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Biomedical subjects

B F McCabe

Publications and source records attributed to B F McCabe.

At least 37 records · Page 2Linked to original sources
PubMed1989

Phonosurgery: indications and pitfalls.

Twenty-five patients underwent type 1 thyroplasty (external medialization of abducted true vocal cord) during a 2-year period 1986 to 1988) at the University of Iowa. The most common indication for thyroplasty was post-thyroidectomy vocal cord paralysis. Eighteen patients (72%) had either a good or an excellent initial result. Five patients were revised. Postrevision, 21 patients (84%) had achieved either a good or an excellent result. Complications were limited to one case of significant vocal cord edema and another instance of vocal cord hemorrhage. No patient required a tracheotomy. No prosthesis extruded. We feel that phonosurgery has the advantages over traditional Teflon injection of allowing the patient's head to be in a neutral position during the operation; of allowing local anesthesia; of permitting a predictable, graduated end point of the procedure; and of being infinitely adjustable, with preservation of the vocal cord mucosal wave.

Female↗
PubMed1989

Audiologic results following reimplantation of cochlear implants.

Five patients using cochlear implants experienced internal device failure 6 weeks to 4 years following implantation. All devices were removed and new electrodes inserted. Single-channel implants were replaced with multichannel systems in three patients, while the others received identical multichannel implants. The performance on a uniform battery of audiologic tests was the same or better with the second implant in all patients. Replacement of intracochlear electrodes did not induce clinically apparent degeneration of auditory performance in this series.

Adolescent↗
PubMed1989

The osteo-mucoperiosteal flap in repair of cerebrospinal fluid rhinorrhea: a 20-year experience.

Chronic cerebrospinal fluid rhinorrhea (present for 2 months or longer) is a serious condition frequently encountered by the otolaryngologist-head and neck surgeon. The purpose of this report is that it can be successfully repaired transsinally, from below, with a high rate of success. Intracranial repair has been associated with reportedly high morbidity and failure rates. From 1967 to 1987, 16 patients underwent repair of chronic cerebrospinal fluid rhinorrhea in the cribriform plate or fovea ethmoidalis at the University of Iowa with an osteomucoperiosteal flap. Follow-up data from 1.6 to 22 years demonstrated no recurrent leaks in this group of patients. Minimal morbidity and no deaths were associated with the osteomucoperiosteal flap. On the basis of our experience, we recommend this technique, which can be performed by any experienced paranasal sinus surgeon, as superior to craniotomy for the repair of chronic cerebrospinal fluid rhinorrhea from cribriform plate and fovea ethmoidalis defects.

Adolescent↗
PubMed1989

Facial nerve function following irradiated cable grafts.

Facial nerve cable grafting preceding postoperative radiation therapy in patients undergoing facial nerve resection for malignant disease remains controversial. Twelve cases of postoperatively irradiated facial nerve cable grafts are reviewed in detail. Of nine patients with long-term evaluations, all have shown some return of facial nerve function, with seven having moderate to excellent return of function, as documented on videotapes and shown in still photographs. We conclude that cable grafting is the treatment of choice, even though postoperative radiation therapy is planned. Cable grafting should almost always result in facial function that is clearly superior to the function provided by static or dynamic slings.

Adult↗
PubMed1989

Synthetic two-formant vowel perception by some of the better cochlear-implant patients.

Synthetic two-formant vowel recognition was tested in some of the better cochlear-implant users to determine their ability to resolve sounds that differ essentially in their frequency content. The vowels /i, epsilon, alpha, u/ were synthesized with equal duration and similar sound pressure level. The formant values were chosen to approximate the values of these vowels in French, German and American English. Performance ranged from 29 to 71% for the 6 patients with the Chorimac implant, from 25 to 67% for the 9 patients with the 3M/Vienna implant, from 63 to 92% for the 10 patients with the Nucleus implant from Hannover, from 17 to 79% for the 10 patients with the Duren/Cologne implant, from 54 to 100% for the 9 patients with the Symbion implant, and from 79 to 100% for the 10 Nucleus patients from the USA. Patients with each of these devices can utilize some spectral information when recognizing steady-state vowels.

Cochlear Implants↗
PubMed1989

Autoimmune inner ear disease: therapy.

