摘要:

ABSTRACTThis report provides histologic data on the cochlear nuclei of a patient who used a cochlear implant in the right ear for about 10 years and in the left ear for about 1 year. The most pronounced abnormality in the cochlear nuclei is sites of gliosis. However, since areas of necrosis with similar size, shape, and content of cells were observed outside the nuclei, the gliosis was not specific to the nuclei. There were no other unusual changes in the cochlear nuclei, such as excessive chromatolysis, excessive accumulation of lipofuscin, swollen neurons, or accumulation of glial cells. Comparison showed no statistically significant differences in sizes of cell bodies, size of nuclei, and total density of neurons in cochlear nuclei between the right and left sides. However, thedensity of normal-looking neurons(with visible nucleoli and without visible pathologic features) was noticeably less on the longer-stimulated side. Some differences between the longer- and shorter-stimulated sides may be due to differences before implantation or other factors, as well as to effects of stimulation.

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACTThe effects of Thomsen's 1981 report of a controlled double-blind study on the surgical treatment of Meniere's disease were studied by reviewing the current literature and Thomsen's subsequent reports. The current surgical literature was found to contain reasonable support for the continued use of endolymphatic shunt procedures despite the criticism of such procedures by Thomsen. Surgical therapy for Meniere's disease continues to be divided into auditory sparing or conservative procedures and auditory ablative or destructive procedures. Conservation procedures are important because approximately 30% of patients with Meniere's disease progress to bilateral involvement. Endolymphatic sac procedures continue to be classified as conservative. Important findings in the current literature are reports of long-term follow-up of patients after sac surgery. These question the long-term control of hearing loss but support the use of the procedure due to its low morbidity and consistent control of vertigo. Other authors have described the different types of endolymphatic procedures and confirm their equal effectiveness. The results of middle fossa and retrolabyrinthine vestibular neurectomy were also reviewed, and its continued control of vertigo were affirmed. The increased number and severity of complications (compared with endolymphatic shunt procedures) were noted. Finally, a strategy for surgical treatment of Meniere's disease, beginning with the patient with uncontrollable vertigo, is presented.

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACTStudies have been undertaken to confirm the biologic safety of the Cochlear Corporation multi-electrode intracochlear implant. The materials used are biocompatible. The electrode array is flexible: it can be inserted with minimal or no trauma, providing the insertion is stopped when resistance is first felt. An atraumatic insertion is facilitated if a good view is obtained along the scala tympani of the basal turn of the cochlea by drilling through the crista fenestrae. The passage of the electrode around the cochlea can be facilitated if the electrode is rotated during insertion (clockwise for the left and anticlockwise for the right cochlea). The electrode can be explanted and another one reinserted with minimal or no trauma. A seal established around the electrode after an implantation period of 2 weeks can prevent infection extending from the middle to the inner ear. The electrical stimulus parameters produced by the Nucleus receiver-stimulator cause no loss of spiral ganglion cells or corrosion of the platinum band electrodes. Long-term stimulation has been carried out for up to 8 years in patients without affecting their clinical performance.

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACTElectromyographic (EMG) feedback procedures were utilized in treating two adult patients with idiopathic subjective tinnitus. The relationship between behavioral severity ratings of tinnitus and EMG activity at the frontalis muscle was investigated using a single-subject, double-reversal experimental design. Biofeedback procedures were effective in modifying EMG activity levels, but changes in EMG levels were not related systematically to behavioral ratings of tinnitus. It was concluded that the physiologic effects of EMG biofeedback procedures may not be the active ingredient in such treatment procedures.

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACTTranstympanic (TT) electrocochleography (ECochG) data recorded with click stimuli and tone bursts (1, 2, 4, and 8 kHz) were evaluated in 50 patients with Meniere's disease and compared with the data from control groups of 10 sensorineural hearing impaired patients and 5 subjects with normal hearing. The mean summating potential (SP) amplitude was larger in the Meniere's disease group for 1, 2, and 8 kHz. The low frequency (1 or 2 kHz) SP decreased in 59% of the Meniere's disease patients during a glycerol dehydration test, whereas subjective hearing improved in only 29%. The use of ECochG with the monitoring of SP thus improves the sensitivity of the glycerol test for the detection of endolymphatic hydrops. There appeared no clear relation between clinical observations and the ECochG data either before of after glycerol. However, the Meniere's disease patients with a large negative SP at low frequencies also had larger action potential (AP) and often had short-term symptoms. The present report confirms the usefulness of measuring the SP in the diagnosis of Meniere's disease.

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACTThis paper reports preliminary results from the 3M/HE1 cochlear implant program conducted on oriental adult patients who speak Mandarin-Chinese. The whole program was performed according to the trained experience and the specific manuals provided by the House Ear Institute. Various testing and training materials (Chinese version of the monosyllable-trochee-spondee [MTS] test) as well as modified candidate evaluation procedures and criteria were applied. Three patients were considered as appropriate candidates. The third patient did not respond to the electrostimulation and is waiting for revision surgery. The warble-tone and speech detection thresholds aided with the implant devices of the first two patients were comparable with those found in western cases. Obvious improvements over the performance of stress discrimination on the MTS test were also noted. The tasks of speechreading, voice monitoring, and use of emergency telephone code were much easier for the first patient. Both patients indicated ability to detect and recognize many environmental sounds. Audiology-oriented findings, testing experiences, and suggestions for the program are presented and discussed. It is hoped that this paper will be helpful for the field and for similar programs in other countries.

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACTA long-term follow-up was performed of 540 myringoplasties that were considered to be successful 3 months after operation. The ears were observed to 12 years, and it was found that 70.8% of the eardrums were intact, fully epithelialized, and without retraction. In 22.4% success was only partial, because there was a small reperforation, a slight retraction of the eardrum, or an epithelial defect. In 7.6% of the eardrums deterioration occurred over the years, for the above three reasons, to a degree that turned an initial successful outcome of the operation into a failure. Of the various factors that characterized and accompanied, the initial perforation before the operation, or the various operative technical aspects, none was found to influence the late outcome of myringoplasty. An exception was the anterior perforation, in which prognosis was less favorable than in any other perforation. During our continuous follow-up about a fourth of the reperforations perforated spontaneously and silently, some doing so several times over and over. This particular phenomenon could bear on the etiology of the group of tympanic membrane perforations that has no obvious inflammatory or traumatic history.

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACTSome patients with hearing impairment cannot use conventional hearing aids. One solution for these patients is the use of bone conduction hearing aids; however, this kind of equipment is associated with several problems related to the necessity for a good contact between the transducer and the temporal bone. Direct bone contact would be an ideal solution provided that safe and reaction-free skin penetration and a safe and permanent bone anchorage could be achieved. Brånemark et al have developed a procedure to furnish edentulous patients with fixed bridges using titanium implants. This report is focused on the clinical status of the soft tissue adjacent to the 67 skin-penetrating devices in 60 patients. The patients have been followed between 3 and 96 months on 313 occasions, which represents a total observation time of 1515 months of clinical performance. Only one implant was extracted due to adverse skin reaction, giving a failure rate of 0.07% per month. This is comparable with the failure rate of cardiac pacemakers 0.02–0.04% per month).

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID

摘要:

ABSTRACTFour examples are cited in which tuning fork tests helped in proper selection of patients for surgery, after audiometric air and bone tests were equivocal or gave the wrong diagnostic and prognostic indication.

ISSN:0192-9763    

出版商:OVID    

年代:1988

数据来源: OVID