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Biomedical subjects

W F House

Publications and source records attributed to W F House.

At least 91 records · Page 5Linked to original sources
PubMed1982

Acoustic tumor surgery with preservation of hearing. A histopathologic report.

The goals of acoustic tumor surgery are total tumor removal, intact facial nerve function, and preservation of hearing. the middle fossa approach offers the opportunity to achieve these goals in selected cases. This article presents the findings from the temporal bones of two patients who had undergone middle fossa removal of an acoustic tumor, nine and ten years before their deaths. Hearing was preserved in one case and lost in the other. The patient with profound postoperative deafness showed severe degenerative changes and ossification in the membranous labyrinth. This was explained on the basis of internal auditory artery occlusion. The goals of acoustic tumor surgery are discussed in light of the histopathologic findings in these two cases. the middle fossa approach is advocated as the best available to achieve these goals in intracanalicular tumors.

Audiometry↗
PubMed1980

Neurotologic manifestations of the osteopetroses.

Facial nerve paralysis or symptoms of audiovestibular nerve dysfunction may be the first indication of one of the group of bone diseases known as the osteopetroses. We describe three such patients. The pathophysiology of these diseases and the treatment of the resulting symptoms of facial and audiovestibular nerve dysfunction are discussed.

Adult↗
PubMed1980

Scanning and transmission electron microscopy of the rugose portion of the human endolymphatic sac--a preliminary report.

The rugose portion of two human endolymphatic sacs--one from a Meniere's disease patient, the other from a patient who underwent removal of an eighth nerve tumor and had no other evidence of inner ear disease--has been examined by scanning and transmission electron microscopy. The only morphological finding that distinguished the normal from the Meniere's disease specimen was more folds in the epithelium of the normal sac. Two types of cells have been distinguished in the two sacs through both scanning and transmission electron microscopy: cuboidal-to-columnar cells with a convex luminal surface and microvilli, and squamous cells with a flat luminal surface and microvilli. Qualitative differentiation of the two specimens according to frequency of cellular type or difference in cellular or microvillar morphology was not possible. Observations of this study on the epithelial morphology of the rugose portion did not correspond with descriptions of the epithelial morphology in animals. It is, therefore, tentatively concluded that the morphology of the rugose portion of the human endolymphatic sac is different from that of animals. This study suggests that scanning electron microscopy can be used to determine the number and location of cell types and/or the quantity of microvilli in the rugose portion of the endolymphatic sac. Comparison of measurements of normal endolymphatic sacs and those from Meniere's disease patients may demonstrate significant differences.

Ear, Inner↗
PubMed1980

Histopathology of cryosurgery for Meniere's disease.

The histopathologic findings in the temporal bones of two patients who underwent a cryo-otic-perotic shunt procedure are reported. Morphologic changes in the inner ear were limited to the area of cryoprobe application on the promontory. The hook region of the cochlear duct showed severe atrophy of the spiral ligament, stria vascularis, and sensorineural structures. The ampulla of the posterior semicircular canal showed fibrosis in the perilymphatic space and ruptured membranous walls. No changes were found in the rest of the vestibular labyrinth or in the facial nerve. The long-term improvement in these patients' symptoms, i.e., eight years in one and four years in the other, could only be explained on the basis that endolymph and perilymph mix across intact, nonfunctioning membranes of the cochlear duct or through, presumably antemortem, ruptures of the posterior semicircular canal ampulla.

Aged↗
PubMed1980

Scanning electron microscopy of the human endolymphatic sac: a preliminary report.

Scanning electron microscopy has been used to examine and compare one normal endolymphatic sac with one endolymphatic sac from a patient with Meniere's disease. The surgical procedure for obtaining these specimens and their preparation for scanning electron microscopy are described. The luminal surface of the rugose portion of both specimens was lined with two populations of epithelial cells: one with a dome-shaped apical surface, the other with a flattened polygonal surface. The surface of dome-shaped cells in both specimens was covered with microvilli. Neither specimen had observable loss of epithelial integrity or fibrosis.

Ear, Inner↗
PubMed1979

Revision of the endolymphatic subarachnoid shunt for Meniere's disease. Review of 59 cases.