Sixty-six patients with this disease have been treated to date with cyclophosphamide and prednisolone resulting in significant improvement in hearing. In some patients the vestibular compartment may be involved as well, but the clinical pattern is significantly different enough from Meniere's disease to distinguish it by the careful historian. The cornerstone of treatment is cyclophosphamide, abetted by prednisolone. A test of treatment is to date the best method of determining who to treat for cure.

Autoimmune Diseases↗
PubMed1988

Lipoid proteinosis of the larynx: a cause of voice change in the infant and young child.

Lipoid proteinosis is an autosomal recessive disorder that may display multiple systemic manifestations involving mucosal deposition of hyalin material. Skin and upper aerodigestive tract mucosal involvement predominate. In approximately two thirds of cases, voice change secondary to laryngeal involvement occurring at birth or early in infancy is the first manifestation of the disease.

Child, Preschool↗
PubMed1988

Use of multichannel cochlear implants in obstructed and obliterated cochleas.

Obstruction that occurs within the scala tympani (after meningitis or otosclerosis) has been considered a contraindication for placement of a multichannel cochlear implant electrode. Two patients who exhibited radiographic evidence of intracochlear narrowing and obliteration were implanted with multichannel electrodes. Implantation involved creation of a channel for the electrode to wrap around the modiolus. The middle ear cavity and the external auditory canal also had to be removed to gain access. The response of one of the patients was similar to that of patients with normal cochlear anatomy who use multichannel devices. These early experiences, along with one case in which a single-channel electrode was placed, is presented.

Adult↗
PubMed1988

Evaluation of five different cochlear implant designs: audiologic assessment and predictors of performance.

The audiologic performance of 54 postlingually deafened adults wearing cochlear implants was uniformly evaluated. The participants had 9 months' or more experience with one of five different cochlear prostheses (Los Angeles Single Channel (N = 11), Vienna Single Channel (N = 4), Melbourne Multichannel (N = 18), Utah Multichannel (N = 19), San Francisco Multichannel (N = 2). The multichannel designs enabled participants to recognize more environmental sounds, provided more speech reading enhancement, and enabled most users to understand limited speech in the sound-only condition, compared to the single-channel implant group.

Adult↗
PubMed1987

American Burkitt's lymphoma of the mastoid.

Primary clinical presentation of malignant lymphoma in the middle ear is rare. One case of African Burkitt's lymphoma involving the mastoid has been reported, but the case herein presented would appear to be the first case of American Burkitt's lymphoma in the literature. American and African varieties have distinct clinical presentations but are histologically identical. Chemotherapy is effective against these aggressive tumors. A 6-year-old boy with the first known case of American Burkitt's lymphoma of the mastoid is presented. He is doing well 23 months from the onset of symptoms.

Burkitt Lymphoma↗
PubMed1987

Hearing results after cholesteatoma surgery: the Iowa experience.

This study compared the hearing outcome of canal-up and canal-down mastoidectomies for removal of cholesteatoma in 455 ears. An intact canal wall procedure was performed in 92 patients while the remainder (N = 363) underwent a canal-down operation. The hearing results for both procedures are dependent on the presence of the stapes superstructure. When the stapes superstructure was intact, 52% of the patients with canal-up operations had an air-bone gap of less than 20 dB. The corresponding figure for canal-down cases was 37%. When there was no stapes superstructure, 54% of the canal-up cases and 19% of the canal-down cases obtained a similar ABG closure. Preserving the posterior external auditory canal wall results in slightly better hearing function. However, when the stapes superstructure is intact, the difference in hearing function is not remarkable, and must be weighed against the potential for residual disease or recurrence associated with canal-up procedures.

Auditory Threshold↗
PubMed1987

Venturi jet ventilation for microlaryngoscopy: technique, complications, pitfalls.

Our experience with Venturi jet ventilation as the method of anesthesia in 872 cases of microlaryngeal surgery is presented. Our indications and exact technique are presented, as well as a review of our complications. Possible pitfalls and their avoidance are discussed. With attention to detail and good clinical judgement on the part of anesthesiologist and surgeon, Venturi jet ventilation can be safe and efficient with minimal complications.

Adult↗
PubMed1987

Perilymph fistula: an important cause of deafness and dizziness in children.

