摘要:

AbstractPediatricians commonly consider aminoglycoside antibiotics to be less ototoxic in neonates than in adults. This concept is based on the results of pure tone audiometry performed in children treated with aminoglycosides during the neonatal period. However, conflicting results were obtained when using brain stem response audiometry (BSRA) in a group of 26 aminoglycoside treated neonates and a control group of 20 treated neonates during their stays in intensive care units (mean gestational age: 34.6 weeks). Latencies of wave V significantly differed between the two groups indicating hearing alterations in the treated group. A statistical correlation was demonstrated between initial and final values of wave V and the total doses of antibiotic administered per kilogram of body weight (p<0.01). Most neonates were premature with an immature hearing apparatus.To demonstrate the effect of aminoglycosides on the developing organ of Corti, neonate kittens were chosen as animal models — the onset of hearing occurs 10 days after birth. BSRA was performed every 3 days from birth for 20 days and thereafter every 6 days for the following 30 days. Five kittens treated with a low dose of gentamicin for 20 days were compared with a control group of 5 untreated kittens from the same litters and a group of S adult cats receiving the same antibiotic therapy. On the 50th day, all animals were sacrificed and their cochleas were prepared for electron microscopic evaluation. No ultrastructural modifications or BSRA alterations were noted in the adult group. The untreated kittens exhibited a normal pattern of BSRA maturation and their organs of Corti appeared normal. On the contrary, evidence of abnormal hearing maturation and of anatomical damage in the outer hair cells of the first coil of the cochlea was found in the treated kittens. Laboratory findings corroborate our clinical findings that aminoglycoside antibiotics are more ototoxic in neonates than in adult cat

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00001

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractHuman cytomegalovirus (CMV) is ubiquitous and has been documented as the etiologic factor in several diseases ranging from respiratory tract infection to congenital deafness. Special clinical manifestations of CMV of interest to the otolaryngologist are presented as related to the temporal bone and audiovestibular system, the facial nerve, the aerodigestive tract, the thyroid, the hematopoietic‐lymphoreticular system, and salivary gland.In addition, current concepts of CMV oncogenic potential are discussed as they relate to head and neck neoplasms. The results of a study performed on surgical pathology specimens obtained from 26 patients, in an attempt to isolate CMV in tissue culture from salivary gland and/or neoplasms of the head and neck, detected no evidence of viral presence. The significance of these findings and the role of future research is discusse

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00002

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractThe round window membrane has been considered as a pathway for the passage of toxic substances from the middle ear cavity to the vestibular labyrinth in cases of otitis media. To determine the role of the round window membrane in this passage, chinchillas were given intrabullar inoculations with staphylococcal exotoxin and the round window membranes were examined electron microscopically. We observed cytoplasmic vacuolization, intercellular edema, cellular and nuclear swelling of the surface epithelia and polymorphonuclear leukocyte (PMN) infiltration of the fibrous layer. Light microscopic observation of the labyrinth revealed PMN infiltration of the most basal portion of the scala tympani. These findings demonstrate a chemotactic effect of the toxin for PMNs and support the concept of the round window membrane as an important avenue of entry.

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00003

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractAlthough tinnitus severely afflicts 7.2 million Americans, the pathophysiology of this problem remains obscure because there presently exists no good animal model in which to study the phenomenon. We have examined changes in activity in the guinea pig auditory pathway using an autoradiographic method of functional brain mapping after short‐term and long‐term cochlear ablations which can, in humans, initiate the occurrence of tinnitus. With this method we have observed a reduction in activity in various nuclei in the auditory pathway between 4 hrs and 10 days after unilateral cochlear ablation. In contrast to these findings we have found a return of activity in these same nuclei if they are observed from 12 to 48 days following the lesion. These preliminary data suggest that this return of activity in the absence of sensory input may be a valid experimental analogue for tinnitus in humans. Such evidence for auditory plasticity may represent a significant first step toward understanding this common and profound otologic symp

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00004

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractCentral tinnitus is defined as an abnormal sensation of sound which is perceived by the patient and established by neurotologic diagnosis to be retrocochlear and/or within the central nervous system in location. A method of diagnosis and evaluation using evoked response audiometry (ABR) is reported. A clinical test, Simultaneous Binaural Auditory Brain responses with monaural stimulation (ABR) for central location of tinnitus is presented. The use of a diagnostic approach to the selection of a tinnitus masker will be presented. Electrophysiologic indices for central tinnitus have been observed based on short latency ABR recordings. A classification has been presented. The use of lidocaine I.V. therapy with ABR recordings is presented. The concept, diagnosis, and techniques at this time, relating to central tinnitus, are presented as clinical observations. These observations are a beginning for the establishment of an electrophysiologic series of indices which can be interpreted as an electrophysiologic correlate of tinnitus to be supported by basic clinical research.

