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Biomedical subjects

Antonio De la Cruz

Publications and source records attributed to Antonio De la Cruz.

5 recordsLinked to original sources

Surgical treatment for vertigo: patient survey of vertigo, imbalance, and time course for recovery.

OBJECTIVES: To assess surgical treatment of vertigo by patient ratings of postoperative vertigo, imbalance, and timing of symptom improvement. METHODS: A total of 3637 surgeries for vertigo were performed since 1974. Questionnaires sent to a random sample of patients operated since 1994 were completed by 28 endolymphatic sac shunt (ES), 54 vestibular nerve section (VNS), and 14 labyrinthectomy patients. RESULTS: All groups rated current vertigo characteristics and AAO-HNS disability as improved (all P <or= 0.001), though "spinning dizziness" remained in some patients in each group. The ES and VNS groups rated all characteristics of imbalance as improved (all P <or= 0.001), but it remained present in the majority. Vertigo resolved within 2 months in 75%, but some indicated months or even 1 to 2 years before attacks stopped. CONCLUSIONS: Based on patient ratings, surgery improved vertigo in all surgical groups and improved imbalance for ES and VNS groups. Imbalance will likely remain after surgery for vertigo. Patients should be informed that symptoms may not immediately resolve.

Adolescent↗

Advances in congenital aural atresia surgery: effects on outcome.

OBJECTIVES: To compare modifications in the surgical technique of congenital aural atresia (use of argon laser, thinner split-thickness skin graft, Silastic sheets in the external auditory canal, and Merocel wicks) by examining hearing results and complications before and after initiation of these changes. STUDY DESIGN AND SETTING: Retrospective chart review of patients who underwent congenital aural atresiaplasty between 1985 and 2002 in a tertiary referral neurotologic private practice. Complication rates and hearing results were compared before (n = 36) and after (n = 80) modifications in the surgical technique. RESULTS: Closure of the air-bone gap to 30 dB or less at short-term follow-up occurred in 63.1% of surgeries performed after modifications in the surgical technique and 44.5% of surgeries performed before these changes. The long-term postoperative air-bone gap was 30 dB or less in 50.0% of the surgeries performed after and 47.1% of the cases performed before the changes in surgical technique. Soft tissue stenosis and bony growth of the external auditory canal were seen in 3.8% of surgeries performed after and 13.9% of surgeries performed before the surgical technique changes. Ossicular chain refixation occurred in 3.8% of surgeries performed after and 25.0% of surgeries performed before such changes. There were no dead ears and no facial palsies. CONCLUSION: The use of argon laser, thinner split-thickness skin graft, Silastic sheets in the external auditory canal, and Merocel wicks, as a group, has helped to improve hearing results and decrease the incidence of complications in congenital aural atresia surgery. SIGNIFICANCE: Refinements in surgical techniques can lead to measurable improvements in outcome in atresiaplasty.

Adolescent↗

Congenital aural atresia surgery: long-term results.

OBJECTIVES: The study goal was to evaluate the stability of hearing results from short- to long-term follow-up in patients who underwent surgery for congenital aural atresia. We also reviewed complications such as external auditory canal stenosis, lateralization and perforation of the tympanic membrane, sensorineural hearing loss, and facial palsy. METHODS: We conducted a retrospective chart review of 116 patients who underwent congenital aural atresiaplasty between 1985 and 2002 at the House Ear Clinic. There were 116 atretic ears. Complication rates and short- and long-term (up to 13.6 years) hearing results were evaluated for primary and revision cases. RESULTS: Closure of the air-bone gap (ABG) to 30 dB or less at short-term follow-up occurred in 58.5% of primary surgeries and 56% of revisions. The long-term postoperative ABG was 30 dB or less in 50.8% of the primary cases and 39.1% of the revisions. Paired comparison analysis found no significant change in ABG from short- to long-term follow-up for either primary or revision cases. Soft tissue stenosis was seen in 8% of primary surgeries and 3.4% of revisions. Ossicular chain refixation was seen in 11.5% and 6.9% of primary and revision surgeries, respectively. There were no dead ears. CONCLUSION: Atresiaplasty surgery in individuals with congenital aural atresia can yield reliable, lasting hearing results with a low incidence of complications.

Adolescent↗