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Biomedical subjects

W Y Adkins

Publications and source records attributed to W Y Adkins.

At least 19 recordsLinked to original sources
PubMed1991

Management of trauma of the facial nerve.

The general principles of management of trauma to the facial nerve from a variety of causes are presented and the indications for and timing of surgery are reviewed. Attention is given to management techniques unique to injuries of the extracranial, intratemporal, and intracranial divisions of the nerve.

Cranial Nerve Diseases↗
PubMed1990

Persistent stapedial artery supplying a glomus tympanicum tumor.

Vascular anomalies of the middle ear are extremely rare. The most common anomaly is a persistent stapedial artery. This artery is important clinically because of the risk of profuse bleeding during middle ear surgery. We describe a 26-year-old woman with a glomus tympanicum tumor. The blood supply to the tumor was from a persistent stapedial artery. A preoperative angiogram supported this finding by demonstrating a small vessel originating from the anterior branch of the middle meningeal artery as the major vascular supply to the tumor. To our knowledge, this is the first case report of a glomus tympanicum tumor vascularized by a persistent stapedial artery that was suggested by angiography and confirmed intraoperatively. To better understand this anomaly, we review the embryological development of the stapedial artery and discuss its clinical significance.

Adult↗
PubMed1990

Upward spread of masking, hearing loss, and speech recognition in young and elderly listeners.

Upward spreading of masking, measured in terms of absolute masked threshold, is greater in hearing-impaired listeners than in listeners with normal hearing. The purpose of this study was to make further observations on upward-masked thresholds and speech recognition in noise in elderly listeners. Two age groups were used: One group consisted of listeners who were more than 60 years old, and the second group consisted of listeners who were less than 36 years old. Both groups had listeners with normal hearing as well as listeners with mild to moderate sensorineural loss. The masking paradigm consisted of a continuous low-pass-filtered (1000-Hz) noise, which was mixed with the output of a self-tracking, sweep-frequency Bekesy audiometer. Thresholds were measured in quiet and with maskers at 70 and 90 dB SPL. The upward-masked thresholds were similar for young and elderly hearing-impaired listeners. A few elderly listeners had lower upward-masked thresholds compared with the young control group; however, their on-frequency masked thresholds were nearly identical to the control group. A significant correlation was found between upward-masked thresholds and the Speech Perception in Noise (SPIN) test in elderly listeners.

Adolescent↗
PubMed1990

Composite autograft for tympanoplasty and tympanomastoid surgery.

In 1982, 40 composite cartilage perichondrial autografts performed to prevent recurrent cholesteatoma secondary to canal wall defects were reviewed. A follow-up of those cases, plus 62 new cases, as well as the composite autografts for severe tympanic membrane retractions (55 cases) and selected tympanoplasties (22 cases) is presented. No recurrent cholesteatomas or retraction pockets developed at the graft sites, with one graft failure in the latter group.

Adolescent↗
PubMed1989

The use of pentoxifylline in a pig random skin flap model.

Pentoxifylline, the first drug in a new class of rheologic agents, has enhanced skin flap survival in previous rat models. In an attempt to find an animal model more similar to the human, a trial using a pig skin flap model was undertaken. Experimental animals received oral pentoxifylline for 21 days. Random skin flaps were elevated on the 14th day, and flap viability was determined on the 21st day. Similar flaps were raised on control animals. Serum fibrinogen levels, platelet aggregation studies, and erythrocyte flexibilities were measured in both groups. No improvement in flap viability or rheologic properties of the blood were shown in the pentoxifylline-treated animals. Although no enhancement of skin flap survival was demonstrated, future studies are warranted. Implications for future investigation and clinical application are discussed.

Animals↗
PubMed1986

The use of the carbon dioxide laser in head and neck lymphangioma.

The carbon dioxide laser has been used to treat various lesions of the head and neck, ranging from carcinomas to hemangiomas, and even including tatoos. A search of the literature does not reveal any reports of the carbon dioxide laser being used to treat lymphangioma. This report discusses the efficacy of treating lymphangioma of the air and food passages with the carbon dioxide laser, and presents three patients who have been treated in this fashion-two for palliation and one for cure.

Carbon Dioxide↗
PubMed1986

Temporal bone showing polyarteritis nodosa, otosclerosis, and occult neuroma.

The clinical and general histopathologic manifestations of systemic vasculitis of the polyarteritis nodosa type are well known. Although hearing loss associated with polyarteritis nodosa has been reported, only two temporal bone studies are available. The findings in a 60-year-old man with well-documented hearing loss who had rheumatoid arthritis, polyarteritis nodosa, and otosclerosis are presented. Polyarteritis nodosa extensively involved the subarcuate arteries and arteries of the facial canal. There were decreased nerve fibers to and sensory cells in the crista of the semicircular canals and macula of the utricle and saccule. Focal and diffuse atrophy of the stria vascularis and decreased cellularity in the spiral prominence and ligament were present. There was a loss of outer hair cells. Otosclerosis involved the left and right oval window niches (bilateral stapedectomy had been performed). There was a small Antoni type A neuroma of the superior division of the vestibular nerve on the left.

