Search PubMed⌕ Search

Biomedical subjects

T Palva

Publications and source records attributed to T Palva.

At least 55 records · Page 3Linked to original sources
PubMed1988

Correlations between meatocisternography and audiological tests in suspected eight nerve tumors.

92 cases of suspected eight nerve tumors are analysed. Correlations between the findings in audiological and vestibular tests, patient histories and findings in conventional x-ray examinations and on the other hand those obtained in meatocisternography with air contrast in computerized tomography are drawn in order to see whether specific features of audiological tests can predict the meatocisternographic finding. The cases with positive findings are verified at surgery.

Audiometry↗
PubMed1987

Inflammatory cell subpopulations in chronic otitis media. The Langerhans' cells.

Langerhans' cells (LCs) were studied in chronic otitis media by the immunoperoxidase technique and monoclonal antibodies. The LCs were a regular finding in ear canal skin, Shrapnell's membrane, thin and thick cholesteatoma epithelium, and open cavity skin; OKT6-positive cells were also found in smaller numbers in subepithelial connective tissue and lymphoid follicles, and in cuboidal secretory epithelium. The HLA-DR antibodies are less suitable for identification of LCs because many lymphoid cells express this antigen. Langerhans' cells form an important part of the immune defense system of the skin, which lacks the humoral secretory IgA defense mechanism of the mucous membranes. There is no proof that LCs are connected with the keratinization process and the possible reformation of cholesteatoma.

Antibodies, Monoclonal↗
PubMed1987

Pneumococcal antigens and endotoxin in effusions from patients with secretory otitis media.

Counterimmunoelectrophoresis revealed pneumococcus capsular polysaccharide antigen in 16% of 108 effusions from chronic secretory otitis media (SOM). Pneumococci were cultured from the effusion in only 1%. In an additional series of 23 SOM ears, only 4.3% were antigen-positive. Tests by means of pneumococcal coagglutination and C-polysaccharide detection gave identical results. Endotoxin was detected in 76% of the specimens. Control tests with aggregated NHS, IgG and IgA diluted 1: 10 were invariably positive. It appears that endotoxin positivity in SOM fluids results from the presence of activated immunoglobulins, most probably dimeric IgA, in the secretion, and so allows no conclusions as to the bacterial etiology of SOM.

Antigens, Bacterial↗
PubMed1987

The effect of tonsillectomy and adenoidectomy on the intra-tympanic pressure.

A group of 67 children were studied (mean age 7 years, 2 months) who underwent adenoidectomy and/or tonsillectomy because of either recurrent otitis media or upper respiratory tract infection. The mean pre-operative intratympanic pressure was -67.3 mmH2O (SD 65.1); three months post-operatively it was -21.9 mmH2O (SD 32.4), a highly significant improvement (p less than 0.001). The size of the adenoids had a nearly significant effect on the pre-operative intratympanic pressure (p less than 0.05). In children with large vs small adenoids the difference was highly significant (p less than 0.001). In a group of five children, tonsillectomy alone (adenoidectomy performed earlier) did not have any effect on the intratympanic pressure. No change in intratympanic pressure was seen in children with nasal allergy as compared with non-allergic children after adenoidectomy.

Acoustic Impedance Tests↗
PubMed1987

Ceramic prostheses used as a columella.

Ceramic stems, their lateral end capped with a modelled ossicle, or ceramic prostheses manufactured with a cap-shaped head were used as a columella from the stapes footplate to the tympanic membrane or a fascia graft in 41 ears operated on during 1982-1985. Six ears had no membrane perforations and no severe disease of the tympanic mucosa. Twelve ears underwent primary operations for cholesteatoma and 23 ears had revision surgery. Good hearing improvement occurred in well-aerated ears while hearing in ears with extensive tympanic disease did not improve after surgery. No tissue reactions to the ceramic prosthesis were observed and no prosthesis was extruded. Ceramic can be regarded as an acceptable alternative to bone for columella grafts used in surgery for chronic middle ear disease when the stapes superstructure is missing.

Biocompatible Materials↗
PubMed1986

Preservation of hearing after removal of the membranous canal with a cholesteatoma.

Normal cochlear function was preserved in a patient after excision of the membranous canal from a huge fistula at revision surgery eight years after the primary procedure. A recurrent cholesteatoma had eroded the entire prominence of the horizontal canal and surrounded its membranous portion. The cholesteatoma, including the membranous canal, was removed in a one-stage procedure. The open ends of the bony canal were sealed with a fascia soaked in fibrin glue. After initial dizziness and severely reduced hearing, the patient quickly recovered, with normal bone conduction and a stable 30-dB hearing level by air conduction. The lumen of the membranous canal was patent, and only the ampullar end was atretic. Presumably, the fistula became separated from fluid spaces by formation of perilymphatic partitions and by collapse of the membranous labyrinth adjacent to the fistula.

Adult↗
PubMed1986

Suboccipital removal of vestibular neurinoma with preservation of the labyrinth.

Hearing preservation in surgery for vestibular neurinoma depends on several factors, the first of which is, of course, early diagnosis. If a small enough tumor is found in a patient with reasonable hearing, there is a fair chance that it can be removed in toto with preservation of some hearing. We report data from 40 operated patients; the question was whether the identification of the transverse crest and the removal of tumor from the lateral part of the internal auditory meatus could be achieved without opening of perilymph spaces. In most of these ears the angle from the medial edge of a suboccipital craniectomy allowed the surgeon a direct view of the lateral part of the internal auditory meatus with good exposure of the transverse crest without his having to open the labyrinth. So far we believe that loss of hearing caused during these operations is mainly due to the unfavorable location of the cochlear blood supply through the meatus.