Members of the Otologic Medical Group, Inc, Los Angeles, diagnose Meniere's disease in patients with fluctuating hearing loss, fluctuating tinnitus, episodic vertigo, and fluctuating pressure symptoms in the ear. Treatment is vasodilation. If medical treatment fails, an endolymphatic subarachnoid shunt operation is performed. If the shunt relieves symptoms for three or more months but symptoms then recur, revision of the shunt is recommended. If the revision surgery also fails, a destructive procedure is suggested.

Audiometry↗
PubMed1979

Bilateral cochlear implants: histological findings in a pair of temporal bones.

The specimens were obtained from a 63-year-old white male with acquired lues. The patient experienced sudden profound deafness on the left side 15 years prior to death, and a similar loss on the right side 3 years later. By the time of death he had carried a single induction coil in the right ear for 3 years and multiple (5) hardwire electrodes in the left ear for 8 years. A complete micro-dissection or "mini-autopsy" of the specimens was performed, and the modiolus was sectioned. Photomicrographs of the dissections will be shown. In the right ear supporting elements and numerous nerve fibers were present in the apical turn. The electrode on this side was apparently tolerated well; scala tympani was normal in shape and appearance. On the left side no nerve fibers were found in the osseous spiral lamina and there was extensive new bone formation in scala tympani. It is difficult to determine if or to what extent the implants were responsible for the severe sensorineural degeneration observed in both specimens. There was severe scarring and ossification of the posterior ampulla in both ears, in all likelihood resulting from the surgery. Some aspects of surgical techniques will be discussed in view of the histopathological findings.

Cochlea↗
PubMed1979

Middle fossa vestibular nerve section. A histopathological report.

A patient with Meniere's disease underwent a middle fossa superior and inferior vestibular nerve section with excision of Scarpa's ganglia. Studies of this patient's temporal bone, conducted two and one-half years post-operatively, showed normal cochlear and facial nerves. The internal auditory canal showed fibrosis and new periosteal bone formation. There was complete denervation of the vestibular labyrinth except for the posterior semicircular canal crista. Fibrous and osteoid tissue filled the superior and lateral semicircular canals. In this case, these severe degenerative changes, presumably associated with biochemical changes in the vestibular labyrinth, altered the natural course of Meniere's disease. Vertigo was completely relieved, tinnitus improved, and hearing thresholds stabilized during the course of post-operative follow-up.

Ear↗
PubMed1979

Histopathology of Endolymphatic subarachnoid shunt surgery for Meniere's disease.

The histopathological findings in the temporal bones of three patients who underwent endolymphatic subarachnoid shunt operation for Meniere's disease are reported. The postoperative follow-up period varied from three to five years. Two patients had a successful operation; the third was unsuccessful. The continuity between th mesothelial lining of the endolymphatic sac and the subarachnoid space was demonstrated in one case; no definite conclusions could be made for the other two cases. Although failure of shunt surgery was presumably due to fibrosis in the shunt area in the reported case, the human endolymphatic sac seemed to be more resistant to surgical trauma than the sac of the experimental animals.

Adult↗
PubMed1978

Human otoconia in surgical specimens.

The utricular otoconia of four patients, which were removed during surgical procedures (one for an eighth nerve section operation and three for removal of acoustic neuromas) with the use of the translabyrinthine approach, were observed with the scanning electron microscope. The otoconia of these patients showed some abnormal features. In three of the four patients, a number of otoconia were found to have cracked lines. One of these patients was a 14-year-old boy; the other patients were more than 40 years old. In the remaining case, the otoconial facet surfaces were rough, and a few otoconia were unusually shaped.

Adolescent↗
PubMed1976

The transcochlear approach to the skull base.

A new approach to tumors of the skull base is described. This approach is accomplished by forward extension of the translabyrinthine opening into the cerebellopontine angle. The facial nerve is mobilized in the temporal bone from the stylomastoid foramen to its entrance into the internal auditory canal. Having removed the barrier of the facial nerve, additional bone removal can be carried forward to the internal carotid artery, which now becomes the forward limit for temporal bone resection. The access attained through this exposure allows removal of tumors arising from the petrous tip, as well as tumors arising directly from the clivus. We provide the case histories of four patients in whom this approach was successfully used in removal of skull base tumors.

Adult↗