Biomedical subjects

F R Balyan

Publications and source records attributed to F R Balyan.

9 recordsLinked to original sources

PubMed1998

Anatomic relationships between surgical landmarks in type b and type c infratemporal fossa approaches.

Anatomic relationships of the structures exposed in type B and C infratemporal fossa approaches were studied in 20 temporal bones. The intrapetrous carotid artery (ICA), cochlea (CH), eustachian tube (ET), foramen spinosum (FS), foramen ovale (FO) and anterior foramen lacerum (AFL) were exposed by drilling of the glenoid fossa and base of middle cranial fossa. The relationships of the ICA with the cochleariform process (CP), CH, ET, FS, FO and AFL were noted along with associated measurements. The CP was lodged at a mean distance of 9.2 mm from the ICA genu. The ET was found to intersect the ICA. The mean distance of the ICA to the CH was 1.6 mm. The carotid canal was dehiscent on its horizontal portion in 30% of the bones studied and on its vertical portion in 5%. The periarterial venous plexus was found in 70% of the bones. No obvious branch was observed emerging from the vertical portion of the ICA. The FS was found to be a canal having a mean length of 5.8 mm.

Adult↗

PubMed1998

Titration streptomycin therapy in Meniere's disease: long-term results.

As soon as the use of streptomycin was started for the treatment of tuberculosis, its ototoxic effect was discovered. Initial reports demonstrated that streptomycin was successful in reducing vestibular responses while preserving cochlear activity. Streptomycin sulfate has been used for almost half a century for the treatment of vertigo in patients with Meniere's disease. At the Gruppo Otologico, Piacenza, Italy, between 1987 and 1995 we treated 16 patients with either bilateral Meniere's disease or with Meniere's disease in their only hearing ear, adopting the titration streptomycin therapy protocol of Graham et al. Three patients with follow-up periods of less than 2 years were not included in this study. The ages of the patients ranged from 36 to 64 years with a mean of 49.2 years. The patients were observed for 2 to 8.8 years. The dose of administered streptomycin varied from 14 to 49 gm. Episodic vertigo was totally relieved in all of the patients after initial treatment, whereas hearing remained the same or was improved when compared with the pretreatment levels. Five of the patients experienced recurring vertigo during a period of 4 to 24 months after initial treatment. Oscillopsia persisted in two patients and ataxia in darkness persisted in another two patients. Hearing was unchanged in 14 ears, improved in 2 ears, and worsened in 4 ears at the last follow-up evaluation. The overall outcome indicated that intramuscular titration streptomycin therapy seems to be one of the most important therapeutic options in the treatment of disabling vertigo in patients with either bilateral Meniere's disease or Meniere's disease in an only hearing ear.

Adult↗

PubMed1998

The cochlear aqueduct: an important landmark in lateral skull base surgery.

The cochlear aqueduct (CA) is used as a landmark in lateral skull base surgery. In this study anatomic relationships between the CA and adjacent neurovascular structures were examined by dissecting 32 temporal bones. Observations of the relationship of the external opening (EO) of the CA with the ninth, tenth, and eleventh cranial nerves, inferior petrosal sinus (IPS), and intrapetrous carotid artery (ICA) were noted. In addition to the distance of the EO of the CA to the vertical portion of the ICA, the entire length of the CA and the width of the EO were also measured. The ninth nerve was the only structure lodged at the EO of the CA in 34.4% of bones. However, in 40.6% of bones only the IPS crossed the EO of the CA, although the ninth nerve was situated just anteroinferiorly in the vicinity of the EO. In 15.6% of bones it was possible to observe both the ninth nerve and the IPS crossing the EO. In 9.4% of bones the EO of the CA was found to be occupied by the tenth and eleventh nerves. It was also observed that the ICA was located anteriorly on the same sagittal plane with the EO in 15.6% of bones. It was concluded that although in 90% of cases the EO of the CA was in close relation with the ninth nerve, other structures such as the IPS, the tenth and eleventh cranial nerves, and the ICA were also at risk during drilling in this area because of their intimate relationships with the EO of the CA.

Adult↗

PubMed1997

Mastoidectomy in noncholesteatomatous chronic suppurative otitis media: is it necessary?

Chronic suppurative otitis media (CSOM) without cholesteatoma, the surgical treatment of which is still controversial, is a common diagnosis in otologic practice. A retrospective analysis of 323 patients who underwent surgery for noncholesteatomatous chronic otitis media in the Gruppo Otologica, Piacenza, Italy, between April 1983 and December 1993 is presented. Cases were separated into three groups according to different surgical treatment modalities and conditions of the ears at the time of operation. Group I (n = 53) consisted of cases of CSOM treated by tympanoplasty without mastoidectomy (TLWOM). Group II (n = 28) included cases of CSOM treated by tympanoplasty with mastoidectomy (TLWM). Intact canal wall technique was used in these cases. The ears in both these groups were discharging severely at the time of surgery. Group III (n = 242) included patients whose ears were dry at the time of surgery but who had had previous recurrent episodes of suppuration and who were treated by TLWOM. At the last follow-up, graft success rates for groups I, II, and III were 90.5%, 85.7%, and 89.2%, respectively, and mean residual gaps were 17.2 dB, 20.1 dB, and 19.4 dB, respectively. There was no statistically significant difference between the three groups either on graft success rates (p > 0.05) or on final functional hearing outcome (p > 0.05). TLWM is the preferable treatment modality for most surgeons in noncholesteatomatous CSOM. Nevertheless, in our experience TLWOM yields comparable results for this group of patients. In addition, we could not find any significant difference in results of graft success and final functional hearing rates between dry and discharging ears (p > 0.05).

