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Biomedical subjects

H A Jenkins

Publications and source records attributed to H A Jenkins.

At least 73 records · Page 4Linked to original sources
PubMed1986

Gunshot injuries of the temporal bone.

Concurrent with the increase in handgun crime in the United States is a rising incidence of gunshot wounds to the temporal bone. These injuries present challenging diagnostic and management problems to the otolaryngologist. A timely multicenter review of this entity revealed 22 cases evaluated and treated by the authors between 1975 and 1984. A wide variety of injuries were encountered, involving anatomic structures within or contiguous with the temporal bone. These included: eight intracranial injuries; 11 traumatized facial nerves; seven vascular wounds; 19 mastoid, middle, or inner ear injuries; and 11 cases of damage to the external auditory canals. A rational scheme for immediate and long-term management of each type of injury is outlined. Illustrative cases representing vascular, neural, temporal bone, and central nervous system injury are presented.

Adult↗
PubMed1985

Tuberculous petrous apicitis.

Tuberculous osteomyelitis of the temporal bone is a rare and dangerous entity that should be included in the differential diagnoses of infectious processes of the base of skull. A 21-year-old man presented with petrous apicitis, extradural and retromandibular abscesses, and paresis of the facial nerve. Immediate middle fossa craniotomy and drainage of the extradural abscess, in combination with a mastoidectomy, incision and drainage of the facial abscess, and antimicrobial therapy for gram-positive cocci, failed to check the destructive nature of the infection. The patient subsequently developed labyrinthitis, sensorineural hearing loss, and meningitis. Intraoperative biopsy specimens confirmed the presence of tuberculoid granulomas, and the infectious process responded to triple-drug therapy. Tuberculosis of the temporal bone should not always be considered an indolent infection. The management of tuberculous infection of the temporal bone is outlined.

Adult↗
PubMed1985

Carbon dioxide laser stapedotomy. Thermal effects in the vestibule.

Small-fenestra stapedotomy has recently been popularized in efforts to reduce the incidence of sensorineural hearing loss following stapes surgery for otospongiosis. Lasers have been advocated as a tool to fenestrate the stapes footplate. Conversion of radiant energy from the laser into heat in the vestibule represents the greatest potential risk to the inner ear. Using a carbon dioxide laser with a focal point of 150 microns at 300 mm, fenestrations of the stapes footplate were performed in a series of 14 anesthetized cats. The laser power output ranged from 0.47 to 3.05 W, with pulse durations of 0.2 and 0.5 s. Resultant temperature elevations in the vestibule, measured by a thin-wire thermocouple, ranged from 0 to 4.4 degrees C (0 to 8 degrees F) and directly correlated to wattage and duration of the laser-beam pulse. Temperature changes could be reduced by use of lower wattage, shorter pulse duration, timed intervals between pulses, and convection cooling of the promontory.

Animals↗
PubMed1985

Osteoblastoma of the temporal bone presenting as facial paralysis.

Osteoblastomas of the head region are rare lesions. This paper describes a case of a 4-year-old child with an osteoblastoma of the temporal bone presenting as a facial paralysis. Only 6 previous cases have been reported and none with nerve involvement. A review of the tumor, its differential diagnosis, clinical course and management is presented.

Bone Neoplasms↗
PubMed1985

Meningioma: a case of transcranial recurrence managed by base-of-skull technique and a review of the tumor.

Meningiomas are the most common benign intracranial neoplasms, and although the otolaryngologist rarely sees these lesions, he or she may encounter them in surgery of the skull base. Surgical removal is the primary treatment modality for these meningiomas. To avoid recurrent disease, the best initial therapy is the most extensive procedure that can reasonably be effected. Chemotherapy and irradiation therapy have, at best, only limited roles in treatment.

Combined Modality Therapy↗
PubMed1985

Long-term adaptive changes of the vestibulo-ocular reflex in patients following acoustic neuroma surgery.

A series of 26 patients undergoing translabyrinthine acoustic neuroma surgery was evaluated pre- and postoperatively using rotatory vestibular testing. Patients were tested immediately prior to surgery and followed long-term at frequent intervals for periods of one week to two years, depending on availability and length of time postoperative. Rotatory testing was performed at multiple frequencies of 0.0125, 0.05, and 0.2 Hz, and the vestibulo-ocular reflex was measured using electro-oculographic techniques. Dependent variables of the slow component of the vestibulo-ocular reflex were derived by computer analysis, including gain, phase, DC bias, ampullopetal and ampullofugal responses of the remaining labyrinth, and asymmetry. These variables changed in a predictable fashion as related to the reciprocal of time. Results of this data are fitted with a linear statistical model, validating the changes.

Adaptation, Physiological↗
PubMed1984

Sensorineural hearing loss associated with ulcerative colitis. A case report.

Autoimmune sensorineural hearing loss was first described in 1979. This may be secondary to a systemic autoimmune disease, or in some cases, to a direct autoimmune insult to the labyrinth. A case of active ulcerative colitis and progressive sensorineural hearing loss responded to corticosteroid therapy.

Autoimmune Diseases↗
PubMed1984

Role of air contrast computed tomography in diagnosis of small acoustic neuromas.

Small acoustic tumors occasionally cannot be diagnosed on standard radiologic studies. Over a 2-year period, air contrast computed tomography (CT) has been used to study 22 patients in whom audiologic and vestibular tests suggested a tumor but no radiologic abnormality could be demonstrated; 8 air contrast scans were positive and subsequent exploration revealed tumors in 7 of these patients. In one patient an aneurysmally dilated anterior inferior cerebellar artery was found on exploration. Thirteen scans showed air filling the internal auditory canal with no evidence of tumor. One scan was nondiagnostic and upon exploration, a vascular loop in the internal auditory canal was found. Air contrast high resolution CT is the most accurate method available for detecting small acoustic neuromas. Indications for this technique are discussed along with general approaches to these patients.

Adult↗
PubMed1984

The human acoustic tensor tympani reflex. A case report.

In a patient with unilateral lower motoneuron facial paralysis secondary to Bell's palsy, we evaluated the characteristics of what we believe to be an acoustically-evoked reflex contraction of the tensor tympani muscle. Ipsilateral stimulation of the involved ear yielded a pattern of impedance change different from the pattern characterizing normal stapedius muscle contraction. Threshold of the reflex was elevated, amplitude was large and variable, onset latency was greater, onset rise was more gradual, and offset decay was more rapid. Contralateral stimulation, with probe in the involved ear, failed to elicit the reflex contraction. Upon return of facial nerve function, the normal stapedius reflex contraction reappeared in response to both ipsilateral and contralateral stimulation.

Acoustic Impedance Tests↗
PubMed1984

Auditory evoked potentials--the cochlear summating potential in detection of endolymphatic hydrops.

With an expanded clinical and normative SP amplitude series, we have re-examined the incidence of SP enlargement in clinically defined Meniere and cochlear ears. The overall incidence of SP enlargement in the expanded series is somewhat less than that found in our previous study (56% versus 68%). This difference may be due to considerable preselection of patients included in the previous smaller clinical population, since many of these patients were recruited for the study because of diagnosed Meniere's disease. In contrast, the present, larger clinical population was selected from our normal service referral base, and thus contains a much higher percentage of diagnostic problems. The comparison between SP enlargement and hearing levels demonstrates that the SP test for Meniere's disease must be interpreted in the light of high-frequency hearing levels. If the patient has normal or near-normal hearing (4- to 8-kHz hearing levels 25 dB or less), SP enlargement will not be a good criterion for detecting the presence of Meniere's disease. Gibson and colleagues and Kumagami and associates have reported similar observations. Also, in the presence of severe high-frequency hearing loss (above about 70 dB), SP enlargement occurs relatively infrequently among ears with clinical diagnoses of Meniere's disease. However, in the mid-range (25 to 70 dB) of high-frequency loss, SP enlargement appears to provide a reasonably accurate test for Meniere's disease (with a "hit rate" among clinically defined Meniere ears of about 71%).(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Stem↗
PubMed1983

Eosinophilic granuloma in the temporal bone and skull.

