Biomedical subjects

M Fradis

Publications and source records attributed to M Fradis.

At least 55 records · Page 3Linked to original sources

PubMed1996

Drug-induced tinnitus and other hearing disorders.

Tinnitus and hearing loss, both reversible and irreversible, are associated both with acute intoxication and long term administration of a large range of drugs. The mechanism causing drug-induced ototoxicity is unclear, but may involve biochemical and consequent electrophysiological changes in the inner ear and eighth cranial nerve impulse transmission. Over 130 drugs and chemicals have been reported to be potentially ototoxic. The major classes are the aminoglycosides and other antimicrobials, anti-inflammatory agents, diuretics, antimalarial drugs, antineoplastic agents and some topically administered agents. Prevention of drug-induced ototoxicity is generally based upon consideration and avoidance of appropriate risk factors, as well as on monitoring of renal function, serum drug concentrations, and cochlear and auditory functions before and during drug therapy. Ototoxicity, although not life-threatening, may cause considerable discomfort to patients taking ototoxic drugs, and in some cases drug discontinuation may be necessary to prevent permanent damage. Much research has been performed to investigate the causes and mechanisms of ototoxicity, to try to prevent this complication. Despite these efforts, ototoxicity still occurs, and there is much work to be done in order to understand the mechanism of ototoxicity of different drugs and to prevent hearing loss and tinnitus in the future.

Anti-Bacterial Agents↗

PubMed1996

Do Frenzel glasses have a place in the modern electronystagmography laboratory?

Electronystagmography (ENG) is generally performed with the patient's eyes closed to prevent visual fixation. In this way, direct observation of eye movements is impossible. By means of Frenzel glasses (FG), the direct observation of eye movements is possible, but the effectiveness of visual fixation suppression and the diagnostic contribution of FG must still be studied. One hundred seven patients with vertigo participated in this study. Each patient underwent a complete ENG test under two fixation modalities: (a) closed eyes and (b) open eyes with FG. The spontaneous nystagmus and the Hallpike test did not show any significant difference between the two fixation modalities. The slow-phase velocity of nystagmus with the caloric test was significantly greater with closed eyes, but the pattern of nystagmus with FG fixation was more tooth-shaped and regular than that with closed eyes. It is concluded that using FG when performing an ENG may improve its diagnostic value.

Adolescent↗

PubMed1996

Tympanoplasty in adults: a five-year survey.

In order to identify factors that could influence the success of tympanoplasties in adults, a retrospective study of 291 tympanoplasties performed on patients aged 15 years and older during the years 1984-1989 was carried out. Surgical success was defined as an intact membrane after two years follow-up and hearing improvement of at least 15 decibels. The success rate of the tympanoplasties was 90%. A functioning eustachian tube was found to be important for graft take. No difference was found in the rate of graft take regardless of whether fascia of the temporal muscle or tragal perichondrium was used or if fibrin glue was used. An audiological improvement was seen in 77% of the patients, and no significant difference regarding hearing gain was found between the different prostheses. It is concluded that tympanoplasty in adults is a simple operation with a high probability of success which can improve the quality of life of those operated upon.

Adolescent↗

PubMed1996

Type I tympanoplasty in children.

To identify factors that could influence the success of tympanoplasties in children, a retrospective study was done of 51 tympanoplasties performed on children aged 9-14 years during the years 1984-1989. Surgical success was defined as an intact membrane found after 3 years' follow-up. The success rate of tympanoplasties was 92%. A functioning eustachian tube was found to be important for graft take. No difference was found in the rate of graft take whether fascia of the temporal muscle or tragal perichondrium was used. An audiologic improvement was seen in 70.6% of the patients. We conclude that tympanoplasty in children has a high probability of success and will enable most children operated on to resume a normal lifestyle.

Adolescent↗

PubMed1995

[The stria vascularis of the inner ear and its normal structural variations].

