摘要:

ObjectiveThe aim of this study was to determine the dimensions of cochlear aqueduct radiologically in patients with Méniére's disease and in normal subjects, and to correlate these findings with normal and low static acoustic compliance (SAC) (high and normal perilymphatic pressure) to see whether the dimensions of the cochlear aqueduct play any role in the perilymphatic pressure in normal individuals and patients with Méniére's disease.Study DesignProspective double-blind study.SettingThe study was conducted at Hacettepe University Medical Faculty, a tertiary care center.PatientsForty patients with Méniére's disease with bilateral involvement, diagnosed by vertigo attacks, fluctuating hearing loss, tinnitus, fullness in the ear, and cochlear sensitivity constituted the patient group. Forty healthy individuals with no otolaryngologic symptoms constituted the control group.InterventionsAll individuals underwent SAC measurement in terms of equivalent volume in milliliters, based on two volume measurements. To measure the dimensions of the cochlear aqueduct, high-resolution computed tomography of the temporal bone in the axial plane was performed.ResultsThere was no statistically significant difference in the width of the cochlear aqueduct between patients with Méniére's disease and normal subjects. When SAC measurements were also taken into account, there was no difference in cochlear aqueduct dimensions between individuals with normal and low SAC values in the two groups.ConclusionThe dimensions of cochlear aqueduct are not significantly different in Méniére's disease patients and normal individuals. Also, the cochlear aqueduct does not appear to play a significant role in normal and low SAC values in the two groups of individuals.

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveTo determine whether long-term vestibular compensation (VC) and clinical outcomes differ after transmastoid labyrinthectomy (TML) versus retrolabyrinthine vestibular neurectomy (RVNS).Study DesignProspective, observational study.SettingTertiary care, university hospital.PatientsTwenty-one subjects were studied several years after they were relieved of spontaneous episodic vertigo caused by peripheral vestibular disease by TML or RVNS.InterventionsAll patients had undergone TML or RVNS more than 2.5 years before the study and returned for physiologic and functional studies of vestibular compensation.Main Outcome MeasuresCompleteness of physiologic VC, as assessed by electronystagmography and rotational chair testing; performance on computerized dynamic posturography; pure-tone and speech audiometry; self-assessment of balance and hearing function with validated survey instruments.ResultsThere were no differences in the incidence of physiologic VC or functional recovery between the TML and RVNS subjects. Although a majority of subjects in each group had evidence of incomplete vestibular compensation, there was no difference in self-assessment of balance or hearing handicap at long-term follow-up.ConclusionsLong-term clinical balance and hearing outcomes are equivalent when TML and RVNS successfully cure spontaneous, episodic vertigo. There is a high incidence of incomplete VC after both procedures, though this does not usually produce a significant balance handicap.

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThis study investigated whether magnetic resonance imaging (MRI) patterns were different between patients with Bell's palsy and those with herpetic facial palsy in whom varicella-zoster virus (VZV) or herpes simplex virus type 1 (HSV-1) reactivation had been confirmed by polymerase chain reaction (PCR) or serologic assay.Study DesignA retrospective study of 15 patients with acute peripheral facial palsy was performed to compare virologic tests and gadolinium (Gd)-enhanced MRI findings.ResultsRamsay Hunt syndrome was diagnosed in one patient. By use of virologic tests, zoster sine herpete (VZV reactivation without zoster) was diagnosed in four patients and HSV-1 reactivation in three. Bell's palsy was diagnosed in the remaining seven patients. No significant difference in the frequency of Gd-enhanced MRI was observed between herpetic facial palsy and Bell's palsy. However, in those patients who underwent MRI on the day viral reactivation was confirmed by PCR, Gd enhancement of the meatal fundus was observed infrequently. In addition, when MRI was performed within 10 days of the onset of palsy, Gd enhancement was not detected at the geniculate ganglion in any patients with herpetic facial palsy. By contrast, both the meatal fundus and the geniculate ganglion were enhanced in all patients with Bell's palsy, regardless of when MRI was performed with respect to the onset of palsy.ConclusionThis study shows a difference in the pattern of Gd enhancement at the meatal fundus and the geniculate ganglion between patients with Bell's palsy and those with herpetic facial palsy. The results suggest that the meatal fundus or the geniculate ganglion may be affected first by virus reactivation in patients with herpetic facial palsy.

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThis study aimed to determine whether postoperative facial nerve paralysis or surgical manipulation causing paralysis could be predicted on train responses during intraoperative facial nerve monitoring in acoustic neuroma surgery.Study Design and SettingThis was a prospective study performed at a tertiary referral center.Patients and MethodsTrain responses were recorded on a floppy disk and compared with postoperative facial nerve function in 51 patients who underwent enlarged translabyrinthine acoustic neuroma surgery.Main Outcome MeasuresThe number, duration, frequency, and peak-to-peak amplitude of train responses were analyzed and compared with postoperative facial nerve function.ResultsTrains were observed in 42 of 51 patients. Six of seven patients with high-amplitude trains more than 250 &mgr;V, and three of five patients with bomber-type high-frequency trains elicited during tumor dissection from the facial nerve or stretching the nerve, showed severe facial nerve dysfunction. On the other hand, seven of the nine patients with no trains also showed severe facial nerve dysfunction.ConclusionsThe presence of high-amplitude or high-frequency trains elicited by surgical manipulation to the facial nerve seems to indicate a critical situation for the facial nerve. However, certain types of mechanical trauma resulting in severe facial nerve paralysis cannot be identified by train responses.

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

ObjectiveThe aim of the current study was to assess the mechanical stiffness properties of the normal pars flaccida and to compare the results with those obtained in earlier studies on the pars tensa.BackgroundPostinflammatory changes such as retraction pockets and cholesteatoma develop in the pars flaccida as well as in the pars tensa of the tympanic membrane. In these authors' previous experimental studies, stiffness changes are shown to develop early in the pars tensa in response to purulent otitis media and otitis media with effusion. These changes are suggested to be precursors to a later development of retraction pockets and cholesteatoma. In the clinical situation, retraction pockets are often found in the pars flaccida only. This study will establish the stiffness properties of the normal pars flaccida and form a base for forthcoming studies of the pars flaccida in response to otitis media with effusion and purulent otitis media, as well as retraction pocket formation and cholesteatoma.MethodsA measure for the mechanical stiffness properties of the normal pars flaccida in the gerbil was assessed as its displacement for a given transtympanic pressure. The method used was moiré interferometry, which is a noncontacting optical technique to measure the shape of the surface of an object.ResultsThe displacement of the pars flaccida was a nonlinear and asymmetric function of pressure. The displacement per pressure unit rose steeply at low middle ear pressures to level out and reach a steady state at higher pressures. The displacement versus pressure characteristics for the pars flaccida strongly differed from those of the pars tensa. The pars tensa seemed more elastic.ConclusionReference values for displacement versus pressure characteristics of the normal gerbil pars flaccida were obtained using a moiré interferometry method. The mechanical stiffness properties of the normal pars flaccida were strongly different from those of the pars tensa.

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1531-7129    

出版商:OVID    

年代:2001

数据来源: OVID