摘要:

AbstractWe reviewed 564 tympanoplasties operated upon over an eight year period at the Otologic Medical Group in which tragal cartilage was used to re‐establish the sound pressure transfer mechanism. Eighty‐six percent of the cases were revisions, and half of these were planned second stage procedures.In the majority of cases the stapes crural arch was missing. The conductive deficit in these cases was reduced to 20 db or less in 67% and 10 db or less in 40%. The commonest single cause of failure was a short prosthesis.There were no instances of cartilage resorption. Extrusion occurred in one case.Tragal cartilage has been more satisfactory than ossicular tissue in many situations. Recently we have been using plastic prostheses (TORP and PORP) in combination with tragal cartilage and believe that the results will be even bet

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00001

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractTumors involving the base of the skull are often occult and may become quite large before detection is possible. Symptomology varies depending upon the nature of the tumor and its placement. These neoplasms have frequently been considered inoperable simply because of their location, but in recent years microsurgical technique and high speed air drills have allowed the modern temporal bone surgeon to gain improved access to the skull base.A wide variety of surgical approaches to tumors in this area have been described in the past 20 years: translabyrinthine, middle fossa, transcochlear, retrolabyrinthine, retrosigmoid, transpalatal‐transclival, and through the jugular bulb. The purpose of this paper is to review the indications, complications, and results of each of these procedures in relation to specific tumors involving the skull base. Case reports illustrate the diagnosis and surgical management of a variety of unusual neoplasms, including an extradural meningioma of the temporal bone and clivus, a low grade squamous cell carcinoma on the tegmen in a radical cavity, a large primary cholesteatoma, an osteoblastoma of the temporal and occipital bones, an XIth nerve neuroma in the jugular bulb area, and an osseous hemangioma involving the facial nerve at the geniculate ganglio

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00002

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractIn a previous communication, one of the authors discussed prolonged congestion of the turbinates following nasal surgery. The clinical factors responsible were allergy or the traumatic effects of nasal packing on the turbinates.A study of turbinate function was done to find the factor responsible for this congestion. Biopsies of an inferior turbinate were obtained pre‐operatively and two weeks after surgery. The specimens were examined for the level of acetylcholinesterase by histochemical assay and were also studied by examining sections histologically.In the majority of cases, the level of acetylcholinesterase fell with the appearance of congestion and rose when the turbinates returned to normal.These results suggest a connection between turbinate congestion and levels of tissue acetylcholinesterase in the presence of inflammation or allerg

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00003

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractThe otolaryngologist does not have to fit hearing aids, but he does have to know with a broad encompassing view what is being done by the hearing aid dispenser and the audiologist in regards to hearing aid fitting and selection. The acquisition of a hearing aid is part of the general care for the hard of hearing. In this particular case, the otolaryngologist should always be the “Captain of the Ship.“ With him, as paramedical advisors and assistors, are the audiologist and the hearing aid dispenser. The ultimate responsibility of the members of this team to see that the patient is properly fitted and cared for is with the otolaryngologist. When problems exist with improper diagnosis or care, the medical‐legal responsibility falls on the shoulders of the otolaryngologist. Having an audiologist work with the otolaryngologist is most desirable for the measurement and recommendations for the hearing aid. The new FDA regulations require an otolaryngologic examination prior to fitting hearing aids, except for personal and religious reasons. Children under 18 years of age require both a medical and audiologic examination.To simplify conversation with other members of this team, one should have some basic concepts clarified: 1) The nature of a hearing aid. 2) The concepts and nomenclature used in and for probably 90% of all descriptions regarding hearing aids. 3) Types of aids. 4) Coupling methods which involve ear molds, tubes, vents, and inserts. 5) Types of fittings, whether cross, bi‐cross, monaural, etc. 6) Distortion. 7) Measurements. 8) Problems in fitting of hearing aids.It is reasonable to assume that adequate background in these simple basic concepts regarding hearing aids will permit the otolaryngologist to supervise and understand the nature of some of the complaints made by patients. It is totally desirable that a patient be seen by an otolaryngologist prior to being fit with a hearing aid. This can be accomplished by education of the public by the otolaryng

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00004

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00005

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractIn the practice of otolaryngology, a definite diagnosis or at least a working diagnosis should be established for all cases of hearing loss and especially sensorineural hearing loss. In this study, we described a time proven method by which the otolaryngologist can meet his responsibility for this important societal problem.

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00006

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractMillions of Americans suffer hearing loss resulting in immense social and economic consequences. Hearing loss is merely a symptom or sign and the evaluation and management of afflicted individuals requires a thorough knowledge of etiologic factors and understanding of the underlying pathophysiology. Hearing loss is either conductive, sensorineural, or mixed. It may be congenital or delayed in onset, genetic or nongenetic, and progressive or stable. Specific diagnosis should be sought in all cases with the objective being reversal of the hearing loss. Often definitive therapy is lacking yet prevention of progression, when possible; recognition of associated disorders, when present; compensation for disability, when applicable; epidemiologic study; genetic and psycho‐social counseling; and habilitation and rehabilitation may still be initiated. A vigorous approach to the patient with hearing loss should be championed by the otolaryngologis

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00007

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractA philosophy of the (re)habilitation of patients with sensorineural hearing losses from a communication point of view is presented. Pediatric and adult populations are discussed separately. Topics of consideration for pediatric patients include the appropriate use of amplification, team management of the hearing handicap, educational placement and the importance of parent counseling. The discussion of the management of adult patients reviews some problems in hearing aid fitting, patient counseling and appropriate case follow‐up. The guiding principle behind these (re)‐habilitation processes is the integration of the hearing‐impaired patient into a hearing

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00008

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00009

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY

摘要:

AbstractOtologists have attempted to close tympanic membrane perforations for 300 years. It has been in the past 25 years that closure with autograft materials has been consistently successful. Homografts have been successful for the past 10 years.One of the autograft materials, ear lobe fat, has been in use for the past 15 years. Over this period 65 patients have been reviewed.This report reviews the literature, explains the technique and summarizes the results as to hearing, graft mobility and graft survival

ISSN:0023-852X    

DOI:10.1288/00005537-197806000-00010

出版商:John Wiley&Sons, Inc.    

年代:1978

数据来源: WILEY