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At least 37 records · Page 2Linked to original sources

Neurogenic concept of bell's palsy. Medical decompression of facial nerve.

According to the author it is the 'transmyringal' portion of the chorda tympani nerve which in practice remains exposed to the cold atmospheric air and triggers the pathologic process involved in Bell's palsy, affecting the facial nerve secondarily, rather than a primary condition of the facial nerve. This theory was proved by creating a Bell's palsy (paralysis a frigore) with cold-air-stimuli to the tympanic membrane in experimental animals (two monkeys). On the basis of this observation the author recommend's 'medical decompression' of the facial nerve by means of infra-red fomentation of the drum, and eustachian insufflation of hydrocortisone, in cases of Bell's palsy before retrograde extension of oedema from the chorda tympani to the facial nerve can cause irreversible damage. Subsequently, the author has successfully managed fourteen cases (93-4 per cent) of Bell's palsy with a definite history of exposure to cold (paralysis a frigore). It is suggested that the ear canal be plugged with cotton as a preventive measure; and that chorda tympani neurectomy be performed to eliminate the chances of recurrence of the disease in cases of recurrent Bell's palsy.

Animals↗

Management of chondrodermatitis helicis by protective padding: a series of 12 cases and a review of the literature.

There are numerous theories concerning the aetiology of chondrodermatitis, and many authors have suggested that pressure is a significant factor. We prospectively gathered information from 14 patients with a clinical diagnosis of this condition. Many of the patients had a physical condition that forced them to lie on the side of the affected ear. Patients were advised to use protective padding of the ear at night. Most patients were rapidly relieved of their symptoms, although healing was frequently prolonged. This positive response rate and the high recurrence rate after surgery suggest that this condition should be primarily treated conservatively; they also support the theory that pressure on the ear is the main aetiological factor. Biopsies in two patients who did not respond to conservative treatment led to an altered diagnosis.

Adult↗

Case presentation: a novel way of treating acute cauliflower ear in a professional rugby player.

Acute auricular haematoma is a common problem in rugby players and can be difficult to treat due to re-accumulation of the fluid and can subsequently cause the unsightly cauliflower ear. We present a case of auricular haematoma affecting the central part of the pinna in a professional rugby player. This was treated successfully by aspiration and the use of silicone splints which allowed the player to continue training and competing.

Adult↗

An audiometric survey of Royal Artillery gun crews following "Operation Corporate".

An Audiometric Survey was carried out on two batteries of 4 Fd Regt RA (n-84) who were exposed to massive levels of impulse noise during "OP CORPORATE". A control group (n-30) was obtained from the remaining battery which did not serve in the Falklands, and it was matched well in age, service and job. They completed a questionnaire, were physically examined and had an audiogram using the MAICO M26 computer audiometer. Results were related to PULHEEMS standards and compared. No subject in the control group was classed below H2 but in those exposed, 17 were H3 or worse. This is significant (p 0.01 for 1 df) but the significance is attenuated medically and statistically. No significant correlation was found between type of ear defender and degree of protection. The survey showed that sufficient numbers had been affected to necessitate a full examination of all troops who fought in East Falkland.

Audiometry↗

External and middle ear trauma resulting from ear impressions.

When taking an impression of the external ear canal and ear, the audiologist is engaged in an invasive procedure whereby a foreign body is first placed into the ear canal and then removed. There is always an element of risk for significant medical problems when a clinician is performing an invasive procedure. Although some minor patient discomfort and, at times, some slight trauma to the ear canal occur when taking ear impressions, the incidence of significant trauma to the external or middle ear appears to be low. The purpose of this report is to provide some illustrative cases of significant external and middle ear trauma as a result of taking impressions of the external ear. Audiologists are advised to develop and implement an appropriate risk management program for taking ear impressions to reduce the potential risks associated with this procedure to their patients and to their practices.

Aged↗

Otoplasty: sequencing the operation for improved results.

LEARNING OBJECTIVES: : After studying this article, the participant should be able to: 1. Understand the anatomy and embryology of the external ear. 2. Understand the anatomic causes of the prominent ear. 3. Understand the operative maneuvers used to shape the external ear. 4. Be able to sequence the otoplasty for consistent results. 5. Understand the possible complications of the otoplasty procedure. Correction of prominent ears is a common plastic surgical procedure. Proper execution of the surgical techniques is dependent on the surgeon's understanding of the surgical procedure. This understanding is best founded on an understanding of the historical bases for the operative steps and the execution of these operative steps in a logical fashion. This article describes the concept of sequencing the operation of otoplasty to produce predictable results combining the technical contributions from many authors. The historical, embryological, and anatomic bases for the operation are also discussed. Finally, the authors' preferred techniques are presented. Sequencing the steps in the preoperative assessment, preoperative planning, patient management, operative technique, and postoperative care will produce reproducible results for the attentive surgeon. Careful attention to the details of the operation of otoplasty will avoid many postoperative problems.

