Search PubMed⌕ Search

Biomedical subjects

M Tos

Publications and source records attributed to M Tos.

At least 217 records · Page 12Linked to original sources
PubMed1983

Sensorineural hearing loss in posttraumatic incus dislocation.

In 34 posttraumatic incus dislocations, the initial sensorineural hearing loss (primary) after the trauma and that 11 years after trauma (late) were analyzed. Primary hearing loss measurements following the trauma showed that 53% of patients had sensorineural hearing loss of more than 10 dB for at least one of the frequencies from 1,000 to 4,000 cps, 18% for more than 30 dB. For late hearing loss after the trauma, the corresponding percentages were 50% and 15%, respectively. No reliable progression of the posttraumatic sensorineural hearing loss was found, although a few exceptions were seen. It may be concluded that sensorineural hearing loss is not a progressive disorder of the inner ear.

Adolescent↗
PubMed1983

Goblet-cell density in human bronchus in chronic bronchitis.

In 50 patients, up to six mucosal biopsy specimens were taken during bronchoscopy from the medial part of the trachea and from the main and lobe bronchi, and the density of goblet cells was studied using the whole-mount method. No significant differences in density were found between the trachea and the main or lobe bronchi in the normal patients or in the cases with abnormalities. In the normal patients, the interindividual median density was 127 cells per field corresponding to 7,200 cells/sq mm; in chronic bronchitis, there were 174 cells per field corresponding to 9,800 cells/sq mm. The goblet-cell density was found to be significantly higher in smokers than in nonsmokers.

Adult↗
PubMed1983

Tympanosclerosis of the drum in secretory otitis after insertion of grommets. A prospective, comparative study.

In 193 consecutive children with bilateral secretory otitis, intubation and adenoidectomy were performed on the right ear and paracentesis on the left. Changes in the ear drum were analysed at re-evaluation one to three years after operation. In ears that had been intubated, tympanosclerosis occurred significantly more frequently (48 per cent) than in ears that had not been intubated (10 per cent). The frequency of atrophy of the pars tensa was the same. Of the right ears, 10 per cent were re-intubated, compared with 23 per cent of the left ears. The cause of the increased frequency of tympanosclerosis in the intubated ears must be mechanical, as decreased movements of the drum with inflammatory fibrous hyperplasia impede spontaneous normalization and promote hyalinization and calcification. The hearing was found to be similar in ears with and without tympanosclerosis.

Child↗
PubMed1983

Acoustic neuromas (diagnostic value of testing the function of the trigeminal nerve, the cerebellum and optokinetic nystagmus).

The involvement of the trigeminal nerve, cerebellum, and optokinetic nystagmus in patients with acoustic neuromas, as well as the methods of investigation, are described. The corneal and/or facial sensibility was found to be reduced in 29 per cent of the whole series and in 53 per cent of tumors larger than 40 mm. There was a significant correlation between reduced corneal and/or facial sensibility and the findings of pressure at the trigeminal root at operation. Only three patients had a persistent reduction of trigeminal function post-operatively. Cerebellar dysfunction was found in 32 per cent, but significantly more frequently (58 per cent) in patients with tumors larger than 40 mm. Post-operatively, six patients had cerebellar symptoms in the form of gait disturbances; five of these patients had a supplementary suboccipital removal performed, after the initial translabyrinthine approach. A defective optokinetic nystagmus was found pre-operatively in 10 patients, nine of whom had tumors larger than 40 mm in diameter. All patients with a defective optokinetic nystagmus had a large anatomic impression in the pons at operation. In patients suspected of having an acoustic neuroma, symptoms from the trigeminal nerve, the cerebellum and the optokinetic nystagmus predict the presence of a large tumor and subsequent difficulties at operation. The symptoms were completely reversible in the vast majority of cases and post-operative symptoms persisted only in patients in whom tumor removal was difficult and the tumor very large. Testing of the trigeminal nerve, the cerebellum and the optokinetic nystagmus still deserves its place in the diagnostic work-up of patients with unilateral acoustic or vestibular symptoms, especially in cases with severe hearing impairment, which necessitate the use of tests that are independent of acoustic function.

Adult↗
PubMed1983

Acute epiglottitis. A management protocol based on a 15-year material.

