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Biomedical subjects

A Belal

Publications and source records attributed to A Belal.

At least 19 recordsLinked to original sources
PubMed1991

Magnetic resonance imaging (MRI) of abnormal uterine masses.

Sixteen women with clinically diagnosed uterine masses were studied by magnetic resonance imaging (MRI). Pelvic study was carried out in the coronal, sagittal and axial planes. Uterine leiomyomas were detected in 12 cases, while the remaining cases were one each of uterine sarcoma, invasive molar pregnancy, cervical malignancy with pyometra and haematometra with congenital cervical stenosis. The uterine origin of the masses could be clearly detected in all patients, as well as the nature of the masses, the presence of degenerative or malignant changes and the nature of the intrauterine fluid. MRI characteristic findings of the studied masses are presented and discussed.

Adolescent↗
PubMed1987

Pathology as it relates to ear surgery. VI. Cochlear implantation.

The surgical anatomy and pathology of the cochlea have been reviewed in relation to cochlear implant surgery. Animal experimentation, as well as human temporal bone studies, have shown that the implant electrodes were well tolerated by the cochlea. The possible chemical and mechanical trauma induced by the electrodes can be avoided by better choice of shape, size, length and material of the implants. Long-term electrical stimulation did not seem to cause any deleterious effects on the neuronal population of the cochlea. In the present state of the art, cochlear implantation seems justified in well chosen cases.

Child↗
PubMed1987

Pathology as it relates to ear surgery. VII. Tympanoplasty.

The surgical anatomy and pathology of the middle ear have been reviewed in relation to tympanoplasty. The results of tympanoplasty in providing a disease-free and functional middle ear varies widely with the pathology involving the eardrum, ossicles, mucoperiosteum, mastoid air cells and eustachian tube. Post-tympanoplasty changes in the eardrum graft, ossicular grafts, and middle ear have been described in six cases which underwent surgery one to eleven years before death. Proper understanding of the pathophysiology of the different diseases of the middle ear is mandatory in planning tympanoplastic procedures. The causes of graft failure and of post-operative conductive hearing loss are discussed and the ways to avoid technical complications are emphasized.

Aged↗
PubMed1987

The ageing ear. A clinico-pathological classification.

While it is clear that the majority of the world's population suffers some deterioration of hearing--especially at high frequencies--with the advance of age, it is equally clear that some individuals reach very old age with clinically normal hearing. It is often difficult to separate the biological changes of senility from the effects of auditory environmental changes, and of specific pathological changes associated with specific disease entities. A better understanding of the etiology of presbyacusis is needed. The first step towards this end is the recognition that not all hearing impairment in the aged is due to biological ageing. This is important because hearing loss due to the acceleration of biological and environmental effects (accelerated presbyacusis) may be preventable, while hearing loss due to biological ageing (presbyacusis) is not treatable. The second step is the realization that not all hearing impairment over age 65 is due to ageing. Hearing impairments that are rapidly progressive, profound, asymmetrical, or fluctuating, and those associated with a marked conductive element or severe dizziness might well be associated with specific ear disease (Nosoacusis) such as infection, otosclerosis, Menière's disease, or acoustic tumor. A full neuro-otological evaluation including ABR, CT scan, ENG and others should be done in any patient over 65 suspected of having a specific ear disease. The classification presented demonstrates the need to revise the criteria used in determining 'Presbyacusis Curves'. These provide a reference standard for normal hearing at any age or decade. There are too many variables in the averages obtained from different subjects to make those averages a dependable standard reference.

Aged↗
PubMed1986

Dysequilibrium of ageing (presbyastasis).

We reviewed clinical findings in 740 patients over age 65 who consulted the Otological Medical Group, Inc., during a one-year period for dizziness. A thorough neurotologic evaluation is indicated in every such case to determine the specific cause of dizziness. In 21 per cent of these patients, a specific cause of dizziness was found. In the remaining 79 per cent, the diagnosis of primary dysequilibrium of ageing (presbyastasis) was made. We classified dysequilibrium of ageing (presbyastasis) according to the character, time course, and precipitating factors of dizziness. Two clinical types were described: constant and episodic; episodic dizziness was subdivided into orthostatic, positional, and unclassified. The histological findings in the temporal bones of four cases with dysequilibrium of ageing were reviewed. Pathological changes other than those in the peripheral vestibular system seem to be responsible for dysequilibrium of ageing. In the present series, about three-fourths of the patients had a daily dose of nicotinic acid to produce flushing of the skin. In 16 per cent, the dizziness was minor, requiring no special treatment. In the remaining 9 per cent with incapacitating vertigo, a vasodilator regimen, antivertiginous drugs, and Cawthorne's vestibular exercises were prescribed.

