete in 8 of 14 ears. The findings of this study suggest that sensorineural hearing loss is common in bullous myringitis. The literature regarding bullous myringitis is briefly reviewed and the implications of this study are discusse

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00004

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe revival of endolymphatic sac surgery has led to many investigations in Meniere's disease, including lateral tomography of the vestibular aqueduct. Contrary to recent literature, we found no difference in the presence and morphology of the vestibular aqueduct when assessed radiologically in a group of Meniere's patients and a control group. Our assessment of this information in regard to etiology and treatment of Meniere's disease is presented.

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00005

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe revival of endolymphatic sac surgery has led to many investigations in Meniere's disease, including lateral tomography of the periaqueductal pneumatization. We radiologically assessed a series of Meniere's patients and a control group, and found hypocellularity to be more common in Meniere's disease as the literature has stated. However, we found this finding bilaterally in patients with unilateral disease. Our assessment of this information in regard to the etiology and treatment of Meniere's disease is presented.

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00006

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractA clinical and pathologic study of cis‐platinum ototoxicity was performed. Twenty‐four patients treated with cis‐platinum for head and neck cancer were studied prospectively. Post cis‐platinum hearing losses were subclinical, detected in 25% of patients, isolated to 4 and 8 kHz, and did not exceed 25 dB at any frequency.Temporal bones from a 9‐year‐old with frontal lobe astrocytoma and with cis‐platinum ototoxicity were studied with routine and special techniques to elucidate oto and neurotoxicity. Degenerative changes in the outer hair cells in the lower turns of the cochlea, in the spiral ganglion, and cochlear nerve were the most stri

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00007

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractNo consensus exists today on the management of immediate‐onset post‐traumatic facial nerve paralysis. Controversy surrounds the timing of surgical intervention and the role of electrophysiologic testing. Three patients are presented who sustained immediate, complete facial paralysis following closed head trauma. They did not have prompt facial nerve decompression. In each case, electroneurography and electromyography showed complete nerve degeneration and denervated muscle. Despite the results of the electrophysiologic tests, all patients underwent late surgical decompression of the nerve: one at 2 1/2 months, one at 3 months, and one as late as 14 months after injury. They all had good recovery of facial function within 6 months of surgery. Early surgical intervention has been advocated in post‐traumatic facial nerve paralysis if any benefit is to be gained. It is thought that late surgical intervention is unlikely to yield further improvement in the facial nerve function. Experience with these cases suggests that surgical exploration of the facial nerve is indicated atanytime, as it may be beneficial even in very old injuries. The prognostic value of electroneurography and electromyography in determining facial nerve recovery and in deciding upon facial nerve surgery is quest

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00008

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractCells which may be tentatively described as myofibroblasts have been identified by transmission electron microscopy from samples of inflammatory tissue present in the tympanic cavity of ears demonstrating clinical chronic otitis media. These cells possess the ultra‐structural characteristics of a markedly indented nucleus, well organized bundles of cytoplasmic microfilaments, and plasmalemma specializations resembling desmosomes. Myofibroblasts are contractile cells which are present in a number of pathological conditions characterized by tissue contraction or distortion such as hepatic cirrhosis, Dupuytren's contracture, and hypertrophic scars. It is possible to hypothesize that myofibroblasts in chronic otitis media may exert synchronized contractile forces which distort the tympanic membrane or ossicular chain and thus lead to conductive hearing los

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00009

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY

摘要:

AbstractThe authors have investigated the thesis that intermittent hearing impairment due to middle ear disease in the early years of life results in a central auditory disturbance which may persist in adulthood. The concept that, during the speech development years, auditory disturbances interfere with the normal maturation of central auditory processing appear to be clearly established.Thirty‐five children, free of active ear disease and normally hearing by standard peripheral audiometry, are the basis for the study. The monotic tests employing temporal and frequency distortion and the dichotic challenges of competing stimuli and central integration provide the test data.Approximately 75% of the study group fail at least 1 segment of the battery, beyond 2 standard deviations from the normal data. A decreasing percentage of the study group exceed the normative values in 2 or more of the test components.In view of these data on aggressive program of auditory conservation is suggested during the early years of lif

ISSN:0023-852X    

DOI:10.1288/00005537-198312000-00010

出版商:John Wiley&Sons, Inc.    

年代:1983

数据来源: WILEY