Recurrent middle ear mucosal herniation: a complication of tympanoplasty.
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Adult↗
Biomedical subjects
M D Graham
Publications and source records attributed to M D Graham.
Malignant hyperthermia. Cause and treatment.
Malignant hyperthermia (MH) is one of the most devastating crises encountered in medicine, and it frequently occurs unexpectedly. Since a patient's survival depends on early detection and treatment, a high index of suspicion must be maintained not only by the anesthesiological but also by all surgical personnel in the operating room. Physical stigmata and historical findings can help surgeons to detect those patients who may be at risk for the development of MH. The surgical procedure should be promptly stopped, and medical therapy should be started. Step-by-step treatment of this threatening complication of anesthesia is necessary.
Anesthesia↗
Afterimage versus photographic ocular torsionometry.
Rotation of the eyeballs about the visual axis due to head tilt, counterocular torsion, can provide information relevant to the neuro-otologic status. Measurement of these reflexive movements, however, involves several difficulties. Two methods are examined: determinations by a behavioral afterimage technique are compared with those of a photographic method in the same subjects using a test-retest format. Results indicate that both procedures yield reliable measurements, and any differences tend to be inconsistent. Thus, the faster and less expensive afterimage technique appears suitable for many clinical purposes in assessing vestibulo-ocular function.
Adult↗
Transmastoid labyrinthectomy: further experience with the indications, complications and early post-operative results.
Persistent labyrinthine symptoms may manifest as unsteadiness, veering, or frank rotational vertigo. When these symptoms are resistant to medical therapy and are associated with hearing in the involved ear which is not of a serviceable level then a transmastoid labyrinthectomy may be of value in ridding the individual of this disability. We have found that this operation may be performed expeditiously and safely, and if the entire vestibular epithelium is removed then the results of surgery are effective and predictable.
Adult↗
Atelectatic tympanic membrane reversal by nitrous oxide supplemented general anesthesia and polyethylene ventilation tube insertion. A preliminary report.
In certain instances an adherent atelectatic tympanic membrane (Sade Stage IV) may be successfully elevated off the promontory and ossicles by the use of nitrous oxide anesthesia and restored to a normal position and configuration by polyethylene ventilation tube insertion. Criteria of reversibility and long term follow-up of the tympanic membranes so restored remain to be elucidated.
Anesthesia, General↗
Surgical exposure of the facial nerve: contemporary transtemporal techniques.
Contemporary surgical exposure of the facial nerve has as its aims adequate exposure of the facial nerve at any point in its course, with preservation of hearing and vestibular function, and without further injury to the facial nerve and the necessity for producing a mastoid cavity. Today it is surgically possible to expose the facial nerve from the brainstem to its terminal branches in the face. A decade of experience has shown that if the operator is armed with intimate anatomic knowledge of the temporal bone and middle and posterior fossae, and if the principles of facial nerve surgery outlined earlier are meticulously adhered to, these aims may be accomplished. A system of surgery has been presented in detail with discussion of the advantages, disadvantages, and technique of the operation. By utilizing the appropriate procedure or combination of procedures, the otologic surgeon will realize the goals of predictable and safe surgical exposure of the facial nerve.
Cranial Fossa, Posterior↗
Postoperative accumulation of bone in the middle ear: effect on hearing and surgical implications.
Two patients with conductive hearing loss caused by the intraoperative accumulation of bone particles in the middle ear are presented. This complication of otologic surgery may be prevented by an awareness of its possibility and by the temporary blockage of the aditus ad antrum in those operations involving mastoidectomy, even utilizing suction irrigation of the surgical field during the procedure. Once this condition is established, tympanotomy may confirm the presence of bone debris in the middle ear and the material may then be removed, with elimination of the conductive hearing loss.
Adult↗
Transmastoid labyrinthectomy indications. Technique and early postoperative results.
Persistent labyrinthine symptoms may manifest as unsteadiness veering or frank rotational vertigo. When these symptoms are resistant to medical therapy and are associated with hearing in the involved ear which is not of a serviceable level, then a transmastoid labyrinthectomy may be of value in ridding the individual of this disability. We have found that this operation may be performed expeditiously and safely; and if the entire vestibular epithelium is removed, the results of surgery are effective and predictable.
Adult↗
Extracanalicular osteomas of the temporal bone.