The ultrastructural effects of gentamicin on the stria vascularis of the inner ear of guinea pigs were studied by transmission electron microscopy. In a single specimen of an isolated, inner ear we found an unexpected variation in the structure of the stria vascularis in a normal, pigmented, guinea pig not treated with ototoxic drugs. There were prominent, wide protrusions from the apical surfaces of marginal cells into the endolymphatic space. This finding has not been previously reported and was seen in only 1 of 7 animals studied. It may be considered a normal structural variation, and is not pathological change in the stria vascularis due to ototoxic drugs.

Animals↗

PubMed1995

Brain stem auditory evoked potentials: effects of ovarian steroids correlated with increased incidence of Bell's palsy in pregnancy.

To investigate the effect of ovarian steroids on the brain stem during changes of estrogen and progesterone blood levels, we recorded brain stem auditory evoked potentials with increased stimulus rates from 26 women treated for sterility by menotropins (Pergonal and Metrodin). These women were divided into three groups according to their estrogen and progesterone blood levels. The brain stem auditory evoked potential results revealed a significant delay of peak III only, with an increased stimulus rate in the group with the highest estrogen level. Estrogen may cause a brain stem synaptic impairment, presumably because of ischemic changes, and thus also may be responsible for a higher incidence of Bell's palsy during pregnancy.

Adult↗

PubMed1995

Post-laryngectomy pharyngocutaneous fistula--a still unresolved problem.

Fifty-six total laryngectomy cases are presented with special reference to post-operative fistula formation. All these patients were operated upon at the Department of Otorhinolaryngology at the Bnai Zion Medical Centre by one surgeon over a 16-year period, from 1976-1992. The incidence of fistula was 12.5 per cent. This paper could not verify reports that any specific factors were significantly related to fistula formation, although there was a preponderance of fistulas in patients presenting with late stage tumours. No relationship was found with rate of infection, age, or between previous neck irradiation (ranging from 5500 to 7000 cGy) and fistula formation in the patient population. If a fistula occurs, the administration of oral solid food keeping the nasogastric tube in place for administration of fluids may lead to spontaneous closure of the fistula, with no need for secondary surgical repair.

Age Factors↗

PubMed1995

Dirofilaria repens infection in northern Israel.

The fourth case of zoonotic Dirofilaria repens infection in Israel is reported, and the diagnostic morphologic characteristics of this filariid are reviewed. The importance of the exact anatomic diagnosis of this filaria is stressed in view of the fact that Israel has pockets of settlers from East Africa, a region endemic for lymphatic filariasis (Wuchereria bancrofti). Since the possibility of introduction of such an infection into the country exists, differentiating this zoonotic Dirofilaria from other filarial worms is essential. The clinicopathological features of a Dirofilaria repens infection are distinct. The patient initially has a painful subcutaneous or conjunctival swelling; the excisional biopsy shows the presence of a dead or alive, usually female worm that measures 220-660 microns across; the central intestine and the genital organs (two uteri) are located in the pseudocoelom; the thick, multilayered cuticle is provided with 95-105 sharp, longitudinal ridges, the latter being separated from each other by a distance of 12 microns; the circumferential muscle cell layer, covering the inner side of the cuticle, is bilaterally interrupted by the large chord cells, two to five nuclei of which are discernible in each cross section.

Animals↗

PubMed1995

Idiopathic Subjective Tinnitus Treated by Amitriptyline Hydrochloride/Biofeedback.

