A retrospective study of 240 stapedectomies for otosclerosis performed in a teaching department during the last 10 years was done. The results and complications in patients operated on by residents and faculty were compared. Strict criteria for evaluating the surgical outcome were used. "Satisfactory" results obtained by residents during their entire training (79 per cent) were significantly poorer (P greater than 0.05) than those achieved by the faculty (90 per cent). In the second period of residency, however, the residents' success rate (89 per cent) was equal to that of the faculty. There was no statistically significant difference in the complication rate between residents and faculty. Two essential conditions are responsible for good stapedectomy results by residents: experience with sufficient numbers of patients requiring middle-ear surgery (including otosclerosis and chronic middle-ear disease) and close supervision by the faculty in the operating room.

Adult↗

PubMedDate not supplied

CT and MR evaluation of the brain in patients with anorexia nervosa.

Thirteen adolescent girls with anorexia nervosa had MR imaging of the brain; 11 were also examined by CT. Fifteen children, ages 10-12 years, served as a control group. The CT and MR studies were evaluated qualitatively for cortical and central atrophic changes. CT detected sulcal and ventricular enlargement in 5/11 patients. On the MR images, enlarged sulci were seen in 10/13 and dilated ventricles in 5/13. In the anorectic patients, the range of the width of the third ventricle was 1-5 mm (mean, 3.2 mm) and the maximal distance between the anterior horns was 22.5-39.0 mm (mean, 30.0 mm). Anterior horns at their minimal width measured 11-30 mm (mean, 16.5 mm). The corresponding measurements in the control group were 1.5-3.5 mm (mean, 2.3 mm) for the third ventricle, 21-35 mm (mean, 28.5 mm) for the distance between the anterior horns, and 10-16 mm (mean, 12.8 mm) for their minimal width. Overall, the patient group had larger ventricles than the control group; however, the difference between the two groups was not significant. Measurement of the number of visible cortical sulci at one cut below the vertex yielded 2-11 sulci in the anorectic girls (mean, 6.6) versus 0-6 sulci (mean, 3.3) in the controls. These results are statistically significant (p = .0009), indicating peripheral volume loss in the anorectic patients. The MR examination did not reveal any additional structural or parenchymal changes when compared with the results of the CT studies. However, the pituitary glands of these patients did not have the expected normal pubertal hypertrophy on the MR examinations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