摘要:

AbstractThe temporal bone histopathological findings in 14 ears with noise induced hearing loss are presented. The morphological changes consist mainly of hair cell loss, which is more severe in the 9 mm to 13 mm region of the cochlear duct. Within the area of maximum hair cell loss, there is a greater loss of outer hair cells than of inner hair cells. There is a good correlation between the permanent auditory threshold shifts and the spatial location of the sensory lesion according to the anatomical frequency scale.

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00001

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractThe clinical course of patients dying of head trauma and the physiologic evaluation of audition in guinea pigs subjected to several forms of head trauma are correlated with the histopathologic findings in the brains and temporal bones. In the patients there was wide spread hemorrhage, edema, disorganization and disruption of neural tissue. Loss of Purkinje cells and other neural elements was prominent. The temporal bone findings in the patients included laceration of and hemorrhage into the VHIth nerve as well as bleeding into the scala tympani. The membranous labyrinths demonstrated no specific changes secondary to the trauma. The guinea pigs developed a central form of hearing loss with elevated thresholds for evoked responses from the inferior colliculus and normal AC cochlear potentials. In the animals hemorrhage in the substance of the brain, necrosis of neural tissue, edema, disorganization and disruption were prominent. Although there was extravasation of blood in the tympanic and vestibular scalae, the membranous structures of the inner ears were well preserved.

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00002

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractWith recent increases in commercial, military, and sport diving to deeper depths, inner ear injuries during such exposures have been encountered more frequently and noted during several phases of diving: during compression, at stable deep depths, with excessive noise exposure in diving, and during decompression. The pathophysiology of these injuries differs, depending upon the phase of diving in which the injuries occur.In this report, 23 cases of hearing loss, tinnitus, and/or vertigo occurring during or shortly after decompression are presented. Thirteen of these cases occurred in helium‐oxygen dives involving a change to air during the latter stages of decompression. A significant correlation is present between prompt recompression treatment, relief of symptoms, and lack of residual deficits.Current knowledge indicates that the management of otologic decompression sickness should include: 1. prompt recompression to at least 99 feet deeper than the symptom onset depth; 2. recompression using the previous helium‐oxygen mixture when the injuries occur during or shortly after a switch from helium‐oxygen to air during the latter stages of decompression; 3. the use of parenteral diazepam for symptom relief and cyclic inhalations of oxygen enriched treatment gases; and 4. the avoidance of further diving by divers who exhibit permanent inner ear injuries after the acute symptoms have sub

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00003

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractIn four instances of revision stapedectomy in patients with sensori‐neural hearing loss, with or without dizziness, a wire prosthesis was found with an extention beyond the knot which could impinge on the contents of the vestibule. Four commercially manufactured knotted wire prostheses were examined, and the end of three was found projecting beyond the knot. The wire piercing the membranous labyrinth appears to be one of the factors in causing further sensori‐neural hearing loss after stapedectomy. A wire loop or piston prosthesis should be considered to eliminate the hazard of a trailing end of a knotted wire in stapes surg

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00004

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractAn evaluation and treatment of fracture of the edentulous maxilla and/or mandible is presented. The LeFort classification of maxillary fractures is the foundation for the program of care. Immobilization techniques are based upon the support of a fracture by suspension from the adjacent stable segments to the modified prosthesis. The mandibular fractures are repaired by interosseous wire fixation in the body and symphysis region, the other fracture sites are supported by circumferential wiring to the prosthesis for immobilization.General principles of time of repair, diet, types of healing factors are reviewed.

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00005

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractThis paper provides an addendum to an earlier paper describing the development of a computer record system for patient data. The specific problems addressed pertain to the storage and retrieval of historical information, physical signs and diagnosis. Some preliminary comparisons of audiological and vestibular test results are given for groups of patients with diagnoses of acoustic neuroma, Meniere's disease, temporal bone fracture and vestibular neuronitis.

