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Biomedical subjects

T Palva

Publications and source records attributed to T Palva.

At least 73 records · Page 4Linked to original sources
PubMed1983

Why does middle ear cholesteatoma recur?

Mucosal biopsy specimens were taken from 75 ears undergoing surgery for chronic ear disease. The specimens were studied for squamous epithelium under the operation microscope, and findings during surgery were recorded for comparison with the results of the histologic examination. In 13 ears (17.3%) the histologic study disclosed squamous epithelium in the biopsy specimens that had been clinically judged to be free of such epithelium. Most specimens contained full-thickness squamous epithelium with some surface keratin. In some specimens up to 3 mm long strips of squamous epithelium without granular cell layer were observed. These areas represented the advancing front of squamous epithelium capable of producing mature squamous epithelium. The positive specimens were all well separated from the clinical cholesteatoma and were either extensions over the perforation edges or from the cholesteatoma epithelium in the middle ear or mastoid. Apparently, this unrecognized and nonremoved squamous epithelium is the main reason for the high incidence of cholesteatoma recurrence reported by some surgeons.

Cholesteatoma↗
PubMed1983

Pneumococcal polysaccharide capsular antigens in chronic secretory otitis media.

In a series of 163 ears with chronic, mucoid effusion, free or immune complex bound pneumococcal capsular polysaccharide antigens were demonstrated with Omniserum and counterimmunoelectrophoresis (CIEP) in 37 ears (23%). In crushed adenoid tissue this figure was 39% (42/107). Using type- or group-specific sera pneumococcus type 6 was found to be most frequent (56%) followed by type 19 (17%). A similar trend was also seen in adenoid suspensions. The results suggest that development of secretory otitis media is much more linked with the pneumococcal serotypes than has been thought hitherto, and that type 6 occurs significantly more often bound in immune complexes than any other subtype.

Adenoids↗
PubMed1982

Surgical treatment of patulous eustachian tube.

Thirteen patients (16 ears) with patulous eustachian tubes were treated with pterygoid hamulotomy combined with transposition (eight ears) or transection (eight ears) of the tendon of the tensor veli palatini muscle. Tubal function was tested preoperatively and postoperatively by sonotubometry. Prior to surgery, only one ear showed normal tubal function on swallowing at the time of the test. The follow-up period ranged from two months to five years. Nine ears yielded normal sonotubometric results during the average follow-up time of two years, while two tubes opened on swallowing, remained open for some time, and closed little by little. The remaining five tubes stayed continuously open as before surgery, and tubal symptoms were unaltered. Transection operation had been performed on two of these ears and transposition on three. The transposition or transection procedure can be used as a routine procedure for correction of patulous tubes. Good results can be expected in about 70% of cases.

Adult↗
PubMed1982

Cerebrospinal fluid and acoustic neurinoma specific proteins in perilymph.

White rabbits were immunized with pooled and concentrated cerebro-spinal fluid (CSF) and with tumour homogenate concentrate from specimens taken from five patients with acoustic neurinoma. The absorbed anti-CSF-antitumour antiserum was tested with the micro-immunodiffusion test against normal human serum (NHS), CSF, perilymph and CSF from tumour patients and tumour homogenate. NHS showed no precipitates in any of the tests. One protein band was observed in all the other four reactants. Tumour tissue and perilymph had two proteins in common. Diffusion from the CSF space into the perilymph can thus occur via both the cochlear aqueduct and the internal acoustic meatus.

Cerebrospinal Fluid Proteins↗
PubMed1982

Dizziness after head trauma: clinical and morphologic findings.

Twelve patients with balance problems resulting from head injury were treated by a translabyrinthine or middle fossa vestibular neurectomy. The clinical, otoneurologic, and surgical data combined with morphologic findings on the removed operative eighth nerve specimens were evaluated with the aim of deciding the site of primary lesion in each case. In six patients a peripheral lesion was interpreted. Four of them had features of delayed endolymphatic hydrops syndrome, the fifth patient might have suffered a fracture of the stapedial footplate with associated perilymphatic fistula. The sixth patient had a deforming fracture of the internal auditory canal that had produced severe hearing loss and constant unsteadiness because of the compression of the eight nerve, which had atrophied as a result. Half of the patients were diagnosed as having a central lesion. Only one of them benefited from the neurectomy. This patient had a large arterial loop within the internal auditory canal and the symptoms may have arisen because of friction of the vessel of the proximal portion of the vestibular nerve. The other five patients probably had a lesion at the level of eighth nerve brain-stem junction or central to it.

Adult↗
PubMed1981

Ear surgery and mastoid air cell system.

Opinion differ whether simple myringoplasty should be combined with mastoidectomy, which is claimed to provide a large air reservoir for the middle ear. Data are reported on 61 ears, 55 of which had reasonably normal tympanic mucosa but distinct chronic mastoid or epitympanic ear disease. Obliteration of the cavity was performed, combined with tympanoplasty, and the patients were followed up for an average of three years. Normal aeration of the middle ear was seen in all cases with normal middle ear mucosa regardless of whether the posterior canal wall was saved or reconstructed in connection with obliteration. It is concluded that there is no reason for mastoidectomies in small mastoid cell systems in simple myringoplasties.

