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Biomedical subjects

A Palva

Publications and source records attributed to A Palva.

At least 73 records · Page 4Linked to original sources
PubMed1979

Can an operation of deaf ear be dangerous for hearing?

After a single or modified radical mastoidectomy the hearing of the contralateral ear was followed by pure tone audiometry in 55 patients. In 12 patients a sensorineural--mostly high tone--hearing loss of at least 20 dB was found in the contralateral ear. In six cases this was persistent. The number of patients with hearing loss increased with increasing operation time. The cause of this hearing loss must be the noise of the bone-cutting burr.

Adolescent↗
PubMed1977

Cholesteatoma in children.

The 65 cholesteatomas operated on in children showed a more expansive and rapid growth than those in adults. In one fifth of the cases cholesteatoma filled the whole air-cell area, which was wide in half of the children. Fifty-two ears of these children had an attic or a posterosuperior perforation. One case was complicated by a fistula in the horizontal semicircular canal, and the ossicular chain was unbroken in 23 cases (35%). Thus, the findings support the idea of the primary soft-tissue spread of cholesteatoma in children. Five ears (8%) discharged postoperatively, and three ears (5%) were reoperated on and showed residual tympanal cholesteatoma. Cavity obliteration with canal wall down technique proved safe, even in the cases of the most extensive and active cholesteatoma.

Adolescent↗
PubMed1977

Arachnoid cyst of the intraorbital portion of the optic nerve with unilateral disc oedema and transient shallowing of the anterior chamber. A case report.

An unusual occurrence of chronic monocular disc oedema, visual loss and shallowing of the anterior chamber in a patient with an arachnoid cyst involving a portion of the intraorbital optic nerve was reported. Decompression of the optic nerve sheath through a Krönlein approach was followed by prompt deepening of the anterior chamber and a gradual, delayed relief of the disc oedema. It is concluded that orbitotomy and decompression of the optic nerve sheath should be done before atrophic changes of the optic nerve and visual loss begin to develop.

Adult↗
PubMed1976

Secretory otitis media in chronic lymphatic leukaemia. A temporal bone report of a case treated for seven months with tympanostomy tubes.

Serially sectioned temporal bones were studied from a patient with chronic lymphatic leukaemia with submucosal infiltration of the nasopharynx, the resulting secretory otitis having been treated with tympanostomy tubes for 7 months. The initially serous sterile secretion turned mucoid, and a low grade infection supervened. For the last 3 months the tympanostomy tubes were open and the ears dry. In the sections, the mastoid air cells showed leukaemic infiltrations and contained AB- and PAS-positive secretion. The drum openings were without reaction and there was no epithelial ingrowth around the margins. The posterior tympanum in both ears contained organizing fibrous tissue extending from the inner surface of the drum to the promontory. In the tympanum the mucosa was flat or columnar and without glands. Distinct AB and PAS-positive mucus film and secretory cells appeared on the promontory epithelium and the inner surface of the drum. In the tubo-tympanic recess some AB- and PAS-positive subepithelial glands appeared and in the tympanic orifice of the tube the secretory cells were prominent and the lumen full of AB-positive mucus. The case reported represents an intermediate stage in the healing of secretory otitis media, most of the glands having disappeared but the intraepithelial secretory elements being still active.

Aged↗
PubMed1976

Immediate and short-term complications of chronic ear surgery.

Complications of chronic ear surgery in a series of 2,192 operations are reported. Inadvertent opening of the inner ear occurred in 18 cases, leading to deafness in six ears. Four ears became deaf without apparent cause, for a total of ten (0.5%). High-tone sensorineural losses resulted in 3% of the ears. Facial nerve paralysis occurred in ten ears; in one of these, a graft was employed during primary surgery. All patients had a good recovery. It is stressed that to keep the number of complications at a minimum, strict rules must be followed and sufficient supervision offered in chronic ear surgery in teaching institutions.

Deafness↗
PubMed1976

Histochemistry of normal middle ear mucosa.

Mucosal biopsy specimens were taken from the middle ear in 19 patients with otosclerosis and stained by Alcan blue and PAS. They were also stained for hydrolytic and oxidative enzymes. In additon, 11 temporal bones from patients without any previous ear disease were serially sectioned for mucopolysaccharides. In otosclerosis, both acid and neutral mucopolysaccharides were present in the mucosa, but not to the same extent as in the temporal bone specimens. Acid phosphatase, lactate malate dehydrogenases, and nonspecific esterase were demonstrated even in very thin epithelium, providing a potential basis for the appearance of these enzymes in large amounts in various inflammatory middle ear diseases.

