Biomedical subjects
D G Pappas
Publications and source records attributed to D G Pappas.
Hearing impairments and vestibular abnormalities among children with subclinical cytomegalovirus.
This paper strengthens the importance of neonatal screening in the early identification and etiological specification of hearing loss by demonstrating that subclinical cytomegalovirus (CMV) is the most common viral agent causing sensorineural hearing loss (SNHL) among pediatric patients. Consequently, if hearing impairment is found on neonatal screening, viral studies should be done at once. In addition to a survey of previous literature, these points are presented from a retrospective study of 14 children with SNHL caused by focal CMV. Moreover, vestibular studies are presented which suggest that hearing and vestibular impairments may operate independently of one another or conjointly in patients infected with CMV.
Barany's History of Vestibular Physiology. Translation and commentary.
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Goblet prosthesis in ossicular chain reconstruction.
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Arachnoid cysts of the posterior fossa.
The clinical symptoms and signs of four patients with arachnoid cysts in the posterior fossa are discussed. In three patients, the cyst was in the internal auditory canal; one patient had an acoustic neuroma and two large cysts in the cerebellum. Whereas the conventional diagnostic tests for acoustic neuroma cannot differentiate between neuromas and arachnoid cysts, the newer thin section body scanners can show a lesion with no enhancement in the case of the cyst. Surgical approaches for removal of this lesion must take into consideration the preservation of hearing in the involved ear.
The value of including optokinetic nystagmus testing in electronystagmography.
Seventy-nine out of 172 patients with abnormal horizontal or vertical optokinetic nystagmus had a specific condition or disease that was diagnosed following a complete ENG. Ocular vertigo, MS, motion sickness, brain stem lesions, cerebellar tumors, cerebellar atrophy, parietal lobe tumors, and Harada syndrome were the diagnoses made. Optokinetic asymmetry--horizontal, vertical, or a combination of these--was the most consistent finding in these conditions (Table). In six patients with cerebellar tumor, abnormal findings on OPK testing suggested the need for further evaluation when physical and neurologic examinations, brain scans, and EEG were normal. Surgery confirmed the diagnosis of cerebellar tumor with these patients. This study suggested the importance of using five progressively faster drum speeds in both the horizontal and vertical planes. All patients who had proven or strongly suspected MS had eye-speed fatigability as the drum speed increased, that is, as the drum speed increased, the eye speed decreased. It is suggested that optokinetic studies be included in the ENG. Vertical asymmetry, although not as common as horizontal, should be included in that 14 patients had only this finding.
Triflanged tube for chronic serous otitis media.
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