This study underscores the importance of considering a perilymph fistula, an abnormal communication between the inner and middle ear, in any child with a progressive sensorineural hearing loss. A concomitant complaint of intermittent dizziness or observed spells of imbalance (56%) is another indication of the disease. Six of 16 patients (37.5%) with proven fistulas were less than 2 years of age at the onset of symptoms. Unless the fistula is identified and repaired by grafting, the ear may become totally deaf. This would be disastrous in the presence of bilateral fistulas, which occur commonly in children (56% of patients had symptoms of bilateral disease). Our experience in recognizing and treating fistulas and thereby saving and restoring hearing is described.

Adolescent↗
PubMed1986

Perilymph fistula: the Iowa experience.

Ninety-one patients with demonstrable perilymph fistulas presented with an amazing array of signs and symptoms ranging from unilateral tinnitus and aural fullness to sudden-and-profound hearing loss, roaring tinnitus, and whirling vertigo. Between 1977 and 1984, 214 exploratory tympanotomies for suspected perilymph fistula (PLF) were performed on 177 patients. One hundred six primary (initial) fistulas were found in 95 ears and 26 recurrent fistulas were identified. Eighty-two percent of the 91 patients with PLF had auditory symptoms, 8% with auditory symptoms as the sole complaint. Eighty-one percent of the patients had vestibular symptoms, 12% with vestibular symptoms alone. The type of hearing loss and the nature of the vestibular symptoms were widely variable. Of the 58 patients with preoperative auditory symptoms, 49% had improved hearing (23% improved to serviceable range), after closure of PLFs. Ninety-five percent of the patients who presented with vestibular symptoms had elimination of or decrease in their dizziness to the extent that it no longer interfered with their daily activities. The highest incidence of recurrent fistula was associated with grafts using fatty tissue. Patients with Mondini deformity were at particularly high risk for fistula recurrence.

Adolescent↗
PubMed1985

Iowa cochlear implant clinical project: results with two single-channel cochlear implants and one multi-channel cochlear implant.

Cochlear implants have become a realistic alternative for the management of profoundly deaf patients. A variety of implants with differing electrode designs and coding strategies have been developed by nine major implant centers around the world. Each center has their "star" patient, but objective comparisons between these different implant designs are unavailable. In order to determine the performance characteristics of the present generation of cochlear implants, comparison data are vital. We have developed an independent center where uniform objective comparisons of different cochlear implants can be performed longitudinally. This report will present results of nine patients implanted with three different cochlear implant prostheses. Four patients have been implanted with the Los Angeles (House) single-channel implant, three patients have received the Vienna (Hochmair) single-channel intracochlear device, and two patients have been implanted with the Melbourne (Clark) 21-channel unit. All patients have had 11 months or more of experience with their cochlear prostheses. The results of a comprehensive audiologic battery which includes audiovisual and environmental tasks are presented. All implants provide significant improvement in speechreading and sound awareness. The findings to date suggest that there is strong correlation between top-down cognitive processing (as reflected by lip reading skills) and performance with cochlear implants.

Adult↗
PubMed1984

Initial Iowa results with the multichannel cochlear implant from Melbourne.

Two subjects who use the Melbourne multichannel cochlear implant were studied. Live-voice word, consonant, and vowel recognition tests, and a speech-tracking task were administered at regular intervals during the first 90 days after implantation. Results indicated 30-50% correct recognition of vowels (given 9 alternatives) and about 30-60% correct recognition of consonants (given 12 alternatives). Speech tracking showed from two to three times faster rates with the implant and vision compared to a vision-alone condition. After 3-4 months of implant experience, a number of recorded tests from the Minimal Auditory Capabilities battery and the Iowa Cochlear-Implant tests were then administered. These results indicated about 80% recognition of everyday sounds in a five-choice closed-set condition and about 50% recognition of everyday sounds in an open-set condition. The subjects were 50% correct at identifying the accented words in a sentence and about 50% correct at determining the number of syllables in a word. One subject was unable to recognize a sentence as a statement or a question. Background noise (+10 dB S/N) reduced their performance on a four-choice spondee test to chance. Both subjects were able to identify a sound as either a voice or a modulated noise at 95% correct, and both could recognize speaker sex at 95% correct. Neither could discriminate whether two (successive) sentences were spoken by the same speaker or by two different speakers. Remarkably, one subject identified 45% and the other 85% of the words in sentences that were preceded by a contextual picture using sound alone. One subject identified 13% of the words in sentences in sound alone even without contextual information.

Adult↗