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C L Driscoll

Publications and source records attributed to C L Driscoll.

7 recordsLinked to original sources
PubMed1998

Irradiated rib cartilage graft for reconstruction of the tympanic membrane: preliminary results.

OBJECTIVE: To evaluate the advantages, disadvantages, safety, and results in reconstruction of the tympanic membrane using irradiated rib cartilage. STUDY DESIGN: Retrospective chart review. SETTING: A tertiary referral center. PATIENTS: All patients who had > or =6 months follow-up who underwent tympanoplasty or tympanomastoidectomy using irradiated rib cartilage graft at our institution from January 1, 1993 to December 31, 1996. INTERVENTION: Tympanoplasty or tympanomastoidectomy using homologous irradiated rib cartilage as graft material. MAIN OUTCOME MEASURES: Postoperative speech reception thresholds, speech discrimination scores, and air-bone gap were compared with preoperative levels. Complications directly related to irradiated rib cartilage tympanoplasty were sought. RESULTS: Speech reception threshold did not significantly change. Speech discrimination scores were stable or improved in all patients. Postoperative air-bone gap was < or =10 dB in 43.2% of patients and < or =20 dB in 70.3% of patients. There was a 16% complication rate regarding tympanoplasty in general. No complications unique to irradiated rib cartilage occurred. CONCLUSION: Irradiated rib cartilage is an alternative tympanoplasty material that may save operating time, spares patients an added incision, provides results similar to other grafting material, and is safe.

Adolescent↗
PubMed1998

Preoperative identification of patients at risk of developing persistent dysequilibrium after acoustic neuroma removal.

OBJECTIVE: This study aimed to identify preoperative signs or symptoms that correlate with poor postoperative vestibular compensation after acoustic neuroma removal. STUDY DESIGN: The study design was a retrospective chart review. SETTING: The study was conducted at a tertiary care center. PATIENTS: A total of 210 patients who had acoustic neuromas removed via the retrosigmoid approach from January 1, 1990, to July 1, 1995, participated. MAIN OUTCOME MEASURES: Persistent dysequilibrium for > 3 months after surgery was measured. RESULTS: Age (p = 0.002), gender (p = 0.007), presence of preoperative dysequilibrium (p = 0.005), duration of preoperative dysequilibrium > 3.5 months (p = 0.003), and central findings on electronystagmography ( p < 0.001) were related to poor outcome. CONCLUSIONS: The authors found 31% of patients to have dysequilibrium lasting > 3 months after surgical removal of an acoustic neuroma. Age > 55.5 years, female gender, constant preoperative dysequilibrium present for > 3.5 months, and central findings on electronystagmography were associated with a worse outcome.

Adult↗
PubMed1997

Low-dose intratympanic gentamicin and the treatment of Meniere's disease: preliminary results.

The most disabling symptom for most patients with unilateral Meniere's disease is vertigo. Eradication of the diseased end organ is effective in eliminating the vertigo. Labyrinthectomy remains the "gold standard"; unfortunately, residual hearing is sacrificed to obtain this end. The purpose of this study is to evaluate low-dose intratympanic gentamicin for the control of vertigo and for the preservation of hearing. A single dose of gentamicin (10-80 mg) was injected into the middle ear space of 23 patients with unilateral Meniere's disease as an office procedure. Eighty-four percent of the patients had no episodes of vertigo during the last 6 months of follow-up. Pure tone average and word discrimination scores were unchanged as a group. Ninety-five percent of patients had a hearing loss at 6 and 8 kHz that averaged 7.5 dB. Caloric function was reduced in 93%. Low-dose intratympanic gentamicin is a safe, simple, office procedure that is effective in controlling the definitive vertiginous episodes in most patients with unilateral Meniere's disease. Control of vertigo can be obtained with preservation of hearing.

Absorption↗
PubMed1997

Pain after acoustic neuroma surgery.

This article focuses on the incidence, pathophysiology, and management of pain removal of acoustic neuroma. The debate regarding the choice of surgical approach and frequency of headaches is reviewed. The proposed causes of postoperative headaches are discussed. Specific surgical strategies to minimize the risk for developing prolonged postoperative headaches are presented, and medical management options are summarized.

Headache↗
PubMed1995

The anatomy of the lower serratus anterior muscle: a fresh cadaver study.

Forty fresh cadaver dissections were studied to determine variations in the anatomy of the lower portion of the serratus anterior muscle. In all cases, the lower three to five slips of the serratus anterior muscle were supplied by one to three branches from the thoracodorsal artery, the so-called serratus branches. Three vascular patterns were identified: type I with one branch (40 percent), type II with two branches (50 percent), and type III with three branches (10 percent). The mean dimensions of the lower serratus anterior flap were 18.0 x 9.0 cm (range 12.0 x 8.0 cm to 21.0 x 15.0 cm). The mean pedicle length was 11.3 +/- 2.8 cm (range 7.3 to 13.3 cm). A crow's foot landmark has been identified to facilitate flap dissection. This landmark marks the juncture of the long thoracic nerve and the dominant serratus branch. This juncture can be found at the superior border of the sixth or seventh rib. The lower serratus anterior flap is ideal for reconstruction of small to moderate-sized defects because of its flat, broad dimensions and its long vascular pedicle.

Adolescent↗
PubMedDate not supplied

Sluder's sphenopalatine ganglion neuralgia--treatment with 88% phenol.

Patients who experience chronic recurring head and face pain present a diagnostic and therapeutic challenge. Treatment options for Sluder's neuralgia, an uncommon cause for recurring head and face pain, are controversial. We reviewed the outcomes of patients who underwent intranasal phenolization of the sphenopalatine ganglion for the treatment of Sluder's neuralgia. Eight patients were treated with intranasal cauterization of the sphenopalatine ganglion between 1990 and 1995. Patients were treated an average of 13 times. Overall, patients experienced a 90% decrease in head and face pain for an average of 9.5 months duration. Interestingly, the patients described recurrent pain as less severe, less frequent, and of shorter duration. Intranasal phenolization of the sphenopalatine ganglion appears to be a safe and effective, although temporary, treatment for patients with Sluder's neuralgia. This article will review the symptomatology, differential diagnosis, and phenolization technique for treatment of Sluder's neuralgia.

Facial Neuralgia↗