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Biomedical subjects

D E Brackmann

Publications and source records attributed to D E Brackmann.

At least 163 records · Page 9Linked to original sources
PubMed1980

Eustachian tube dysfunction and Meniere's disease: a report of 341 cases.

Tympanometric results were reviewed for 341 cases of Meniere's disease and 200 cases of sensorineural hearing loss of unknown causes. The results indicate that the incidence of Eustachian tube dysfunction in patients with Meniere's disease is nearly the same as in a control group of patients with sensorineural hearing loss of unknown causes: The percentage of patients with Meniere's disease having Eustachian tube dysfunction was similar to the percentage of normal-hearing listeners with Eustachian tube dysfunction reported by Jerger.

Acoustic Impedance Tests↗
PubMed1979

Brainstem audiometry in neurotologic diagnosis.

Brainstem electric response audiometry (BERA) has been found to be a valuable adjunct to the neurotologic diagnosis. Ninety-eight percent of patients with surgically confirmed acoustic neuromas has positive BERA findings. We report six cases that illustrate the value of this technique in examining patients with suspected retrocochlear lesions.

Adult↗
PubMed1979

Cholesteatoma surgery: management of the labyrinthine fistula--a report of 97 cases.

Preoperative, operative and postoperative findings in 97 cases of labyrinthine fistula are presented. Most of these patients had had symptoms of chronic otitis media for 20 years or more and manifested some degree of sensorineural hearing impairment. Two-thirds had experienced dizziness. The fistula was limited to the lateral semicircular canal in 83 cases and involved the labyrinth more extensively in 14 instances. The intact canal wall technique was used in less than 60% and an open cavity technique in 25% of the cases. Severe or total sensorineural hearing impairment developed postoperatively in 8% of the lateral canal cases and in over half of the extensive fistula cases. Five percent had incapacitating dizziness for up to six months postoperatively. When a labyrinthine fistula is encountered in an only hearing ear we usually recommend a classical modified radical mastoidectomy. In other instances the procedure performed will vary with the status of the opposite ear, the extent of the fistula, the sensorineural function of the involved ear and the size of the mastoid.

Adolescent↗
PubMed1979

Tympanoplasty: TORPS and PORPS.

We reviewed 106 cases in which PlastiPoreTM prostheses were used for ossicular reconstruction. In all cases a piece of cartilage was interposed between the prosthesis and the tympanic membrane graft to prevent the potential problem of prosthesis extrusion. With total ossicular replacement prostheses (TORPs) 55% closed to within 10 db and 85% closed to within 20 db of the bone conduction level. Closure to within 10 db of the bone conduction level was accomplished in 64% of partial ossicular replacement prostheses (PORPs) cases. These results are better than obtained previously with either ossicles or cartilage alone.

Ear Cartilage↗
PubMed1978

Acromegaly and the temporal bone.

Acromegaly is a chronic disease of middle life resulting from excessive secretion of growth hormones by the acidophil cells of the anterior pituitary. The typical clinical features include enlargement of the skull, thorax, hands and feet. Recently, three patients with acromegaly have been operated upon for active otologic disease. In spite of massive mastoid cortex bone, the structures of the otic capsule were found to be of normal dimensions and in the usual relationships.

Acromegaly↗
PubMed1978

Retrolabyrinthine approach: technique and newer indications.

Excellent exposure of the cerebellopontine angle is obtained by an approach through the mastoid posterior to the labyrinth. Since the major portion of the dissection is extradural, this approach is associated with a very low morbidity. The retrolabyrinthine approach has been used for several years for selective partial section of the posterior root of the trigeminal nerve in cases of trigeminal neuralgia. Complete relief of pain has been accomplished in 25 of 28 cases, and the other 3 patients had partial relief of pain. The only complications in these patients were partial hearing impairment in 2, and 1 partial abducens nerve paralysis which subsequently recovered completely. Two patients required secondary closure of cerebrospinal fluid leaks. This approach has also been used for exploration and biopsy of cerebellopontine angle tumors and for treatment of other cranial nerve problems. We conclude that the retrolabyrinthine approach is the preferred route to the cerebellopontine angle in a variety of clinical conditions.

Abducens Nerve↗
PubMed1978

Electric response audiometry: clinical applications.

