摘要:

AbstractThe nose relates intimately to the upper lip. As in all facial cosmetic surgery, anatomic and aesthetic diagnosis of the deformity is essential to providing the best treatment possible in a particular patient. Within a reasonable range, changes may be made easily in the columella‐labial area. Often these changes enhance the results of typical rhinoplastic maneuvers and make safer and more predictable the results of the rest of the rhinoplastic surgery.Techniques for altering the columella‐labial region are presented. Examples arc shown demonstrating diagnostic, aesthetic, and therapeutic aspe

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00001

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY

摘要:

AbstractBecause of anatomical deformity, trismus, or for other reasons, it may on occasion be impossible to visualize a larynx by the usual laryngoscopy methods. Such difficulties in patients who have paralytic dysphonia may also make it impossible to effect improved vocal cord closure by the usual techniques of Teflon® injection. We have applied a new technique, detailed in this report, to these problem cases.Following topical anesthesia of the nose, nasopharynx, and larynx, 1% Xylocaine is injected over the cricothyroid membrane. A flexible or telescopic laryngoscope connected to a television camera is introduced through the nose or oral cavity, respectively. A 16‐gauge spinal needle is introduced into the subglottic tracheal lumen via the cricothyroid membrane and directed into the undersurface of the paralyzed vocal cord under indirect visual control. Teflon® is then injected, monitored via the television image. Our early experience with this simple technique indicates that voice improvement is comparable to that expected using conventional transoral laryngoscopic techniq

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00002

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY

摘要:

AbstractThe experience at the Mayo Clinic with 18 patients who had Cogan's syndrome is reviewed. Typically, the illness began with systemic symptoms. The ocular and audiovestibular symptoms included ocular discomfort and redness, photophobia, and fluctuating sensorineural deafness with imbalance. Each patient had interstitial keratitis; the ocular symptoms periodically recurred but responded to therapy. Thirteen patients who had fluctuating bilateral sensorineural deafness subsequently suffered total bilateral deafness. Two patients who are unilaterally deaf have good residual hearing. Two other patients regained hearing within normal limits after treatment with corticosteroids. No hearing symptoms were observed in one patient who had severe vertigo and whose condition is stable. Seventeen patients had vertigo: 11 have no labyrinthine function, 1 had absent responses on vestibular testing initially but currently demonstrates good responses, and the 5 others have remained stable with diminished vestibular function. If Cogan's syndrome is diagnosed early and treatment with corticosteroids is initiated promptly, hearing can be stabilized; otherwise, the prognosis for auditory function is poor.

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00003

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY

摘要:

AbstractThis report describes the diagnosis and surgical management of two patients with similar inner ear malformations resulting in recurrent otitic meningitis. Each patient had a meningocele presenting through the oval window associated with Mondini's anomaly. Details of radiographic diagnosis and surgical management strategies will be discussed and long‐term follow‐up presen

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00004

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY

摘要:

AbstractCholesterol granuloma of the petrous apex is a newly recognized clinical entity distinct from cholesteatoma. Cholesterol granuloma usually produces symptoms of trigeminal, facial, and abducens nerve palsy and may not affect the auditory nerve. The characteristic computerized cranial tomographic (CCT) finding is a nonenhancing, smooth‐walled, expansile lesion that is isodense with brain tissue in a patient with bilaterally well pneumatized mastoids and petrous apices. Treatment is limited to drainage of the cyst and insertion of a stent for permanent aeration of the petrous apex.Of ten cases of cholesterol granuloma of the petrous apex recently diagnosed at the Otologic Medical Group, the correct preoperative diagnosis was made in nine patients on the basis of CCT findings. Six of the nine patients had serviceable hearing preoperatively; serviceable hearing was maintained postoperatively in five patient

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00005

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY

摘要:

AbstractWe have had the opportunity to cure for four patients who experienced barotrauma or implosive trauma to their ears. The differential diagnosis in these cases included ossicular injuries as well us possible perilymph fistulae. In euch of these cases there was a small conductive hearing loss which fluctuated and u high compliance tympnnogrnm. Careful otoscopy with the ald of pneumomassage revealed un isolated malleus handle (manubrium) fracture. Exploration of one ear was performed to rule out perilymph fistula und the diagnosis of malleus handle fracture was confirmed. Recognition of this injury preoperntively in these three other patients made exploration unnecessary. While injuries to the ossiculnr chain have been well‐described in the literature, isolated malleus handle fracture has not been previously reported.The salient features of the presenting symptoms, diagnostic signs, und laboratory findings will be discussed and illustrate

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00006

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY

摘要:

AbstractThe anterior middle ear has always been a difficult area to visualize and access. This report reviews the experience with a new approach to gain exposure of the middle ear. This technique involves separating the entire pars flaccida from the handle of the malleus for better exposure and then replacing the drum. Four patients were treated in this fashion; one glomus tympanicum, two congenital cholesteatomas, and one benign adenoma. All patients benefited from improved exposure and resection. No patients had postoperative lateralization of the drum and hearing was maintained.

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00007

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY

摘要:

AbstractLateral sinus thrombosis, a frequent complication of ear infections in preantibiotic days, is seldom seen today. When it does occur, it is usually in a patient with a known history of a chronic ear infection. Two patients are described with septic pulmonary emboli from inapparent lateral sinus thrombosis. Lateral sinus thrombosis should be suspected in any patient with chills, fever, neck paln, and septic pulmonary emboli.

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00008

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY

摘要:

AbstractPosterior fossa arachnoid cysts arc more common than previously reported. While they may present with symptoms of hearing loss, vertigo, and tinnitus, often they are associated with vague, nonspecific complaints such as headache, dizziness, or generalized unsteadiness. We present five cases of posterior fossa arachnoid cysts discovered in adult patients. Four of the five patients had nonlocalizing symptoms (three of those sought medical evaluations for persistent dizziness and/or headache). Two patients had prolonged symptoms despite medical evaluation and normal audiometrie testing before the correct diagnosis was made. We describe the case of our senior author (C.P.D.) in detail and include computerized tomographic and nuclear magnetic resonance studies outlining his pathology. A review of the management of these lesions is included.Dizzy patients and those patients with nonspecific complaints referable to the inner ear or posterior fossa who have normal audiometrie testing, and in whom the index of suspicion is high, should have high resolution computerized tomography of the posterior fossa.

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00009

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY

摘要:

AbstractWarthin's tumor or papillary cystadenoma lymphomatosum {PCL) represents a clinically significant entity, not because of pernicious behavior, but because its cytohistological characteristics tell us much about the development and morphology of the parotid region. Three cases operated on in which PCL developed in an extraglandular location from the parotid, formed the basis for a series of observations on what is known about:1. etiology of PCL;2. the nature of the lymphocytic components;3. the relatively high incidence of bilateral and multiple occurrence, as well as male predominance. These studies employed immunohistological techniques using a series of monoclonal antibodies.

ISSN:0023-852X    

DOI:10.1288/00005537-198506000-00010

出版商:John Wiley&Sons, Inc.    

年代:1985

数据来源: WILEY