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Biomedical subjects

M M Paparella

Publications and source records attributed to M M Paparella.

At least 19 recordsLinked to original sources
PubMed1979

Infiltration of the tensor tympani and stapedius muscles in otitis media. An experimental study in the cat.

A longitudinal sequential study of otitis media was done in an experimental animal (cat) using eustachian tube obstruction. Fifty animals were used. Cellular infiltration of the tensor tympani and stapedius muscles was studied in a continuum from day 1 to 6 months after inducing otitis media. We observed that there is infiltration of the connective tissue of both muscles in otitis media, and that the cellular changes follow the same pattern as that seen in the mucoperiostium and the round window of the middle ear, although to a lesser degree. In this first report of sequential changes in middle ear muscles in otitis media, clinical implications of these findings are discussed.

Animals↗
PubMed1979

Endolymphatic hydrops and otitis media.

Clinical observation of patients with fluctuant sensorineural hearing loss following or occurring with chronic otitis media led to the hypothesis that endolymphatic hydrops can result from chronic otitis media. Illustrative case reports are described. This hypothesis resulted in a temporal bone study of 560 cases in which 109 temporal bones demonstrated the presence of hydrops and 194 evidenced otitis media. Seventy-five cases demonstrated both otitis media and hydrops, of which 20 cases were selected for more detailed histopathological study. An interesting finding was the presence of apical hydrops in every case of the latter group. Statistical interpretation of this data helped rule out a coincidental or chance occurrence. A discussion of this clinical relationship included the significance of subclinical (silent) otitis media as a possible cause of endolymphatic hydrops.

Adult↗
PubMed1979

Air caloric testing in otitis media. (preliminary studies).

On certain occasions it becomes important to evaluate vestibular function in a patient with otitis media. The potential application of the air caloric test in evaluating such patients was examined. Patients with unilateral otitis media before and after surgery were studied to answer certain clinical questions. More questions were raised than answers provided. The preliminary conclusions from this study are: 1. Patients with tympanostomy tubes or small perforation of one ear may show a caloric response in the perforated ear equal to that of the intact ear. 2. Patients with a large tympanic membrane perforation on one side may show hyperactive caloric responses on the perforated side. 3. Patients with a moist ear may show inverted horizontal nystagmus to warm air caloric testing. This applies to patients with a large perforation or mastoidectomy cavity. 4. Patients with a dry open mastoid or fenestration cavity are likely to show a hyperactive caloric response on the side of previous surgery, accompanied by vegetative symptoms. This size of the cavity appears to be less important than the presence of the cavity per se. 5. Patients may be safely tested in the early postoperative period.

Air↗
PubMed1978

Lactate dehydrogenase as a measure of inflammation in experimental otitis media.

A reliable animal model for acute otitis media due to Streptococcus pneumoniae was used to study the accumulation of lactate dehydrogenase (LDH) in middle ear effusion during acute pneumococcal otitis media and after penicillin treatment. The findings indicate that LDH levels rise in the middle ear effusion during the early phase of acute infection and decrease as the infection resolves over time. Penicillin treatment affects the natural course of infection by resolving most visible signs of inflammation and by sterilizing the middle ear. However, once middle ear infection was established, penicillin treatment did not reduce the elevated levels of effusion LDH, suggesting that inflammation persists after sterilization of infected middle ears.

Animals↗
PubMed1978

Mastoiditis and brain hernia (mastoiditis cerebri).

Ten patients with brain hernia occurring as an insidious complication of chronic mastoiditis coincidentally discovered at the time of surgery are described. Four had previous surgery, six did not. A history of trauma was othwise absent. Cerebrospinal fluid otorrhea did not occur. Our method of management is described. Pathology and pathogenesis are discussed. Three patients had pedunculated brain hernias, while seven had diffuse (fungoid) herniation. Granulation tissue appeared as an important part of the disease process. These may represent abortive attempts at brain abscess formation since the widespread use of antibiotics. Pacchionian bodies may also play a role in the pathogenesis.

Adult↗
PubMed1978

Ménière's disease in children.

Approximately 3% of all patients with Meniere's disease are in the pediatric age group. These children require extensive evaluation. A history of physical or acoustic trauma should be sought and an allergic work-up should be obtained. A search for metabolic disturbances and identification of inflammatory disorders is also necessary. If a treatable etiology is identified, specific therapy should be directed toward its control. If, after careful evaluation, the etiology remains obscure, non-specific therapy should be instituted in an effort to alleviate the symptomatology of Meniere's disease. Surgical decompression of the endolymphatic sac and drainage into the mastoid cavity results in relieving the symptoms, particularly vertigo, and appears to be efficacious in patients who have failed diligent attempts at medical therapy.

Age Factors↗
PubMed1978

Congenital cholesteatoma.

Congenital cholesteatoma of the temporal bone may be encountered by the otologist in the cerebellopontine angle, petrous bone, or middle ear cleft; the latter occurrence seems most likely. The etiology, epidemiologic factors, location of intracranial occurrence, clinical features, methods of diagnosis, differential diagnosis, gross and microscopic pathologic features, and surgical treatment of congenital cholesteatoma are presented. Our personal experience is described. The advantages and complications of various operative approaches are discussed.

Adult↗