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Biomedical subjects

U Fisch

Publications and source records attributed to U Fisch.

At least 91 records · Page 5Linked to original sources
PubMed1988

Local anaesthesia for middle ear surgery.

Thirty-two consecutive patients undergoing middle ear surgery using local anaesthesia were assessed on the adequacy of anaesthesia for their surgery, both by the patients themselves, and by the surgeon. A method of local anaesthesia is described which includes the possibility of inducing an iatrogenic transient homolateral facial weakness in order to simplify the technique of administration of anaesthesia. Both the surgeon and the patients were happy with the quality of the anaesthesia, and no adverse effects occurred either as a consequence of the local anaesthesia itself, or of the transient facial weakness.

Adult↗
PubMed1988

Effect of ligating peripheral branches on facial nerve regeneration.

Bilateral transection and reanastomosis of the main trunk of the facial nerve was performed on 18 rats. On one side of each rat, all peripheral branches except the mandibular branch were ligated with silk suture and divided distal to the ligatures. Axon counts after 1, 3, and 6 months showed a statistically significant increase in the number of axons in both the mandibular branch and the main trunk on the side with the peripheral ligation. These data indicate that peripheral branch ligation is a useful adjunct in facial nerve rehabilitation.

Action Potentials↗
PubMed1988

The histopathological and clinical features of irradiated and nonirradiated temporal paragangliomas.

This study was undertaken to determine the effects of radiation on temporal paragangliomas. The histological features were assessed in a blind fashion from 20 surgical specimens obtained from 20 patients, half of whom received radiotherapy. All patients had progressive temporal paragangliomas and were selected on a random basis for this study. The derived data clearly identify the unpredictable response of these tumors to radiation and supports our contention that surgery is the preferred form of treatment for temporal paragangliomas even after radiation therapy. Analysis of clinical histories reveals that previous radiation therapy is associated with a greater operative blood loss and a longer mean postoperative hospital stay due to delayed healing. Despite this, there was no mortality or serious morbidity from surgery.

Adult↗
PubMed1988

Histopathology of the facial nerve after longitudinal temporal bone fracture.

The temporal bone histopathology in a patient who suffered repeated head trauma and a longitudinal temporal bone fracture shows unusual features associated with the facial nerve. In the distal meatal segment, a type of traumatic neuroma was found with disorganized nerve bundles and distinct areas of Schwann's cell proliferation but lacking fibrosis. Periosteal new bone formation in the labyrinthine segment narrows the fallopian canal and protrudes into the nerve, which completely fills the canal. The tympanic and mastoid segments of the nerve show severe degeneration of nerve fibers and an increase in connective tissue between fascicles. An attempted facial nerve decompression did not reach the area of primary pathology in the labyrinthine and meatal segments of the nerve, which could have been exposed by the transtemporal supralabyrinthine approach.

Adult↗
PubMed1987

A morphological study of the effect of the Cavitron ultrasonic surgical aspirator system near human peripheral nerves.

The Cavitron ultrasonic surgical aspirator system was used to clear superficial tissue from the greater auricular nerve in four human subjects. Following stimulation, the nerves were removed together with an untreated section and processed for examination by light microscopy. Significant damage had been sustained by these nerves, which was not apparent in the control sections. Disruption of the perineurium, intraneural hemorrhage, endoneural edema, and degenerative changes of the myelinated nerve fibers were seen. Damage to neural tissue was evident 0.5 to 1.5 mm in advance of the point of contact with the cutting tip.

Edema↗
PubMed1987

Endolymphatic pressure in experimental hydrops.

Perilymphatic and endolymphatic pressures were consecutively measured by means of a servomechanical nulling pressure system through the round window and basilar membrane one to 2.5 months after obliteration of the left endolymphatic sac and duct in seven guinea pigs. The position of the pipette was monitored by the simultaneous recording of the direct current potential through the micropipette used for the pressure measurement. (1) The perilymphatic and endolymphatic pressures of the control ears were equal. (2) The histological evaluation showed that the ears operated on had a significantly greater endolymphatic space than the control ears. (3) The endolymphatic pressure of the ear operated on was significantly higher (0.78 +/- 0.32 mm Hg) than that of the perilymph. (4) The endolymphatic direct current potential was equal in both ears.

Animals↗
PubMed1987

Intracranial facial nerve anastomosis.

A technique of intracranial facial nerve anastomosis using fenestrated collagen splints was used in eight patients operated upon for acoustic neuroma or glomus temporale tumor. This technique is rapid and simpler than suturing in the cerebellopontine angle. Clinical results are as good as or even better than those obtained with more peripheral facial nerve anastomosis or grafting. An animal study demonstrated no undue histologic reaction to the collagen splints.

Animals↗
PubMed1987

Spontaneous cerebrospinal fluid otorrhea.

