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Biomedical subjects

A Mudry

Publications and source records attributed to A Mudry.

At least 19 recordsLinked to original sources
PubMed2001

The origin of eponyms used in cochlear anatomy.

The anatomy of the cochlea, one of the most complicated parts of the inner ear, is associated with numerous eponyms, mostly originating from German anatomists of the 19th century. In addition to the organ of Corti and Reissner's membrane, which are the best known, nine other eponymic anatomic terms are associated with the cochlea: Deiters' cells, Hensen's cells, Hensen's strip, Claudius' cells, Boettscher's cells, Rosenthal's canal, Hardesty's membrane, Huschke's teeth, and Nuel's space. All of these anatomic eponyms are described, with their original references.

Cochlea↗
PubMed2001

Knowledge about cholesteatoma, from the first description to the modern histopathology.

OBJECTIVE: The aim of this study was to understand the historical development of the knowledge of cholesteatoma. MATERIALS AND METHODS: Review of the literature from 1683 to 1999 concerning the date-related knowledge of cholesteatoma. RESULTS: In 1683, Duverney first described a temporal bone tumor probably corresponding to a cholesteatoma. Until 1838, when Müller coined the term cholesteatoma, nothing new about this condition appeared in medical publications. After 1838, three main theories about the pathogenesis of cholesteatoma were published. Virchow, in 1855, considered cholesteatoma to be a tumor arising from the metaplasia of mesenchymal cells to epidermal cells, growing then as tumoral cells. Gruber, Wendt, and von Troeltsch, in 1868, considered cholesteatoma to be the result of a metaplasia not of bone cells but of tympanic mucosa cells into a malpighian epithelium. Politzer, in 1869, assumed that cholesteatoma was a glandular neoplasm of middle ear mucosa. Bezold and Habermann, in 1889, considered cholesteatoma to be the result of migration of the external ear canal epidermis into the tympanic cavity via a marginal perforation after acute or chronic otitis. It took 40 years of discussions about these three theories to finally confirm that Habermann and Bezold were correct. CONCLUSION: The knowledge of cholesteatoma has evolved with other medical branches. As otologists began to monitor their patients in vivo, not limiting their observations to temporal bone dissections, the genesis of cholesteatoma became well understood. Today, with immunology and new histopathologic techniques, it is anticipated that we will learn much more about cholesteatoma.

Cholesteatoma, Middle Ear↗
PubMed2001

[Birth of otology illustrated by original texts].

To be born, to appear, to begin. Though setting the birth of otology in the 19th century may seem a bit pretentious, the texts published at that time are ample proof of the fact. The combined impact of technical, scientific, medical and social factors led to the development of otology as a medical specialty. We discuss these different aspects in this article, illustrating them with extracts from the texts of the era. Once could say that the first half of the 19th century was a period of gestation for otology that was to come into full bloom during the second half of the same century.

England↗
PubMed2000

Cholesteatoma in children: techniques and results.

A retrospective analysis of the medical records of all cases of cholesteatoma in children treated between 1981 and 1996 was performed. The charts of 59 children with cholesteatoma were reviewed. A total of 62 ears received surgery over 15 years. The median follow-up period was 5 years. There were 132 operations. An intact canal wall (ICW) procedure was performed in 29% of the ears in the first stage, a canal wall down (CWD) procedure in 37%, a transmeatal atticotomy (TA) in 21%, a tympanoplasty (T) in 6.5% and a myringoplasty (M) in 6.5% of the ears. The ICW procedure had a higher rate of residual/recurrent cholesteatoma than did CWD (P=0.8), TA (P=0.4), T (P=0.5), and M (P=0.05). The CWD procedure had a lower rate than TA (P=0.7), but a higher rate than T (P=0.6) and M (P=0.09). Lastly, TA had a higher rate than T (P=0.7) and M (P=0.1). Auditory results were similar for type II and type III reconstructions (P=0.5). An air-bone gap of less than 20 dB was achieved in 51% of the ears, and 80% had a gap of less than 40 dB. We found a clear difference, although not statistically significant, in the personal rate of recurrent cholesteatoma. It was 26% for surgeons who had performed more than 350 otological surgeries and fell to 15% for the most-experienced surgeon (1715 operations). It rose to 34% for the less experienced surgeons (P=0.8). We recommend that surgery for children with cholesteatoma be reserved for experienced surgeons.

Adolescent↗
PubMed2000

[Results and extraordinary complications of surgery for exostoses of the external auditory canal].

