Biomedical subjects

J R Dickins

Publications and source records attributed to J R Dickins.

29 records · Page 2Linked to original sources

PubMed1981

Approach to diagnosis of skull base lesions.

The ability to operate safely on the skull base and yet preserve cranial nerves and leave the patient with minimum neurologic deficit is a fairly new development. The field is expanding rapidly, and lesions that were once deemed unresectable can now be resected. With this in mind, one must maintain an extremely high index of suspicion for lesions in this area. Early diagnosis of skull base lesions is enhanced by a careful neuro-otologic history and physical examination on all patients with complaints of pain, headache, or cranial nerve dysfunction, either motor or sensory. Based on a thorough examination, a tentative lesion localization is made and appropriate special sensory, laboratory, and radiographic tests are used to confirm the abnormality. In addition, it is our responsibility to maintain a knowledge of the state of the art as to treatment possibilities for skull base lesions.

Brain Diseases↗

PubMed1980

A comparative study of neuropathologic changes following pulsed and direct current stimulation of the mouse sciatic nerve.

A controlled study was undertaken to determine whether potentially harmful neuropathologic changes occur in a nerve stimulated with direct current or pulsed current in an experimental setting simulating a clinical procedure. Pulsed current stimulation for 5 and 25 seconds' duration produced nonspecific inflammatory changes similar to those observed in nonstimulated control nerves. Equivalent direct current stimulation produced not only frequent myelin degeneration but also occasional axon degeneration. The pulsed current stimulator thus appears to be equally effective yet far safer than the direct current stimulator.

Animals↗

PubMed1980

Vascular anomalies of the middle ear.

The patient presenting with a red mass behind the eardrum and a pulsating tinnitus may well have a vascular tumor. One must be ever mindful, however, that the mass may represent a congential vascular anomaly. The most common one seen is the uncovered jugular bulb in which the vessel extends superiorly into the middle ear to or above the incudostapedial joint. More rare is the uncovered and posteriorly displaced carotid artery. The purpose of this paper is to review the literature on the subject of vascular anomalies of the middle ear and temporal bone and to discuss the diagnosis and management of these lesions. Illustrative case reports with color photographs are presented as well.

Adolescent↗

PubMed1979

Rehabilitation of the face following traumatic injury to the facial nerve.

Etiology, diagnosis, and surgical management of facial paralysis due to traumatic injury of the VIIth cranial nerve are discussed. Sixty patients are reviewed who underwent some type of surgical procedure for the repair of the facial nerve. These cases are categorized according to etiology, which includes temporal bone fractures, iatrogenic injuries, and penetrating wounds of the head and neck. The results of a poll of eight leading otologists on their approaches to several aspects of the surgical management of these injuries are presented in the Discussion section. The diagnostic and prognostic studies associated with facial paralysis, as well as the more common surgical procedures available for repair of the facial nerve, are briefly reviewed.

Adolescent↗

PubMed1979

Panel discussion: glomus jugulare tumors of the temporal bone. The surgical management of glomus tumors.

The authors describe the diagnosis and surgical management of 70 glomus tumors seen at the Otology Group in an 8 yr. period. The need for bilateral arteriograms to detect associated tumors (carotid body and intervagale) is stressed. A new surgical technique, the modified intratemporal fossa approach, is described for the removal of large glomus jugulare tumors involving the carotid artery. Complications and results are discussed in detail.

Adult↗

PubMed1979

Surgical management of brain tissue herniation into the middle ear and mastoid.

In the well pneumatized temporal bone, the temporal lobe of the brain is separated from the middle ear and mastoid process by a thin layer of bone known as the tegmen. Congenital defects, infection, and trauma can alter this structure in such a way that cerebral tissue herniates into the ear. This unusual condition may precipitate numerous otologic problems such as hearing loss, trapped squamous epithelium, and the potential for meningitis or encephalitis. The purpose of this paper is to define the problem as well as discuss the diagnosis and surgical management. The authors feel this should be a team effort, in many cases employing the assistance of a neurosurgeon, as the repair must often be intradural. Case histories and an extensive review of the literature are to be included.

Adult↗

PubMed1979

Brain stem evoked response audiometry in a clinical practice.

Brain stem evoked response audiometry (BERA) is an effective method of evaluating the auditory pathway from the peripheral endorgan through the brain stem. The authors have found this test to be a valuable adjunct to the neurotologic evaluation and have applied the study to over 500 patients (639 ears) in a 22 month time span. BERA has an excellent success rate (98%) in determining the presence of cerebellopontine angle lesions and is helpful in establishing whether a hearing loss is of cochlear or retrocochlear type. The authors have found BERA of use in the diagnosis of multiple sclerosis as well as other neurologic diseases affecting the brain stem. It is a valid method of dealing with suspected malingerers and those who cannot respond to standard audiometric techniques. BERA has been helpful in determining the threshold of hearing in these patients. The authors conclude that BERA is a clinical study of practical significance and that more otolaryngologists should consider adding it to their diagnostic protocol.

Adolescent↗

PubMed1979