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Biomedical subjects

G W Facer

Publications and source records attributed to G W Facer.

At least 37 records · Page 2Linked to original sources
PubMed1993

Middle ear adenoma and adenocarcinoma.

Adenomas and adenocarcinomas originating from the middle ear are few in number and have met with significant controversy in the literature. Our experience with 11 previously described patients is updated and five new cases are added. These tumors were seen in persons whose ages ranged from 7 to 77 years. The most common initial symptom was decreased hearing (11 cases), followed by otorrhea (4 cases), and otalgia (4 cases). At the time of diagnosis, facial nerve weakness was present in several patients (seven), and this was a poor prognostic sign. These glandular tumors engender controversy regarding histologic origin and the pathologic demarcation between adenoma and adenocarcinoma. In this review, we show that otorrhea, bone erosion, facial nerve involvement, and aggressive clinical behavior can be the result of lesions that appear microscopically benign. Furthermore, we present evidence of the similarity of these glandular lesions to paragangliomas and carcinoid tumors. Finally, pathologic data are presented to develop the previously unreported theory that the origin for this group of tumors is paraganglionic tissue.

Adenocarcinoma↗
PubMed1990

The clinical behavior of inverting papilloma of the nose and paranasal sinuses: report of 112 cases and review of the literature.

Between 1944 and 1987, 112 patients with inverting papilloma of the nasal cavity were treated. The average duration of follow-up for this population was 6.2 years. The most common symptoms were nasal obstruction and history of previous surgery for nasal "polyps". Recurrence rates were lower when treatment consisted of lateral rhinotomy with medial maxillectomy (14%) vs. transnasal operation with a sinus procedure (35%) or transnasal operation alone (58%). Recurrence rates between men and women were not significantly different when treatment methods were analyzed; however, a higher-than-expected association with tobacco usage was noted. Eight (7%) of the 112 patients had associated nasal carcinoma. Current treatment is lateral rhinotomy with medial maxillectomy to prevent troublesome and potentially malignant recurrent disease.

Adolescent↗
PubMed1988

Vibrotactile device in patients with single-channel cochlear implant: a preliminary study.

Two patients who had been using 3-M Vienna extracochlear implants were given two-channel KS Sensoraid vibrotactile units to wear for 1 month. At the end of that period, several tests commonly used to assess cochlear implant function were administered to compare the effectiveness of the vibrotactile system with that of the cochlear implants. The results obtained from the vibrotactile devices were encouraging, although the units had some shortcomings. Overall, the subjects' test scores with the vibrotactile units were comparable to, if not slightly better than, those with the extracochlear implants.

Adult↗
PubMed1987

Modified Lynch procedure for chronic frontal sinus diseases: rationale, technique, and long-term results.

The modified Lynch operation (Neel-Lake) differs in several ways from the operation described by Lynch. The operation begins with an intranasal anterior ethmoidectomy. The agger nasi cells are removed by curetting forward between the frontal process of the maxilla and the septum. The middle turbinate, normal-appearing mucosa of the frontal-ethmoid complex, and frontal process of the superior maxilla are preserved. Bone removal is limited in most cases to the anterior floor of the frontal sinus, a portion of the lacrimal bone, and the bone over the anterior ethmoid cells. Another important difference is the use of soft, nonreactive material (thin Silastic sheeting) to stent the nasal-frontal passageway. Removal of all the mucosa of the frontal-ethmoid-sphenoid complex is unnecessary for a good postoperative result, and the remaining normal mucosa hastens the process of reepithelialization of the nasal-frontal duct. The patients in our original study group have been observed for a period of 5 to 20 years (mean, 13.5 years) after the surgical procedure. This is the longest period of follow-up for any group of patients reported in the literature. The incidence of failures increased from 7% (one duct) to 20% (3 of 15 ducts) after an additional 7 years of follow-up.

Adolescent↗
PubMed1986

Surgical treatment of stenosis of the external auditory canal.

Analysis of the outcomes of reconstruction for stenosis of the ear canal in 20 patients revealed that the key step in the procedure after the stenotic meatus and ear canal skin have been removed (in the process accomplishing a wide meatoplasty) is widening the posterior bony canal wall until some mastoid cells are encountered. After the tympanic membrane has been deepithelialized, the bony canal should be lined with two separate pieces of split-thickness skin grafts and protected with Silastic sheeting and packing. Average follow-up of 3 1/3 years revealed that 2 ear canals have restenosed, 2 have partially restenosed, and 18 have healed. Of the 22 ears, 15 have had hearing improved to within 25 dB SRT or better, 5 have moderate hearing improvement, and 2 have no improvement. There were no complications.