Ear, Inner↗
PubMed1985

Large cholesterol granuloma cysts in the mastoid. Clinical and histopathologic findings.

Large cholesterol cysts were found in revision surgery in six patients with previous ear surgery one to 28 years ago. The cysts mimicked brain herniation in open cavities, filled the mastoid and ear canal in closed cavities, or caused postauricular swelling. Bone around the cysts was soft and granulomatous. Secretory cells were scarce in the epithelial lining of the lumen, but subepithelial glands were frequent. Cholesterol granulomas and hemosiderin-laden macrophages were present inside the wall. The cyst lining and the glands under it showed cytokeratin staining typical for simple and glandular epithelia. Antiprekeratin antibodies showed no decoration of the lining but reacted positively with the meatal skin. These findings prove that respiratory-type epithelium separated from an aerated middle ear does not undergo changes into keratin-forming epithelium.

Adult↗
PubMed1985

Pneumococcal immune complexes and clinical course of secretory otitis media.

One-hundred-and-six children (182 ears) with secretory otitis media (SOM) were included in a follow-up study to determine whether presence of immune complexes to pneumococcal capsular polysaccharides in the middle ear fluid or adenoid suspension was related to the clinical course of SOM. The patients with immune complexes did not differ significantly from those without demonstrable immune complexes as to length of healing period or chronicity. The presence of immune complexes must be seen as evidence of the infectious etiology of SOM (pneumococcal in at least 25%), the immune complexes forming part of the immunological defense system. Poor immune response to serotype 6 can explain why this serotype plays a dominant role in the pneumococcal immune complexes in SOM fluid and adenoid suspension.

Adenoids↗
PubMed1985

Acute and latent mastoiditis in children.

During the period from 1974 to 1981, surgery for acute mastoiditis was performed on 12 ears, giving an annual incidence of 0.004 per cent among cases of acute otitis media. All ears made a full long-term recovery. The low incidence is ascribed to the world-wide early use of antibiotics. During the same period 52 ears with secretory otitis media (SOM) underwent mastoidectomy. Histologically extensive mastoid inflammation was found in 96 per cent. The changes appeared as formation of secretory cells and cysts, resorption of bone, and infiltration of soft tissues with both mononuclear cells and polymorphonuclear leucocytes. The number of SOM patients undergoing mastoid operations account for 1.4 per cent of the patients admitted to hospital because of SOM. Thirty-four ears (65 per cent) have healed during the follow-up period (mean 2.9 years), while the tympanostomy tube is still in place in 18 ears (35 per cent). In the latter group, factors causing oedema in the pharyngeal end of the Eustachian tube are apparently still present.

Acute Disease↗
PubMed1985

Immunoglobulin E in mucoid secretory otitis media.

19 serum and 23 middle ear mucoid fluid samples from patients with chronic secretory otitis media (SOM) were analyzed for total IgE using the PRIST technique and for specific IgE against dog epithelium, house dust mite, milk, egg-white and wheat using the RAST technique. All serum samples showed IgE values well within the normal range, and the middle ear fluid-serum ratio for total IgE was less than 1. In three sera there was a weak (score 1) positive RAST result to milk (2 cases) and to egg-white (1 case). None of the middle ear fluids showed positive reactions. Routine clinical assessment of total and specific IgE is not indicated in SOM.

Child↗
PubMed1984

Sonotubometry in chronic ear disease.

Aeration of the tympanic cavity was studied after 81 operations were performed on ears with cholesteatoma, in which sonometry was used preoperatively to measure the eustachian tube (ET) function. Twenty-nine of the 44 ears in which all or part of the tympanic mucosa could be preserved had positive sonometric test results, and 25 ears (86%) retained satisfactory aeration. Eight (53%) of the 15 ears with negative test results showed good postoperative aeration while adhesive changes developed in seven ears (47%). In 37 ears after the removal of all tympanic mucosa, aeration was satisfactory in eight (55%) of the 15 ears with positive sonometric test results, whereas only three (14%) of the 22 ears with negative test results developed an aerated tympanum. A positive sonometric test result can be regarded as a fair prognostic indicator of normal ET function. In extensive tympanic disease, there is a clear correlation (86%) between a negative test result and postoperative adhesion.

Adolescent↗
PubMed1984

Complement in chronic secretory otitis media. C3 breakdown and C3 splitting activity.

Occurrence of in vivo C3 breakdown and in vitro C3 splitting activity was studied in serum and middle-ear effusion (MEE) samples from 30 children with chronic secretory otitis media (SOM). The MEE showed strongly elevated levels of both low- and high-molecular-weight C3 breakdown products, along with decreased factor B, C4, and C3 levels. Total hemolytic complement component activity was virtually absent from MEE. The MEE fluids were found to contain C3 splitting factors as demonstrated by their high capacity to convert C3 in vitro from fresh normal human serum. This activity was not inhibited by the classic complement pathway inhibitor, 0.01M ethylene glycol tetra-acetic acid with 0.005M magnesium chloride. The results suggest that a strong local complement activation has taken place and that the factors responsible are present in the MEE of patients with SOM.

Antigen-Antibody Complex↗