Electric response audiometry is an exciting new development in the field of otology. At the present time it is the best objective audiometric test for predicting the threshold in infants or uncooperative patients. Brain stem audiometry is a valuable addition to the audiologic test battery for acoustic tumor diagnosis. Electrocochleography offers a means for the study of the function of the inner ear and the differentiation of types of sensorineural hearing impairment.

Acoustic Stimulation↗
PubMed1977

Acoustic tumor detection with brain stem electric response audiometry.

Tumors that press on the audiotry nerve can cause a latency increase that is detectable from the scalp by electric response audiometry (BERA). The response delay is best seen by comparing the Jewett wave V, or P5, latencies for the two ears. This interaural latency difference is normally less than 0.2 msec, but was 0.4 msec or greater for 35 acoustic tumor cases and for seven of ten other temporal bone tumors. Acoustic tumor size can be estimated from the amount of latency delay.

Audiometry↗
PubMed1977

Eustachian tube blockage and Meniere's disease.

On the basis of our clinical experience, it has been noted that an unusually large proportion of patients with Meniere's disease have intermittent eustachian tube blockage. A review of the tympanograms of 81 patients with Meniere's disease, representing 107 ears, showed that 25 (30.9%) of the patients and 35 (32.7%) of the ears had abnormal negative middle ear pressure. The maximum compliance peak was in at a pressure point in excess of --100 mm H2O. Further investigation of these patients has led us to conclude that intermittent eustachian tube blockage frequently accompanies Meniere's disease, yet it is not necessarily the cause of the symptomatic disorder.

Adult↗
PubMed1977

Salivary gland choristoma of the middle ear.

We discuss the eighth reported case of a benign salivary gland tumor in the middle ear. The lesion was a smooth lobulated mass and was found to be intimately associated with the tympanic portion of the facial nerve. Recommended treatment is biopsy without attempting removal. This concept of management is supported by a report of a similar case with a 15-year follow-up.

Child↗
PubMed1976

The cochlear implant; basic principles.

In recent years the cochlear implant has been a subject of much discussion and controversy. The clinician has often been confused by the conflicting reports of success and failure. In this paper the development of the cochlear implant is reviewed and its present status summarized. It is hoped that the clinician may thereby gain an understanding of this device so that he can better evaluate its present and future status. Selection of Patients for Cochlear Implantation. The cochlear implant will benefit only those patients with hair cell loss who have remaining viable auditory neurons. In order to determine whether viable neurons remain, an electric current is passed through a small needle which is place into the promontory through the tympanic membrane. If patients experience an auditory sensation as a result of this electrical stimulation, it is felt that they are suitable candidates for a cochlear implant. Feasibility of Long-Term VIIIth Nerve Stimulation. Many questions have been raised regarding the feasibility of long-term stimulation of the auditory nerve. The first question raised was whether the auditory nerve would survive severe hair cell degeneration. Studies have shown that in most cases at least a few auditory neurons remain. The next question was whether the cochlear implant itself would destroy the remaining auditory neurons. Preliminary studies have shown that the nerve will survive the placement of electrodes both into the modiolus and the scala tympani. Several electrode materials and insulation have been found to be well tolerated, and there has been minimal damage from thermal or electrolytic processes; therefore, it appears feasible to stimulate the auditory nerve over a long period. Information Transfer by Electrical Stimulation. Single-channel stimulation produces only periodicity pitch, and information transfer is insufficient for speech discrimination. Experience to date indicates that it will be possible to produce both place and volley pitch by electrical stimulation with multiple electrodes in the scala tympani. These findings give promise for the feasibility of producing a device which will transfer sufficient information to produce speech discrimination. Present Status of the Cochlear Implant. To the present time 15 patients have been implanted with a unipolar electrode under the direction of the Ear Research Institute. These patients have all benefited from their devices. They are able to perceive background sounds and receive a cadence or rhythm to speech which makes the device helpful in lipreading. None of the patients have developed significant speech discrimination.

Auditory Cortex↗
PubMed1975

Artifical hearing for the deaf by cochlear stimulation: pitch modulation and some parametric thresholds.

The periodicity and place-pitch modulation data, along with the data on loudness, offers promise of the development of a multielectrode, multichannel cochlear auditory prosthesis. Also, the currents required for cochlear stimulation are of the magnitude which can pass across the electrode-perilymph interface, by double-layer charging, without production of toxic by-products of electrolysis(6), supporting the feasibility of long-term chronic stimulation.

Acoustic Stimulation↗