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PubMedDate not supplied

[Transmeatal direct myringoplasty].

A surgical method of transmeatal direct myringoplasty (TDM) was performed in 30 patients. Out of those, 21 patients were previously treated for chronic otitis media, 4 patients were with dry perforations of neomembrane following myringoplasty, and 5 patients were with blasttraumatic ruptures of the eardrum. Fascia of the temporal muscle was used in the defect reconstruction. Graft healing and closure of the eardrum defect were observed in all patients 3 months after the surgery. Postoperative improvement of hearing in an interval of 15-20 dB was found in 21 patients. Milder sensorineural hearing damage was found in 1 patient, while in the others the hearing was on the preoperative level. Simplicity of the method, minimal surgical procedure and favorable postoperative results were the reason why the authors recommended TDM as the method of choice in the reconstruction of the eardrum defects caused by an inflammation or blasttraumatic damages of the eardrum.

Blast Injuries↗
PubMed2002

[Surgical treatment of acquired external auditory canal atresia].

Acquired atresia of the external auditory canal is a relatively rare disease, that can be the result of the recurrent external otitis, chronic media otitis, ear trauma, neoplasms or iatrogenic complications. The surgical treatment results after operation in the 7 patients with acquired external auditory canal atresia were presented. The mean age of the patients was 34.1 and the female to male ratio was 2:5. In 6 cases we performed transcanal operation. The meatus atresia was removed and then the stenotic canal was widened by removing the skin and fibrous tissue. We especially focused our attention on the state of the anterior angle of the tympanic membrane. The bony canal was widened by burr in cases with bony overhangs. The bony canal walls were lined with pediculate or free skin grafts. In cases of tympanic membrane perforation we performed myringoplasty with temporal muscle fascia or tragus perichondrium. The follow-up period was from 8 to 39 months. The hearing improvement with primary closure of air bone gap within 20 dB was achieved in 43% of cases. In 28% of the patients recurrent atresia developed. The early surgical treatment is recommended in all the cases because cholesteatoma behind the atresia was found in 28% of patients.

Adolescent↗
PubMedDate not supplied

[Fronto-ethmoidal anterior encephalocele (case report)].

The author presents a case of Encephalocele fronto-ethmoïdal in a 9 year old girl without hereditan or personal antecedent history. Surgery was performed the hernial sac was cut and the neck ligated; a piece of fascia of the temporal muscle was used as a graft. The patient was seen two years later with good result.

Child↗
PubMed1975

[Meatomyosynangiosis (Ugo Fisch operation) in progressive perceptive deafness. Principles, results and indications].

Meatomyosynangiosis is the operation suggested by Ugo Fisch. It consists of positioning a flap of superficial temporal muscle in contact with the osteoperiosteal and vasculo-neural elements of the internal auditory meatus. In about one third of the cases this operation results in tonal and vocal improvement for patients suffering from progressive perceptive deafness. According to Ugo Fisch, these results are due to retrograde revascularisation of the internal ear starting from the implanted muscular flap. Our own surgical experience confirms these clinical findings. The greatest chance of securing such an improvement is with young patients under fifty and results from this operation in other cases of perceptive deafness are definitely less conclusive and more uncertain. The main indication then for this meatomyosynangiosis is, at present, for progressive perceptive deafness in young patients with no more than 50 Db at lower frequencies. Furthermore, the arteriolar anastomosis pictures we have obtained after this operation was carried out on animals would appear to confirm the physiopathogenetic explanation suggested by Ugo Fisch.

Adolescent↗
PubMed2002

[Intraoperative rupture in the aneurysmal neck: suggestion for surgical management].

The per operative rupture of the aneurysm during dissection impairs the delicate microsurgical procedure and increases the risk of a bad evolution for the patient. During operation the aneurysm generally ruptures in its belly but it could happen just in its colon, between the main vessel and the sac. This brings a serious problem to the neurosurgeon once the placement of a clip at this place will increase the bleeding. Our technical suggestion is to perform the clippage over a small piece of temporal muscle gently placed over the hole of bleeding after temporary clippage. This is a very simple procedure but very useful that must be reminded in such cases. We did not found a similar description in the main books and articles related with intraoperative aneurysm rupture.

Aneurysm, Ruptured↗
PubMedDate not supplied

[Causes of failure in open cavity mastoidectomy].

