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Biomedical subjects

B Nageris

Publications and source records attributed to B Nageris.

At least 19 recordsLinked to original sources

Dysfunction of the auditory efferent system in patients with traumatic brain injuries with tinnitus and hyperacusis.

OBJECTIVES: Tinnitus, hyperacusis and difficulty listening in background noise are common symptoms reported by patients with traumatic brain injury (TBI). The aim of this study was to explore the function of the auditory system in TBI patients with and without auditory complaints but having normal pure-tone audiograms. METHODS: The study consisted of 24 TBI patients with and 10 TBI patients without auditory complaints. In addition, 15 normal controls were included in the study. The function of the auditory system was tested by recording transient otoacoustic emissions (TEOAE) during the presentation of increasing levels of white noise in the contralateral ear. RESULTS: Most of the TBI patients with auditory complaints (87%) showed absent or significantly reduced effect of the auditory efferent system as compared with the TBI patients without auditory complaints and to normal controls. However, the global amplitude of the TEOAE was significantly higher in TBI patients with auditory complaints compared to those without. CONCLUSIONS: Due to its role in peripheral and central auditory activity, dysfunction of the efferent system may be at least partially responsible for these auditory complaints. This study underscores the importance of testing and evaluating the functional integrity of the medial efferent system by an objective and non-invasive method in patients with TBI.

Acoustic Stimulation↗

[The endoscopic approach to isolated sphenoid sinus disease].

UNLABELLED: We reviewed the records of 38 patients aged 16 to 76 years with isolated sphenoid sinus disease who were treated by intranasal endoscopic sphenoidotomy at our hospital during the period 1992-1997. Diagnosis was made on the basis of history rigid nasal endoscopy and computed tomography (CT) scan of the sinuses. Headache was the main symptom in 29 (76%) patients. Other complaints were rhinitis, cough, nasal obstruction and nasal bleeding. Sphenoidotomy was performed endoscopically, directly through the area of the natural ostium. Acute or chronic sinusitis was found in 57% of the patients, cysts in 13%, polyps in 10%, mucocele in 8%, and fungal infection, pituitary adenoma, inverted papilloma and adenocarcinoma, in 3% each. Surgical results were excellent. The endoscopic approach proved to be both safe and effective. CONCLUSION: Sphenoid sinus disease is mostly inflammatory in origin. The endoscopic approach to the sphenoid sinus is currently the most appropriate method of surgery for an isolated sphenoid lesion.

Adolescent↗

The effects of passive smoking on olfaction in children.

The effect of passive smoking on odor identification was studied in 10 children exposed to passive smoke at home. All had at least one parent who smoked at least one pack of cigarettes a day. The control group consisted of 10 children of nonsmoking parents. Ten odorants were tested: vinegar, ammonia, peppermint, roses, bleach, vanilla, cough drops, turpentine, licorice and mothballs. Each child was presented with five test trays containing all 10 odorants in random order. Of the total of 500 odors presented, the control group correctly identified 396 (79%) and the study group, 356 (71%) (p < 0.005). This work demonstrates that children exposed to passive smoke have difficulty identifying odors in comparison to children raised in relatively smoke-free environments. Since the study group tend to misidentify four of the 10 odorants tested--vanilla, roses, mothballs and cough drops--we suggest that these four odorants should suffice in testing odor identification in children.

Adolescent↗

Effects of passive smoking on odour identification in children.

BACKGROUND AND OBJECTIVE: The effect of passive smoking on odour identification in children has rarely been reported. This study assessed the ability of such young subjects to identify a variety of odours. METHODS: The study population consisted of 20 children, 10 who were exposed to passive smoke at home and 10 with nonsmoking parents. Ten odourants were tested: vinegar, ammonia, peppermint, roses, bleach, vanilla, cough drops, turpentine, licorice, and mothballs. Each child was presented with five test trays containing all 10 odourants in random order. RESULTS: Of the total of 500 odours presented, the control group correctly identified 396 (79%) and the study group identified 356 (71%) (p < .005). The study group tended to misidentify 4 of the 10 odourants tested, namely, vanilla, roses, mothballs, and cough drops-56 of 200 (28%), compared with 96 of 200 (48%) in the control group. This was a highly significant finding (p < .0005). CONCLUSION: This work demonstrated that children exposed to passive smoke have difficulty identifying odours in comparison with children raised in relatively smoke-free environments. The identification of four odourants, vanilla, roses, mothballs, and cough drops, was particularly diminished in this study group.

