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Biomedical subjects

M D Graham

Publications and source records attributed to M D Graham.

At least 91 records · Page 5Linked to original sources
PubMed1984

Glomus tumors of the temporal bone: contemporary evaluation and therapy.

Surgical management of glomus tumors of the temporal bone requires accurate preoperative assessment and a knowledge of temporal bone anatomy, contemporary microsurgical techniques, and appropriate postoperative management. Care should be exercised to minimize postoperative neurologic deficit and deformity resulting from surgery of this usually benign lesion. The primary preoperative goal is to determine the extent of the lesion; although the history and physical examination are helpful, radiologic delineation of the tumor is imperative. Recent advances in surgical approaches and techniques have allowed the removal of larger tumors with lessened mortality and morbidity. Our overall experience in this series of glomus tumors leads us to believe that surgical excision is the treatment of choice for the treatment of glomus tumors of the temporal bone.

Adult↗
PubMed1984

Conductive hearing loss, middle ear ossicular anomalies, malformed thickened lop auricles, and micrognathia. A rare autosomal dominant congenital syndrome.

A rare congenital autosomal dominant syndrome of thickened bilateral lop auricles, conductive hearing loss, ossicular anomalies, and micrognathia is reported. The anomaly is presumably a defect in the first and second branchial arch development during the sixth and seventh weeks of gestation with an auricle abnormality (first and second arch), abnormal incus and malleus (first and second arch), abnormal stapes (second arch), and micrognathia (first arch). Recognition of low-set or malformed auricles with a unilateral or bilateral conductive hearing loss should alert the otolaryngologist to possible middle ear abnormalities and other associated branchial cleft anomalies. Surgical correction of the congenital conductive hearing loss may include prosthetic ossicular reconstruction and otoplasty. The possibility of associated congenital anomalies of other systems (for example, vestibular, cardiac, genitourinary, reproductive, and so on) should be evaluated. An accurate pedigree and family medical and genetic history should be obtained to screen for other involved family members and for assessment of genetic passage of the trait.

Adult↗
PubMed1984

Post-traumatic cholesteatoma of the external auditory canal.

Post-traumatic cholesteatoma of the external auditory canal is a rare condition which is not mentioned in any of the American or British otological reference works. Three cases are described, and the pathogenesis, management, and medico-legal implications discussed.

Adult↗
PubMed1984

Surgical management of Meniere's disease with endolymphatic sac decompression by wide bony decompression of the posterior fossa dura: technique and results.

The results of wide bony decompression of the posterior fossa in 49 consecutive individuals with idiopathic unilateral Meniere's disease are reported. These results are similar to many previously published series, 71% of individuals are free of vertigo and 86% have unchanged or improved hearing. Utilizing the classification proposed by the American Academy of Ophthalmology and Otolaryngology, 73% fell into Class A, B, or C with relief of vertigo. These results together with the low complication rate encourages us to consider surgery at an earlier date, hoping to stabilize hearing at a more useful level and to relieve vertigo.

Adolescent↗
PubMed1984

Tympanic membrane cholesteatoma (keratoma).

Four cases of tympanic membrane cholesteatoma are presented and the characteristics of this lesion are discussed. Failure to recognize and remove all the squamous epithelium medial to the tympanic membrane at the time of grafting eventually will result in graft breakdown due to continued production and desquamation of squamous epithelium into the middle ear.

Adult↗
PubMed1984

Transmastoid labyrinthectomy: surgical management of vertigo in the nonserviceable hearing ear. A five-year experience.

