Biomedical subjects
Publications and source records attributed to Ronald G Amedee.
Facial nerve schwannomas are clinically challenging tumors. This is a case study of a young woman with an extensive facial nerve schwannoma. The clinical presentation, radiographic diagnosis, pathological confirmation, and treatment options for this relatively rare tumor are discussed.
Benign paroxysmal positional vertigo is a disorder of the peripheral vestibular system characterized by brief episodes of vertigo precipitated by head movements in certain planes. It is one of the most common causes of vertigo. Displaced otolithic debris in the posterior semicircular canal is the proposed mechanism of this disorder and explains the success of repositioning procedures in treating these patients. The pathophysiology, diagnosis, and treatment options are discussed.
BACKGROUND: This study was designed to investigate whether two different surgical approaches in endonasal sinus surgery lead to different postoperative results in patients with chronic rhinosinusitis. METHODS: Sixty-five patients suffering from chronic rhinosinusitis were operated on with either a limited approach or an extended approach. They were examined preoperatively and reassessed during 3 months, 6 months, and long-term follow-up visits that included endoscopy, saccharin transport time, and the assessment of symptoms. RESULTS: The concept of this study was prospective, randomized, and multicenter (Mainz, Germany, and Moscow, Russia). The results of the two different surgical approaches were compared with each other. CONCLUSION: Surgical results and symptomatology were similar in both groups of patients, suggesting that a conservative approach may be sufficient in most patients.
Acute otitis externa is a common presenting disorder seen in many primary care offices. Serious complications may be avoided by appropriate diagnosis and treatment. This article will summarize the basic anatomy and physiology of the external auditory canal, the pathophysiology and microbiology of acute otitis externa, the clinical presentation and diagnosis of this disease, and its potential complications and treatment.
BACKGROUND: Stenosis of the nasolacrimal drainage system is a relatively frequent complication of acute or chronic inflammation, trauma, tumor, or congenital malformation. Symptoms include epiphora, intermittent purulent secretion, and swelling of the nasolacrimal sac. The principle of dacryocystorhinostomy (DCR) is to create an artificial opening of the lacrimal sac into the nasal cavity. This can be done via an external as well as an endonasal route. METHODS: In this retrospective study, we examined 74 microscopic endonasal DCRs. which were performed on 70 patients between 1990 and 2000. All of the 74 DCR operations had no major complications intraoperatively. RESULTS: Sixty DCR procedures (81.1%) were successful after a mean follow-up time of 3.18 years. This success rate is lower than those rates reported in the literature for the external approach, which range between 85 and 99%, although follow-up times were shorter in most of these studies. CONCLUSIONS: Advantages of the endonasal approach such as saving the medial palpebral ligament, the lacrimal pump mechanism, and the horizontal apparatus are obvious. If necessary, additional management of sinus, septal, and conchal disease can be performed simultaneously. Our results reveal that the microscopic endonasal approach is a safe and reliable procedure in the management of postsaccular or saccular nasolacrimal duct obstruction and is an alternative to the traditional external route.
BACKGROUND: This article compares the use of the microdebrider as a form of powered instrumentation designed to decrease mucosal trauma with traditional surgical instruments for endonasal sinus surgery. METHODS: Surgery was performed with the shaver or conventional instruments using an endonasal approach in 24 patients with bilateral chronic rhinosinusitis. Each patient served as his/her own control, meaning that one side was operated on with conventional instruments and the opposite side was operated on with the microdebrider to evaluate postoperative recovery, healing, and incidence of complications. They were stratified preoperatively and reassessed during 3- and 6-month follow-up and long-term (mean, 13 month) follow-up visits, which included nasal endoscopy, saccharin transport time, assessment of mucociliary transport times and clinical symptoms. RESULTS: In this prospective randomized study we were unable to find a statistical difference (p > 0.05) in surgical outcome for patients when using either conventional instruments or mechanical debriders. CONCLUSION: In the literature, mechanical debriders are supposed to provide for mucosal preservation and faster healing. However, for surgical outcome, the use of microdebriders in our study was not better than the results at 3-, 6-, and at 13-month follow-up visits when compared with conventional instruments. Synechia formation, patency of middle meatal antrostomy, and ostial reocclusion were the same in both groups. The incidence of polxyposis as a sign of recurrent or persistent infection was similar. Functional results using the saccharin transport time, as a marker of mucociliary function, or episodes of recurrent purulent secretions, again, were identical.