Adolescent↗
PubMed1986

Microbiologic analyses of nasal polyp tissue.

Nasal polyps from 40 patients were cultured within 2 1/2 hours after surgical removal to determine whether microorganisms were present. The first 20 polyps were cultured for aerobic and anaerobic bacteria, viruses, fungi, mycoplasmas, and mycobacteria. Of these 20 polyps, eight were sterile by all tests, one grew Cryptococcus albidus, one grew Sporobolomyces, one had large numbers of Peptostreptococcus micros and Propionibacterium acnes, greater than 10(6) colony-forming units per gram (cfu/gm), and nine had aerobic bacteria including 10 different species at levels less than 10(5) cfu/gm. The second 20 polyps were cultured for aerobic bacteria only; 11 polyps were positive. Overall, 14 of 26 polyps from patients with asthma and two of 14 polyps from patients without asthma were positive for aerobic bacteria at levels greater than 10(3) cfu/gm (p less than 0.05). Multiple aerobic bacterial species tended to occur in polyps from patients with asthma (11 of 26) more frequently than in those from patients without asthma (one of 14) (p less than 0.01). There was a highly significant positive correlation between tissue neutrophilia and bacterial count (r = +0.9; p less than 0.001). The results indicate that patients with asthma have a significantly higher number and a tendency to a greater variety of aerobic bacteria in nasal polyp tissue than patients without asthma and that the number of infiltrating neutrophils is directly related to the number of bacteria.

Adolescent↗
PubMed1986

Individual data from the 3M/Vienna extracochlear implant.

Five patients who received the 3M/Vienna extracochlear implant were given a standard battery of tests before and after implantation. Pure-tone audiograms, hearing aid evaluation, and promontory threshold and dynamic range stimulation were conducted to evaluate implant candidacy and to determine whether a particular patient met the criteria for inclusion in the study. Speech reading tests were also given before implantation. Postimplantation testing consisted of thresholds and tolerance levels for pure tones and speech reading with and without acoustic stimulation. Tests on environmental sounds, speech discrimination, and word discrimination were scored. Minimal Auditory Capabilities (MAC) Battery scores were determined on MAC, I, II, IV, V, VII, VIII, and XII subtests over several time intervals (sessions). The hearing results varied greatly among patients. All five patients expressed satisfaction and are presently wearing their units.

Adult↗
PubMed1984

Meniere's disease: a 30-year epidemiologic and clinical study in Rochester, Mn, 1951-1980.

One hundred eighty cases of Meniere's disease were identified in the Rochester, MN population during the 30-year period, 1951 through 1980. The annual age-adjusted incidence rate per 100,000 population was 15.3; the preponderance for females (16.3) over males (13.3) was not statistically significant. There was no change in annual incidence rate from 1951 through 1970, and a slight decrease in the period, 1971 through 1980. The prevalence rate on January 1, 1980, was 218.2 per 100,000 population. Clinical aspects of Meniere's disease noted during the course of this study are reported.

Adolescent↗
PubMed1982

Adenocarcinoma and adenoma of the middle ear.

Primary middle ear glandular tumors of the adenocarcinoma and adenoma types are rare. The terminology used in describing them is quite varied. Some investigators presume that a distinct recognizable group of these tumors are benign, but because of the rarity of the lesions, such conclusions have been difficult to verify. We review the literature of these lesions and report 11 additional cases. The course was documented in 25 cases in the literature; 20 of these were reported to be benign over periods of follow-up from 1 month to 10 years, and 5 were fatal. Among our patients, 5 had a benign course, 3 died of causes related to the tumor, and 3 had persistence of their lesion and substantial consequent morbidity. We emphasize the slow growth and elusive nature of these lesions. Histologic evidence of mitoses, roentgenologic evidence of bony destruction, and cranial nerve involvement were factors consistent with a poor prognosis. The origin of these tumors may vary. A similarity to paragangliomas is noted. The ultimate course of these tumors cannot always be predicted from the histologic appearance. Early surgical removal appears to be the most successful therapy. Three of the 4 types of glandular tumors of the external ear canal described by Wetli, et al, can be found in the middle ear: adenoma, adenocarcinoma, and adenoid cystic carcinoma. In addition, several other types of glandular lesions can occur in the middle ear--the "choristomas," mucoepidermoid carcinomas, and what we believe to be a variant of paragangliomas. The adenoid cystic tumors are well described in the literature and will not be discussed here. We reviewed cases of the adenoma and adenocarcinoma types, some of which bore a resemblance to the paragangliomas.