Extracanalicular osteomas of the temporal bone are rare neoplasms. Eight new cases are reported and a review of the literature is presented. These tumors are benign, slow growing, and composed predominantly of mature bone. Although they may occur anywhere in the temporal bone, they are prevalent in the mastoid and squama. Except for cortical lesions that are seen initially as cosmetic deformities, these tumors are usually unsuspected roentgenographic findings. Treatment is indicated for symptomatic osteomas. Mastoid lesions are readily excised. Tumors involving the middle and inner ear are most frequently small and tend to remain stable in size; consequently they are usually managed expectantly.
Adult↗
Panel discussion: glomus jugulare tumors of the temporal bone. Radiological appearance of glomus tumors.
Depending upon the stage of pathogenesis, some glomus tumors demonstrate characteristic radiographic findings which permit a presumptive diagnosis of this type of tumor. Three factors are helpful in interpreting multidirectional tomography of the temporal bone when a glomus tumor is suspected. The tumor shows a predilection for bony erosion of the carotid crest and hypotympanum. It tends to destroy bone in its path by small lobulated invasions producing a fairly well demarcated border of crescentic shaped translucencies. In contradistinction to other tumors and infections, glomus tumors tend to spare the lateral wall of the attic and the ossicular chain even when the tumor if fairly well advanced in size.
Glomus Jugulare Tumor↗
The ultrastructure of cholesterol granuloma of the middle ear: an electron microscope study.
The ultrastructure of giant cells in cholesterol granuloma is described, with particular reference to their role in the absorption of cholesterol needles. Cholesterol is a highly resistant substance in its crystalline form and it is confirmed that the giant cells are endowed with endoplasmic structures and organelles and are partly crowded with lysosomes, as evidence of the active role of the giant cells in the absorption and removal of cholesterol formed in the granuloma from blood, mucus or necrotic material.
Adult↗
Theoretical analysis of diffuse reflectance from a two-layer tissue model.
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Absorption↗
Human otoconia in surgical specimens.
The utricular otoconia of four patients, which were removed during surgical procedures (one for an eighth nerve section operation and three for removal of acoustic neuromas) with the use of the translabyrinthine approach, were observed with the scanning electron microscope. The otoconia of these patients showed some abnormal features. In three of the four patients, a number of otoconia were found to have cracked lines. One of these patients was a 14-year-old boy; the other patients were more than 40 years old. In the remaining case, the otoconial facet surfaces were rough, and a few otoconia were unusually shaped.
Adolescent↗
Human incus long process depressions in the surface of the normal ossicle.
Depressions in the bone surface of the normal human incus long process are found with great frequency. This paper reviews the frequency and distribution of these depressions, discusses their histologic appearance, and speculates upon their significance. While their clinical significance is unclear, they may be related to several conditions encountered in otologic practice.
Ear Ossicles↗
Acromegaly and the temporal bone.
Acromegaly is a chronic disease of middle life resulting from excessive secretion of growth hormones by the acidophil cells of the anterior pituitary. The typical clinical features include enlargement of the skull, thorax, hands and feet. Recently, three patients with acromegaly have been operated upon for active otologic disease. In spite of massive mastoid cortex bone, the structures of the otic capsule were found to be of normal dimensions and in the usual relationships.
Acromegaly↗
Toward organism identification through analysis of bacterial colonies.
The clinical problem of bacterial identification has been approached by applying pattern-recognition techniques to multi-wavelength surface-scattering and reflectance data derived from real-time scans of isolated colonies. Preliminary results, obtained from blood-agar plates inoculated with a mixture of staphylococci, streptococci and escherichieae, indicate that these organisms can be differentiated with better than 90% certainty, provided the colonies are physically separated and their growth conditions closely controlled. Data collection and classification characteristics of the experimental system are briefly described; it is felt that the technique, possibly expanded to include boundary characteristics of the colonies, may offer a viable means of identifying clinically important bacteria.
Autoanalysis↗
The jugular bulb: its anatomic and clinical considerations in contemporary otology.
Advances in neurotologic diagnosis and surgery has pointed to the need for a complete reassessment of the relationship and significance of the jugular bulb and sigmoid sinus is discussed and selected temporal bone sections presented to illustrate the varying locations of the jugualr bulb. Considerations in differential diagnosis are presented and examples of surgical procedures are discussed wherein the jugular bulb was encountered and the methods of management are detailed in these instances.
Adult↗
The hypoglossal nerve. Its relationship to the temporal bone and jugular foramen.
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Bone Neoplasms↗