We have continued to employ transmastoid labyrinthectomy since reporting our results for the first 15 patients. Further experience has confirmed our earlier findings that the vestibular system rapidly accommodates to complete unilateral surgical vestibular ablation, regardless of age and vestibular activity of the ear operated upon as measured by bithermal caloric testing. Patients are able to ambulate in one to three days and typically return home three to eight days postoperatively. Only 7 percent of sixty patients retained occasional unsteadiness and only two individuals stated that they suffered constant unsteadiness. Once compensated, there was no instance in which vertigo or unsteadiness returned during the follow-up period. In the individual with unilateral sensorineural hearing loss and incapacitating dysequilibrium, the ear with the hearing loss can be reliably implicated as the one producing the vertigo, regardless of the vestibular activity in that ear as measured by the bithermal caloric test. As we gain more experience, this has continued to be a valid assumption. No individual has lost hearing in the contralateral ear during the period of observation. Dysequililbrium with all its variants--rotary vertigo, instability, veering , ataxia, and lightheadedness--is one of man's most disabling and incapacitating afflictions and affects an individual's ability to pursue normal life and work. We continue to be impressed with the length of time many individuals have borne this incapacitation; one-third of our patients have been incapacitated for over five years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Facial nerve neuromas: radiologic evaluation.

Eight patients who had facial nerve neuromas were examined, and the radiographic findings are reported. Thin section tomography, high resolution computed tomography, posterior fossa computed tomography, and cerebellopontine angle cisternography using Pantopaque (iophendylate) demonstrated bone erosions and soft tissue masses conforming to the course of the facial nerve. The lesions generally exhibited either a proximal or a distal pattern of nerve involvement. Radiologic imaging frequently permits a correct preoperative diagnosis and accurate definition of the extent of facial nerve neuromas, assessments that are important for proper patient management.

Adult↗
PubMed1983

The human vestibular organs observed by scanning electron microscopy.

In many of the reports dealing with disorders of the human inner ear the histology comes from temporal bone dissection. In the past decade the scanning electron microscope has changed, to a degree, the approach to inner ear investigation. However, many problems remain with adequate preservation of specimens from human temporal bones. Ordinarily, human material is obtained from cadavers at autopsy as soon as possible after death, and postmortem changes are evident. At the Otologic Medical Group, Inc., in Los Angeles, many translabyrinthine operations for acoustic neuromas are performed. This report covers findings from vestibular specimens obtained during surgery for removal of acoustic neuromas (four cases) and during eighth nerve surgery (one case).

Acoustic Maculae↗
PubMed1983

Hemangioma of the external auditory canal.

Hemangiomas involving the posterior bony external auditory canal and adjacent tympanic membrane, although rare, do appear to be a specific disease entity of the human external auditory canal. To date it has been reported in two males in their sixth decade of life. This third case in the world literature, which is reported here, appears to confirm the original description of Freedman and colleagues in 1972. Total surgical excision with tympanic membrane grafting appears to be effective in removal of this benign neoplasm.

Ear Canal↗
PubMed1982

Osteomas and exostoses of the external auditory canal - medical and surgical management.

Osteomas and exostoses have distinct clinical and histopathologic features. Osteomas are usually solitary, pedunculated, bony growths attached to the tympanosquamous or tympanomastoid suture line, characterized histologically by an internal structure of abundant discrete fibrovascular channels surrounded by irregularly oriented lamellated bone. Exostoses are usually multiple, bilaterally symmetrical, broad based elevations of bone involving the tympanic bone. They are histologically characterized by parallel, concentric layers of subperiosteal bone. The infrequent symptoms resulting from these lesions can usually be managed medically; however, on occasion surgical removal is indicated. While surgical removal of the osteoma is usually possible via the external auditory meatus, we recommend that an exostosis be removed utilizing a postauricular approach.

Adult↗
PubMed1982

Recovery from prolonged sensorineural hearing loss.

Five cases of sensorineural hearing loss are presented in which partial or complete recovery of hearing occurred after periods of deafness lasting from three months to more than five years. Three of the cases were diagnosed as Meniere's disease, one as sudden deafness of probable viral origin, and one as idiopathic sudden deafness. A review of the literature reveals brief mention of only a few similar cases, although it is suspected that the phenomenon is not as rare as these isolated reports suggest. It is proposed on the basis of experimental work in animals that the reversible deafness in these patients may be due to temporary obstruction of capillaries in the stria vascularis, which produces strial hypoxia resulting in a reduction in the endolymphatic potential, with consequent hearing loss.

Adult↗