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Biomedical subjects

D C Fitzgerald

Publications and source records attributed to D C Fitzgerald.

At least 19 recordsLinked to original sources
PubMed2001

Perilymphatic fistula and Meniere's disease. Clinical series and literature review.

There continues to be considerable confusion concerning the diagnosis and treatment of perilymphatic fistulas (PLFs) and Meniere's disease. This paper reports an 8-year experience with patients whose symptoms were compatible with Meniere's disease but who had some other element that raised the possibility of their having a PLF. This review is a retrospective report on 64 patients who had fluctuating hearing loss, vertigo, tinnitus, and aural fullness typical of Meniere's disease. However, they also had a positive fistula test and/or symptoms beginning immediately after head trauma. They all underwent at least a unilateral PLF repair, and some also underwent an endolymphatic sac-mastoid shunt operation. This report provides a literature review to help put this series' results into perspective. Of those 40 patients who underwent an initial PLF repair, 58% had a successful outcome. Of the 10 patients who underwent an initial PLF repair plus an endolymphatic sac-mastoid shunt, 70% had a successful outcome. Since it is often difficult to distinguish patients with PLFs and secondary endolymphatic hydrops (Meniere's syndrome) from patients with Meniere's disease (idiopathic endolymphatic hydrops), PLF repair is a reasonable first operation, reserving an endolymphatic sac-mastoid shunt operation as a secondary procedure if needed. The decision to consider a PLF repair is guided by a positive fistula test or an immediate onset of Meniere's disease symptom complex after head or ear trauma.

Adolescent↗
PubMed2001

Nasopharyngeal abscess and facial paralysis as complications of petrous apicitis: a case report.

An 83-year-old man with a lifelong history of intermittent otorrhea and hearing loss was referred for management of a facial paralysis of 3 weeks' duration. Computed tomography (CT) of the head detected a neoplasm of the nasopharynx along with chronic otomastoiditis. A followup CT suggested the development of a nasopharyngeal abscess, which was confirmed by needle aspiration. A later coronal-projection CT showed definite bone destruction in the anterior petrous apex, confirming suspicions that a petrous apicitis was responsible for the facial paralysis and abscess. This article describes the management of this patient and reviews the historical, medical, and surgical aspects of petrous apicitis.

Abscess↗
PubMed1999

Medium-sized business employees speak out about smoking.

UNLABELLED: A health promotion study, funded by a state health department to meet objectives 3.4 and 3.11 of Healthy People 2000, was designed to: (1) identify tobacco use; (2) assess employees' beliefs on one's health and family member's health; and (3) assess the type of smoking policies favored. Using the Health Belief Model, it was hypothesized that there were differences in the health beliefs of tobacco users, former users, and never users. A 34-item questionnaire was administered to 1090 employees with a return rate of 603 (55%). RESULTS: tobacco users perceived weight control and reduction of tension as benefits; they accepted warning label as hazardous but reported smokeless not as harmful; they perceived heart disease and cancer as related to tobacco use; and 62% had tried to quit smoking. Former and never users wanted "total ban policies" while, tobacco users wanted "designated areas" for smoking. All perceived their smoking and environmental tobacco smoke hazardous to their health and the health of family.

Adult↗
PubMed1999

Intralabyrinthine schwannomas.

OBJECTIVE: To describe characteristic features of intralabyrinthine schwannomas (ISs) that may be used to distinguish them from other otologic disorders with similar symptoms so that appropriate evaluation and management can be instituted. STUDY DESIGN: This study was a retrospective case review. SETTING: This study was conducted at a university-affiliated urban tertiary care medical center and a university medical center in the same city. PATIENTS: Seven patients with ISs were included in this study. INTERVENTIONS: Tumor removal versus observation and monitoring with periodic magnetic resonance imaging (MRI) scans was investigated. MAIN OUTCOME MEASURES: Hearing, vertigo, and tumor growth were measured. RESULTS: Four of seven patients with ISs underwent surgical excision with no evidence of tumor recurrence. The remaining three patients are being followed-up with repeat MRI that has demonstrated minimal or no tumor growth. CONCLUSIONS: ISs can be detected in early stages if MRI is performed in patients with unilateral sensorineural hearing loss without vertiginous symptoms typical of Meniere's disease. Although complete surgical excision can be achieved readily with labyrinthectomy, observation and monitoring with rep--MRI is an option for some patients.

Adult↗
PubMed1998

Sudden hearing loss: frequency of abnormal findings on contrast-enhanced MR studies.

BACKGROUND AND PURPOSE: Our purpose was to determine the frequency of abnormal findings on contrast-enhanced high-resolution MR imaging studies in patients with sudden hearing loss. METHODS: Seventy-eight consecutive patients with sudden hearing loss underwent contrast-enhanced MR imaging of the temporal bone, cerebellopontine angle, and brain. Additional tests included audiologic examination, electrocochleography, fistula tests, and serologic tests for viral agents and autoimmune disorders. RESULTS: Probable causes of the sudden hearing loss in these patients included viral or immune-mediated disease, Meniere disease, vascular disorder, syphilis, neoplasm, multiple sclerosis, and perilymphatic fistula. Twenty-four (31%) of the 78 patients were found to have abnormal imaging results early in the course of their work up and treatment. CONCLUSION: The prevalence of abnormal findings on contrast-enhanced MR studies is higher than previously reported in patients with sudden hearing loss.

Adult↗
PubMed1997

Ménière disease.

Explore the source record for details and available documents.

Endolymphatic Hydrops↗
PubMed1997

Perilymphatic fistula: a Washington, DC, experience.

One hundred ninety-seven patients who underwent surgical repair for a presumed unilateral perilymphatic fistula were reviewed. Of those patients, 87% with vestibular symptoms reported complete or near-complete relief of their symptoms. Forty percent of the patients with sudden hearing loss had an improvement in their hearing levels. An analysis of several diagnostic tests revealed their sensitivity and specificity ratings. A review of the patients' operative records showed a marked disparity between the visual identification of an actual fluid leak during surgery and their postoperative outcome. This review supports the premise that at the present time, the patient's surgical outcome is the best way of documenting a successfully repaired perilymphatic fistula.

Adolescent↗
PubMed1996

Head trauma: hearing loss and dizziness.

OBJECTIVE: Because the physicians who care for patients with head trauma may be family practitioners or internists, this article provides these physicians some knowledge of the causes and pathophysiology of such trauma with respect to neurologic sequelae to aid in their decisions to seek consultation with neurologists and otoneurologists in diagnosis and management. METHODS: This article reviews the literature concerning differential diagnosis, appropriate evaluation, and possible treatments of patients who exhibit hearing loss and dizziness after head trauma, whiplash injuries, or both. I also relate those findings to my extensive experience with such neurologic problems. FINDINGS: The findings are grouped according to injuries that cause dizziness, including trauma to the brain stem - eighth nerve complex, the semicircular canals (labyrinthine concussion), benign paroxysmal positional vertigo, Meniere's syndrome -- vestibular symptoms, perilymphatic fistula -- vestibular symptoms, and cervical vertigo; and those that cause hearing loss, including trauma to the brain, eighth nerve, middle ear, cochlear concussion, Meniere's syndrome, and perilymphatic fistula.

Craniocerebral Trauma↗