During a 15-year period 141 patients were treated for acute epiglottitis. 70 of the patients needed an artificial airway which was established by means of nasotracheal intubation. The mean intubation time was 41 h. All patients except 1, who suffocated before a free airway could be established, were discharged from the hospital without any serious sequelae. A follow-up study revealed no serious physical or psychological damage caused by the intubation treatment. On the basis of our 15-year material and the literature a protocol for the handling of patients suspected for acute epiglottitis is presented.

Acute Disease↗
PubMed1983

Changes in point prevalence of secretory otitis in preschool children.

By performing annual tympanometric screenings of randomly selected children in the winter, the changes in the point prevalence rate of secretory otitis could be estimated during childhood. The tympanometric conditions deteriorated from the age of 4 to the age of 5, and a significant increase in the point prevalence of type B, i.e. flat curve, from 14 to 18% was noted. However, from the age of 5 to the age of 6, an insignificant change was found in the point prevalence of type B (15%) and Eustachian tube dysfunction. In contrast, a marked improvement of the function of the Eustachian tube as well as a drastic fall in the prevalence of secretory otitis to 7% could be demonstrated from the age of 6 to the age of 7. At each trial some children have dropped out for various reasons. However, the tympanometric conditions of the dropouts largely followed the general pattern of the children who attended all trials.

Age Factors↗
PubMed1983

Placebo effect in surgery for Meniere's disease: three-year follow-up.

In 1981 we published the results of a double-blind, placebo-controlled study in which the efficacy of a regular endolymphatic sac mastoid shunt was compared with a purely placebo operation (mastoidectomy) in controlling the symptoms of 30 patients with typical Meniere's disease. Minor differences could be demonstrated between the shunt and the sham operation, but the greatest difference was between the preoperative and postoperative scores, and both groups improved significantly. It was concluded that the impact of the various endolymphatic sac shunts on the symptoms of patients with Meniere's disease is nonspecific, and that the 70% improvement in both groups was most likely caused by a placebo effect. At the time of the presentation, the results were based on a 1-year follow-up of all patients. As of January 1982 the patients had been followed for a minimum of 3 years. The 3-year results are the same as our results from the first year: no significant difference could be found between the two groups.

Adult↗
PubMed1983

Specific cellular immunity in acoustic neuroma patients.

An indirect leukocyte migration agarose technique to detect cell-mediated immunity was modified to obtain a specific assay for release of human leukocyte migration inhibitory factor. Acoustic neuroma patients exhibited a significant cellular immune response against acoustic neuroma extract (P less than .01) as well as perilymph from acoustic neuroma patients (P less than .01) when compared to healthy control persons. All 19 patients tested reacted to acoustic neuroma extract. Seven of 21 perilymph samples did not elicit migration inhibition. Crossover determination of antigenicity of two negative and four positive perilymph samples against three patients revealed highly reproducible results, uncorrelated to perilymph concentration of potassium and protein. Flow cytofluorometry did not reveal malignant DNA patterns in 10 acoustic neuromas examined. Immunofluorescence studies did not reveal autoantibodies against acoustic neuromas in sera from 11 patients. The responsible antigen(s), the mechanism of immunization, and the diagnostic implications remain to be determined.

Adult↗
PubMed1983

Distribution of mucus producing elements in the respiratory tract. Differences between upper and lower airway.

Based on quantitative studies of glands and goblet cells in the nose, sinuses, trachea and bronchi a short survey on distribution of mucus producing elements is presented and the density of glands and goblet cells compared between upper and lower respiratory pathways. The gland density is highest in the nose 8.3 glands/mm2 low in the trachea, bronchi and nasopharynx, but the gland mass per gland is 3-4 times larger in these regions than in the nose. In the paranasal sinuses the gland density is extremely low and the mucus producing capacity almost negligible. In the nose the goblet cell density is highest in the inferior turbinate, lowest in nasal septum.

Adult↗
PubMed1983

Epidemiology and spontaneous improvement of secretory otitis.

The results of 25 repetitive impedance screenings of three cohorts of children are presented. The point prevalence of a type B tympanogram was 13% at the end of the first year of life, 11-18% during the second, third, fourth and fifth year of life, decreasing to 7% during the sixth and seventh year of life. The period prevalence during the first year of life was 15% and at least 30% during the second, third, fourth and fifth year of life, indicating that about 80% of all healthy children have had at least one period with a type B tympanogram and 40% have had at least one recurrent episode. Spontaneous improvement of secretory otitis occurs frequently, and it is recommended to wait 3-6 months before instituting surgical treatment.