Spontaneous cerebrospinal fluid (CSF) otorrhea is rare. We present four new cases and an analysis of the literature. Two distinct subtypes occur. Seventy-two percent of cases are the childhood type with congenital defects of the otic capsule. Meningitis, usually pneumococcal and frequently recurrent, occurs in 92% of these cases. CSF otorrhea follows myringotomy for a presumed serous effusion. The child usually has unilateral and sometimes bilateral absence of cochlear and vestibular function and commonly exhibits a Mondini deformity. CSF usually enters the inner ear through a dural defect in the lateral aspect of the internal auditory canal and exists through the oval window. Treatment should consist of stapedectomy and packing of the vestibule with muscle or subtotal petrosectomy. Twenty-eight percent of cases of spontaneous CSF otorrhea are the adult type characterized by bony dehiscenses, most commonly of the tegmen tympani or tegmen mastoideum and less commonly of the posterior fossa plate. The meningeal defects are either meningoencephaloceles or simply holes in the dura. Therapy should consist of a mastoidectomy in conjunction with a transtemporal supralabyrinthine (middle fossa) approach if a meningoencephalocele of the tegmen is found.

Adolescent↗
PubMed1987

[Technic and spate results of stapedotomy].

The long-term results of 253 stapedotomies and of 444 stapedectomies were compared. Stapedotomy yielded significantly better and more stable results for the higher frequency range (1-4 kHz) than stapedectomy. Reversal of the classic sequence of the surgical steps of stapedectomy has improved the precision of the technique and reduced the possibility of inner ear trauma. Perforation of the footplate and the introduction of the prosthesis into the stapedotomy opening and its crimping to the long process of the incus are performed before separating the incudostapedial joint and removing the stapes arch. For optimal results the 0.4 mm platinum teflon prosthesis should protrude 0.5 mm into the vestibule. If the incus is too short or the oval window niche too narrow the prosthesis is attached directly to the malleus handle, bypassing the incus.

Follow-Up Studies↗
PubMed1986

Primary and revision surgery (selective neurectomy) for facial hyperkinesia.

Symptomatic relief for hyperkinetic movements of facial musculature can be obtained by selective neurectomy of the peripheral divisions of the facial nerve with preservation of the frontal branch. Hemifacial spasm and blepharospasm represent the most common forms of facial hyperkinesia. Satisfactory results using the described technique on 191 patients were achieved in 74% of the patients with hemifacial spasm and blepharospasm in the follow-up period of one to 12 years. In hemifacial spasm, 80% were relieved after a single operation, and 95% were relieved after revision surgery. There were no major postoperative complications. Minor complications included insufficient lid closures in 1.5% of the patients and delayed wound healing with minor salivary fistulas that closed spontaneously in 7% of the patients. Resection of all fibers innervating the orbicularis oculi muscle is essential in preventing recurrence.

Adult↗
PubMed1986

The comparison of facial grading systems.

To evaluate the relative merits of objective and subjective facial grading systems, we compared the results obtained with the Fisch, House, and Linear Measurement grading techniques in 12 subjects exhibiting varying degrees of palsy. Although most grading systems correlate well with each other, systems can vary dramatically in patient discrimination, interobserver variability, relative underrating and overrating, properties of nerve function selected, objectivity, and clinical definition. Objective and subjective data offer selective advantages.

Evaluation Studies as Topic↗
PubMed1986

Surgical correction of congenital atresia of the ear.

Severe congenital atresia of the ear often requires--or indicates the need for--reconstructive surgery. We have developed a new technique for reconstruction of the external auditory canal. What follows is description of this technique and the results of its implementation.

Ear Canal↗
PubMed1985

[Infratemporal approach in nasopharyngeal cancer: operative technics and initial results].

When nasopharyngeal cancer recurs after radiotherapy, and when the dura is not invaded, radical excision is still possible by means of the infratemporal fossa approach (ITFA), developed by the senior author. In an effort to improve the results of radiotherapy, 13 cases of residual or persistent disease were operated on by this approach between 1977 and 1981. Of seven patients with T4 tumours, all died of persistent disease within two to three years. Six patients with T1 or T2 non-keratinizing squamous cell carcinoma are alive two to five years after surgery. Only one patient needed additional surgery for another recurrence. The approach results in a complete conductive hearing loss and permanent anaesthesia of the mandibular nerve. The procedure is safe and well tolerated. Average hospital stay is 14 days. A combination of radiotherapy and surgery is recommended for T1 and T2 carcinoma in order to improve longterm survival rates.

Carcinoma, Squamous Cell↗
PubMed1984

Prognostic value of electrical tests in acute facial paralysis.

The prognostic value of electroneurography has to be based on repeated tests performed as soon as the palsy has become clinically complete. The sun should not set over a complete facial palsy without an electrical test being performed and a decision reached on when to perform the next. The time course (velocity) and the end point (maximal value) of denervation as well as the early return of voluntary movements (early deblocking) are the best prognostic signs in acute facial palsy. The practical implications of the prognostic guidelines obtained by serial electroneurograms are demonstrated for facial paralysis secondary to fractures, iatrogenic injury, and Bell's palsy.

Acute Disease↗