摘要:

AbstractDuring the first year of life, the bone of the petrous apex grows rapidly. At birth, only 5 mm of bone separates the cochlea from Dorello's canal as compared to 2 cm in the adult. More than half this growth occurs during the first year of life. The subarcuate fossa is a cavity within the superior semicircular canal which reaches from the posterior fossa to the future mastoid in fetuses and nearly to the mastoid antrum in newborns. During the second year of left it is nearly obliterated to form a shallow depression or slit on the posterior aspect of the temporal bone and the variable petromas‐toid canal which contains the subarcuate artery and vein. Clinical petrositis of infants less that 1 year of age is rare, and provides a challenge for surgery. A case is reported and discusse

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00001

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractCertain patterns of “lymphoma masquerade” are examined, where the diagnosis is very difficult to establish. The presence of prolonged symptoms prior to the acute event or indolent slow healing wounds should alert clinicians to the possibility that lymphoma may be involved. Localizing tumors in order to make a tissue diagnosis is one potential problem encountered even with computerized tomography, but magnetic resonance imaging has been helpful in demonstrating the presence of tumor mass. Included in this report is an unusual series of non‐Hodgkin's lymphoma cases in which there was not an obvious tumor. Three patients presented with symptoms and findings of deep neck abscess, two of which were associated with an esophageal perforation or tracheoesophageal fistula. The other cases involved chronic sinusitis and an apparent viral polyneuropathy affecting multiple cranial nerves. Treatment of these non‐Hodgkin's lymphomas and techniques for establishing the pathological diagnosis are di

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00002

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA series of experiments was conducted to investigate the rate of Autologous Fibrin Tissue Adhesive (AFTA) degradation by the fibrinolysis inhibitor, epsilon amino caproic acid (EACA). The duration of AFTA clots in vitro, subcutaneous, and in the middle ear was prolonged for a time interval that was proportional to the concentration of EACA in Component II of the adhesive. No toxic reactions were observed in the middle or inner ear. Systemic pathology (thrombosis or emboli) could not be related to the presence of EACA applied in the middle ear or directly into the blood stream at concentrations (mg/kg body weight) up to 1,500 times that expected to occur during surgery on humans.

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00003

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA technique for achieving permanent middle ear aeration by inserting a flanged silicone tube (SPAT) through a hole drilled in the external auditory canal was introduced in 1970.Since 1970, we have used the transosseous procedure in 36 patients (11%) of cases that required middle ear ventilation. The average length of time the transosseous SPAT functioned was 51 months (range 0–138). Best results were obtained in patients over 16 years of age, when chronic ear surgery was not performed simultaneously. Transient otorrhea occurred in 23% of cases. Forty‐four percent of tubes became blocked and required removal or were extruded. No patient developed facial weakness, middle ear cholesteatoma, or persistent tympanic membrane perforation. In selected cases, the transosseous SPAT provides long‐term middle ear aeration without the risk of permanent tympanic membrane perfor

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00004

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractWhen a surgeon encounters an absent lenticular process of the incus, he must either reposition the incus or attempt to bridge the small gap between the remaining incus long process and the stapes capitulum. Our solution to this problem is to place a Lippy modified Robinson stapes prosthesis on the stapes footplate and attach it to the remaining long process, thus bypassing the stapes superstructure. This modified Robinson prosthesis has a portion of the well removed allowing the eroded long process to enter from the side. The hearing results of 63 cases at 6 months (two‐thirds of which had a concurrent tympanoplasty) are 67% within 10 dB and 91% within 20 dB of the preoperative bone hearing level. The use of an existing and proven prosthesis provides both stability and, to date, the most successful hearing results for reconstructing the absent lenticular proces

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00005

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe round window niche and membrane can be involved in clinical problems including perilymphatic fistulas, sensorineural hearing loss in otitis media, and a variety of others. The background of these problems is documented by a review of the literature and recent experimental evidence on round window grafting and tracer studies. Clinical pathological correlates including recent clinical experience are discussed for perilymphatic fistulas (sudden deafness, chronic progressive fluctuating sensorineural hearing loss, and association with Meniere's disease), sensorineural hearing loss in acute and chronic otitis media, and findings in round window membrane including absent round window reflex in cases of exploratory tympanotomy and otosclerosis. In addition, a new syndrome termedperilymphatic hypertensionis described as seen in a subset of patients with sudden sensorineural hearing loss.

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00006

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractBenign paroxysmal vertigo of childhood is a vestibular disorder characterized by multiple sudden brief episodes of true vertigo with nystagmus usually beginning after the age of 4. The diagnosis is based on the characteristic history, because the otologic and neurologic examinations, electronystagmogram, audiogram, and electroencephalogram are usually normal. The etiology of the disorder remains unknown, although a vascular disturbance of the posterior circulation with ischemia of the labyrinth or vestibular nuclei is most commonly postulated. A review of the literature and five new cases are used to acquaint otolaryngologists with this entity, review the characteristic clinical history, discuss differential diagnosis, and emphasize the usual clinical course.

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00007

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractThe first 100 patients in a series of 616 cerebellopontine angle tumors were compared to the most recent 100 patients. All of the first 100 patients were evaluated prior to the common use of CT or ABR. Recently, improved diagnostic studies have resulted in the discovery of significantly smaller tumors. The later group of patients was also found to have their symptoms for a shorter period of time and had better overall hearing at the time of diagnosis. Reductions in the rates of various complications were also observed. These trends are felt to be the direct result of improved audiologic and radiologic diagnostic studies. A heightened awareness of all otolaryngologists to seek the diagnosis of acoustic neuroma also improved early diagnosis.

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00008

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA retrospective study was conducted on all 23 patients who underwent operation for residual or recurrent acoustic neuromas during the 10‐year period January 1976 through December 1985. The most common symptoms at the time of reoperation were ataxia (16 patients), facial paresthesias (13 patients), and headaches (9 patients). Primary procedures had consisted of suboccipital posterior fossa approaches in 22 patients and a middle fossa approach in one. Reoperation for recurrent or residual tumor consisted of a retrosigmoid approach in 17 patients and a translabyrinthine or translaby‐rinthine/retrosigmoid approach in six patients. This study confirms that residual or recurrent acoustic tumors are not common. It also suggests that long‐term follow‐up, for at least 7 to 8 years, is in

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00009

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractTechnological advances in neuroradiology and the development of skull base surgery in neurotology have improved diagnosis and management of lesions eroding the tegmen tympani. The diagnosis of brain hernia is to be suspected in patients with a history of complicated chronic ear surgery and a slowly developing pulsatile mass with CSF leak. Patients are best evaluated in the upright position, with an otomicroscope and by magnetic resonance imaging (MRI). Over 6 years, our group has treated seven patients with eight space‐occupying lesions eroding the tegmen. Five of the lesions were repaired with a temporalis muscle flap, 2 with fascia and bone, and 1 with Marlex. A review of new technology in the diagnosis of brain hernia and a modification of previous techniques is give

ISSN:0023-852X    

DOI:10.1288/00005537-198710000-00010

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY