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Biomedical subjects

J Elidan

Publications and source records attributed to J Elidan.

At least 55 records · Page 3Linked to original sources
PubMed1994

The superior wall of the cavernous sinus: a microanatomical study.

The superior wall of the cavernous sinus was studied in 30 specimens obtained from 15 cadaver heads fixed in formalin. Trapezoidal in shape, the superior wall of cavernous sinus is limited laterally by the anterior petroclinoid ligament, medially by the dura of the diaphragma sellae, anteriorly by the endosteal dura of the carotid canal, and posteriorly by the posterior petroclinoid ligament. An interclinoid ligament bisects the wall, dividing it into two triangles: the carotid trigone anteromedially and the oculomotor trigone posterolaterally. Similar to the lateral wall of the cavernous sinus, the superior wall is formed by two layers: a smooth superficial dural layer and a thin, less defined deep layer. In the area of the carotid trigone, both layers separate to wrap the anterior clinoid process. The removal of this process will reveal a "clinoid space" medial to which the internal carotid artery can be identified. This clinoid segment of the artery, still extracavernous, is surrounded by two fibrous rings: a distal ring formed by fibers of the superficial dural layer and a proximal ring related to the deep dural layer. Below the proximal ring, the internal carotid artery becomes intracavernous; above the distal ring, the artery is continuous with its supraclinoid segment. The complex dural anatomy of the superior wall, its fibrous rings, and the clinoid space in relation to a superior surgical approach to the cavernous sinus are discussed.

Abducens Nerve↗
PubMed1993

Traumatic macroglossia.

A case of severe macroglossia resulting from trauma (tongue biting) during eclampsia and causing respiratory obstruction is described. Despite medical treatment with steroids and antibiotics for a week, followed by tracheostomy, no significant improvement was observed. After an energetic but cautious maneuver of reducing and restraining the tongue in the oral cavity, the swelling reduced dramatically in 24 to 48 hours. Earlier manual replacement of the tongue into the oral cavity is advised in order to arrest the cycle of venous and lymphatic obstruction and congestion that leads to further edema and increased tongue swelling. The mechanism of traumatic macroglossia is discussed.

Adult↗
PubMed1992

[Transoral approach to the lower clivus and upper cervical spine].

5 cases were operated via a transoral approach for basilar impression (2 cases), tumor (2), or traumatic dislocation of the odontoid process (1). In all except 1 there was compression of the lower medulla and/or upper cervical cord. Posterior cervical fusion was also performed in 2 patients. There was significant improvement in all the patients who presented with neurological deficits. Surgical morbidity was low and there was no mortality. The use of the operating microscope, microdrill, self-retaining mouth retractor, flexible oral endotracheal tube, and intraoperative fluoroscopy permit a safe, direct approach to the lower clivus and upper cervical region.

Child, Preschool↗
PubMed1992

The microsurgical anatomy of the abducens nerve in its intracranial course.

The microsurgical anatomy of the abducens nerve through its intracranial course was studied in 20 specimens obtained from 10 cadaver heads fixed in formalin. Another 20 specimens were used to study the pattern of branching of the nerve trunk. The following intracranial segments were studied: subarachnoid or intracisternal, petroclival, and intracavernous. Angulations, neurovascular relationships, and branching patterns of the nerve are described. The long intracranial course of the abducens nerve, its tortuosity, and its tight attachment to the skull base at the level of the petrous apex may influence its vulnerability in some pathological conditions.

Abducens Nerve↗
PubMed1991

[Tumors at the skull base].

Tumors at the skull base, usually benign, present diagnostic and therapeutic challenges. Thus they necessitate close cooperation between the departments of otolaryngology, head and neck surgery, neurosurgery, anesthesia and diagnostic radiology. We therefore set up a special team for diagnosis and treatment of such cases. 2 representative cases of benign tumors at the skull base operated through the combined middle cranial fossa--infratemporal fossa approach are presented in detail.

Adult↗
PubMed1991

Effect of cyclosporine A on the hearing loss in Behçet's disease.

Thirty-five patients with Behçet's disease (20 under cyclosporine A [CyA] treatment and 15 under the conventional therapy), 12 patients suffering from endogenous uveitis, and 35 normal subjects were evaluated audiologically before entering the study and were followed up for at least a year. Twenty-eight Behçet patients (80%) showed some degree of hearing loss. The averaged pure tone audiogram of the Behçet group showed statistically significant auditory deficits in comparison with that of the control group. None of either the Behçet group or the uveitis group showed any hearing deterioration during the follow-up period. Five Behçet patients under CyA therapy demonstrated improvement in their hearing. The difference between the two groups of Behçet patients (CyA versus conventional treatment) was found to be statistically significant (p less than .05). Thus, CyA might serve as an important mode of treatment of sensorineural hearing loss on an inflammatory "autoimmune" background.

Acoustic Impedance Tests↗
PubMed1991

Short latency vestibular evoked response to angular acceleration impulse in human beings.

Vestibular evoked response (VsEP) to acceleration stimuli were recorded in experimental animals and in human beings by scalp electrodes. The stimuli are angular acceleration impulses (up to 30,000 deg/sec2) transmitted to the skull by special devices. The short latency vestibular evoked response consisted of several waves during the first 10 msec. The first two waves (P1 and P2), which are the most consistent, have been shown in cats to originate from the vestibular nerve and nucleus, respectively. The middle latency response is believed to be of myogenic origin. It is hoped that the recording of VsEP in human beings will enable the localization of the site of lesion in vertiginous patients.

Adolescent↗
PubMed1991

Transverse ligament rupture and atlanto-axial subluxation in children.

We report four children aged two to nine years with traumatic tears of the transverse ligament of the atlas and atlanto-axial subluxation. This is extremely rare in this age group since trauma usually causes a skeletal rather than a ligamentous injury. The injuries resulted from falls or motor vehicle accidents, with considerable delay in diagnosis. Flexion radiographs showed atlas-dens intervals (ADI) of 6, 7, 8 and 13 mm; all four patients were treated by posterior fusion at C1-C2 after the failure of conservative treatment. In one child with quadriparesis and a fixed ADI of 13 mm, transoral anterior resection of the odontoid was performed before the fusion. Diagnosis of this traumatic lesion requires a high level of suspicion. Conservative treatment is likely to fail; surgical stabilisation is indicated.

Atlanto-Axial Joint↗
PubMed1991

Dorello's canal: a microanatomical study.

The microsurgical anatomy of Dorello's canal has been studied in 20 specimens obtained from 10 cadaver heads fixed in formalin. The bow-shaped canal through which courses the abducens nerve before reaching the cavernous sinus is located inside a venous confluence which occupies the space between the dural leaves of the petroclival area. The petrosphenoidal ligament (Gruber's ligament), which forms the posteromedial wall of the canal, appears as a fibrous trabecula surrounded by venous blood. Canal measurements were performed and its anatomical relationship with the sixth cranial nerve is described. Angulations of variable degrees were observed in the course of the nerve inside and outside the canal. The influence of this relatively tortuous course of the abducens nerve upon its vulnerability in some pathological conditions is discussed.

Abducens Nerve↗
PubMed1990

Manometry and electromyography of the pharyngeal muscles in patients with dysphagia.

Simultaneous recording of the electromyographic activity of the pharyngeal muscles and the intraluminal pressure in the upper sphincter zone was performed routinely in patients with swallowing problems for the first time, to our knowledge. This technique was found to be very useful for the localization of the "site of lesion." The procedure is safe, easy to master, and causes minimal inconvenience. It can reveal, in the most direct way, whether the disturbance is in the hypopharyngeal musculature (represented by the inferior constrictor muscle), in the cricopharyngeal muscle (spasm or lack of relaxation), or in the synchronization between them. Simultaneous recording of intraluminal pressure adds valuable information about the mechanical events associated with electromyographic activity. It was found that in pathologic cases there is quite often no correlation between the electrical and mechanical events. Thus, simultaneous recording of both electrical and mechanical events is essential for the understanding of the pathophysiology of disturbances of deglutition.