Adolescent↗

PubMed1997

Clinical observations on coexistence of sudden hearing loss and vestibular schwannoma.

It has long been recognized that sudden hearing loss (SHL) may be a harbinger of vestibular schwannoma (VS). Among 192 VS patients who underwent operation in the Gruppo Otologico, Piacenza, Italy, from April 1987 to October 1995, the charts of 14 (7.3%) cases with a history of SHL were examined. SHL was the first symptom in 8 (4.2%) patients. Eight (57.1%) of 14 VS cases with SHL anamnesis had reported recovery of their previous hearing either totally or partially before establishment of tumor diagnosis. Five (35.7%) cases had recurrent bouts of SHL. SHL was observed less frequently in cases with large tumors (>3 cm). However, the frequency of SHL in patients with small tumors did not differ from that of medium-sized tumors. Awareness about coexistence of SHL and VS, as well as concomitant use of auditory brain stem response and magnetic resonance imaging, is crucial to rule out the diagnosis of VS in a patient with SHL.

Adult↗

PubMed1997

Anatomical considerations of high jugular bulb in lateral skull base surgery.

In order to study high jugular bulb management in lateral skull base surgery, an anatomical study was conducted on 30 temporal bones by examining the relationship between the internal auditory canal (IAC) and the jugular bulb. The following parameters were measured: 1) Height of the jugular bulb (H)... distance between the level of jugular bulb dome and the line passing through the confluence of the sigmoid sinus with the jugular bulb (SS-JB), 2) Mastoid length (ML)... distance between the mastoid process and middle cranial fossa dura, 3) Distance between the most inferior part of the porus acousticus and jugular bulb dome (A), 4) Distance between the porus acousticus and SS-JB (B). The jugular bulb was defined as high when it occupied more than two thirds of (B). The incidence of a high jugular bulb was 23 per cent in this study. When the jugular bulb was high, the mean (H) and (A) were 9.4 +/- 1.9 mm and 2.7 +/- 0.5 mm, respectively. (H) was higher on the right side than on the left side. No statistically significant difference was found between small and large mastoids (t-test: p > 0.05). It was concluded that when a high jugular bulb was encountered during lateral skull base surgery, the jugular bulb position allows a very small working area inferior to the IAC. In these cases, a 3 or 4 mm depression of the jugular bulb is necessary in order to expose the lower cranial nerves. This can be accomplished by lowering the jugular bulb with the technique already described.

Humans↗

PubMed1997

Rhinolithiasis.

Rhinoliths are mineralized masses located in the nasal cavity. In this report, 12 patients with rhinolithiasis who were operated at the 2nd ENT Clinic of Ankara Numune Hospital are presented. The most frequently seen symptom is nasal obstruction, which has been seen in 9 patients. The disease most frequently seen in association with rhinolithiasis is chronic sinusitis. All masses have been extracted intranasally.

Adolescent↗

PubMed1996

Anatomical relationship between position of the sigmoid sinus and regional mastoid pneumatization.

In order to examine the relationship between the location of the sigmoid sinus (SS) and mastoid pneumatization, 25 adult temporal bones were dissected. Pneumatization was evaluated according to findings during dissections of three separate regions of the mastoid: i.e., the sinodural angle (SDA) area, inter-sinofacial area and mastoid apex. In addition, the SDA and distance between the SS and vertical portion of the facial nerve, were measured at the second genu (G) of the facial nerve, the junction (J) of the nerve and digastric ridge and the midpoint between G and J.A good correlation was observed between pneumatization of the cells surrounding the SDA and the distance between the SS and facial nerve at the mid-point of its vertical segment. However, pneumatization of the inter-sinofacial air cell tract could not be correlated with this distance. A significant decrease in the values of the SDA was found when the air cells surrounding the SDA were poorly pneumatized. This study indicated a correlation between the position of the SS and pneumatization of the mastoid in the area of the SDA.

Adult↗

PubMedDate not supplied

Morphometric evaluation of the infralabyrinthine approach to the internal auditory canal.

Morphometric evaluation of the infralabyrinthine approach to the internal auditory canal (IAC) was performed using 20 fresh human temporal bones in order to assess the exposure limitations, inherent risks and technical difficulties that may arise due to common anatomic variations of this region. While performing the infralabyrinthine approach to the IAC, minor problems such as an anteriorly placed sigmoid sinus were easily managed. However, in 50% of the specimens, this approach was limited due to variations of the jugular bulb, restricting access to the IAC. Sacrificing the endolymphatic duct in these specimens did not significantly improve the surgical access to the eighth nerve. Furthermore, it was noted that this approach puts the facial nerve and cochlea under the risk of inadvertent damage during drilling. The authors conclude that vestibular nerve sectioning using the infralabyrinthine approach may be performed only in few selected cases and extreme care is needed in order not to damage the structures that limit this approach.

Adult↗