Acoustic Impedance Tests↗
PubMed1983

Treatment of cholesteatoma in children. A long-term study of results.

The late results of cholesteatoma surgery in a consecutive study of 122 children primarily operated on in one stage from 1965 to 1978 and seen at follow-up several times are presented. Of the children, 97 percent were seen at least once during an observation period of 2 to 16 years. Recurrent cholesteatoma was found in 12 percent, of whom 8 percent had residual cholesteatoma in the tympanic cavity, 2 percent in the attic, and 2 percent had recurrent cholesteatoma in the attic. Results with a modified canal up technique were slightly better than with canal down technique. Retractions in the attic using canal up technique were found in 30 percent, but the openings gradually increased and they ended up being harmless, self-cleaning cavities. The results of various hearing tests were satisfactory--best in cases with an intact ossicular chain, which it is recommended always to preserve. Cholesteatoma surgery must be strictly individualized according to the pathology of the patient. No single method is superior in all cases.

Adolescent↗
PubMed1983

Acoustic neuromas. Progression of hearing impairment and function of the eighth cranial nerve.

The results obtained by conventional otologic evaluation are reported for fifty-nine patients with acoustic neuromas, sixty-one patients primarily suspected of an acoustic neuroma but in whom Pantopaque cisternography had invalidated the diagnosis, and in seventy-one patients with Meniere's disease. The audiologic tests were confined to the following: pure-tone audiometry, speech audiometry, recruitment examination by ABLB and Metz recruitment tests, and examination for reflex decay a.m. Anderson. Nineteen patients had an audiogram taken at their initial visit with the otologist, and already at this examination--4.2 years before the diagnosis was made--a high-tone hearing impairment was present. Fourteen patients had anacusis in the tumor ear and one patient had an impairment of 90 dB. The audiologic evaluations are based only on patients with hearing equal to or better than 80 dB. There was no connection between preoperative hearing impairment and the age at operation, and anacusis was found in all age groups. Four patients had recruitment by the ABLB test and six patients by the Metz recruitment test. When these two tests were combined, two patients had recruitment by both tests. Twenty percent had pathologic stapedial reflex decay. Only one patient had a normal differential caloric test. It is concluded that the typical patient with an acoustic neuroma has a gradually increasing unilateral hearing impairment of eight years' duration. A pronounced high-tone impairment with PTA of 55 dB and a poor discrimination score are to be expected. The patient is uncertain at pure-tone threshold determination and displays a lack of recruitment at both ABLB and Metz recruitment tests. The patient has a decreased or nonexistent differential caloric reaction in the ear in question. A normal differential caloric test does in all probability exclude an acoustic neuroma; however, all possible audiometric and anamnestic configurations may be encountered, and deviation from the "typical" picture should not lure the investigator into excluding the presence of a neuroma.

Adult↗
PubMed1982

Spontaneous course and frequency of secretory otitis in 4-year-old children.

Five repetitive tympanometric screenings performed during one year in 288 randomized, otherwise healthy 4-year-old children showed that 50% of ears changed tympanogram type between each trial. The total frequency of secretory otitis was high; thus, 32% of all 576 ears had type B at least once and 73% had either type B or C2, indicating a middle ear pressure of -200 mm H2O or lower. At three trials during at least six months, 8% had type B and 24% either type B or C2. The spontaneous improvement of secretory otitis was high, and type B improved in 78% to 88% of ears, although in some ears the type again deteriorated. Severe changes of the tympanic membrane were found in 0.5% of ears, and it is therefore advised to postpone surgical treatment of secretory otitis for three to six months.

Acoustic Impedance Tests↗
PubMed1982

Modification of combined-approach tympanoplasty in attic cholesteatoma.

Late results of operations on 224 attic cholesteatomas were analyzed three to 16 years after operation. In 133 ears a modification of combined-approach tympanoplasty was applied and in 91 ears a conservative radical operation with obliteration was performed. All ears were operated on in one stage and 11% were reoperated on during the observation period. No significant differences between the two methods were found, neither with regard to recurrent cholesteatoma--found in 6% with canal-up technique and in 2% with canal-down technique--nor regarding hearing results. With canal-up technique, retractions developed in 38% of ears that progressed and often ended up being small, peaceful, open cavities. It is concluded that treatment of cholesteatoma should be individualized, that no single method is preferable in all cases, and that an intact ossicular chain should be preserved.

Cholesteatoma↗