Adenocarcinoma↗
PubMed1981

Facial nerve paralysis: it is always Bell's palsy?

Most patients with facial nerve paralysis have idiopathic, or Bell's palsy. Nevertheless, other more serious causes should be carefully excluded before Bell's palsy is diagnosed. Several tests can help the physician determine the site of the lesion and the physiologic extent of involvement of the facial nerve. The type of treatment depends on the cause of the paralysis and whether it is complete or partial. Familiarity with facial nerve anatomy and the various causes of facial paralysis should facilitate early diagnosis and appropriate treatment.

Cerebrovascular Disorders↗
PubMed1981

A blow to the nose: common injury requiring skillful management.

The physician who initially examines the patient with a nasal or facial injury should thoroughly inspect the external and internal aspects of the nose and also evaluate the facial bones. General anesthesia may be necessary in examining children. Although roentgenograms of the nose and facial bones are usually obtained in cases of nasal injury, they rarely influence treatment. Treatment goals should be to maintain or restore satisfactory function and to ensure a good cosmetic result. The patient (or parents) should be advised to be alert to possible delayed abnormalities from the injury.

Adolescent↗
PubMed1980

Nasal gliomas.

Nasal glioma is a developmental abnormality of neurogenic origin with o malignant potential. An intranasal mass requires careful rhinologic and occassionally ophthalmologic, neurologic, and roentgenologic examinations. With a bony defect, pneumoencephalography, angiography, or computerized tomography may be helpful. In such cases, a neurosurgeon should be available at the time of biopsy. Biopsy is necessary for establishing a histopathologic diagnosis. Aspiration of the tumor with a needle or incisional biopsy may yield inconclusive findings and may be associated with CSF rhinorrhea and meningitis, especially if there is an intracranial connection. With adequate initial removal, excisional biopsy usually offers complete cure. A frontal craniotomy approach is preferred for those patients who have nasal glioma with an intracranial connection, CSF rhinorrhea, or recurrent episodes of meningitis. With no evidence of an intracranial connection, a conservative extracranial approach is recommended.

Adolescent↗
PubMed1980

Unusual causes of unilateral serous otitis media.

Two cases of nonkeratinizing squamous cell carcinoma (transitional cell carcinoma), both of which arose in the Eustachian tube, and two cases of neurilemoma of the nasopharynx are reported. All four patients presented with unilateral serous otitis media. The duration of the unilateral serous otitis media in these patients ranged from 1 1/2 to 8 years. This emphasizes the fact that adult patients with unilateral serous otitis media without a history of an upper respiratory tract infection or of barotrauma should undergo thorough examination to rule out the presence of an unusual underlying pathologic condition.

Carcinoma, Squamous Cell↗
PubMed1979

Nonsurgical closure of nasal septal perforations.

Seventy-three patients had medical-grade Silastic buttons inserted transnasally (between June 1972 and June 1976) into a perforation of the nasal septum. This nonsurgical technique was done as an office procedure on 67 of the patients with the use of topically applied 5% cocaine solution. The Silastic button has remained in place in 72.6% of the entire study group; follow-up times for this group range from six months to four years. This mechanical covering of the perforation substantially reduced crusting and epistaxis, and it improved nasal respiration in many cases.

Adolescent↗
PubMed1979

Experience with a polyethylene total ossicular replacement prosthesis.

Surgical reconstruction of ossicular defects in chronic middle ear disease is a difficult problem. We have reviewed our results with the use of the Plastipore total ossicular replacement prosthesis (TORP). Of 29 procedures that were analyzed, nine were considered successful. None of our patients had a stapes superstructure, and 13 had no malleus. Placement of the TORP under the malleus handle and use of extra tissue between the prosthesis and the tympanic membrane provided better hearing results, but extrusion of the prothesis still occurred. Positioning of the prosthesis and contraction of the middle ear space, which causes extrusion of the prosthesis, remain problems in this type of reconstruction.

Adolescent↗
PubMed1979

Nasal septal perforations: use of Silastic button in 108 patients.

Between June 1972 and November 1977, 108 patients had medical-grade Silastic buttons inserted transnasally into a perforation of the nasal septum. This nonsurgical technique was done as an office procedure with use of 5% cocaine applied topically in 97 of the 108 patients. The Silastic button has remained in place in 70.4% of the patients, with follow-up ranging from 9 months to 6 years. This mechanical device is inserted easily and has reduced crusting and bleeding considerably in many patients. The failures frequently were related to patient intolerance or poor mechanical fit and occurred in the first few days or first few months after insertion.

Adolescent↗