The efficiency of two treatment modalities for subjective/idiopathic tinnitus (SIT): biofeedback (BF) and amitriptyline hydrochloride (AT) was investigated in 225 randomly selected subjects. Findings show that after 10 weeks of treatment in the BF group, 43.5% of the patients reported an improvement of tinnitus during activity. In the AT group, 27.5% of patients reported subjective improvement of tinnitus at rest although only 15.8% of the AT patients reported improvement during activity. Biofeedback during rest had a significantly better effect on tinnitus disturbance than AT. No objective diminishment of tinnitus loudness was found as a result of any of the treatment modalities. We believe that BF can help tinnitus patients especially during periods of rest and we also suggest trying tricyclic antidepressant drugs such as AT for treatment of tinnitus patients, in small doses, however, to minimize the side effects of this drug. Subjective tinnitus (ST) is one of the most common and yet most unclear of otologic symptoms.(1-4) ST can accompany any type of hearing loss including both sensorineural as well as conductive hearing loss, and may originate from any part of the auditory pathway.(1,5) Treatment of ST must be primarily directed to the basic illness diagnosed after a thorough general ear-nose-throat and neurologic evaluation.(6) Severity of ST is evaluated both objectively, by determining the pitch and intensity of the tinnitus,(7) and subjectively as described by the patient. Because of the relatively high incidence of ST and in some patients, the severe personal reaction to it, many different treatments have been suggested, but generally only small to moderate success has been achieved in reducing tinnitus and its consequences, if any at all.(8) In this study we examined the effect of two treatment modalities: amitriptyline hydro-chloride and biofeedback.

Journal Article↗

PubMed1995

Tinnitus in Children - Still a Neglected Problem.

In general, pediatric tinnitus and head trauma, induce tinnitus in children, in particular, which are a neglected problem in Ear, Nose, and Throat and pediatric medicine. A case report and the pertinent literature demonstrating this issue are presented. It is recommended to perform controlled studies regarding pediatric tinnitus in order to identify, and treat it, so as to minimize its damage. Subjective tinnitus which is often reported as being very disturbing is rarely mentioned in the pediatric population.(l) Nodar(2) mentioned in his literature review of 11 years, that he found only two publications dealing with tinnitus in children. This fact is even more amazing as tinnitus is not uncommon in the pediatric population; 13%(3) to 29%(4) of normal hearing children and 59% of children who had their hearing screened at school(3) complained of tinnitus. Tinnitus was reported in 66% of children with moderate to severe deafness and in 29% of deaf children.(5) Out of those with moderate to severe deafness, 30% complained of a very disturbing tinnitus (every day in frequency, of at least 30 minutes duration and grade III out of three severity degrees of loudness). Although tinnitus in children is as common as in the adult population, children generally do not complain spontaneously of having tinnitus.(5) Out of 403 children with tinnitus only 3% complained spontaneously.(4) This discrepancy between the high incidence of tinnitus and low rate of spontaneous complaint in children may be explained by the fact that the child considers tinnitus to be a normal event, as it has usually been present for a long period of time.(6) A second explanation of this discrepancy lies in the fact that the child may not distinguish between the psychological impact of the tinnitus and its medical significance.(6) Even if a child does not mention the existence of tinnitus, nevertheless, it may cause difficulties in concentration and bring about behavioral problems.(5) Pediatric tinnitus, despite its incidence and behavioral sequela, has not received adequate consideration in the otolaryngological and pediatric literature; furthermore, there is complete disregard concerning the post traumatic tinnitus in children. There is no reason why such an important etiologic factor reported in the adult population(7,8) would not be present in the pediatric population, in which head trauma is, at least, as frequent as in the adult one.

Journal Article↗

PubMed1995

Results of surgery for chronic otitis media: a 5-year study.

The results of 601 operations of the middle ear, including 50% of myringoplasties, performed between 1984 and 1989 are analysed. The standard Schuller's view radiography and the scanner are unreliable in determining the presence of a cholesteatoma recorded in 119 cases. The functional value of the Eustachian tube is important for taking the graft. On the other hand, there was no significant difference in the results depending on whether or not fibrin sealant was used, depending on the seat of the perforation, on the use of a homograft or of an autograft, and on age (before or after 14 years).

Adolescent↗

PubMed1995

Angiolymphomatoid hyperplasia with eosinophilia of the oral mucous membrane.