OBJECTIVES: We assessed the causes of failure in patients who underwent open cavity mastoidectomy. PATIENTS AND METHODS: Of sixty-three patients who had undergone open cavity mastoidectomy for chronic otitis media, 11 patients (7 females, 4 males; mean age 35.2 years; range 8 to 59 years) required revision mastoidectomy. Membrane repair was accomplished with the use of temporal muscle fascia and tragal cartilage; ossicular reconstruction was performed by the interposition of incus and TORP. The mean follow-up was 13.1 months (range 6 months to 2 years). RESULTS: The involved ear was the right in seven and the left in four patients. None of the patients, but one with nasal allergy had any immune or systemic diseases. In all patients cavity epithelialization was completed in a mean of 1.6 months (range 1 to 3 months). The indications for revision included residual cholesteatoma in three patients, inadequate meatoplasty and lowering of the facial ridge in four patients, patent tuba and serous discharge in two patients, and tympanic membrane perforation and granulation tissue in the hypotympanum and mastoid apex in two patients. CONCLUSION: The incidence of revision mastoidectomy may be decreased when a safe open cavity is obtained through lowering the facial bridge down to the level of the facial nerve, adequate meatoplasty, and by a complete exenteration of all the mastoid cells.

Adolescent↗
PubMed2002

[Application of lateral attic wall reconstruction and sealing of attic cell in tympanoplasty].

OBJECTIVE: To observe the effects of lateral attic wall reconstruction and sealing of attic cell in prevention of recurrence of cholesteatoma and limitation of ossicular chain after tympanoplasty. METHODS: 150 cases of chronic tympanitis and mastoiditis were studied. Forty patients with intact ossicular chain after opening mastoidectomy underwent lateral attic wall reconstruction with autologous cartilage of auricular concha (n = 15) or "bone cement plate" made of autologous bone cortex powder adhered by glue of fibrinogen and thrombin (n = 25). Eighty-nine of the 110 cases with damaged ossicular chain underwent reconstruction of ossicular chain and sealing of tympanic cavity with bone powder and glue of fibrinogen and thrombin and fascia of temporal muscle was used to restore the tympanic membrane in 21 of them. Follow-up was conducted for 3 to 5 years to observe the recovery of tympanic membrane, hearing, and whether cholesteatoma recurred. RESULTS: No recurrent cholesteatoma and serious retracted tympanic membrane were found. Eardrum re-perforated in 8 cases (5.33%). The patients with lateral attic wall reconstruction obtained a significant hearing improvement (97.5%). Hearing was improved among 80.8% of the cases that underwent sealing of attic cell and ossiculoplasty. CONCLUSION: Lateral attic wall reconstruction and sealing of attic cell prevent the recurrence of cholesteatoma. Reconstruction of lateral attic wall provides a new space for vibration of ossicular chain.

Cholesteatoma↗
PubMed2003

Brain hyperthermia is induced by methamphetamine and exacerbated by social interaction.

Hyperthermia is a symptom of methamphetamine (METH) intoxication and a factor implicated in neurotoxicity during chronic METH use. To characterize the thermic response to METH, it was injected once daily into rats at increasing doses (0, 1, 3, and 9 mg/kg, s.c.) while brain [nucleus accumbens (NAcc), hippocampus] and body (deep temporal muscle) temperatures were continuously monitored. METH produced dose-dependent hyperthermia, with brain structures (especially the NAcc) showing a more rapid and pronounced temperature increase than the muscle. At the highest dose, brain and body temperatures increased 3.5-4.0 degrees C above basal levels and remained elevated for 3-5 hr. Stressful and other high-activity situations such as interaction with a conspecific female are also known to induce a significant hyperthermic response in the rat. A combination of social interaction and METH administration was tested for additive effects. Male rats were exposed daily to a conspecific female for a total of 120 min, and METH was injected at the same doses 30 min after the initial contact with the female. An initial hyperthermic response ( approximately 1.5 degrees C) to social interaction was followed by a large and prolonged hyperthermic response (3.5-5.0 degrees C, 5-7 hr at 9 mg/kg) to METH, which was again stronger in brain structures (especially in the NAcc) than in the muscle. Although the combined effect of the hyperthermic events was not additive, METH administration during social interaction produced stronger and longer-lasting increases in brain and body temperature than that induced by drug alone, heating the brain in some animals near its biological limit (>41 degrees C).

Amphetamine-Related Disorders↗
PubMed2003

[Endoscopic reconstruction of the anterior skull base in cerebrospinal rhinorrhea].

Cerebrospinal rhinorrhea is a discharge of cerebrospinal fluid caused by the break continuity in dura mater and by bone defect in the base of anterior skull base. The pathological connections appear mainly in the regions of the skull base with the weaker bone structure (the roof of the frontal, ethmoid, sphenoid sinus and cribriform plate). The aim of the study was presenting the possibility of the endoscopic-surgical closing the fistula within the ethmoid roof. The E.N.T Department in Poznań treated 5 patients with cerebrospinal rhinorrhea. In four cases, cerebrospinal rhinorrhea was caused by operative trauma. In one case the rhinorrhea could not be established. All patients with traumatic rhinorrhea underwent operation treatment based on covering of the loss in dura mater with a piece of mucous membrane together with perichondrium of nasal septum or lyophilised dura. The material used for the plastic operation was sealed by tissue adhesive. In 2 cases rhinorrhea recurred. Using the endoscopic technique, after the identification the leak of the cerebrospinal fluid within ethmoid roof, the fistula has been reconstructed with use of the adipose tissue and temporal muscle fascia. Both cases led to complete recovery. Easy access, precision and accuracy of performance the surgery, the approach without external incision of the patient, makes the endoscopic technique very valuable method in treating rhinorrhea caused by the loss in ethmoid roof and cribriform plate.