Aged↗
PubMed1986

Cerebral atrophy: a schistosomiasis manifestation?

Preliminary studies with sonography indicated that a reduced brain mantle index and dilated ventricles were frequently seen in patients with chronic Schistosoma mansoni infection. Computerized tomography (CT) was used to confirm our earlier observations and to obtain more accurate measures. Brain scans of 25 patients with chronic S. mansoni infection showed mild to moderate degrees of cortical atrophy in 9 cases (36%) and central atrophy in 3 (12%). The remaining 16 subjects and 10 controls showed normal brain scans. The present study is the first report documented by CT showing a significant correlation between chronic S. mansoni infection and cerebral atrophy.

Adolescent↗
PubMed1986

Retrolabyrinthine surgery: anatomy and pathology.

Retrolabyrinthine surgery is done to expose the cerebellopontine angle directly through the ear. It is indicated when the hearing in the ear to be operated upon is useful. The surgical technique entails four steps: complete mastoidectomy, extended posterior exposure of the sigmoid sinus, exposure of the posterior fossa dura, and exposure of the cerebellopontine angle. Retrolabyrinthine exposure of the cerebellopontine angle is indicated in tic douloureux, atypical facial pain, and hemifacial spasm. Recently, this approach has been used for sectioning the vestibular nerve, exploration of the posterior fossa to obtain a diagnosis, subtotal resection of large cerebellopontine angle tumors, and for the treatment of other cranial nerve problems. The histopathologic findings in the temporal bones of two patients who underwent retrolabyrinthine removal of cerebellopontine angle masses were reviewed. In one, subtotal resection of an acoustic tumor was attempted to preserve hearing in the presence of a bilateral tumor, with no adverse effect on the middle or inner ear. In the second, retrolabyrinthine exploration of the cerebellopontine angle was done for primary cholesteatoma, and operative injury to the nonampullated end of the posterior semicircular canal was noted. Retrolabyrinthine subtotal resection of large acoustic tumors is advocated in bilateral cases and in elderly persons to delay the inevitable loss of hearing by decompression and partial removal of the tumor mass. In primary cholesteatoma of the cerebellopontine exploration may be indicated to obtain a definitive diagnosis before surgical extirpation of the disease is planned.

Adult↗
PubMed1986

Contraindications to cochlear implantation.

Cochlear implantation is still a controversial surgical procedure because its results in providing hearing for the deaf patient are far from ideal. The possible benefits of implantation should be carefully weighed against the complications that might arise. Many individuals with profound deafness are candidates for this procedure; however, there are some patients who are not. Contraindications to cochlear implantation, absolute and relative, systemic and local, are discussed. The surgeon's decision to withhold surgery is based on these contraindications.

Age Factors↗
PubMed1986

Cochlear implantation in developing countries.

A cochlear implant program was started in Jeddah, Saudi Arabia, in September 1983. Three totally deaf adult patients have received implants so far, with encouraging results. The problems of cochlear implantation in developing countries are discussed with regard to the patient, team, and device. The rationale, stages, and future of the program are outlined.

Adult↗
PubMed1985

Metastatic tumours of the temporal bone. A histopathological report.

Metastatic tumours of the temporal bone seem to be more common than is recognized. Most of these tumours are microscopic and asymptomatic in nature. Microscopic examination of 22 temporal bones belonging to 13 cases of metastatic tumours is reported. The commonest site of involvement in the temporal bone was the petrous apex followed by the tegmen tympani, mastoid bone and internal auditory canal. Primary tumours were most commonly located in the breast. Other sites of primary tumours included the thyroid gland, brain, lungs, prostate and blood (leukaemia). Two cases had undetermined sites of origin. Full neurotologic evaluation is indicated in every case suspected of having a temporal bone metastasis. All three modalities (of surgery, radiotherapy and chemotherapy) are used in combination for the treatment of these tumours.

Adenocarcinoma↗
PubMed1984

Pathology as it relates to ear surgery. IV. Surgery of Menière's disease.