We present a retrospective study on 22 operations of exostosis of the external auditory canal in 20 patients. 8 patients were passionated by water sports. The most frequent indication for surgery (13 operations) was recurrent external otitis or ceruminal obstruction. In 7 cases the need for a wider access to the middle ear indicated surgery. Surgery was usually performed as an outpatient procedure, maximum hospitalization was 3 days. The mean healing period was 6 (3-10) weeks. Mean follow up was 43 (3-110) months. There were no severe intraoperative complications such as facial paresis, lesions of the ossicles or of the inner ear. As intraoperative complications we found 2 perforations of the tympanic membrane, 2 expositions of the capsule of the mandibular joint, one of which was followed by chronic pain. As postoperative complications we found an early soft tissue stenosis of the external auditory canal and one late soft tissue stenosis which recurred after revision surgery. No recurrence of exostosis was seen. We describe an up to now unknown complication: the appearance of bilateral petrositis caused by staphylococcus epidermidis after bilateral surgery in an otherwise healthy patient. This study confirms that severe complications are rare, minor ones however relatively common. And that also minor complications may have a troublesome follow. Therefore and because of the potential of severe complications indication for surgery must be made cautiously and risks of the operation must not be underestimated.

Adult↗
PubMed2000

History of the technological development of air conduction hearing aids.

This was a study of the history of the technological development of air conduction hearing aids, and a review of international literature on the subject. The technological evolution of amplification devices, from their origin to the present day, can be divided into seven distinct periods: the period of sound collectors, the period of hearing devices constructed from carbon, the period of vacuum tubes, the transistor period, the period of integrated circuits, the microprocessor period and the period of digital hearing instruments. Throughout these different stages, hearing instruments have progressively developed reaching their present state. The current era is itself undergoing constant development and change. With the introduction of new technologies, we expect that the rate of change will increase rapidly in the future.

Correction of Hearing Impairment↗
PubMed2000

[Is homeopathy a scientific therapy?].

BACKGROUND: Homoeopathy is not considered as a scientific therapy. AIM OF THE STUDY: To systematically re-examine research concerning homoeopathy and to analyse whether these works show homoeopathy as being a scientific therapy. METHOD: The review of international literature on the subject. RESULTS: Scientific research on homoeopathy is divided into four principal directions: the demonstration of the clinical activity of homoeopathic medicines, the demonstration of the biological activity of the high dilutions and of the principle of similarity, the research of the mechanical action and the medical conception of homoeopathy. Homoeopathy cannot rest on a fixed doctrine but must be continually brought up to date by medical discoveries and present day science. More and more research in these four domaines is being published in the best international medical journals, providing publicity for homoeopathy and its activities. Up to now, no research has categorically proven that homoeopathy has a specific pharmacological action, consequently it is not a proven scientific therapy. CONCLUSION: If homoeopathy wants to be recognised by classical medicine, it must continue its academic research. It is only by doing this that homoeopathy will be accepted by the scientific world.

Evidence-Based Medicine↗
PubMed2000

The role of Adam Politzer (1835-1920) in the history of otology.

PURPOSE: To study and understand the contribution made by Adam Politzer (1835-1920) to 20th century otology and analyze his place in the history of otology. METHOD: A study of his four reference works, some of his hundreds of publications in medical journals, and diverse publications written about him. RESULTS: All areas of otology have been studied, compiled, and improved through his assorted publications, notably his atlas of otoscopy published in 1865, the first work of its kind, expanded and reedited in 1896; his 10 tables of the anatomy of the ear amended in 1873; his textbook of the diseases of the ear, which was first published in two volumes in 1878 and 1882 and subsequently reedited four times as one volume, the last time being in 1908; his anatomy and histology book published in 1889; and his book on the history of otology, which up to now is the most complete tome existing on the subject, edited in two volumes in 1907 and 1913. No other has been as prolific as he. He invented, in particular, a revolutionary method of making the eustachian tube permeable--a method that made him famous and carries his name. He also developed an acoumeter to measure hearing and was the first to describe certain pathologic conditions histologically, of which otosclerosis is one. CONCLUSION: Politzer is certainly the greatest otologist of the 19th century and probably one of the greatest of all time. His influence on the 50 years of otology has never been equaled. He deserves a double mention in the history of otology: as an otologist and as a historian. It is in his honor that the International Society of Otology bears his name.

Anatomy, Artistic↗
PubMed2000

[Guichard Joseph Duverney (1648-1730), first French otologist in the 17th century].

