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Biomedical subjects

T M McGee

Publications and source records attributed to T M McGee.

At least 19 recordsLinked to original sources
PubMed1993

The role of KTP laser in revision stapedectomy.

In recent years, the safety and efficacy of revision stapedectomy has come under scrutiny. Experienced surgeons report that the results of such surgery are often worse than the results after primary surgery and that the risks of sensorineural hearing loss, tinnitus, and vertigo are increased. With the addition of laser technology to revision stapes surgery, the procedure to open the neomembrane over the oval window and gain access to the inner ear can now be performed safely. This allows positive identification of the oval window and assures placement of the prosthesis through the fenestra rather than on an intermediate segment of scar or bone in the region of the footplate. Our studies have shown the laser to be an important tool that enhances the safety and efficacy of revision stapedectomy.

Audiometry↗
PubMed1991

Electromagnetic semi-implantable hearing device: phase I. Clinical trials.

Conventional hearing aids have improved significantly in recent years; however, amplification of sound within the external auditory canal creates a number of intrinsic problems, including acoustic feedback and the need for a tight ear mold to increase usable gain. Nonacoustic alternatives which could obviate these encumbrances have not become practical due to inefficient coupling (piezoelectric techniques) or unfeasible power requirements (electromagnetic techniques). Recent technical advances, however, prompted a major clinical investigation of a new electromagnetic, semi-implantable hearing device. This study presents the details of clinical phase I, in which an electromagnetic driver was coupled with a target magnet temporarily affixed onto the lateral surface of the malleus of six hearing aid users with sensorineural losses. The results indicate that the electromagnetic hearing device provides sufficient gain and output characteristics to benefit individuals with sensorineural hearing loss. Significant improvements compared to conventional hearing aids were noted in pure-tone testing and, to a lesser degree, in speech discrimination. Subjective responses were quite favorable, indicating that the electromagnetic hearing device 1. produces no acoustic feedback; 2. works well in noisy environments; and 3. provides a more quiet, natural sound than patients' conventional hearing aids. These favorable results led to phase II of the project, in which patients with surgically amendable mixed hearing losses were implanted with the target magnet incorporated within a hydroxyapatite ossicular prosthesis. The results of this second-stage investigation were also encouraging and will be reported separately.

Acoustics↗
PubMed1990

Laser applications in ossicular surgery.

In the past 8 years, the author has used the laser in more than 2800 cases of tympanomastoid surgery. Of these, more than 600 involved middle ear ossicular surgery including otosclerosis, congenital deformities, and fixations of the ossicular mass for various reasons. During this time, there have been no complications, either short-term or long-term, associated with the use of the laser. There are many tasks the laser can perform with less trauma, more precision, and greater speed than conventional hand-held tools. The laser does not replace these tools in otologic surgery, but it does add an instrument that allows the microsurgeon to perform difficult tasks with greater ease and confidence.

Ear Diseases↗
PubMed1989

Acute appendicitis in pregnancy.

Acute appendicitis is the commonest nongynaecological surgical problem occurring during pregnancy. Almost 10 year's experience at a large teaching hospital is supplemented with an extensive review of the literature to offer guidelines for diagnosis and management. Symptoms, signs and investigations are unhelpful in diagnosis. The overwhelming message is that because perinatal mortality rises from less than 3% in both uncomplicated appendicitis and negative laparotomy, to 20% in perforated disease, the maxim regarding acute appendicitis--if in doubt, take it out--is never more true than in pregnancy.

Acute Disease↗
PubMed1989

Lasers in otology.

The author describes the use of lasers in over 2500 tympanomastoid surgical procedures. The advantages of using laser energy in microsurgery, which include fewer complications and the possibility of outpatient treatment, are presented.

Ear, Middle↗
PubMed1985

Surgical sequelae of abnormal eustachian tube function.

Mechanical, neural, and immunologic factors controlling eustachian tube function are discussed in detail. Relationships of normal tubal function to the development of otitis media with effusion and its pathologic sequelae are reviewed.

Chemoreceptor Cells↗
PubMed1983

The argon laser in surgery for chronic ear disease and otosclerosis.

The use of the argon laser in chronic ear disease and otosclerosis surgery is reviewed. Its advantages and limitations are discussed, and safe parameters for use established. The argon laser is an effective tool to remove, cut, and coagulate tissue. It was used in over 500 microsurgical otologic procedures without deleterious effects. One hundred primary laser stapedotomies were performed, and the audiological results were compared to those obtained using conventional small fenestra stapedectomy techniques. No significant statistical difference was present in the audiologic results after 1 year of observation. The clinical course of the laser stapedotomy patients suggested this technique was less traumatic than conventional techniques.

Chronic Disease↗
PubMed1981

The loose wire syndrome.

The loose wire syndrome occurs in patients who have had stapedectomy surgery and insertion of a prosthesis which attaches to the long process of the incus by means of a crimped wire. The syndrome consists of a triad of one or more symptoms which improve temporarily with middle ear inflation. These include improvements in auditory acuity, in distortion of sound, and in speech discrimination. Forty-three patients were studied for age, sex, and symptom distribution, and for results of corrective surgery. In all cases, a loose wire at its attachment to the incus was found and corrective surgery (tightening of the wire) was performed. Objectively and subjectively all but two patients were relieved of their symptoms.

Adult↗
PubMed1979

Management of the totally disabled middle ear.

A short review of past techniques and materials used in treating the totally disabled middle ear is presented. Basic principles to be observed in management of this problem are discussed and the method of middle ear rehabilitation using the double layer Silastic technique is introduced. Cases (231) are reviewed with comments on the functional results achieved. It is concluded that a reliable total ossicular replacement prosthesis has yet to be produced.

Ear Ossicles↗