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Biomedical subjects

R J Ruben

Publications and source records attributed to R J Ruben.

At least 73 records · Page 4Linked to original sources
PubMed1986

Rhinorrhea and pneumocephalus after cerebrospinal fluid shunting. The role of lateral extensions of the sphenoid sinus.

Pneumocephalus is usually seen after trauma or neurologic surgery. A rare presentation is after cerebrospinal fluid (CSF) shunting for rhinorrhea. This may be a manifestation of shunt malfunction or of the failure to close a preexisting fistulous tract. A common site of failure is the sphenoid sinus, where CSF may leak from a dehiscence in the middle cranial fossa floor. These dehiscences often communicate with lateral extensions of the sphenoid. This complication is best managed by craniotomy with direct inspection of the floor of the middle cranial fossa and correction of deranged CSF dynamics.

Brain↗
PubMed1984

Assessment of efficacy of intervention in hearing impaired children with speech and language deficits.

The diagnosis of hearing loss in children with speech and language deficits by the otorhinolaryngologist involves a large allocation of sources. The ability to assess the efficacy of intervention in order to minimize speech and language deficits is an aspect in the care of these children which has not been generally considered as part of the child's ongoing medical care. These children have speech and language deficits predominantly from hearing impairment and occasionally from a primary language disorder. The effect of intervention (usually a hearing aid), the special education program for the hearing impaired child, and the language therapy for the child with a primary language disorder are seldom measured. The ability to assess and monitor the child's progress is essential for the care of these patients. The continual monitoring of the child's progress is accomplished by periodic assessment of the child's speech and language. An instrument to do this has been developed and used by the Department of Otorhinolaryngectomy at the Albert Einstein College of Medicine for a number of years. The utilization of this instrument, as demonstrated by a series of case reports, will be presented. These will include children in which intervention was successful and those for whom it was unsuccessful, with an analysis of the reasons underlying the effectiveness for each child. It is recommended that every child with a speech and language deficit should be monitored periodically so that the child's progress, or lack of progress, can be determined. If the child is not progressing, additional remediation can be instituted to attempt to prevent a permanent speech and language deficiency.

Child↗
PubMed1983

Cerebrospinal fluid dynamics and rhinorrhea: the role of shunting in repair.

CSF rhinorrhea can have many causes: traumatic, neoplastic, and iatrogenic origins are common. Most traumatic rhinorrhea ceases after a trial of conservative management. While obvious erosion or traumatic destruction of vital structures may be the underlying cause, other pathophysiologic mechanisms may be working in the formation of CSF rhinorrhea, which may require the combined skills of the otolaryngologist and the neurosurgeon. Leakage of CSF is seen in "high-pressure rhinorrhea," a pathophysiologic state wherein the underlying problem is poor CSF resorption. The result is increased intracranial pressure and eventual rhinorrhea or otorrhea. Areas of CSF leakage correspond to sites of congenital weakness in the cribriform plate region, the parasellar region, or the temporal bone. Weak areas in old base-of-skull fracture sites may leak with increased intracranial pressure. The initial management should stress correction of the deranged pathophysiology, namely shunting. Surgical repair is secondary to controlling the abnormal CSF dynamics.

Adolescent↗
PubMed1982

Effects of recurrent middle ear effusion in preschool years on language and learning.

Eighteen healthy 8- to 11-year-old children with normal hearing and histories of recurrent middle ear effusion (MEE) before the age of 5 years were evaluated by a battery of audiologic, psychologic, language, and achievement tests. Each of these children was compared to a non-MEE sibling who was tested at the same age. None of the children had been diagnosed as learning disabled. Both groups tested in the bright normal range of verbal ability on the WISC-R. Paired comparison of sibling data revealed that the MEE subjects had deficits in verbal ability, auditory decoding, and spelling skills compared with control siblings. Significant strength in visual sequential memory in the MEE subjects suggests that the availability of compensatory strategies for auditory deficits in these subjects. Sex and/or birth order differences did not explain the differences observed between siblings.

Achievement↗
PubMed1980

Pathogenesis of hereditary inner ear abnormalities in animals.

There are many different genetic syndromes in animals which result in deafness. Two major types of inherited deafness are known. The most common in animals, including man, is that in which there is early cell death of the neural epithelium. This is found in the cat, dog, mink, guinea pig, and mouse. The second type of inner ear deafness is associated with malformations of both the bony form of the inner ear and the neural epithelium. This type of deafness is that which is found in the kreisler mouse. It is also found in man, but appears to be less common than the early cell death in which there is no malformation of the bony labyrinth. This form of inherited deafness has been associated and may be secondary to genetic abnormalities of the developing CNS.

Animals↗