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At least 793 records · Page 44Linked to original sources
PubMed1976

Stapedectomy: gelfoam compared with tissue grafts.

The commonest causes of failure with the prefabricated wire loop-gel foam pad technique are inferior displacement of the loop in the window, high membrane formation and window fibrosis. As a result of these problems some members of the Otologic Medical Group have abandoned the use of gelfoam in favor of tissue grafts. A comparison of the results with gelfoam, fat grafts, and fascia grafts in 573 primary cases is made. Tissue grafts yielded a lower incidence of postoperative vertigo, of temporary and permanent sensori-neural hearing impairment, of fistulas and of long-term hearing regression. The conclusion is that a tissue graft is preferable to gelfoam as an oval window covering in stapedectomy.

Adipose Tissue↗
PubMed1978

Gelfoam paste injection for vocal cord paralysis: temporary rehabilitation of glottic incompetence.

Vocal cord paralysis frequently results in open glottic incompetence with aspiration, an ineffective cough, and poor voice production. Glottic competence can be restored temporarily be injecting the true vocal cord with Gelfoam paste. This clinical use of Gelfoam for temporary rehabilitation is indicated in : 1) situations in which paralysis may be temporary, 2) patients for whom an open operative procedure must be delayed, and 3) circumstances in which it is desirable to determine the effect of vocal cord injection prior to placement of nonabsorbable material. The injection of Gelfoam paste results in minimal tissue reaction. Absorption is gradual over a period of six to ten weeks, allowing time for some glottic compensation. The injection may be repeated without adverse effects until the paralysis resolves or intervention of a permanent nature is indicated.

Gelatin Sponge, Absorbable↗
PubMed1979

Hearing results following atticotomy.

Transmeatal atticotomy, a common otosurgical procedure near the turn of the century, has since enjoyed only sporadic periods of popularity. An earlier report illustrated the efficacy of the atticotomy operation in ablating cholesteatoma in 83% of cases. However, the ossicular chain usually suffers discontinuity either through erosion by cholesteatoma or surgical disarticulation. In ears with an intact chain, the incudostapedial joint is usually separated to avoid injury that may be transmitted to the inner ear if the rotating burr contacts the ossicles. The purpose of this paper is to portray the types of hearing restoration attempted and the results achieved in 55 patients who had an atticotomy procedure and had been followed for six months to eight years. The number of patients who attained serviceable hearing are compared to those that did not, with regard to such factors as the hearing level and state of the ossicles preoperatively as well as the extent of the surgery required for removal of the disease. The hearing results in these patients who underwent atticotomy compare favorably to those cited in the literature for tympanoplasties done with the modified radical mastoidectomy or the intact canal wall tympanomastoidectomy.

Auditory Threshold↗
PubMed1979

Management of the totally disabled middle ear.

A short review of past techniques and materials used in treating the totally disabled middle ear is presented. Basic principles to be observed in management of this problem are discussed and the method of middle ear rehabilitation using the double layer Silastic technique is introduced. Cases (231) are reviewed with comments on the functional results achieved. It is concluded that a reliable total ossicular replacement prosthesis has yet to be produced.

Ear Ossicles↗
PubMed1980

Vocal cord paralysis--1979: etiology and management.

Because of the development of reinnervation surgery, approximately 400 patients have been seen by the author with a referral diagnosis of vocal cord paralysis. Because these patients were being entered into a research protocol to evaluate the efficacy of reinnervation surgery, very careful evaluation and records have been kept. Retrospective analysis of these records has permitted an up-to-date evaluation of the epidemiology, natural history, symptoms, signs and presenting complaints, as well as the status of treatment of vocal cord paralysis at the present time. Since this subject has received only limited treatment in the recent literature, it was felt that such an opportunity to evaluate a large personal experience might be a worthwhile addition to current knowledge of the subject.

Gelatin Sponge, Absorbable↗
PubMed1983

The anterior tympanomeatal angle in tympanoplasty: surgical techniques for the prevention of blunting.

The surgical repair of the anterior tympanic membrane with reconstruction of the vibrating anterior tympanomeatal angle is particularly difficult because of problems with graft separation, recurrent perforations, scar formation and blunting. The multilayer tympanoplasty technique anchors the structural layer of the drum to the annulus, by fixing the underlay fascial graft to the overlay graft, and reduces scar formation and blunting by immediate epithelial coverage of the vibrating anterior tympanomeatal angle. The purpose of this paper is to describe the multilayer sandwich graft tympanoplasty technique that has been effective in reconstructing the anterior tympanic membrane with preservation of the vibrating anterior tympanomeatal angle.

Cicatrix↗
PubMed1988

Utilizing angiogenic agents to expedite the neovascularization process in skin flaps.

The revascularization of a skin flap after flap transposition is an important step in flap survival. This study investigates the efficacy of certain angiogenic agents to expedite the neovascularization process and to increase the viability of skin flaps. Eighty-four island skin flaps were designed on the auricles of 42 New Zealand White rabbits to achieve 90% necrosis over a 7-day period. Thirty-six flaps were treated with Endothelial Cell Growth Supplement (ECGS) or Endothelial Cell Growth Factor (ECGF) at several concentrations topically or immersed in Gelfoam. The remaining flaps were used as normal saline controls. Flap viability and peripheral neovascularization were documented by polar planimetry, angiography, and histological analysis. The flap viability of the ECGS-Gelfoam -treated flaps was 100% greater than their normal saline-Gelfoam controls (p = .021). Flap angiograms demonstrated increased vascular ingrowth among the treated flaps compared to the controls. This study suggests that angiogenic agents can expedite flap neovascularization and have the potential to increase flap viability.

Administration, Topical↗
PubMed1991

Cerebrospinal fluid fistula and endoscopic sinus surgery.

Seven cases of cerebrospinal fluid fistulae occurring as a result of endoscopic sinus surgery in a total of 800 ethmoidectomies are discussed, along with 1 case referred for consultation. One cerebrospinal fluid fistula was intrasphenoid, 4 were posterior ethmoid/base of skull, 2 were anterior ethmoid, and 1 was ethmoid cribriform. Six of 8 fistulae were closed endoscopically. The sphenoid sinus cerebrospinal fluid fistula was closed successfully with fibrin glue and Gelfoam. Five cerebrospinal fluid fistulae were closed successfully using fascia, muscle, and Gel-foam. Two cerebrospinal fluid fistulae were treated conservatively, and only 1 stopped. Anatomic and technical aspects related to the occurrence of cerebrospinal fluid fistulae are discussed. Management and treatment of cerebrospinal fluid fistulae occurring during and after endoscopic sinus surgery is emphasized. When identified intraoperatively or delayed, cerebrospinal fluid fistulae can be managed successfully by endoscopic technique.

Adult↗
PubMed1992

Long-term morbidity and mortality in patients undergoing surgery for unilateral vocal cord paralysis.

Fifty-six patients who had undergone surgery for unilateral vocal cord paralysis (UVCP) were reviewed retrospectively. The etiologies; indications for surgery; timing of onset, diagnosis and surgery; complications; and survival rates are presented. Forty patients had neoplasms of which 32 were malignant and 8 were benign. UVCP was due to direct tumor involvement in 16 cases and surgical trauma in 21 cases. Mean survival for patients who presented with UVCP which was due directly to a malignancy was 5 months versus 22 months for those patients with UVCP due to surgical trauma during resection of malignancies. Mean survival for lung cancer patients was 5 months versus 24 months for patients with other malignancies. The etiology and manner of presentation of UVCP are important prognostic indicators which should be considered when planning surgical intervention for UVCP.

Adolescent↗