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Biomedical subjects

G J Spector

Publications and source records attributed to G J Spector.

72 records · Page 4Linked to original sources
PubMedDate not supplied

Distant metastases from laryngeal and hypopharyngeal cancer.

A retrospective tumor registry analysis of patients with squamous cell carcinoma (SCC) of the larynx and hypopharynx who were treated with curative intent in the Department of Otolaryngology--Head and Neck Surgery at Washington University School of Medicine and Barnes Hospital between January 1971 and December 1991. In 2,550 patients, the mean age, sex and tumor differentiation did not affect the incidence of distant metastases. The overall incidence of distant metastases was 8.5% (217/2,550 patients) with the following distribution: glottis 4.4%, supraglottis 3.6%, subglottis 14%, aryepiglottic fold 16%, pyriform sinus 17% and posterior hypopharynx 17.6%. The overall 5-year disease-specific survival for distant metastases was 6.4%. Distant metastases were related to advanced local disease (T3 + T4), lymph node metastases at presentation (N+), tumor location (hypopharynx) and locoregional tumor recurrence (p < or = 0.028). A meta-analysis of variables which predispose to a higher incidence of distant metastases indicate that tumor location (hypopharynx > larynx), advanced primary disease (T3 + T4), regional disease (N+), locoregional recurrences, and advanced regional metastases (N2 + N3) are statistically significant.

Adult↗
PubMedDate not supplied

Glomus tumors in the head and neck: III. Analysis of clinical manifestations.

Seventy-five patients with glomus tumors in the head and neck had a 37% incidence of cranial nerve paralysis and a 14.6% incidence of intracranial extension. Jugular foramen syndrome is associated with 50% and hypoglossal nerve involvement with 75% posterior fossa tumor invasion. Horner's syndrome is associated with 50% middle cranial fossa tumor invasion. The incidence of central nervous system (CNS) involvement with cranial NERVE PARALYSIS (NOT INCLUDING VII nerve) is 52%. Otologic findings and VII nerve paralysis did not correlate with tumor resectability, CNS extension, and prognosis.

Central Nervous System Diseases↗
PubMedDate not supplied

Fluorocitrate ototoxicity. A morphologic and cytochemical model for primary neural degeneration in the guinea pig cochlea.

Fluorocitrate, an inhibitor of the tricarboxylic acid cycle at the aconitase reaction, produces a time and dose related neural dystrophy in the guinea pig cochlea. There is direct inhibition of succinic dehydrogenase activity but not nicotinamide adenine dinucleotide dehydrogenase and cytochrome oxidase via cytochrome c activities. The dystrophic neural changes morphologically are similar to those noted in primary neural degeneration and neural presbycusis in man. Neural degeneration in aging appears to be the result of a dissociation of biochemical reactions preventing the proper utilization of organic fuel molecules for generation of energy and direct or indirect inhibition of respiration.

Animals↗
PubMedDate not supplied

Histopathologic and experimental models for sensory and neural deafness.

Six selected cases with neonatal and fetal cochlear pathology are presented. Those denoting cochlear sepsis are: H. influenza purulent labyrinthitis, cytomegalovirus endolabyrinthitis, and aseptic meningitis and labyrinthitis. Those denoting cochlear neural aplasia are Goldenhar's syndrome, left-sided cardiac hypoplasia with partial basal turn neural aplasia, and cerebral cortical and ventricular hemorrhage with modiolar extension. These findings are compared to the fluorocitrate ototoxicity model for neural deafness in the guinea pig. This study suggests hypotheses for viral trophism in the inner ear and neural degeneration of the cochlea as mechanisms for sensorineural deafness.

Abnormalities, Multiple↗
PubMedDate not supplied

Glomus jugulare and vagale.

The therapeutic results in 72 patients with glomus jugulare and nine with glomus vagale have indicated a surgical cure rate of 80% in the former and 100% in the latter. Radiotherapy demonstrated a 65% tumor response rate and a 25% cure rate histologically and clinically. Embolization with Gelfoam beads in seven patients resulted in diminished tumor size and arterial circulation from the external carotid system. However, in all cases the tumor persisted. Embolization diminished intraoperative bleeding. Nevertheless, the use of embolization as a palliative modality demonstrated significant symptomatic relief in aged, debilitated patients and in all patients with large inoperable glomus jugulare tumors.

Adolescent↗
PubMedDate not supplied

Intramembranous and mesotympanic cholesteatomas associated with an intact tympanic membrane in children.

A series of 15 intramembranous (IMTC) and mesotympanic (MTC) cholesteatomas associated with intact tympanic membranes in children is presented. Clinical observations, audiometric and radiographic data, and surgical findings are correlated. A history of recurrent otitis media was obtained in 85% (13/15) of the cases, differentiating them from the usual congenital cholesteatomas. The possibility that many of these are indeed "acquired" lesions is emphasized. Hypothetical pathogenetic mechanisms are discussed. The basal cell papillary proliferation theory is considered the most attractive explanation of the development of both IMTCs and MTCs. The need for careful, prolonged, follow-up otoscopic examination of children with recurrent otitis media is stressed, if more of these lesions are to be recognized early.

