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Biomedical subjects

S C Parisier

Publications and source records attributed to S C Parisier.

12 recordsLinked to original sources
PubMed1992

Auditory perception changes after reimplantation in a child cochlear implant user.

The ability to remove cochlear implants from children and subsequently reimplant a more complex device in the same ear was the concern of this single case study. A postlinguistically deafened child, J.L., received a single-channel cochlear implant 1 yr after contracting meningitis and suffering a profound bilateral sensorineural hearing loss. After 3 yr of successful implant use, J.L. suffered an internal coil failure. She was then explanted and reimplanted with a multichannel cochlear implant in the same ear. This case report details her speech perception skills with her single-channel cochlear implant, a vibrotactile aid, and a multichannel cochlear implant. Results from auditory perceptual measures suggest that the explantation/reimplantation process was technically feasible with no adverse effects on J.L.'s ability to utilize a more sophisticated device and to exceed her previous performance levels.

Acoustic Stimulation↗
PubMed1979

A clinical-radiographic classification of skull base lesions.

Lesions involving the base of the skull can be divided into primary and secondary disease processes. The primary group consists of bone lesions more often seen elsewhere in the skeletal system while the secondary group consist of those lesions extending to the base of the skull by direct extension from adjacent intracranial or extracranial sites. The purpose of this paper will be to arrive at a classification of skull base lesions based on the roentgen localization of the disease process. The base of the skull because of its anatomically variable curvature can be difficult to evaluate on good quality conventional radiographs. In addition to the changing angles of the bone itself, the overlying soft tissues of the pharynx and neck only serve to further conceal areas of bone pathology. The advent of polytomography and CAT scanning has greatly aided the evaluation of this region which clinically is extremely difficult to assess. In some instances invasive modalities such as angiography and posterior fossa myelography are necessary to define the lesion. With these diagnostic methods available, rather than discovering classical patterns of disease, a variety of disease processes have been found that radiographically mimic each other. Similarly, on a purely clinical basis, many of the disease entities present in a similar fashion. It is only by a combined approach that an intelligent differential diagnosis can be offered.

Adolescent↗
PubMed1978

Tympanic neurectomy and chorda tympanectomy for the control of drooling.

Seventeen patients suffered from drooling that either occurred as a sequelae of extensive head and neck cancer resections or was due to neurological disorders. In these patients, a tympanic neurectomy and/or chorda tympanectomy was performed in an attempt to eliminate the drooling. The conditions in five of 12 (41%) patients with head and neck cancer were improved following such surgery. Two of four children with cerebral palsy initially had a good result. However, the long-term follow-up of the patients demonstrated that the drooling recurred. An additional patient suffering from bulbar weakness and drooling owing to a cerevrobascular accident had less problems with salivary secretions. The results were relatively disappointing; there are several possible explanations for this.

Adolescent↗
PubMed1978

Tuberculous otitis media.

Tuberculous otitis media is a variable and puzzling infectious disease which may remain undiagnosed or confused with other acute or chronic middle ear conditions if appropriate diagnostic studies are not performed. Among the common clinical findings are insiduous onset of painless watery drainage, severe hearing loss, multiple perforations of the tympanic membrane and subsequent appearance of profuse granulation tissue. As the disease progresses destruction of the middle ear conductive apparatus, facial paralysis, cochlear involvement with labyrinthitis and further hearing loss, and finally intracranial dissemination of infection may occur. The case histories of two patients recently treated at Mount Sinai Hospital illustrate some of the clinical problems encountered with this disease.

Adult↗
PubMed1978

The evaluation of middle ear meningiomas using computerized axial tomography.

Meningiomas localized within the middle ear and mastoid which have no intracranial component are rare tumors. Three patients with meningiomas which were thought to involve only the middle ear were treated surgically, were followed for two to six years and were thought to have been cured. However, when computerized axial tomography became clinically available, these patients were examined using this radiographic technique. Unexpectedly, all three patients were found to have a large intracranial meningiomatous extension. A review of the literature reveals only 13 primary meningiomas; these case reports are summarized. It was noted that definitive tests for an intracranial extension of the meningioma were performed in only 2 of the 13 cases. Therefore, in view of our recent clinical experience, it is recommended that a patient presenting with a middle ear meningioma should have a computerized axial tomographic examination of the head to detect the possible presence of a clinical silent intracranial involvement.