Adult↗
PubMed1992

[Experimental study of extracochlear electric stimulation].

The efficiency and feasibility of chronic extracochlear implantation and electric stimulation were studied in two adult cats and four 2-month kittens. The first electrode was placed on the round window by fixing the lead wire on the bridge of aditus between the middle ear and bulla cavity; the second electrode was placed on the surface of the tympanic promontory; the third was inserted into the temporal muscle out of the bulla and the forth fixed in transverse sinus with dental cement. ABRs and EABRs were recorded pre- and postoperatively and during electric stimulation. The results indicated that: (1) The chronic electric stimulation could be carried on with round window electrode; the fixation of round window electrode is satisfactory without the influence of postnatal skull growth. (2) EABRs evoked by electrically stimulating round window electrode were mainly generated by the auditory system, but its short response was partly generated by the vestibular system. (3) EABRs evoked by electric stimulation of round window electrode were contaminated by facial nerve response which could be inhibited by 2% xylocaine injection of foramen stylomastoid. (4) The EABRs evoked by stimulating tympanic promontory electrode is uncertain.

Animals↗
PubMed1992

[Otologic manifestations of the pain dysfunction syndrome of the stomatognathic system].

Phylogenesis, ontogenesis and anatomy explain the close relationship between temporo-mandibular joint and the middle ear and can therefore help understanding otologic symptoms such as: otalgia which often correspond to articular and muscular pain irradiation (coming from sterno-cleido-mastoid, lateral and medial pterygoid, deep layer of the masseter and temporal muscles); acouphens and ear block sensation that could be caused by a spasm extension of the manducatory (i.e. medial pterygoid) to levator and tympani tensors. These three muscles, which originate from the first branchial arch, have a proprioceptive sensitivity and share the same innervation. What is more tensor and levator veli exchange certain muscular fibers. Tensor tympani spasm can be held responsible both for a decrease or abolition of the Klockhoff's reflex, together with a decrease of the stapedian reflex, the latter due to tympani rigidity induced by a spasm of the tensor tympani.

Ear Diseases↗
PubMed2003

[Headache caused by sexual activity].

Headache caused by sexual activity, or coital headache, is included in International headache classification (1988). The paper presents 19 cases (15 males, 4 females, mean age 34 years) examined by the authors. In 58% of the cases, headache developed before orgasm, in 26%--during orgasm and in 16%--after it. Duration of severe headache was from several to 15 min and of moderate one--up to 7 h. In total, disease lasted from 1 week to 8 years. Focal neurological symptoms were absent; magnetic resonance tomography did not reveal any changes in 68% of the patients, while the others had mild hydrocephalia. However, there was a tension of jugular, trapeziform and, less often, of temporal muscles, and, in some of the patients, an increase of arterial pressure. Among psychological features, hypochondria in men and emotional lability in women were detected. According to the clinico-pathophysiological results obtained, different pathogenetic mechanisms of coital headache were suggested: (1) disturbance of venous outflow and dysfunction of antinociceptive systems; (2) increase of arterial pressure combined with tonic tension of pericranial muscles on the background of vertebrogenic disturbances.

Adult↗
PubMed1992

[Analysis of intracranial pressure pulse wave in experimental hydrocephalus].