Air↗
PubMed1981

The effect of vitamin A acid on the middle ear of the guinea pig.

The bulla in guinea pigs was filled with 0.01%, 0.1%, and 0.5% vitamin A acid (retinoic acid) solution once or twice daily for an average of five days. Pure arachnoid oil was used as a control solution. The mucous membrane appeared normal in the ears receiving arachnoid oil or 0.01% vitamin A acid. In bullae receiving 0.1% and 0.5% solutions, the epithelium remained close to normal, but there were small areas of ossification that were particularly notable in the submucosal layer. There was no indication that the normal guinea pig mucosa showed a metaplastic change into a secreting gland, forming epithelium.

Animals↗
PubMed1981

Inflammatory cells in the middle ear mucosa in cases of chronic otitis media.

Middle ear mucosal biopsy specimens were taken from 12 patients with chronic otitis media. The specimens from 11 cases contained enough inflammatory cells for a detailed study of the inflammatory cell subtypes in the lamina propria. T lymphocytes, mononuclear phagocytes, and plasma cells were the most frequent cell types except in two patients, in whom most of the inflammatory lymphocytes were B lymphocytes. The relative scarcity of B lymphocytes could be caused by activation and transformation to plasma cells. The close contact between different immunocompetent cells suggests T- and B-cell interactions. However, pseudolymphoid transformation with primary and secondary lymphatic follicles was observed in only one patient. The relative scarcity of granulocytes in the submucosal infiltrate could be caused by the movement of these cells through the epithelium into the discharge.

B-Lymphocytes↗
PubMed1981

Further observations in the eighth nerve in Menière's disease.

Forty patients with advanced Menière's disease were operated upon by vestibular or eighth nerve neurectomy. The biopsied nerve specimens were studed by light and electron microscopy. Round areas containing no or very few axons and bundles of proliferated processes of fibrous astrocytes were found in six cases. A combination of clinical and histopathologic findings suggests that some patients with symptoms identical to Menière's disease might have a primary neuronal disease leading to nonspecific reparative response by fibrous astrocytes.

Astrocytes↗
PubMed1981

Inflammatory cell subpopulations in the middle ear mucosa of ears with effusion.

Middle ear mucosal biopsies were taken from 11 patients with middle ear effusion. In 8 cases the specimens were sufficiently large to allow detailed studies of the submucosal cellular components. It appears that in noncomplicated serous middle ear effusion, due to mechanical obstruction of the Eustachian tube, the submucosa is not infiltrated by inflammatory cells. In all types of mucoid effusion of variable duration, various lymphocyte classes, i.e. T- and B-lymphocytes and plasma cells, were present, suggesting a normal cellular immune response. The lack of granulocytes seems to indicate that there is no submucosal infection.

B-Lymphocytes↗
PubMed1981

Secretory otitis media and allergy. With special reference to the cytotoxic leucocyte test.

This study is an investigation on whether allergy, and especially food allergy, is more common in patients with secretory otitis media (SOM) than in others. At the same time, the effectiveness of the cytotoxic leucocyte test (CLT) as an aid in the diagnosis of food allergy was also studied. The material comprised 90 patients: 69 suffering from secretory otitis media and 21 without the disease as controls. Patients were studied using allergy history, ear status, tests for nasal and blood eosinophilic cells, total IgE, skin tests for 20 allergens. RAST for milk and wheat, immunoglobulin A, G and M, precipitating antibodies for milk and gluten. Mantoux test, and the CLT for 23 allergens. Allergy was found in 20% of the SOM patients and 10% of the control patients; the difference was not statistically significant. The best methods for verifying allergy were history, skin tests, and tests for nasal eosinophils cells. Laboratory tests could not verify objectively that food allergy was more common among SOM patients than controls, although 16% of the SOM patients compared with none of the controls had a history of food allergy. Of the tests used, the CLT correlated best with a history of allergy, but the results of the different tests were not in accordance wtih each other.

Adolescent↗
PubMed1981

Middle ear mucosa in chronic effusions.

Biopsies of the middle ear mucosa were performed in 11 patients receiving their first ventilation tubes and in 5 patients who were admitted for reinsertion of tubes for chronic mucoid effusion. All patients had had the disease for at least 6 months. Mucosubstances were seen in the form of a mucus blanket, and as positive staining in the apical parts of the epithelial cells. Goblet cells varied greatly in frequency and larger subepithelial glands were present in cases of longer duration and intermittent discharge. In the majority of specimens, mononuclear cells were frequent in the propria, forming lymphocyte follicles in some cases. One-third of the specimens showed distinct fibrotic changes, and only a few inflammatory cells were present. Thus, mucosal response consisted of immune cells and could be due to chronic irritation, caused by bacteria and their immune complexes. Polymorphonuclear leukocytes were not present except in the effusion itself, a circumstance which points to infection as the causative factor. Pronounced proprial changes may indicate irreversibility of the disease.

Child↗