Adolescent↗
PubMed1977

The middle cranial fossa approach to the internal auditory canal -- an anatomical study stressing critical distances between surgical landmarks.

The middle cranial fossa approach to the internal auditory canal and petrous apex has proven to be an extremely useful otologic surgical procedure. Ths historical evolution of this approach and its present day application were reviewed. The purpose of the study was to describe the normal anatomical variations encountered during the course of the middle cranial fossa approach to the internal auditory canal. Measurements between surgical landmarks were made on 20 dissected, and 41 histologically sectioned temporal bones. The values obtained were statistically analyzed. Finally, the practical implication of the observed anatomical measurements and of the statistical evaluations were discussed.

Adolescent↗
PubMed1976

Recurrent meningitis secondary to idiopathic oval window CSF leak.

Bacterial meningitis remains a life-threatening infection even in the present antibiotic era; thus, any abnormality which predisposes a patient to a recurrence of this serious disease, must be identified and corrected. This report describes the histroy of a 12-year old boy with a profound neurosensory hearing loss, a related absence of vestibular function and a Mondini-type of temporal bone dysplasia who developed recurrent episodes of meningitis which were due to an idiopathic cerebrospinal fluid otorrhea. Even though the meningitis was labyrinthogenic in origin, the patient did not experience the associated symptoms of hearing loss and/or vertigo since the affected inner ear was clinically unreactive. By surgically exploring the middle ear, the presence of a cerebrospinal fluid otorrhea was confirmed. The leak was observed to be coming from a defect in the stapes footplate, and it was controlled by firmly packing the inner ear vestibule with muscle. A remarkable similarity exists between the patient described above and the 15 previously reported cases of meningitis due to a spontaneous cerebrospinal fluid otorrhea. Generally, the problem occurred in young children, the average age being 6.4 years; male and female were equally afflicted. All 15 previously reported cases had a severe neurosensory hearing loss which was unilateral in 10 individuals and bilateral in the other five. In 11 of the case reports, the vestibular function was evaluated, and the labyrinth was noted to be unreactive in the affected ear. An associated congenital abnormality of the inner ear was described in 11 of the patients reviewed. Anatomically, in 13 cases, the leak was observed to be coming from the oval window area. Other affected sites included one report of a fissure of the promontory and one report of a defect in the roof of the eustachian tube. Multiple surgical procedures were required in 11 of the 15 patients in order to identify the exact source of the otorrhea and to seal it permanently. In three cases, the successful procedure was a middle ear exploration with stapedectomy and packing of the inner ear vestibule. Overall, a total of 36 operations was performed in the 15 patients reviewed. In conclusion, when the physician is confronted by a case of meningitis in a patient with a unilateral or bilateral total loss of hearing and vestibular function, the possible presence of an idiopathic cerebrospinal fluid leak should be considered, expecially if radiographic studies demonstrate a temporal bone dysplasia. In these selected cases, if the etiology of the meningitis is obscure, a middle ear exploration should be performed both for diagnostic purposes as a means to ascertain definitely the presence of a leak and for therapeutic purposes to seal it effectively.

Adolescent↗
PubMedDate not supplied

Evaluation of tympanic neurectomy and chorda tympanectomy surgery.

Thirty patients were treated by tympanic neurectomy, chorda tympanectomy, or both for a variety of conditions. Out of six patients with gustatory sweating treated by tympanic neurectomy, two patients were relieved of symptoms, two were improved, and two remained unchanged. In five cases of benign recurrent painful parotid swelling, only two patients noted improvement in symptoms. Seventeen patients suffered from drooling. Out of 12 postresection head and neck patients, 5 (41%) were improved following such surgery. Two of four cerebral palsy children initially had a good result. However, the long term follow-up of the patients demonstrated that the drooling recurred. An additional patient who suffered from drooling caused by bulbar weakness following a cerebrovascular accident had fewer problems with salivary secretions postoperatively. The pertinent anatomy and pathophysiology is outlined. The possible reasons for the relatively disappointing results achieved are discussed.

Adult↗