PURPOSE: Much has been written about the relationship between the pulse pressure (PP) of the intracranial pressure pulse wave (ICPPW) and ventricular dilatation. Some data suggest that high PP is the cause of ventricular dilatation, and other authors have reported that high amplitude of PP results from decreased intracranial compliance. In order to clarify these points, the amplitude of PP and Pressure-Volume Response (PVR: an indicator of intracranial compliance) were measured in bilateral ventricles using Howchwald's hydrocephalic model (right-left difference in ventricle size is clear, due to hemicraniectomy). METHODS: Hydrocephalus was developed by means of intracisternal injection of a Kaolin powder solution using dogs. The mean ICP, amplitude of the PP, PVR and ventricular size (studied by MR image) were evaluated under pathological conditions induced by the following procedures. Group A: control. Kolin induced hydrocephalus without craniectomy. Group B: Kaolin induced hydrocephalus with right side craniectomy. Group C: Kaolin induced hydrocephalus with right side craniectomy and dural resection. Group D: Kaolin induced hydrocephalus with right side craniectomy, dural resection and temporal muscle resection. RESULTS: Using MR imaging, the same degree of symmetrical ventricle dilatation were identified in all groups except Group D. Group D alone demonstrated the difference of ventricular size (craniectomy side > non craniectomy side). There was no appreciable difference in mean ICP between each group. However the amplitude of PP and the PVR decreased stepwise from Group A to Group D. The difference of the amplitude of the PP and PVR between the right and left ventricles in each group was not significant. Even in the larger ventricle side (right) of Group D, the amplitude of PP was same as that of the left ventricle, and much smaller than that of other groups. CONCLUSION: The results of our research suggest that: 1) There was no relation between the ventricular dilatation and the amplitude of PP. This means that the increased amplitude of PP was not the cause of the ventricular dilatation in this model. 2) These evidences suggest that a high degree of correlation exists between the amplitude of PP and the PVR. This means that PP can be a good parameter of the intracranial compliance in this model.

Animals↗
PubMed1992

[Temporo-masseter vascular malformations].

Temporo-masseterine vascular malformations are mature capillarovenous malformations. Being congenital lesions, they are present at birth and progress throughout life, particularly before adolescence. The clinical diagnosis rests on the finding that the malformation swells when the patient is in supine position. Its extent is determined by MRI. Treatment is radiosurgical and always begins with one or several embolizations using Ethibloc. Surgical resection, which is exceptionally complete, may be performed to make the face symmetrical.

Arteriovenous Malformations↗
PubMed2004

Individual variations in numerically modeled human muscle and temporomandibular joint forces during static biting.

AIMS: To test the effects of occlusal force (OF) angle on the variations in predicted muscle and temporomandibular joint (TMJ) forces during unilateral molar bites. METHODS: The craniomandibular (CM) geometries of 21 individuals were determined from lateral and posteroanterior cephalometric radiographs. These geometries were used in a numerical model based on minimization of muscle effort. This model was previously validated for this subject group through the use of jaw tracking and electromyographic data. The model predicted muscle and TMJ forces associated with static OFs on the right mandibular first molar. OF angle was varied from vertical to 40 degrees in the buccal and lingual directions, in increments of 10 degrees. RESULTS: Intra- and intersubject variations in predicted muscle and TMJ forces for unilateral molar biting were dependent on OF angle and CM geometry. Nonvertical OFs were associated with either large anterior temporalis muscle forces (> 100% of applied OF in 3 subjects) or large inferior lateral pterygoid muscle forces (> 90% of applied OF in 3 subjects). On average, vertically and buccally directed OFs were associated with higher mean contralateral TMJ forces (60% of applied OF, SD 12%). Two subjects had large ipsilateral or contralateral TMJ forces (> 90% of applied OF). CONCLUSION: In a group of healthy subjects, depending on the individual CM geometry, large muscle and/or TMJ forces were predicted to be associated with specific unilateral molar OF angles. Propensities to increased muscle or joint forces may be predisposing factors in the development of myofascial pain or intracapsular disease. The results may explain, in part, the variation in location of symptoms in individuals who first present with temporomandibular disorders.

Adult↗
PubMed1992

[A case of transethmoidal encephalocele].

A case of a 3-year-old boy with transethmoidal encephalocele is presented. The patient was found to have bacterial meningitis, which responded well to an intravenous antibiotics therapy. No physical anomaly was evident on examination but plain skull X-ray film showed cloudiness of the left nasal antrum. Coronal CT scan disclosed a defect in the left cribriform plate and soft tissue mass in the left nasal cavity. MRI showed an anterior basal encephalocele protruding into the nasal cavity. Hypothalamic-pituitary system and the optic nerves appeared normal in the sagittal image. CSF rhinorrhea was confirmed by RI cisternography. An operation was performed transcranially. After a left frontal craniotomy, a unilateral bony defect in the cribriform plate and protrusion of the brain was observed subfrontally. The crista galli was intact. The herniated brain substance was transected and partially removed and the bony defect plugged by temporal muscle and covered by lyofirized dura. Microscopic examination of the herniated brain mass revealed gliosis and capillary proliferation. The patient recovered well and there has been no recurrence of CSF rhinorrhea or meningitis. Basal encephalocele is a very rare congenital anomaly. It is reported to constitute 1 to 10% of all encephaloceles. Incidence is estimated as 1 in every 35,000 to 40,000 live births. The anomaly is classified into two subtypes; transethmoidal (TE) and transsphenoidal (TS).(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed2004

Bruxism: two case reports.

The present report refers to two patients presenting with grinding of the teeth (bruxism). A brief review is made of the literature concerning the aetiology of the disease, the clinical manifestations and diagnosis, as well as the therapeutic approach.

Adult↗