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Biomedical subjects

M Tos

Publications and source records attributed to M Tos.

At least 379 records · Page 21Linked to original sources
PubMedDate not supplied

Inverted papilloma: a follow-up study including primarily unacknowledged cases.

Inverted papillomas (IPs) in the nose or the paranasal sinuses exhibit a tendency for rapid growth with bone destruction, a high recurrence rate, and an association with malignancy, requiring early diagnosis and aggressive surgical therapy. A number of operative approaches have been reported in the literature, with greatly varying results. Furthermore, the incidence of IP and the association with carcinoma are not well-established. In this study, we present a series of 42 patients with IP. Drawing from the resources of two institutes of pathology, we reviewed all specimens of nasal cavity or paranasal sinus tissue taken between the years 1975 and 1986, and performed a thorough follow-up of all IP patients. The incidence was found to be 0.6 cases per 100,000 inhabitants per year in a well-defined representative geographic region. Two patients had concomitant carcinoma. When the initial surgical approach was lateral rhinotomy, the recurrence rate was 50%. This was not significantly different from that noted following excision through a sinusectomy (62%) or simple endonasal excision (43%). However, initial procedures were selected individually, mainly on the basis of tumor size and location. Accordingly, a limited procedure is considered justified even in cases with lateral lesions, if the tumor is sufficiently visible and confined. In other cases, lateral rhinotomy is required. Septal IPs are often detected at an early stage and are therefore often amenable to local excision.

Adult↗
PubMedDate not supplied

Radiologic aspects of inverted papilloma.

A series of 42 patients with inverted papilloma is presented. Of these, 38 patients had radiologic examinations. Thirty patients had comparable radiologic examinations in the form of X-ray of the sinuses and/or tomography and/or CT scan. The preoperative findings were compared and related to the extent of the tumor at surgery. Clinical examination combined with CT appears to be the optimal preoperative procedure. Follow-up should include CT in order to allow comparison with postoperative status and, preferably, also with preoperative radiologic findings.

Biopsy↗
PubMedDate not supplied

Secretory otitis and pneumatization of the mastoid process: sexual differences in the size of mastoid cell system.

Seventy-nine children (41 girls and 38 boys) were subjected to tympanometry nine times from the age of 2 years to the age of 7 years. In addition, otoscopy was performed, and the children's otologic history was recorded. At the age of 7 years, roentgenograms were taken of the mastoid process, and the area of the air cell system was measured by planimetry. The smallest cell systems were found in ears with a history of secretory otitis or chronic tubal dysfunction--a finding which supports the environmental theory of pneumatization. Boys had significantly smaller cell systems (mean, 7.5 cm2; range, 2.75-16.75) than girls (mean, 9.0 cm2; range, 2.5-15.7). The degree of middle ear pathology was significantly higher in boys, as expressed by the total tympanometric score. The more pronounced middle ear pathology in boys was caused by more frequent and severe episodes of upper respiratory tract infections. The analysis of the sex differences provides substantial support of the environmental theory of pneumatization, since upper respiratory tract infections in childhood often cause tubal dysfunction and secretory otitis, conditions that disturb the normal process of pneumatization and result in hypocellularity.

Acoustic Impedance Tests↗
PubMedDate not supplied

Long-term results of surgery for chronic granulating otitis.

The late results of planned one-stage procedures in 229 ears with chronic granulating otitis were analyzed, and the justification for two-stage procedures is discussed. All ears were discharging despite intensive preoperative treatment, and all had severe mucosal pathology. The total re-perforation rate was 12%. Five per cent were closed at re-operation, so that at the last follow-up perforations were found in 7% of the ears. The average observation period was 11 years (range, three to 20 years). After one operation, 91% of the ears were dry, and after the re-operations, 98% of the ears were dry. The re-operation rate was 16%. Because of these results obtained by planned one-stage procedures, the authors do not recommend two-stage procedures in non-cholesteatomatous conditions. The authors furthermore conclude that canal-up mastoidectomy is preferable in non-cholesteatomatous granulating otitis.

Adolescent↗
PubMedDate not supplied

Nasal glands and goblet cells in chronic hypertrophic rhinitis.

Partial turbinectomies were done in 13 patients suffering from chronic hypertrophic rhinitis. The mucous membranes were fine-dissected, and mucous elements were stained and counted using the PAS-alcian blue whole-mount method. Cross-sections were made from the whole-mount specimens. There was a great variety of epithelial types. Comparison of the density of mucous elements in normal patients and patients with chronic hypertrophic rhinitis revealed no statistically significant differences.

Adult↗
PubMedDate not supplied

Epidemiology of acute suppurative otitis media.