Conservative shunting procedures, i.e. ESS, ultrasonic irradiation and cryosurgery, are based on the assumption that there is increased volume and/or pressure of endolymph in Menière's disease. Since there is no reliable clinical test to detect endolymphatic hydrops, shunting procedures on cases without hydrops are doomed to failure. Surgery on the endolymphatic sac was not associated with fibrosis or obliteration of its lumen. Silastic shunt tubes were well tolerated by the body, and the shunt between the sac and the subarachnoid space seemed to remain open. The results of experimental surgery on the endolymphatic sac and its applicability to humans should be revised. Temporary improvement of Menière's symptom-complex may be expected from any surgical procedure on the membranous labyrinth, even in cases without endolymphatic hydrops. Post-operative serous labyrinthitis with associated biochemical changes is the cause of this improvement. The success of shunting procedures cannot be judged histologically by the position of Reissner's membrane. This membrane acts like varicose veins: once dilated, always dilated. Ultrasonic irradiation and cryosurgery of the labyrinth result in limited degenerative changes close to the site of probe application. Degenerated intact membranous walls may act as an internal otic-perotic shunt and may result in symptomatic improvement in Menière's disease. The idea of selective vestibular neurectomy and internal shunting procedures, i.e. without drainage of endolymph to the outside (mastoid) or to the inside (CSF), should be developed further. Recurrence of symptoms following shunting procedures may be due to failure of the shunt, or to the presence of endolymphatic hydrops in the non-operated ear. MF vestibular neurectomy results in complete denervation of the vestibular end-organs, without effect on the cochlea or facial nerve. Excision of Scarpa's ganglion causes retrograde degeneration in the proximal stump of the vestibular nerve, most probably to the level of the brain-stem. Recurrence of dizziness following TC labyrinthectomy is most commonly due to inadequate removal of the vestibular end-organs. The high regenerative capacity of the vestibular nerve is evidenced by the formation of traumatic neuromas in the vestibule following TC labyrinthectomy. Whether these neuromas produce symptoms is unknown. Persistent cochlear hydrops occurs following TC labyrinthectomy and TL vestibular neurectomy owing to obstruction in the hook region of the cochlea and in the ductus reuniens. This may result in persistent tinnitus and feeling of pressure in the ear.

Aged↗
PubMed1984

Pathology as it relates to ear surgery. V. Ossiculoplasty.

In the present state of the art, autografts and homografts behave equally well in ossiculoplasty. Allografts are to be reserved for cases in which these two are in short supply. Bone grafts, autogenous and homologous, did not show gross changes in physical characters or surface structure. No obvious remodelling occurred in the grafts eight years after their insertion in the middle-ear. Microscopically, progressive deposition of new bone occurred, resulting in narrowing of the bone lacunae and bone marrow spaces. Cartilage autografts underwent progressive ischemic calcification in the middle-ear. No evidence of erosion, dissolution or remodelling was apparent eight years after their insertion in the middle-ear. Plastipore prostheses resulted in a consistent local fibrous tissue and foreign body reaction. Micro-disintegration of the prostheses is questionable. No gross changes in the physical characters or surface structure of these prostheses was evident 34 months after their insertion in the middle-ear. Inadequate hearing results following ossiculoplasty in this series were most commonly due to loss of contact between the graft and the remaining ossicles. Eustachian tube dysfunction was another possibility. Dissolution of the grafts was not the cause in any of our cases.

Aged↗
PubMed1984

Acoustic tumors in developing countries.

Acoustic tumors are one of the common problems that both the otologist and the neurosurgeon face in Egypt. Early diagnosis and choice of surgical approach--whether middle fossa, translabyrinthine, or suboccipital--are discussed after review of forty-one cases of cerebellopontine angle masses we have seen over the last fifteen years. Particular attention is given to the difficulties in the diagnosis and management of acoustic tumors in developing countries. The reliability of the simple, inexpensive radiologic and audiometric tests is compared with that of the sophisticated CT scanning, polytomography, and brain stem evoked response audiometry. The high operative morbidity and mortality rates in this series are analyzed and the value of microsurgery in total extracapsular tumor resection is stressed.

Adult↗
PubMed1983

Pathology as it relates to ear surgery II. Labyrinthectomy.

Five human temporal bones and three surgical VIIIth nerve biopsies from patients who had previously undergone labyrinthectomy, five months to ten years before examination, were studied by light and electron microscopy. Post-labyrinthectomy dizziness could be explained on the bases of inadequate surgical removal of the vestibular sense-organs, neuroma formation in the vestibule, and high regenerative potential of the vestibular nerve. Post-labyrinthectomy pressure sensation and tinnitus are most probably due to cochlear endolymphatic hydrops and need cochlear neurectomy. The severe atrophy in the sensorineural structures of the cochlea was not associated with retrograde degeneration of the cochlear nerve central axons. This may be of significance in the artificial electrical stimulation of the cochlear nerve in deaf patients.

Adult↗