Hearing Loss, Bilateral↗
PubMed1985

Carotid arteriospasm.

Arteriospasm can result from manipulation or fresh blood around an artery. This myogenic reflex can spread to obliterate collateral flow and can last from minutes to days. Ischemic strokes from carotid spasm ensue neurosurgical procedures, endarterectomies, and even chiropractic manipulation. The diagnosis and prevention of arteriospasm are presented, and a patient who has carotid arteriospasm following excision of a branchial cleft cyst is detailed. If the vessel constriction is noted at surgery, topical application of a local anesthetic is effective. Transfusion, hydration, oxygenation, and maintenance of blood pressure are the cornerstones of nonoperative therapy.

Adult↗
PubMed1979

Soft tissue ameloblastoma.

A case of massive peripheral ameloblastoma is presented. The lesion had been present for many years and had apparently spread by direct extension. There has been no recurrence after two years of follow-up. Proper oropharyngeal continuity has been maintained by the placement of a maxillary prosthesis.

Ameloblastoma↗
PubMed1979

Temporary threshold shifts in humans exposed to octave bands of noise for 16 to 24 hours.

Groups of human subjects were exposed in a diffuse sound field for 16--24 h to an octave-band noise centered at 4, 2, 1, or 0.5 kHz. Sound-pressure levels were varied on different exposure occasions. At specified times during an exposure, the subject was removed from the noise, auditory sensitivity was measured, and the subject was returned to the noise. Temporary threshold shifts (TTS) increased for about 8 h and then reached a plateau or asymptote. The relation between TTS and exposure duration can be described by a simple exponential function with a time constant of 2.1 h. In the frequency region of greatest loss, threshold shifts at asymptote increased about 1.7 dB for every 1 dB increase in the level of the noise above a critical level. Critical levels were empirically estimated to be 74.0 dB SPL at 4 kHz. 78 dB at 2 kHz, and 82 dB at 1 and 0.5 kHz. Except for the noise centered at 4.0 kHz, threshold shifts were maximal about 1/2 octave above the center frequency of the noise. A smaller second maximum was observed also at 7.0 kHz for the noise centered at 2.0 kHz, at 6.0 kHz for the noise centered at 1.0 kHz, and at 5.5 kHz for the noise centered at 0.5 kHz. After termination of the exposure, recovery to within 5 dB of pre-exposure thresholds was achieved within 24 h or less. Recovery can be described by a simple exponential function with a time constant of 7.1 h. The frequency contour defined by critical levels matches almost exactly the frequency contour defined by the E-weighting network.

Adult↗
PubMed1979

Solitary frontal sinus fracture.

Both the anterior and/or posterior wall of the frontal sinus as well as the nasofrontal duct may be injured by blunt force, commonly secondary to automobile accidents. In this group of 13 solitary frontal sinus fractures, the anterior wall was involved in all cases, and the posterior wall in 2. Antibiotic therapy was given to prevent anticipated infection. Comminuted or depressed fractures of the anterior wall were treated by elevation and/or wiring. Surgical treatment was not employed when there was a linear fracture of the anterior wall in good alignment. Posterior wall fragments were removed and periosteal flaps used to close the defect when the dura was intact. One case required neurosurgical treatment for a dural tear and necrotic frontal lobe cortex.

Accidents, Traffic↗
PubMed1978

Nonotosclerotic ankylosis of the stapedial footplate.

A woman with a long history of chronic otitis media had a stapedectomy after a surgical diagnosis of otosclerosis. In the histologic study of the temporal bones, done after her death four years later, the main portion of the stapes footplate was present but fractured and no otosclerosis was present. New celluluar bone which simulated otosclerosis filled the anterior oval window niche and was continuous with the middle ear surface of the footplate fragments. The new bone extended anteriorly to overlie a tympanosclerotic focus and inferiorly was continuous with the periosteum of the middle ear. At least part of the new bone formation occurred after stapedectomy. This may explain the poor long-term results frequently encountered when a stapedectomy is done on patients with tympanosclerotic fixation of the stapes footplate.

Diagnosis, Differential↗
PubMed1977

Long-term middle ear ventilation.

Successful long-term middle ear ventilation was established in 12 patients with chronic eustachian tube hypofunction that had failed to respond to repeated myringotomy and tympanotomy tube insertions by conventional techniques. The 12 patients (13 ears) had insertion of an untrimmed large flange "Per-Lee" type tube through a posterior-inferior tympanomeatal flap approach. The flange extended under the long process of the malleus, and into the hypotympanum and middle ear opening of the eustachian tube. The stem of the tube was brought out through the inferior central pars tensa. All tubes have remained in place for more than three years without serious complications providing adequate middle ear ventilation and preventing adherence of the tympanic membrane to the promontory.

Adolescent↗