Audiometry↗
PubMedDate not supplied

Labyrinthine segment and geniculate ganglion of facial nerve in fetal and adult human temporal bones.

The later stages of development (15-40 weeks in utero) of the geniculate ganglion and labyrinthine segment of the facial nerve in the human fetus demonstrate minimal neuronal growth. The vascular supply is well established. The major changes occur in the perineural ossification pattern. The canal of the labyrinthine facial nerve segment ossifies first via the petrous apex and periotic capsule. The narrowest portion of the canal is at the geniculate ganglion in the earlier stages and at the fundus of the internal auditory canal at term. The geniculate ganglion area ossifies by means of two bony plates. The medial plate is a derivate of the periosteal growth of the petrous apex and the lateral plate is an extension of membranous bone from the squama. The major relationships to the middle ear do not change. The hiatus of the facial canal diminishes in size during gestation, but remains patent at birth.

Adult↗
PubMedDate not supplied

Endolymphatic sac surgery for Menière's disease.

An endolymphatic-mastoid Silastic shunt procedure was performed in 122 cases of Menière's disease having a mean follow-up period of three years. In accordance with American Academy of Ophthalmology and Otolaryngology 1972 criteria, there were 43% class A, 20% class B, 21% class C, and 17% class D results. Analysis of 35 recent cases having a mean follow-up period of nine months revealed 57% class A, 25% class B, 9% class C, and 9% class D results. Sixteen percent of the patients who experienced classes A, B or C results complained of other fluctuating symptoms which were not relieved by surgery. Moreover, three new cases of otolithic crisis were found in the postoperative group. Seven of ten patients who experienced a class A or B result had either a recrudescence of their vertigo or a significant decrement in hearing in response to a postoperative salt-loading test. It is concluded that the surgical success rate decreases with time and that the procedure appears to alter the symptom complex but does not cure Menière's disease.

Ear, Inner↗
PubMedDate not supplied

Auditory function in children with diabetes mellitus.

Fifty-one insulin-dependent diabetics and 13 nondiabetics between the ages of 8 and 21 years, without a history of exposure to noise, ototoxic drugs or ear disease, were evaluated to examine the relation between auditory function and diabetes, diabetic control and diabetic complications. Audiologic assessment included pure-tone audiometry, speech audiometry, impedance measures and brainstem evoked response audiometry. No statistically significant differences in auditory function were noted between insulin-dependent diabetics and normal controls, between the diabetics in good or poor control or between diabetics with or without neurologic or vascular complications.

Adolescent↗
PubMedDate not supplied

Developmental temporal bone anatomy and its clinical significance: variations on themes by H. F. Schuknecht.

Fifty-eight fetal and neonatal temporal bones were studied to evaluate the mechanisms of development of the hiatus of the facial canal, hypotympanic fissures, periotic duct, tympanomeningeal fissures, and fetal inner ear vascularity. These were correlated with the clinical pathologic entities of temporal bone trauma, glomus jugulare tumor extension within the temporal bone, CNS-temporal septic conduits, and inner ear vascularity. Temporal bone developmental anatomy and histopathology provide rich sources of information on which to base the scientific and clinical study of otology.

Adult↗
PubMedDate not supplied

Surgery for glomus tumors at the skull base.

Glomus tumors of the temporal bone frequently involve the skull base. In the present study, 34% of the tumors occurred with cranial nerve palsies and 15% invaded the CNS. The procedure for surgical resection of glomus tumors of the skull base is described. Results of the procedure included successful surgical resection of 80% of the glomus jugulare tumors and of 94% of the glomus tympanicum tumors. Tumor recurrence and persistence occurred only in the patients with CNS invasion.

Cranial Nerve Neoplasms↗
PubMedDate not supplied

Development of the hypotympanum in the human fetus and neonate.

The human hypotympanum develops over a 10-week period in utero (22-32 weeks) as a triphasic osseous mosaic. The tympanic bone ossifies as a membranous bone (8-36 weeks in utero). The canalicular otic capsule ossifies in cartilage by 26 weeks in utero. A petrosal ledge of bone ossifies as periosteal bone at 24-29 weeks in utero. The fusion of these three bony structures closes the hypotympanum and forms two persistent hypotympanic fissures. The medial hypotympanic fissure forms between the canalicular otic capsule and petrosa at 24 weeks in utero. It transmits the medial hypotympanic artery and vein (from the posterior CNS circulation) and Jacobson's nerve (from the ninth nerve). The lateral hypotympanum fissure forms between the tympanic bone and the petrosa at 29 weeks in utero. It transmits the lateral hypotympanic artery and vein from the external carotid circulation. The two vascular supplies form a rich hypotympanic plexus on the floor of the middle ear. The fibrous annulus and middle layer of the tympanic membrane form an avascular plane.

Ear, Middle↗