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Biomedical subjects

M M Paparella

Publications and source records attributed to M M Paparella.

At least 163 records · Page 9Linked to original sources
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↗
PubMed1977

Hearing loss. The physician's responsibility.

Hearing loss is a very important and common problem in the United States, affecting 13 to 14 million people. It is primarily a medical problem, requiring diagnosis and, when indicated, treatment by a physician, preferably in collaboration with an audiologist. History taking is the most important part of the diagnostic process, followed by a physical examination with special attention to the head, neck, and ears. The primary object of the workup is to exclude all possible extrinsic causes of hearing loss. Intrinsic or genetic deafness is a diagnosis of exclusion. After the hearing loss has been classified as congenital or delayed and as genetic or nongenetic, a differential or working diagnosis can be made in all cases and a specific diagnosis in most cases. The hearing loss must then be identified as stable, progressive, or fluctuant over time. Follow-up at least every two years is important to check for possible changes in status.

Diagnosis, Differential↗
PubMed1977

Presbycusis: what is it?

The history and current misusage of the term presbycusis is discussed and current knowledge of pathology associated with presbycusis and aging are reviewed. A study involving retrospective analysis of audiometric data and clinical information on three groups was performed. Results suggest that a group of individuals previously identified as "presbycusic" probably represent undiagnosed cases of familial or genetic related hearing loss. We urge as thorough an identification of correct diagnosis as possible, thus reserving the term "presbycusis" for those rare, soley age-related cases of sensorineural loss.

Aged↗
PubMed1977

Mastoidectomy update.

The long-term results of 375 primary mastoidectomy operations for chronic otitis media and chronic mastoiditis are described and discussed. Two-thirds of these cases were open cavity mastoidectomies and 1/3 closed cavity mastoidectomies. Primary pathology was cholesteatoma in 1/3 and granulation tissue in 2/3 of the cases. The method of reducing the size of the mastoid cavity by sculpturing mastoid cavity by sculpturing mastoid cortical bone is most important in avoiding large postoperative cavity problems. Principles and methods are described. Healing (dry ear) is a more important management objective than hearing and, indeed, enhances the prospects of obtaining a long-term hearing result. Three important phases of controlling mastoid disease (preoperative, operative, and postoperative) are equally stressed. Intact wall tympanomastoidectomy is not recommended in sclerotic mastoids (the majority of our cases) as being unsafe and unnecessary. Revisions, mostly minor, were done in 31% of the cases for a total of 521 procedures. We recomment a one-stage tympanomastoidectomy. Multiple planned procedures are, in the main, unnecessary and should be avoided to reduce unnecessary hospitalization and expense.

Adolescent↗
PubMed1976

Certain oxidative and hydrolytic enzymes in the middle ear effusion in serous otitis media.

Activities of various oxidative (LDH, MDH) and hydrolytic (LAP, alkaline- and acid phosphatase, and lysozyme) enzymes in serous middle ear effusions (MEE) and serum from patients with serous otitis media were studied. The ratio of enzyme activity between MEE and serum (MEE/serum) was greater than one for all enzymes studied indicating a higher activity of these enzymes in MEE than in serum. These findings are consistent with a hypothesis suggesting the release of enzymes from inflammatory processes in the middle ear cavity. These enzymes presumably originate from 1) enzymes normally present in blood, 2) release of enzymes from inflamed middle ear mucosa, 3) release of enzymes from inflammatory cells present in the effusions.

Acid Phosphatase↗
PubMed1976

Endolymphatic sac drainage for intractable vertigo (method and experiences).

This paper describes a method of endolymphatic sac decompression and drainage. The method emphasizes widely exposing dura, avoiding skeletonization of the posterior semicircular canal and draining the sac via a T tube. The results of this procedure in 75 patients, including statistics in 46 ears are discussed. In patients with unilateral disease good results were obtained in control of vertigo in 94 percent of patients and significant improvement in cochlear function in over 30 percent.

Drainage↗
PubMed1976

Meningiomas of the temporal bone.

Meningiomas should be considered in the differential diagnosis of otologic tumors arising from the middle ear and mastoid. It is generally recognized that meningiomas may invade the temporal bone via direct extension from the intracranial space (secondary). It is not generally recognized that meningiomas can develop initially in the middle ear cleft (primary). Representative cases of primary and secondary meningiomas of the temporal bone are described and clinical aspects of diagnosis surgical management are discussed. In order to assess the pathogenesis of meningiomas of the temporal bone, histological studies were done on 200 temporal bone specimens. In certain specimens, ectopic arachnoid granulations, from which primary meningiomas may originate, were identified and described, according to location. One specimen was most unusual in that it contained ectopic glial as well as arachnoidal tissue.

Brain Neoplasms↗