Use of intraoperative auditory brainstem responses to guide prosthesis positioning.
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Biomedical subjects
Publications and source records attributed to S L Liston.
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We report a technique for reconstruction of orbital exenteration cavities following irradiation using a free latissimus dorsi myocutaneous flap. This technique preserves the bony structure of the maxilla and the function of the infraorbital nerve.
The histopathology of the facial nerve 1 week after the onset of Bell's palsy is reported. The entire nerve was infiltrated by inflammatory cells. Myelin breakdown, axonal changes, and edema were present, suggesting viral neuritis. The role of decompression in this disease process is discussed.
Bacterial tracheitis is characterized by acute upper airway obstruction in which indirect laryngoscopy is normal. Roentgenograms reveal an irregular tracheal air column. Endoscopic evaluation demonstrates a normal supraglottic and glottic larynx with purulent debris, mucosal ulcerations, and edema of the subglottic larynx and trachea. To our knowledge, this entity has not been previously described in an adult. We report herein three cases of bacterial tracheitis in adults.
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Plastic bronchitis is an uncommon disease of children characterized by the formation of long, branching bronchial casts. Of three children with such bronchial casts, one developed status asthmaticus and coughed out a complete cast of the tracheobronchial tree. One other child also had a course of desensitization for allergies. Two children presented with what was originally thought to be pneumonitis, but when chest x-rays were taken, one child was suspected of having an inhaled foreign body, and the other had complete opacification of one lung. When these two children were examined bronchoscopically the tracheobronchial tree was found to be filled with white, cheesy material. This material was extremely hard to remove bronchoscopically as the material was too soft to grab with forceps but too thick to suction. The material extended all the way down into the tertiary bronchi, and in one child multiple bronchoscopies were necessary to remove this material, and even so he developed bronchiectasis. The pathologic examination of these casts showed layers of inspissated mucus and inflammatory cells.
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There are several categories of lateral pharyngeal diverticula. The most common type passes through the thyrohyoid region and is usually diagnosed when a pharyngo-esophagram is performed during the investigation of dysphagia. The understanding of the terminology describing the various types of such diverticula could be improved by noting whether they dilate with air, the neck is wide or narrow, and by describing the anatomic region of pharynx through which they pass.
Vertical eye movements were recorded in alert, restrained cats that were subjected to whole-body rotations which stimulated the vertical semicircular canals. The results showed a significant asymmetry between the upward and downward slow-phase eye movements, which suggests differences in the CNS processing of vertical canal inputs vis-á-vis the vestibulo-ocular reflex.
Expectoration of large, branching, bronchial casts, termed plastic bronchitis, is an uncommon condition in children. Asthma or allergy often is the cause of cast production, but in some instances no etiology is found. Five children produced large, obstructing bronchial casts that either were expectorated or were extracted at bronchoscopy. Four of the children had asthma or allergies and the fifth had congenital tricuspid atresia and chronic pericardial and pleural effusions. In two patients, expectorated casts initially were thought to be aspirated food material. Radiographic findings during periods of cast formation included atelectasis, obstructive emphysema, bronchiectasis, pleural effusion, and pneumomediastinum. Cast formation may be self-limited but generally ceases with appropriate treatment of the causative disorder. Bronchoscopic extraction of casts may benefit some patients.
Given the right circumstances, a traumatically severed ear can now successfully be reimplanted. The career of George Washington was influenced by the involvement of his half brother Lawrence Washington in a war (1739 to 1742) fought between England and Spain on account of a severed ear. It was called The War of Jenkins' Ear.
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With proper teamwork between the hemotologist and otolaryngologist, children with hemophilia A and otitis media can obtain the benefits of tympanostomy tubes; 90% phenol applied topically to the tympanic membrane is a useful hemostatic agent. The technique may allow the hemophiliac child to undergo myringotomy and insertion of tympanostomy tubes without the use of blood products. There is evidence that the use of such blood products derived from pooled human plasma may be associated with the development of acquired immune deficiency syndrome (AIDS).