Size/shape analysis of aerodigestive foreign bodies in children: a multi-institutional study.
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Child, Preschool↗
Biomedical subjects
N W Todd
Publications and source records attributed to N W Todd.
Bony anatomy of the anterior epitympanic space.
The anatomy of the anterior epitympanic space is complex and relatively unfamiliar to the surgeon. The size of the space is unpredictable. From the surgeon's perspective, we studied the bony anatomy of the anterior epitympanic space in 35 cadavers. There was an impressive variability of bony openness into the anterior mesotympanum; the openness was bilaterally symmetrical. As a potential auxiliary ventilation route for the epitympanum of the chronic otitis patient, each specimen was found to have sufficient room to surgically establish a route at least 2 mm in diameter to connect with the anterior mesotympanum. None of the specimens had dehiscent facial nerve in the anterior epitympanic space, but 60% of specimens had dehiscent facial nerve adjacent to the stapes. The anatomic variations of the anterior epitympanic space were not related to prior otitis media. Three fourths of the medial walls of the anterior epitympanic spaces lacked the bony trabeculae that are otherwise typical of the epitympanum. Because the medial wall contours were bilaterally symmetrical, because the contours were unassociated with indicators of prior otitis media, and because of apparent contour differences in Orientals and Caucasians, a congenital factor is suggested to determine the contour of the medial wall of the anterior epitympanic space.
Adult↗
Sympathetic stimulation and otic blood flow.
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Animals↗
Relationship of eustachian tube bony landmarks and temporal bone pneumatization.
Anatomic and functional differences of the eustachian tube have been suggested as etiologic factors in patients with otitis media. We studied eustachian tube lengths and vectors of the tensor veli palatini muscle in 25 unilateral specimens from adult human cadavers. The extent of temporal bone pneumatization, as determined by computed tomography and plain lateral radiographs, was used as an indicator of prior otitis media. Increased length of the cartilaginous eustachian tube was associated positively (r = .53, p less than .01) with volume of pneumatization. However, neither the length of the bony eustachian tube nor the vector of maximum pull of the tensor veli palatini muscle was associated statistically with the extent of pneumatization. It may be that the longer cartilaginous eustachian tube is more protective of the middle ear.
Adult↗
Side-hole suction for ear surgery.
Surgical trauma to the soft tissue of the external ear canal and middle ear increases inflammation and scarring. A side-hole suction tip has been found to minimize suction-tip trauma, preclude the need to aspirate through synthetic sponge or cotton, and facilitate graft placement.
Ear, Middle↗
Mastoid size determined with lateral radiographs and computerized tomography.
Minimal pneumatization of the temporal bone is characteristic of otitis media. The classic radiographic assessment of mastoid air cell system size is the Runström II view, but the Law lateral view is the commonly used clinical view in the United States. Isolated temporal bone specimens are most accurately positioned using a modified Law Lateral view (with the film perpendicular to the central X-ray beam). Computerized tomography is the best radiographic means of assessing mastoid pneumatization. The mathematical relationships of mastoid pneumatization size determined by the Runström II, Law, and modified Law lateral radiographs, and computerized tomography were determined in 30 adult cadaver specimens. These data may facilitate additional study of otitis media.
Adult↗
Observations on the relation of environmental and behavioral factors to the occurrence of otitis media among Indian children.
Studies were conducted to assess the relation of environmental and behaviora factors to occurrence of acute suppurative otitis media (ASOM) among four populations of Indian children in Arizona. Episodes of ASOM were recorded for 1,428 children observed during the first year of life. Data obtained on the households and premises of these children included number of persons in the household, number of sleeping rooms, type of water supply and sewage disposal, type of heating and cooling, availability of electricity, method of infant feeding, distance to a health facility, and mother's education. The rates of ASOM for the four populations ranged from 1.1 to 2.2 attacks per child and differed significantly from each other, with one exception. The differences between populations apparently were not related to any of the factors evaluated. Additional analyses to evaluate the association of each factor with occurrence of ASOM included (a) a comparison of rates among children living in homes having each factor with rates among children living in homes lacking the factor, (b) a comparison of the frequency of each factor in homes of children who had no recorded attacks of ASOM with the frequency in homes of children who had three or more attacks (high-risk children), and (c) an evaluation of the relation between frequency of encounters for ASOM and the environmental factors. Results did not indicate that any environmental or behavioral factor observed was consistently or strongly associated with either the incidence of ASOM or the frequency of attacks. Similarly, no differences were apparent in the frequency of adverse environmental conditions in homes of infants with contrasting rates of ASOM. Rates of ASOM during the first year of life were not associated with either the presence or the absence of adverse environmental conditions.
Arizona↗