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00006

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractRecent investigations using animal models and human subjects have helped to define the limits which are achievable in terms of information transfer with single‐channel electrical stimulation of the auditory nerve. These studies are reviewed, and presented as a context for a description of the development of an implantable multiple‐electrode multiplexing system which may provide control for several stimulus channels. While such a device may enable the stimulation of small segments of the auditory nerve independently, it does not contain any means of complex stimulus analysis and recording. This latter aspect of prosthesis development remains as the most formidable problem, from a technical viewpoint, that stands in the way of any significant progr

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00007

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractRecent awareness of the magnitude of sudden unexplained deaths in apparently healthy infants has lead to an increased interest in those circumstances that are associated with or can elicit prolonged and serious apneic episodes. In the present studies, attention was directed toward the study of physiologic activity during sleep and feeding.Apneic episodes of varying durations occur during sleep which, in some instances, can be of sufficient length to warrant resuscitative intervention. A number of infants also reveal transient upper airway obstruction following brief periods of sleep apnea. This functional airway obstruction produces sudden and severe bradycardia. Similarly, infant feeding can induce dangerously prolonged periods of apnea and, in some infants, transient airway obstruction.Few detailed studies have been performed to identify the anatomical level or characteristics of the obstruction. Available evidence suggests that this can take the form either of muscle hypotonicity or hypertonicity. Two infants observed by means of direct laryngoscopy revealed transient failure of vocal cord abduction. These results have provided for the development of two theoretical models that can result in the sudden infant death syndrome; furthermore, continuous recordings of respiratory and cardiac activity during feeding and sleep can be extremely valuable in elucidating the mechanisms responsible for the sudden development of apneic and cyanotic episodes in infants.

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00008

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractFor over 15 years, upper respiratory tract obstruction due to adenoton‐sillar hypertrophy has been known to cause hypoxia, hypercapnia, increased pulmonary vascular resistance and thereby cor pulmonale and congestive heart failure. This is now an uncommon but not rare entity and three recent cases prompted this report. The typical patient is dyspneic with retractions, cyanosis, occasional periods of apnea and somnolence. Edema and hepatomegaly and at times splenomegaly are common. X‐rays show cardiomegaly, which on electrocardiogram is found to involved mainly the right ventricle.The strict definition of cor pulmonale is right ventricular hypertrophy secondary to lung disease or abnormal pulmonary function, a definition that may logically be stretched to include abnormal respiratory function secondary to upper airway pathology. The mechanisms by which this occurs are generally agreed upon. Hypoxia has been demonstrated to cause pulmonary vasoconstriction. Acidosis and hypercapnia are thought by some to have the same effect. Pressure across the pulmonary vascular bed is also increased, as predicted by Poiseuille's law, by the high rate of blood flow required to maintain tissue oxygenation with poorly oxygenated blood.Conditions producing hypoxia of hypercapnia or both lead to hypertrophy and eventually to dilatation of the right ventricle.Three cases of children who underwent cardiac catheterization while suffering from cor pulmonale due to adenotonsillar hypertrophy are reported. Right ventricular pressure averaged 44/5, PAO272, pH 7.32, and PACO252. All were clinically improved following adenotonsillectomy. Cardiac catheterization was repeated in one case, with right ventricular pressure dropping from 44/5 to 21/2, pulmonary vascular resistance from eight units to three, and PACO2from 62 to

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00009

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY

摘要:

AbstractEndocrine as well as oncologic attributes mark this rare tumor as unique. It is derived from “C cells” resembling the parafollicular cells of lower animals; these cells elaborate Calcitonin which acts as a sensitive signal of the presence of the tumor. Other endocrinopathies are present in 70 percent of cases so that the tumor may present as part of a complex but increasing well known clinical picture. In 10 percent the tumor occurs as an autosomal dominate trait; in the remainder, the occurrence is sporadic. As expected the lesions are “cold” on I131scan. The histologic appearance of amyloid is characteristic. Regional lymph node metastasis occurs early.The tumor deserves appropriate aggressive management. Essentially surgical therapy should begin early and vigorously; the minimum procedure should be total thyroidectomy. Frequent lymph node metastasis speaks for the need for radical neck dissection which should be extended into the superior mediastinum. Management should also include the frequently associated endocrinopathies, particularly pheochromocytomas which must be suspected and eradicated prior to treatment of the thyroid tumor. A genetic workup should be included.Six cases are described, ranging in age from the third to the eighth decade. Only two were free of disease at this writing, two were alive with their disease and two were dead of their disease. All were of the sporadic group, and only one had associated endocrinopathies. None of these cases were diagnosed preoper

ISSN:0023-852X    

DOI:10.1288/00005537-197609000-00010

出版商:John Wiley&Sons, Inc.    

年代:1976

数据来源: WILEY