Adult↗
PubMed1990

Vestibular evoked potentials with short and middle latencies recorded in humans.

Following success in recording short latency vestibular evoked potentials in experimental animals, we have succeeded in our attempts to record such potentials in human subjects. The stimuli were repetitive, short steps of high intensity angular acceleration (10,000 degrees/sec2) with short rise times which would synchronously activate many neurons of the vestibular pathway. Stringent control procedures ensured that the recorded activity was not an artefact. Short latency vestibular evoked potentials were recorded in 10 normal subjects with peak latencies of 3.5, 6.0 and 8.4 msec and amplitudes of 0.5 microV. Middle latency potentials were also recorded with latencies of 8.8, 18.8 and 26.8 msec and amplitudes of 15 microV. These responses were absent in a cadaver and in patients with bilateral dead labyrinths. In normal subjects, these vestibular evoked potentials were not affected by white noise. In conclusion, short and middle latency vestibular evoked potentials were recorded in normal human subjects.

Adolescent↗
PubMed1990

Electromyography of the inferior constrictor and cricopharyngeal muscles during swallowing.

Electromyography (EMG) of the inferior pharyngeal constrictor (IC) and the cricopharyngeal (CP) muscle was recorded in 18 patients with swallowing and/or aspiration problems who were candidates for cricopharyngeal myotomy. The EMG recordings were compared to those of 13 "normal" subjects who did not suffer from such problems. Differences in EMG activity between the control group and the patient group were considered with respect to the clinical symptoms in the patient group. Recording of EMG in the CP and IC muscles is relatively safe, useful, and easily mastered. The technique may provide important information regarding the function of some of the muscles involved in deglutition.

Adult↗
PubMed1990

Posttraumatic gustatory rhinorrhea.

We describe a case of gustatory rhinorrhea in which gustatory stimuli caused nasal obstruction and secretion simulating cerebrospinal rhinorrhea. This disorder was presumably caused by faulty regenerated parasympathetic nerve fibers reaching the nasal mucosa or, possibly, by a congenital condition. The characteristics of this disorder are compared with other autonomic disorders of the head and neck.

Autonomic Nervous System Diseases↗
PubMed1989

The firing properties of second-order vestibular neurons in correlation with the far-field recorded vestibular-evoked response.

Action potentials of the second-order vestibular neurons of ten cats were recorded, both in rest and responding to sinusoidal and intense impulse acceleration stimuli. The data were compared with the far-field recorded vestibular-evoked response induced by the same impulse stimuli. It was found that the irregular (kinetic) neurons, which had a phase lead relative to head velocity, were capable of responding to these impulses with a latency as short as 3.5 msec after the start of head acceleration. It is assumed, therefore, that these neurons are the generators of the second wave of the vestibular-evoked response, having a similar latency. A high correlation was found between the latency of the first peak in the poststimulus time histogram in response to acceleration impulses and the phase of the response to sinusoidal rotations. The regular (tonic) vestibular neurons did not respond to acceleration impulses and probably did not contribute to the vestibular-evoked response.

Animals↗
PubMed1989

Metastatic maxillary sinus melanoma treated by local excision and brachytherapy.

Malignant melanoma has traditionally been considered a radioresistant tumor. A rare case of metastatic malignant melanoma into the nose and maxillary sinus is presented. Local control was achieved by a combination of local excision and teleradio and brachytherapy. The response of melanomas to radiation treatment is discussed in light of the recent literature.

Aged↗
PubMed1987

The neural generators of the vestibular evoked response.

A new method for the induction and recording of a short-latency vestibular evoked response (VsER) to intense acceleration impulses with skin electrodes was studied in cats. The first two waves, P1 and P2, had latencies of 2.5 and 3.5 ms, respectively, and coincided with the recorded gross neural activity in the vestibular nerve and nuclei, respectively. Single second-order vestibular neurons with low and irregular activity responded to the same acceleration impulses with a latency as short as 3.5 ms.

Animals↗