Acid Phosphatase↗
PubMed1976

Benign cartilagenous tumour of the temporomandibular joint.

An unusual case of a benign cartilagenous tumour of the temporomandibular joint is presented. The difficulties encountered in histological diagnosis, the benign behaviour of the tumour and the need for restraint in treatment are emphasized.

Adult↗
PubMed1976

Mycotic flora in tonsils and adenoids. A microbiological and histological evaluation.

The tonsils of 147 patients with chronic tonsillitis and the adenoids of 134 children with recurrent respiratory infections were cultured for fungal organisms and studied microscopically. A control group consisted of 68 healthy persons. Positive cultures were obtained in 64% of patients with chronic tonsillitis, in 21% of children treated with adenoidectomy, and in 69% of the control group. Candida albicans, Saccharomyces sp. and Aspergillus were the most common organisms. The histological investigations revealed no evidence of pathogenecity in these organisms. They were found in the tonsillar crypts, and no granulomatous inflammation was seen surrounding them.

Adenoids↗
PubMed1975

Staged surgery in ears with excessive disease of tympanum.

Results regarding tympanic healing and hearing improvement are reported in a series of 84 one-stage operations on the middle ear, using thin silicone elastomer sheeting, and of 76 two-stage operations using temporary filling of the middle ear with paraffin wax, and of ten with silicone elastomer sponge. All epithelium was removed from the tympanic cleft at the primary operation. Staging of the operation gave better hearing results and resulted in fewer adhesive middle ears. Middle ear mucosal biopsies from ears with mucus production around the paraffin showed an increased number of glands and secreting epithelial cells, much as in glue ears. Residual or recurrent cholesteatoma appeared in only 2.4%, which is attributed to resection of the posterior canal wall in cases of cholesteatoma, as contrasted with the intact canal wall technique.

Air↗
PubMed1975

Mastoid Obliteration. Histopathologucal Study of Three Temporal Bones.

Three temporal bones were serially sectioned to study the postoperative fate of the meatally based postauricular musculoperiosteal flap. In all three ears, the flap sealed off the middle ear effectively from the mastoid cavity and in one, with resected canal wall, formed a new soft posterior wall with good meatus. All flaps contained viable muscle, fat, collagen, reticulin, and elastin, and were richly vascularized. In two flaps, small granulating foci of infection were noted. In two temporal bones, from a child with hypogammaglobulinemia, small cholesterol cysts formed behind the falp during the delayed healing of the mastoid wounds.

Adolescent↗
PubMed1975

Middle ear mucosa and chronic ear disease. III. Enzyme studies of thick noncholesteatomous epithelium.

Thick mucosa removed from the promontory in cases with chronic otitis media showed prominent PAS-positive glands and epithelial secretory cells. Alcian blue positivity was less pronounced, contrary to the mucosa from glue ears. Enzyme activity in the epithelium and propria was comparable to that in glue ears, with some increase in alkaline phosphatase and some decrease in proprial lactate dehydrogenase and malate dehydrogenase activity. Removal of thick, permanently altered mucoas is recommended even in the absence of squamous epithelium. Steps should be taken to allow regrowth of thin, normal middle ear epithelium on the promontory.

Acid Phosphatase↗
PubMed1975

Tracheostomy in children.

Tracheostomies were performed on 47 children, using the flap technique. Thirteen patients (28%) died of their basic disease and two (4%) died of complications resulting from the tracheostomy. Decannulation was difficult in four patients, and there was one case each of bleeding, infection, and tracheocutaneous fistula. Thus, the primary complication rate was 19%, including the two deaths. Clinical reexamination with tracheography was made on 20 patients after a follow-up period varying from four to ten years (average, eight years). One small stenotic ring in the area of the distal end of the cannula site and two slight depressions in the tracheal forewall were found. According to these results, the flap technique, if properly performed, is safe also in children.

Child↗
PubMed1975

Re-mediastinoscopy.

In a series of 1,188 mediastinoscopies, six re-mediastinoscopies (0.5%) were made. The indications for repeated mediastinal exploration can be made more lenient since the adhesions between the innominate artery and the trachea need not always be extensive; if they are, an alternative paratracheal route can be used. Caution should be used, keeping possible vascular complications in mind, but we believe that an earlier mediastinoscopy does not contraindicate a repeated procedure.

Adult↗