摘要:

AbstractThis clinical study attempts to evaluate the effectiveness of Eustachian tube function in 30 ears, 11–29 months after insertion of the Silastic® Eustachian tube prosthesis (SETP). Indications for the SETP were limited to persistent Eustachian tube dysfunction. Preoperatively, 13 patients had intact tympanic membranes with persistent serous otitis media. Seventeen patients underwent tympanoplasty and demonstrated persistent serous otitis media in the opposite ear.Postoperatively, aeration of the middle ear was evaluated by tympanometry, microscopic examination, and myringostomy. Microphotographs demonstrate the state of the middle ear. Histology of the middle ear mucosa was obtained in a few cases.Ninety‐six percent of the ears with an SETP demonstrated confirmed persistent Eustachian tube dysfunction beginning an average of six months after insertion. Complications were co

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00001

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractEight cases, the largest series of malignant fibrous histiocytomas of the head and neck to date, are reported. In over one‐half of the cases, the initial problems encountered in the case made the true diagnosis misleading. For correct diagnosis multiple biopsies may be required. The diagnosis is further confirmed by the clinical behavior of the tumor and its site, size, and depth of involvement. Four specific histopathologic variants are described. Wide surgical excision is the preferred treatment. The potential role of adjunctive irradiation should be considere

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00002

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractTwo cases of gastric heterotopias in the head and neck are described. Also, a brief review of previous case reports is presented as well as a discussion of the etiologic possibilities.

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00003

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe objectives of the present investigation are as follows: to prospectively assess the incidence of sensorineural hearing loss (SHL) associated with bacterial meningitis; to evaluate the onset and degree of SHL; and to describe the audiometric pattern.Forty‐seven patients were studied otologically and audiologically. The incidence of SHL was 11%. Late onset of SHL was not observed, however, one patient demonstrated a probable progressive hearing loss. Both bilateral and unilateral hearing loss were noted. The degree of hearing loss varied from mild to profound, with no consistent audiometric pattern. Intensive follow‐up on one hearing‐impaired patient included temporal bone polytomograms. Obliterative labyrinthitis is detailed.Antibiotic treatment and laboratory data are evaluated. Suggestions are provided for the post‐meningitic

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00004

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractWegener's granulomatosis is characterized by a necrotizing granulomatous vasculitis which can be found in both the upper and lower respiratory tracts and with either focal or proliferative glomerulonephritis. However, any organ system can be affected by the disease.Over the past 17 years, 47 patients with histologically proven Wegener's granulomatosis have been treated at the National Institute of Allergy and Infectious Disease. Since 1972, patients with head and neck manifestations have been managed in collaboration with the Department of Otolaryngology, National Naval Medical Center. Experiences with these patients have shown that all have had some degree of respiratory tract involvement, with 42/47 having disease in the nose or paranasal sinuses. An effective therapeutic regimen is possible with immunosuppressants (particularly cyclophosphamide) and locally supportive measures. As a result of such therapy, more than 80% of the patients treated have experienced long‐term remissions. The clinical implications of this therapy are discussed, and a protocol for patient management presente

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00005

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractA stainless steel goblet shaped prosthesis is used to attach the repositioned incus to the stapes. A two year follow‐up was made of the first 116 patients in which the prosthesis was used for ossicular reconstruction.The incidence of extrusion and ankylosis is diminished, and 75% of all cases had closure within 10 db. An additonal 20% had closure within 20 db of bone conduction thresholds. Revisions have been less with this technique than with others: 40% of 116 patients had an uncomplicated tympanoplasty; 60% had a tympanoplasty with mastoidectomy. The results are, of course, more favorable in the group without mastoidectomy. Of these, 86% had closure to within 10 db of bone conduction level. These findings suggest that the use of the goblet prosthesis results in improved hearing. These findings conclude that the use of the goblet prosthesis results in better hearing than that obtained with other methods of ossicular chain reconstructio

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00006

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe attainment of a more youthful appearance is one of the goals of cosmetic facial surgery. In the orbital area this is usually accomplished by performing a blepharoplasty. There are, however, a number of cases in which performance of a blepharoplasty of the upper or lower lids or both does not produce as much of an improvement as the patient or the surgeon would desire. Proper preoperative analysis enables one to determine that the blepharoplasty alone will not produce the desired result. In those instances in which the ptosis of the blow is a contributing factor to the aged appearance, an operative procedure to correct the brow would be undertaken prior to or in conjunction with the blepharoplasty procedure. The various operative procedures will be discussed and analyzed from their positive and negative aspects.

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00007

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractConstant reassessment of professional services is necessary in order to maintain responsiveness to patient needs. As a result of current trends in patient population, amplification technology and legislative intervention, many otolaryngologists and audiologists have included the dispensing of hearing aids as a part of their provision of clinical services. The primary philosophical objective in dispensing hearing aids is to provide a more allencompassing total hearing health care within the clinic setting for patients with all types of hearing loss, whether their needs are medical, surgical or prosthetic. Procedures for each patient receiving a hearing aid fitting include the following: audiological evaluation, otolaryngological examination, physician counseling, audiological counseling, ear mold fabrication, hearing aid evaluation and fitting, 30 day trial period, and follow‐up hearing aid counseling.A total of 1319 aids have been dispensed over a five year period. The large majority of the aids are postauricular instruments, fitted on adults over 60 years of age with sensorineural hearing loss. Dispensing aids within the clinic has established a constant quality service, improved patient follow‐up, improved the convenience for patients, offered research opportunities, and reduced the cost to our patients. Having a within‐clinic dispensary provides a coordinated program of professional management for the aural rehabilitative process; when a hearing aid is dispensed through such a program, the quality of patient care for the hearing impaired population can be imp

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00008

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractVestibular dysfunction associated with otosclerosis has been observed for many years. In a recent clinical study of patients exhibiting progressive sensorineural hearing loss of unknown origin, it was demonstrated that approximately 50% of the cases had cochlear otosclerosis/otospongiosis as the most probable cause for the hypacusis. Of these, approximately 55% had vestibular symptoms. In the present study, the effect of sodium fluoride therapy in this group of patients is analyzed. It will be demonstrated that such therapy is beneficial not only in controlling the progressive sensorineural hearing loss but also the symptoms of vestibular dysfunction in patients with cochlear otosclerosis (otospongiosis).

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00009

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe inflammatory nasal polyp is the most common benign or malignant nasal mass seen in children. Nasal polyps in the pediatric population appear to occur as inflammatory responses to bacterial infections. In 33% of the patients with polyps whom we studied, antral choanal polyps were noted, and in 20% of the patients the polyps were unilateral but not antral choanal. In 18% of the patients the polyps were bilateral and in an additional 29% they occurred bilaterally in association with cystic fibrosis. History of an allergy is infrequently associated with nasal polyps; allergies are potentially major contributing factors to nasal polyps only in patients without cystic fibrosis whose nasal polyps are bilateral. Patients with antral choanal polyps are most successfully managed by simultaneous Caldwell‐Luc antrostomy and polypectomy. Sixty percent of patients with nasal polyps and cystic fibrosis are adequately managed with a single intranasal polypectomy. Simultaneous sinus surgery and polypectomy should be considered for all patients with recurrent polyps and for all patients with clinical or radiographic evidence of significant sinusitis. Complications, including epistaxis and intranasal synechia, occurred in 3% of the 170 surgical procedures performe

ISSN:0023-852X    

DOI:10.1288/00005537-198009000-00010

出版商:John Wiley&Sons, Inc.    

年代:1980

数据来源: WILEY