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Biomedical subjects

P F Anthony

Publications and source records attributed to P F Anthony.

11 recordsLinked to original sources
PubMed1996

Utricular macular ablation for benign paroxysmal positional vertigo.

Seventeen percent of all vertiginous patients have benign paroxysmal positional vertigo. Treatment can include occlusion of the posterior semicircular canal for control of these positional vertigo symptoms. More recently, use of an argon laser technique to occlude the posterior membranous semicircular canal has been proposed. However, this laser technique was not tolerated by a diabetic patient. This report describes a new technique using the argon laser to ablate the utricular macula in the affected ear in patients with benign paroxysmal positional vertigo. This procedure is done as outpatient surgery under local anesthesia. The procedure successfully resolved benign paroxysmal positional vertigo in 14 patients. Symptoms in these patients improved from 20-100% (median 87%; mean 80%) as measured by the Dizziness Handicap Inventory.

Adult↗
PubMed1996

Laser applications in inner ear surgery.

Argon and carbon dioxide lasers can cause heat shrinkage of the membranous labyrinth without injury to hearing. The argon laser can penetrate the membranous labyrinth and cause destruction of targeted vestibula special sensory epithelium also without injury to hearing. Consequently, these lasers have been used successfully in two treatment techniques for benign paroxysmal positional vertigo, which are discussed in detail. The early techniques for laser assisted resection of the pars superior portion of the inner ear with hearing preservation are discussed.

Animals↗
PubMed1993

Partitioning the labyrinth for benign paroxysmal positional vertigo: clinical and histologic findings.

The incidence of benign paroxysmal positional vertigo (BPPV) has been documented at 17 percent of all vertiginous patients. Partitioning of the labyrinth is a laser technique for resolution of BPPV. In 1991 Anthony partitioned the posterior semicircular canal of two patients and eliminated their BPPV in 24 hours, which was much sooner than anticipated. This paper presents an animal study that was undertaken to determine why laser partitioning of the posterior semicircular canal resolved BPPV so promptly. The histologic changes 24 hours post-partitioning in the guinea pig showed bony semicircular canal fistula creation, and constriction of the membranous semicircular canal. The constriction caused decreased endolymphatic flow and led to BPPV-resolving long-term obstruction of the membranous canal described by Wilpizeski. Also, the clinical study of the application of partitioning to 14 patients with BPPV is described. The technique under investigation provided the resolution of positional vertigo within 7 days in most cases, and within 8 weeks in all uncomplicated cases. Results included some temporary postoperative motion sensitivity for 6-8 weeks, a transient sensorineural hearing loss in 6 of 14 (43%) patients, and a permanent hearing loss in one (7%) insulin-dependent diabetic patient. Location of the partition on the posterior semicircular canal did not affect the resolution of BPPV, the incidence of transient hearing loss, or the motion sensitivity. Partitioning provided prompt, permanent resolution of BPPV and did not put the hearing at risk in nondiabetic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Partitioning of the labyrinth: application in benign paroxysmal positional vertigo.

Partitioning of the labyrinth is a new laser technique that creates a fibrous band within the inner ear. The application of this technique to benign paroxysmal positional vertigo (BPPV) is described in the first two patients to undergo this procedure. The partitioning technique involves blue-lining the posterior semicircular canal near its ampulla and lasing the blue-lined area. The technique provides a prompt decrease and the ultimate elimination of BPPV. There is some mild motion sensitivity of 6 to 8 weeks duration, and some transient (3-week) sensorineural hearing loss. The use of immediate postoperative low dose steroids provides marked decrease in the motion sensitivity and elimination of the transient sensorineural hearing loss. Lasing two adjacent areas on the posterior semicircular canal may prevent transient recurrence of the positional vertigo during the healing process.

Adult↗
PubMed1982

Surgical treatment of external auditory canal cholesteatoma.

The authors present a series of 12 ears in 10 patients ranging from 18 to 72 years old with external auditory canal cholesteatomas (EACC) seen over an 8 year period. Males and females were equally involved. The left ear was involved 3 times as frequently as the right. No association with sinus or bronchial diseases was seen. Two cases were examined, 3 1/2 and 7 years before the development of any external auditory canal symptoms, and were normal. Two cases of bilateral involvement by EACC were reported. The clinical findings of EACC in this series are discussed. The authors describe a method of surgical treatment used in 12 ears with an average 3 year follow-up and excellent results. The technique involves the excision of the involved skin and periosteum followed by bone debridement. Fascia was used when 1. a large amount of skin had been removed, 2. mastoid air cells were exposed, 3. a soft tissue graft was used to fill a bony defect, or 4. when a portion of the tympanic membrane was sacrificed or its continuity interrupted.

Adolescent↗
PubMed1976

Hearing loss in prosthetically treated adults with cleft palate.

The effect of obturator treatment of cleft palate on middle ear disease and hearing loss has not been established. This study serves as an otologic and audiologic review of a previously reported adult population with cleft palate. A substantial improvement in hearing levels subsequent to obturation was demonstrated; however, it was believed to be based on stabilization of pathologic features of the ear with age. A statistically significant correlation of hearing level with length of use of prosthesis or with type of lesion could not be demonstrated. Results are compared with those reported on the only other adult population with cleft palate. Prosthetic management of cleft palates is not shown to be detrimental, as has been generally thought.

Adolescent↗
PubMedDate not supplied

Tinnitus: diagnosis and treatment.

Few conditions are seen as commonly by the otologist and are more poorly understood than subjective tinnitus. Tinnitus has been reported in as high as 80% of patients seen in an otolaryngology practice. This symptom is especially marked in patients with a hearing problem and can be so severe that it becomes incapacitating. Careful diagnosis and classification of tinnitus is important for understanding of the problem. Identification of the frequency and intensity of masking, using a tinnitus analyzer, is useful in selecting the form of treatment. Analysis of the history, physical findings and the use of special electrocochleography and brain stem evoked response audiometry help to identify the site of lesion, which may be within the cochlea, cochlear nerve, cochlear nucleus, brain stem, midbrain or auditory cortex. Specific disease entities should be identified and treated. Lesions of the end-organ or cochlear nerve can be treated when necessary by translabyrinthine or middle cranial fossa section of the cochlear nerve. Tinnitus from cervical nerve lesions can be treated by rhizotomy. The use of a hearing aid or introduction of a sound with a tinnitus masker has been found to be 82% effective in suppressing tinnitus. Maskers can be combined with a hearing aid in some cases. The pathogenesis of tinnitus is discussed, but the method of action of tinnitus relief by auditory stimulation is still unclear. A thoughtful and complete examination with our new diagnostic tools and the judicious selection of therapy now makes it possible to give relief to the majority of patients suffering with disturbing tinnitus.

Adult↗