Adolescent↗

Connections of the facial and vestibular nerves: an anatomic study.

The facial and vestibulocochlear nerves emanate from the brain stem and then run parallel to each other within the internal auditory canal prior to their more peripheral distribution. Although anatomic connections between the facial and cochlear nerves have been described, reports outlining facial-vestibular anastomoses are few and may be found primarily in the non-English literature. The present study documents the existence of vestibulofacial neural connections as part of an anatomic dissection of 17 fresh human temporal bones.

Facial Nerve↗

Cochlear histopathologic analysis in diabetic rats.

HYPOTHESIS: This study aimed to show whether sensorineural hearing loss in diabetes mellitus is secondary to changes in the organ of Corti and stria vascularis. BACKGROUND: The high rate of sensorineural hearing loss in diabetes mellitus has led to much speculation as to whether there is an association between the two. METHODS: A well-established diabetic animal model was used to examine the inner ear histopathologically. RESULTS: No statistical difference in the inner and outer hair cells or in the stria vascularis was shown between the genetic-diabetic rats and control subjects. CONCLUSIONS: If there is hearing loss with diabetes, its pathogenesis does not involve damage to the hair cells or stria vascularis.

Animals↗

[The parapharyngeal space: tumors and surgical approaches].

The potential parapharyngeal space contains the great vessels of the neck, cranial nerves IX-XII, the sympathetic chain and lymph nodes. Surgical access is difficult and the infrequency of tumors in it make surgery of this part of the head and neck a challenge, 8 women and 2 men (mean age 54.7, range 31-70 years) with tumors of the parapharyngeal space operated on during the past 6 years are presented. The most common surgical approach was the cervical submandibular, used in 6 of our patients with relative ease and minimal complications. Tumors of deep lobe parotid origin should be operated through a transparotid approach. Large benign or malignant tumors have a better prognosis when the transcervical transmandibular approach is used, providing wider access.

Adult↗

A human temporal bone study of changes in the basilar membrane of the apical turn in endolymphatic hydrops.

We observed that some temporal bones with endolymphatic hydrops (EH) showed varying degrees of basalward displacement (towards the scala tympani) of the basilar membrane (BM) in the apical turn of the cochlea. In some, the BM was adherent to the bony wall of the scala tympani (i.e., the interscalar septum). Such mechanical distortion of the BM could conceivably alter cochlear mechanics and lead to sensorineural hearing loss. The results of a systematic evaluation of 234 temporal bones to characterize, quantify and determine the functional significance of this observation are presented. Four groups of bones were evaluated: normal (N = 78), presbycusis (N = 96), Ménière's disease (N = 23), and EH secondary to labyrinthitis (N = 37). The incidence of extreme displacement of the BM in the apical turn such that it adhered to the interscalar septum was 52% in Ménière's disease, 57% in EH secondary to labyrinthitis, 10% in presbycusis, and 1% in normals. These differences were significant and could not be explained on the basis of age, sex, postmortem time, or artifact of technique or processing. Displacement of the BM was not observed in other turns of the cochlea. Its pathogenesis is not known, but may be related to atrophy of the spiral ligament. It is likely that such BM displacement results in sensorineural hearing loss. However, our data and theoretical analyses both indicate that such a loss will be restricted to frequencies below 100 Hz and that this pathologic change alone is not likely to cause appreciable hearing loss at clinically tested frequencies of 250 HZ and higher. Hence, even though this pathologic finding is common in endolymphatic hydrops, it cannot explain the low-frequency hearing lost observed in Ménière's disease.

Adult↗

Temporal bone fractures.

The diagnosis and monitoring of patients presenting to an emergency department with blunt temporal bone fracture and complications requiring acute management were reviewed for a four-month period. Of 104 trauma patients with closed head injury, 15 patients were diagnosed with temporal bone fracture, 12 of whom survived their injuries. Four patients developed cerebrospinal fluid (CSF) otorrhea and two patients developed facial nerve paralysis; all patients had resolution of complications with conservative management. Significant shortcomings in the initial evaluation and monitoring of patients with temporal bone fracture were identified. Specific and thorough facial nerve examinations were not initially conducted on temporal bone fracture patients and subsequent inpatient monitoring for facial nerve paralysis and CSF otorrhea was incomplete. The outcome of temporal bone fracture is discussed. This article reminds the emergency physician of the importance of initial diagnosis and documentation of temporal bone fractures.