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00005

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractEpidemiologic considerations which are pertinent to cancer of the head and neck are broad and varied. Cigarette smoking continues to be the major cause of head and neck neoplasms. Occupational and environmental exposures to carcinogens have been well identified. Tumors may develop as a result of medical therapies. Susceptibility on a genetic basis has been shown, and the role of viruses in carcinogenesis has been further documented.

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00006

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractCardiopulmonary bypass surgery is commonplace in many medical centers and rare instances of unilateral hearing loss in these patients have been reported and have been attributed to embolism. Two more patients are reported and their discovery prompted a study of pre and postoperative hearing in 68 patients at Newark Beth Israel Medical Center, where a single team performs the cardiopulmonary bypass surgery. Previous similar studies showed no changes following CPB surgery. Almost all patients have been male and prolonged pump times (over 150 min.) were noted in 7 of 11 reports.Based on changes in hearing found on pre and postoperative testing in the 6 patients, 3 groups were developed: those with no change and those with slight changes were compared with those having average deficits of more than 10 db. Prolonged pump times occurred only twice in the series and were not associated with loss. A second milder form of hearing loss, which was bilateral and affected the high tones, was noted in significant numbers. Two of these patients had persistent tinnitus after surgery. Although the series is small, there appears to be an increased susceptibility in males to the development of high tone loss as well.Based on the preponderance of males, with their high incidence of basilar artery atherosclerosis, and the frequent prolonged pump times, perfusion failure seems to be the most likely etiology for the rare cases of hearing loss accompanying cardiopulmonary bypass surgery.

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00007

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractReview of the literature reveals 76 cases of fibrous histiocytoma of the deep structures of the head and neck. To this we have added 11 of our own cases, and analyzed the total group to determine clinical and histological features of a high risk population. Age, sex, presence of pain, location of tumor, size of tumor, and local invasion appear to be important clinical criteria. Bizarre giant cells, numerous and atypical mitoses, necrosis, and inflammation appear to be important histologic features. The treatment of choice is wide local excision. Chemotherapy appears to produce tumor regression.

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00008

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractInverted papilloma of the nose and paranasal sinuses is a neoplastic growth of epithelium which inverts into the underlying stroma rather than proliferating outward from the surface. These neoplasms probably arise from the area of the lateral nasal wall. Inverted papilloma is characterized by its: A. capacity to destroy; B. tendency to recur; and C. association with malignancy.During the past decade, we have come to understand better the histologic, biologic, and anatomic features of this tumor. More studies focusing on inverted papilloma have been published in recent years, and the authors of these reports have advocated more aggressive surgical procedures in the management of this tumor. The application of the technique of lateral rhinotomy and en bloc excision of the lateral nasal wall has dramatically decreased the recurrence rate while providing the patient with quite acceptable cosmetic and functional results. The surgical approach to inverted papilloma associated with squamous cell carcinoma varies with the extent of disease; but a good cure rate, especially with localized tumors, may be achieved with aggressive surgery combined with radiation therapy in these cases.We present a series of 19 patients with inverted papilloma. In 6 of these 19 patients, squamous cell carcinoma was associated with the inverted papilloma; 13 of the patients with inverted papilloma and 3 of the patients with an associated malignancy underwent lateral rhinotomy with en bloc excision of the lateral nasal wall. The tumor did not recur in these patients. The rationale for this surgery, as well as the details of these patient's case histories, form the basis of this report.

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00009

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY

摘要:

AbstractA method of studying lymphatic drainage of the larynx was undertaken using radioactive colloids. Sites of injection were the true and false cords, aryepiglottic folds, anterior and posterior commissure, epiglottis and arytenoid. The patient was then scanned with the gamma camera 3 to 5 hours and again 24 hours post injection. Thirty‐six patients were injected and results were recorded as to previous X‐ray therapy, nodal activity post scanning, ipsilateral or contralateral and distant spread, and the type of radioactive particle —99mTc labeled sulfur collond,99mTc microalbumin (200‐800 nm diameter), and99mTc mini‐microalbumin (less than 50 nm diameter).The three radiopharmaceuticals gave similar results. Previous X‐ray therapy did not alter lymphatic drainage. Of 36 patients, 23 showed nodal activity on scintiscanning: none showed any axillary nor mediastin

ISSN:0023-852X    

DOI:10.1288/00005537-198112000-00010

出版商:John Wiley&Sons, Inc.    

年代:1981

数据来源: WILEY