A 59-year-old patient is reported with a protruding, mucosal nodule within the mandibular alveolar fold. Histological examination of the excised mass disclosed angiolymphoid hyperplasia with eosinophilia (histiocytoid hemangioma). Though the lesion was not completely excised and invaded the adjacent muscle of the floor of the mouth, there was no recurrence during a follow-up period of 17 months.

Angiolymphoid Hyperplasia with Eosinophilia↗

PubMed1995

[Chronic otitis media].

Results of middle ear operations performed between 1984-1989 were analyzed. The operations included 139 simple mastoidectomies, 68 radical mastoidectomies, and 41 simple mastoidectomies with tympanoplasty. 342 tympanoplasties were also performed, 51 in children up to 14 years old and 291 in those over 14. We conclude that the Schuller view and CT are not conclusive as to the presence of cholesteatoma, and cannot be relied on without other confirmation in planning the type of operation. Of patients with cholesteatoma who underwent simple mastoidectomy, in 21.1% the cholesteatoma recurred and revision or radical mastoidectomy was necessary. When the Eustachian tube was patent, the graft took in more than 90% of cases. Fibrin glue did not affect the results of tympanoplasty or myringoplasty. Graft take was similar in those under and over the age of 14. Tympanoplasty in children has a good chance of succeeding, and enables most to return to a normal life (including swimming).

Adolescent↗

PubMed1995

The precision level of the objective hearing tests.

A comparative study was performed with 51 patients, using the stapedial reflex (ART), early auditory brain-stem responses (ABR), later auditory evoked potentials (SN10) and the audiogram, to assess the value of objective tests in the evaluation of the auditory level. The ABR and the SN10 are valid to determine the level of hearing. The ART s of limited value.

Audiometry↗

PubMed1994

[Supravoltage irradiation as a cause of maxillary fibrosarcoma].

Therapeutic doses of supravoltage radiation are not commonly thought to be carcinogenic and post-irradiation fibrosarcoma of the head and neck regions is rare. We present a 43-year-old man with post-irradiation fibrosarcoma of the maxilla, who had had supravoltage radiation 12 years before for nasopharyngeal carcinoma.

Adult↗

PubMed1994

Perilymphatic fistula--the value of diagnostic tests.

Perilymphatic fistula (PLF) remains one of the most challenging problems in otological practice. Fifty-two consecutive patients (53 ears) who underwent explorative tympanotomy for suspected PLF between 1985-1992 were included in this study. The clinical picture, history, patients' complaints and laboratory tests were analysed and compared with the operative findings. The conclusions of our work are that the diagnosis of PLF is based mostly on the clinical picture and a battery of laboratory diagnostic tests, but no one test is truly diagnostic for PLF.

Adult↗

PubMed1993

Is the vestibular system affected by middle ear effusion?

The association between middle ear effusion (MEE) and vestibular pathology is controversial. To investigate this point, 50 children with MEE scheduled for myringotomy and grommet, and 20 normal hearing children without MEE scheduled for adenotonsillectomy, underwent vestibular investigations by craniocorpography and rotatory chair, preoperatively and postoperatively. Most of the correlations, preoperative vs. postoperative, and study vs. control groups, were nonsignificant. Assuming that serous labyrinthitis is responsible for vestibular involvement in MEE, the lack of significant vestibular pathology in our study could probably be explained by the fact that no children with acute otitis media episodes or otalgia were included.

Audiometry↗

PubMed1993

Squamous cell carcinoma of the nasal septum mucosa.

Primary squamous cell carcinomas of the nasal septum constitute only 9% of all malignant tumors of the nasal cavity. We present 16 cases occurring during a 14-year period. As the initial signs of these carcinomas are no different from non-neoplastic disease, a high index of suspicion is necessary in order to correctly diagnose these lesions. It seems to us that when the diagnosis of nasal septum carcinoma is established, the best method of treatment is wide surgical excision and immediate repair of the defect by a split-skin graft.

Adult↗