Cerebrospinal Fluid Otorrhea↗

Aerodigestive tract obstruction as a late complication of radiotherapy.

Oedema, fibrosis, and stenosis of the hypopharynx and the oesophageal inlet are described in a few publications as a complication of post-laryngectomy irradiation treatment. In this paper a case of laryngeal carcinoma, treated exclusively by irradiation, where severe laryngeal and hypopharyngeal stenosis with complete occlusion of the oesophageal inlet were manifested as a late complication is described. We have found no similar case described in the English literature.

Adult↗

Method for embedding temporal bones of rats in methyl-methacrylate.

The commonly used method of preparing the temporal bone for light microscopy is a refinement of a basic formula that has been employed for a century. This process includes fixation, decalcification, neutralization, dehydration, embedding in celloidin, and hardening. The main disadvantage of this process is that decalcification is performed. This article describes a new method for preparing the temporal bone of rats for light microscopy. The main advantage of this new method is that no decalcification is involved, so that all bony elements are retained in their normal shape and location, and even retain some enzymatic activity. Other advantages are that the fixation is reversible and the process is short (approximately 2 weeks) and therefore relatively inexpensive. Our vast and positive experience with this technique has led us to report this method not in a specific experiment, but rather as a specific laboratory technique.

Animals↗

Fibrosarcoma of the vocal fold: a late complication of radiotherapy.

The carcinogenic effect of ionizing radiation is a well known phenomenon. However, the induction of malignancies following irradiation for head and neck cancers is quite rare (Steeves and Vataini, 1982). Most reported cases are osteogenic sarcomas with soft tissue sarcomas encountered less often. We report a rare case of fibrosarcoma of the larynx, following radiation therapy for glottic carcinoma.

Carcinoma, Squamous Cell↗

Traumatic macroglossia.

A case of severe macroglossia resulting from trauma (tongue biting) during eclampsia and causing respiratory obstruction is described. Despite medical treatment with steroids and antibiotics for a week, followed by tracheostomy, no significant improvement was observed. After an energetic but cautious maneuver of reducing and restraining the tongue in the oral cavity, the swelling reduced dramatically in 24 to 48 hours. Earlier manual replacement of the tongue into the oral cavity is advised in order to arrest the cycle of venous and lymphatic obstruction and congestion that leads to further edema and increased tongue swelling. The mechanism of traumatic macroglossia is discussed.

Adult↗

Sudden onset deafness as a presenting manifestation of chronic lymphocytic leukemia.

An unusual patient with typical Rai Stage 2 (Binet Stage A) chronic lymphocytic leukaemia (CLL), who presented with sudden onset deafness as the initial manifestation of disease is reported. This sensorineural hearing loss improved dramatically after the administration of chemotherapy. This unique observation was also associated with reduction of the circulating B-CLL cells and with the achievement of a partial response, lasting for almost three years. Recently there was another episode of sudden deafness, associated with a rising leukocyte count, and disease activity followed once again by recovery after chemotherapy. Audiograms were recorded showing positive findings on presentation and recovery after therapy. This very rare manifestation of CLL was presumed to be due to infiltration of the cochlear duct or the 8th cranial nerve although all imaging techniques were negative, because of the rapid relief and recovery achieved after specific chemotherapy. The importance of early diagnosis and therapy is stressed in the light of the rapid clinical recovery observed here.

Adult↗

[Penetrating neck injuries].

The frequency of penetrating neck injuries has increased in recent years. In 16 patients with such injuries treated during the past 2 years, neck exploration was performed immediately. In 4 there was destruction of the throat or trachea, in 3 a tear in the esophagus, in 1 a tear in the hypopharynx and in 1 a tear in the submandibular region penetrating the floor of the mouth. In 8 there was no damage to the neck organs. Of the 16, 1 died on the operating table from hemorrhage from multiple tears of the hypopharynx, the esophagus and the thyroid gland. 2 different approaches are used in dealing with penetrating neck injuries: immediate exploration, or the use of imaging methods to diagnose the degree of damage, followed by close supervision. In the light of our experience we advocate immediate neck exploration.

Humans↗

Liposarcoma of the nasopharynx: a case report.

We present a case of liposarcoma of the nasopharynx in a 28-year-old woman. The tumor was incompletely resected through an intraoral approach and supplementary radiotherapy of 50 Gy in a restricted field was therefore administered. Eleven years of follow-up show the patient to be disease free.

Adult↗