Eosinophilic granuloma is a benign lytic lesion of bone, probably arising from an abnormal proliferation of histiocytes. It may occur within the temporal bone and be confused with more common disorders such as aural polyps or chronic suppurative otitis media. If untreated, the disease may destroy the bony labyrinth and spread to the middle and posterior cranial fossas. Temporal bone lesions may represent only one manifestation of a more extensive multifocal disorder (i.e., Hand-Schüller-Christian or Letterer-Siwe disease). From 1967 to 1982, 25 patients with eosinophilic granuloma of the skull were treated in the radiation therapy department of The Methodist Hospital in Houston. Six of these patients had disease involving the temporal bone. After analyzing these cases and reviewing the literature, we conclude that the management of the patient with eosinophilic granuloma in the temporal bone requires a diagnosis based on microscopic examination of the affected tissue, a definition of the extent of disease, therapy consisting of biopsy and low-dosage radiotherapy in the unifocal disease, and careful and continued follow-up.

Adolescent↗
PubMed1981

Glomus tumors of the temporal region. Technique of surgical resection.

Since a previous study conducted at the Ear, Nose and Throat Department, University Hospital, in Zurich, Switzerland, 16 additional cases of glomus jugulare of the temporal region have been evaluated and treated surgically in this department. This article describes our experience with these additional cases and gives an in-depth description of the surgical techniques that are used in the treatment of more complicated tumors. We report one case in detail.

Adult↗
PubMed1981

Polyarteritis nodosa as a cause of sudden deafness. A human temporal bone study.

Pathological changes in the temporal bone are described in a case of polyarteritis nodosa in a 48 year old man in whom the onset of sudden unilateral deafness and vertigo occurred seven months prior to death as one of the early manifestations of the disease. The patient had received only a seven week course of prednisolone and, earlier, a two week course of anti-inflammatory agents. Autopsy revealed involvement of the arteries supplying the kidneys, testes, and pancreas. Changes within the temporal bone were seen bilaterally and there was thickening of the mucosa of the middle ear. Inner ear involvement was mainly limited to the cochlea, the deaf ear showing more pronounced changes. These changes included loss of the organ of Corti in the hook portion of the basal coil, absence of the tectorial membrane, and atrophy of the stria vascularis. The scala tympani was obliterated by fibrosis and new bone formation. The scala media showed hydrops, and a marked decrease in the spiral ganglion cells and nerve fibers supplying this portion of the cochlea was evident. Focal changes were seen throughout the remainder of the cochlea. The vestibular structures showed no detectable pathologic changes. Small vessel arteritis was found in the dural and subacuate vessels in both temporal bones.

Arteries↗
PubMed1980

Identification of the location of vestibular lesions on the basis of vestibulo-ocular reflex measurements.

Quantitative analysis of electro-oculographic recordings of eye movement in response to precise visual and vestibular stimuli makes possible the differentiation of three categories of vestibular syndromes due to pathological changes in three different parts of the visual vestibulo-ocular reflex arc: (1) decreased vestibulo-ocular reflex gain (e.g., decrease in slow component velocity), but normal fast components and visual-vestibular interaction (labyrinth and eighth nerve); (2) normal slow component velocity but abnormal fast components to all stimuli (pontine or medullar reticular formation); and (3) normal slow component velocity to vestibulo-ocular stimulaton but abnormal visual-vestibular interaction as well as normal fast components (visual-motor pathways or cerebellum).

Cerebellar Diseases↗
PubMed1980

Intact acoustic reflexes in the presence of ossicular disruption.

The potential usefulness of impedance studies is reviewed and a case of osteogenesis imperfecta, having bilateral ossicular discontinuity and intact acoustic reflexes, is presented. This seeming paradox was explainable on the basis of surgically confirmed, bilateral disruption of the stapes crura, central to the stapedial tendon insertion.

Acoustic Impedance Tests↗