PURPOSE OF STUDY: Study and understand the role of Guichard Joseph Duverney in the history of French otology. METHOD: Study of the different works and articles published about him, linked with reading his principal writings. RESULTS: Duverney published one of the first complete works on otology titled Traité de l'organe de l'ouïe (Treatise of the organ of hearing) in 1683. Following a first part containing numerous new notions of anatomy, Duverney developed in the second part a theory of hearing very similar to that of von Helmholtz. In the third part, he finally cover several pathologies of the ear without great innovation. Translated into many languages, this book became the book of reference for all the otologists of the 17th and 18th centuries. CONCLUSION: Duverney is rightly considered to be the first French otologist of the 17th century and also, as certainly one of the first European otologists.

Ear↗
PubMed2000

The history of the microscope for use in ear surgery.

PURPOSE OF STUDY: To study the historical development of the binocular microscope used in ear surgery. METHOD: Compilation of the texts of the era and books dealing with ear surgery, and a review of the international literature on the subject. RESULTS: The first descriptions of the microscope date to the 17th century; however, it was not until 1921 that the microscope was used for the first time in ear surgery by a Swedish otologist, Carl Olof Nylen. This monocular microscope was rapidly replaced by a binocular microscope developed in 1922 by Gunnar Holmgren. Because of its limited field of vision, very short focal distance, poor light quality, and instability, this microscope was seldom used initially. Despite the development of many different models, it was not until 1951 that a new model appeared, perfected by Littmann and the Zeiss Company. This model replaced all other models progressively, thanks to its ease of use and the possibility of changing the magnification without modifying its focal distance. It allowed for the development of tympanoplasties and stapes surgery. The latest developments include the three-dimensional imaging and navigation systems. CONCLUSION: The microscope followed an evolutionary process that led to the actual binocular microscope, which is found in every institution where otology and ear surgery are performed.

Ear↗
PubMed1999

Necrotizing otitis externa caused by Staphylococcus epidermidis.

We present a case of malignant necrotizing otitis externa (MNOE) caused by Staphylococcus epidermidis, which is usually a non-pathogenic microorganism. The patient is an otherwise healthy, nondiabetic 58-year-old white man. Contributory history began in 1994 after surgery for bilateral exostoses of the external auditory canals. Between April 1994 and May 1998 persistent otalgia occurred, with progressive mixed hearing losses, purulent discharge from both ears, spontaneous perforations of the tympanic membranes and ulceration of canal wall skin. From the beginning, Staph. epidermidis was isolated in all but one culture, but was not recognized as the pathological agent because of the presence of other more frequently involved bacteria and fungi. After multiple intravenous and oral antibiotics and antifungal treatments failed, further management involved frequent debridement of both external auditory canals and tympanic membranes, right tympanoplasty, bilateral mastoidectomy, revision tympanomastoidectomies and left modified radical mastoidectomy. Antistaphylococcal therapy including ceftazidime, vancomycin, teicoplanin, clindamycin and rifampicin was tried. Following the modified radical radical mastoidectomy, normalization of the status of his ears took approximately 2 months and has since remained stable to date. His left ear is deaf because of vancomycin administration, while magnetic resonance imaging and gallium scintigraphy have shown persistent inflammation of the skull base.

Aminoglycosides↗
PubMed1999

[Controversies concerning acute otitis media].

Acute otitis media is the subject of many unresolved points of controversy: 1) correct diagnosis; 2) whether or not bacteria are present in each case of acute otitis media; 3) spontaneous course; 4) indication of antibiotherapy; 5) treatment of recurrent acute otitis media; and 6) the place of alternative medicine, such as homeopathy. There is no ideal response. It is important, however, to take into account the knowledge of the different otoscopic stages of acute otitis media and the fact that the course of the disease is spontaneously favorable in the majority of cases. Selective prescription of an antibiotic in cases of purulent otitis only, and attention directed towards early recognition of complications, appear to be the most appropriate attitudes in the management of the disease, helping to reduce the alarmingly increasing numbers of resistant bacteria.

Acute Disease↗
PubMed1999

Contribution of Ambroise Paré (1510-1590) to otology.

PURPOSE OF STUDY: To analyze Ambroise Paré's otologic knowledge and thus his contribution to otology. METHOD: Written materials on otology, taken from the fourth and final edition of Ambroise Paré's complete works, were reviewed. These works were published in French in 1585, which was during his lifetime. This study also includes a review of the international literature on the subject. RESULTS: Ambroise Paré did not have as much effect on otology as he did on 16th Century surgery. Nevertheless, his otologic knowledge was vast for the period, and he developed numerous treatments for auricular traumas. CONCLUSION: Because of his long experience as a war surgeon, Ambroise Paré's contribution to the discipline of the treatment of auricular traumas is undeniable.

France↗