The incidence of acute otitis media in childhood reported in the literature varies considerably, particularly for children in the first year of life. In three cohorts of otherwise healthy children, followed from birth to the age of 9 years, the authors have attempted to determine more accurately the incidence and prevalence of acute otitis media in childhood. The incidence is highest in the first year of life, at about 22 per cent, after which time it gradually decreases from 15 per cent in the second and 10 per cent in the third and fourth years of life to 2 per cent in the eighth year. By the end of the third year of life, 50 per cent of all children have had at least one episode of acute otitis media; by the age of 9 years, 75 per cent have had an episode. The prevalence is almost constant at about 25 per cent during the first five years of life, dropping to 7 per cent during the eighth and ninth years of life. For the entire series, no sexual differences could be demonstrated with regard to incidence and prevalence of acute otitis media. By far, the majority of attacks (80 per cent) during the first two years were bilateral, whereas after the sixth year of life, 86 per cent of the children experienced unilateral disease.

Acute Disease↗
PubMedDate not supplied

Cholesteatoma in children: recurrence related to observation period.

From 1965 to 1978, 122 children with cholesteatoma had one-stage surgery. Follow-up examinations were carried out several times, with the last two taking place in 1980/81 and 1985/86. Ninety-eight percent of the children were seen at follow-up; the median observation time was 11 years, with a range of three to 21 years. The increase in recurrence rate with increasing observation time was analyzed. In 1980/81 there was a total recurrence rate of 12 percent of patients, including residual cholesteatoma in the tympanic cavity in 8%, in the attic in 2%, and recurrent cholesteatoma in 2%. In 1985/86 the recurrence rate had increased to 17%, distributed among residual cholesteatoma in the tympanic cavity in 10.6%, in the attic in 1.6%, and recurrent cholesteatoma in 4.8%. The recurrence rate was the same regardless of whether modified canal-wall-up mastoidectomy or canal-wall-down mastoidectomy had been employed. We conclude that cholesteatoma surgery should be individualized according to pathologic findings in the tympanic cavity, tubal function, and size of the mastoid air cell system. Small cholesteatomas confined to the tympanic cavity may be removed by tympanoplasty alone, without mastoidectomy. In ears with adhesive otitis, canal-wall-down mastoidectomy is preferred; and in ears with a reasonably good tubal function and a large air cell system, canal-wall-up mastoidectomy is recommended. The long-term results reported here seem to indicate that, in children, canal-wall-up mastoidectomy is preferable to canal-wall-down mastoidectomy.

Adolescent↗
PubMedDate not supplied

Cerebrospinal fluid loss and threshold changes. 1. Hearing loss in the contralateral ear after operation for acoustic neuroma: an analysis of the incidence, time course, frequency range, size and pathophysiological considerations.

In a prospective study, 60 patients who underwent surgery for unilateral acoustic neuromas had the hearing on the contralateral ear tested before and several times after surgery. In 40 patients, a threshold increase was found during the following 9 days. The changes were greatest in the low frequencies immediately after surgery, but after 1 week the treble also became involved. After 3 months, the hearing was normalized. The elder patients more than 50 years of age were more often affected, whereas sex, tumor size, surgical approach or duration of surgery had no influence. The pathophysiological mechanisms are discussed and an intracochlear fluid dysfunction caused by the loss of cerebrospinal fluid is suggested.

Adult↗
PubMedDate not supplied

Silastic and gelatin film sheeting in tympanoplasty.

In 78 patients, representing 10% of the most severe case of chronic otitis media and in whom the mucosa from the promontory had been removed or severely damaged, the promontory was covered in one-stage mastoidectomy-tympanoplasty with a large piece of thin silastic or of Gelfilm. The results in the silastic group, comprising 50 patients, and in the Gelfilm group, comprising 28 patients, were compared on the basis of various criteria. The results proved better in the Gelfilm group. In particular, the percentage of recurrent perforations was considerably lower than in the silastic group. In one-stage operations, which we prefer, it is therefore recommended to use Gelfilm rather that silastic.

Chronic Disease↗
PubMedDate not supplied

Goblet cell population in the normal middle ear and Eustachian tube of children and adults.

On 54 temporal bones from entirely normal prematures and newborn infants, children, and adults, 30,000 to 90,000 counts of goblet cells were done in different parts of the Eustachian tube and middle ear. In the Eustachian tube, normal prematures showed a very low density of goblet cells in all localities, increasing in the pharyngeal parts gradually through childhood and reaching in the normal adult a very high density in the pharyngeal orifice. There are no differences in density between the medial and lateral wall, but in some parts a decrease of density towards the tubal roof. In the middle ear the density is low in normal prematures, increasing slightly in infants, and decreasing again during the age range 7-14 years and in adults. Goblet cells are present in all middle-ear localities, but in markedly decreasing density in this sequence: hypotympanum anteriorly, posteriorly, promontory anteriorly, in the middle, epitympanum, niche of oval window, antrum, niche of round window, mastoid process, incus, and promontory posteriorly.

Adolescent↗