Bandages↗

Blast criteria for open spaces and enclosures.

A review of the history of blast research is presented from before World War II to the present time. The mechanisms of blast injury and the nature of the injuries are described. Casualty criteria applicable to man's exposure to single blasts in open terrain as a function of overpressure duration and orientation are given. Damage-risk criteria for man exposed to repeated blasts of low and high intensity are described. The hazards from blast waves entering open structures are described with criteria for personnel located in a standard two-man open foxhole. Methods of establishing the air blast dose in a variety of exposure conditions are illustrated. The present state-of-the-art on personnel protection afforded by rigid and soft protective garments is given. Information on animal response to blast waves generated inside enclosures from the firing of recoilless weapons and the detonation of high-explosive charges is discussed along with the problem of defining the extent of performance decrement in relation to the air blast dose.

Acoustic Stimulation↗

Earmuffs, exploratory head movements, and horizontal and vertical sound localization.

In a semi-anechoic room, normal-hearing adults judged the position of that loudspeaker emitting a narrow-band noise centered at 1 kc/s, from a vertical array of 10 loudspeakers in 18 degrees steps, or a similar horizontal-arc array intersecting at 0 degrees azimuth and 0 degrees vertical. Stimuli were narrow-band noise bursts terminated by S when judgment was made. Ss (N:17) were free to move their heads, or were asked to restrict such movement. In the horizontal plane, Ss without earmuffs and with free head movement performed with 95% absolute accuracy but, with earmuffs, accuracy fell off to 50%, and when head movements were restricted accuracy fell off further to 24%. The results of Fisher and Freeman (J. Aud. Res., 1968, 8, 15-26) were generally confirmed, but free head movements did not, as in their study, totally "wash out" functional pinna removal. In the vertical plane, Ss with earmuffs even with free head movements yielded only 19% absolute accuracy, though without earmuffs accuracy rose to 72%. A postulate arising from this study is that listeners are unable to recruit remaining (interaural) cues when these are generated under different bodily orientations. The potential practical hazard suggested by the results is noted.

Auditory Perception↗

Head bandaging following otoplasty--how we do it.

One of the most common problems following otoplasty is that the bandage applied at the time of surgery slips prematurely, falling over the patient's eyes and thereby requiring replacement. We present a simple technique which prevents this from occurring.

Bandages↗

Traumatic thermal injuries of the middle ear.

Eleven cases of thermal otic injury are reviewed. The final outcome of therapy, whether medical or surgical is poor--only two of 11 patients were restored to normal. The possible pathogenesis of failure is discussed. Most cases could have been prevented by wearing ear plugs.

Accidents, Occupational↗

Assessment of comfort of various hearing protection devices (HPD).

To evaluate the comfort of hearing protection devices, two models of ear plugs and five models of ear muffs were tested. The psychophysical method of 'single stimuli' was applied on a group of 30 subjects with or without wearing the devices for a short duration of 15 min under noise condition of 100 dBa in the acoustic chamber as also on a group of 10 weavers with the protection devices worn for longer durations of 1 h, 4 h and 8 h under noise exposure of 102-104 dBA in the weaving shed. Each subject performed 8 trials with each type of device on different days. Application force and tightness of spring were also evaluated. The results yielded a comfort grading for hearing protection devices. The comfort grading, however, depended on several factors in addition to application force and tightness of spring, which has been discussed.

Adult↗

Pritt Tak: another hazard of grommets and swimming.

There is argument about whether, whilst swimming, water should be excluded from ears which have middle ear ventilation tubes in place in the tympanic membrane. The adhesive putty substance BLU-TACK (registered Trade Mark, Bostik Ltd, Leicester, England, LE4 6BW) has been suggested as an effective ear plug for this purpose. A case is described in which an alternative adhesive putty substance was used as a waterproof plug. The result was that the plug became semi-solid and impossible to remove without the use of micro instruments and removal would have required general anaesthetic in a less co-operative patient. Patients should be warned of this risk.

Adhesives↗