[Fistulas in the ear--diagnosis and therapy].
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Ear Diseases↗
Biomedical subjects
C Wennmo
Publications and source records attributed to C Wennmo.
[What happens with the ear in temporal bone fractures?].
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Ear, Middle↗
Treatment of snoring--with and without carbon dioxide laser.
Thirty patients with bedpartners complaining of their heavy snoring which had resulted in separate bedrooms were treated surgically. Three different methods were used, each group consisted of 10 patients. In group A conventional scalpel excision was used for uvulopalatopharyngoplasty including tonsillectomy. In groups B and C, patients with small tonsils were selected and therefore the tonsils were saved. Group B was operated with carbon dioxide laser under a microscope and using micromanipulator. The same kind of excision was used as in group A but the tonsils were saved. Group C was operated as group B but using conventional scalpel excision technique. With a starting-point of snoring score 3 preoperatively in all groups, the mean postoperative snoring score in Group A was 1.0, in Group B 0.2 and in Group C 1.1. Patients with postoperative snoring scores of 0 and 1 were regarded as successful responders to surgery. No serious side effects were noted due to treatment.
Airway Obstruction↗
Temporal bone fractures. Vestibular and other related ear sequele.
Vertigo is a common symptom after head injuries, though often overlooked in the acute stage due to other concomitant manifestations. According to previous investigations the mechanisms of injury to the vestibular system cannot be defined as clearly as for the auditory system. Twenty patients with temporal bone fractures were reviewed and later re-examined. The results of conventional X-ray, computerized tomography, clinical, otoneurological and audiological findings were analysed. The sequelae of dizziness and auditory defects were considered and follow-ups with computerized electro-oculography were performed. Radiological evaluation revealed fractures in approximately 65%. Half complained of dizziness and positional nystagmus was the most common vestibular observation. In 25% of the patients, dizziness remained to some degree. Hearing was permanently impaired in 75%. The hearing impairment depended in 20% on fractures of the ossicular chain and in 55% on sensorineural hearing loss. In those cases where a conductive hearing loss persisted, surgery on the middle ear was indicated. The vestibular system is not so vulnerable as the auditory system. Conductive hearing loss disappeared spontaneously or could be relieved by surgery. The vestibular symptoms improved or disappeared in all cases, whereas not infrequently, a sensorineural hearing loss remained.
Adolescent↗
Pleomorphic adenomas of the parotid gland: superficial parotidectomy or limited excision?
In this retrospective study of parotid tumours, 57 patients with pleomorphic adenomas were treated with superficial parotidectomy and 33 patients with limited excision. The follow-up period has been 4-14 years. When the operation was superficial parotidectomy, recurrences occurred in 8.7 per cent compared to 6 per cent in cases of limited excision. Side-effects such as permanent weakness of the facial nerve or post-operative gustatory sweating were also more common when superficial parotidectomy was performed. The post-operative results observed suggest that limited excision under magnification is more favourable than superficial parotidectomy in the treatment of pleomorphic adenomas.
Adenoma↗
Drug-related dizziness.
Various causes of drug-related dizziness are reviewed. Several medical agents, such as antianxiety drugs, tricyclic antidepressants, antihypertensive drugs, antituberculous drugs, polypeptide antibiotics, local anaesthetics and non-steroidal anti-inflammatory drugs, are known to produce dizziness as a side effect.
Aminoglycosides↗
Vertical saccades and the "rider artifact".
Quantitative studies of vertical saccades are sparse, due to a lack of reliable recording techniques. In this study, electro-oculographic (EOG) and photo-electronystagmographic (PENG) techniques showed that up-directed saccades were faster than down-directed ones. In the EOG recording, however, the velocity of the up-directed saccade was correlated to the size of an artifact caused by movement of the upper eye lid. Further investigations are needed to analyse the characteristics of vertical eye movements.
Electronystagmography↗
[Contact allergy to nickel as a cause of external otitis with therapeutic difficulties].
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Adult↗
A model of visual-vestibular interaction in cerebellar disorders.
The number of saccades, vestibular gain and visual suppression as a function of smooth pursuit gain were determined in 10 cerebellar cases. Visual suppression increased and the number of saccades decreased with increasing smooth pursuit gain while a high vestibular gain was found in most cases but without relation to the gain of smooth pursuit. An eye-motor model is presented according to which all findings could be related to a disturbance of proper cerebellar processing of optic impulses and of impulses to the vestibular nuclei in the paramedian reticular formation.
Cerebellar Diseases↗
Vertical saccades in brain stem disorders.
Mean peak velocity and accuracy of vertical saccades were measured in 15 patients with disorders in the brain stem and in 12 normal subjects. (1) In the normal group up-directed saccades were faster than down-directed and the velocity of the saccade was not dependent on the age of the subject. Up-saccades were faster whether electro-oculography or photo-electro-oculography were used. (2) In patients with brain stem disorders the velocity of vertical saccades did not significantly differ from the saccadic velocity in the normal group. This is in contrast to what was found in horizontal saccades, where a reduced velocity was characteristic.
Adult↗
Visually evoked slow eye movements, visual-vestibular interaction, and infratentorial lesions.
The maximum velocity gain of smooth pursuit and optokinetic, vestibular, and optovestibular slow phases was examined in 15 patients with pontine, 10 with medullary, 10 with cerebellar, and 5 with combined cerebello-brain stem disorders. Marked dissociations were observed between smooth pursuit and optokinetic slow phases, especially in medullary disease. A cerebellar deficit enhanced slow phase velocity gain during rotation in darkness, whereas the corresponding gain during rotation in light was normal.
Adolescent↗
Eye-velocity programming in brain-stem disorders.
Eye movements in 30 patients with brain-stem lesions were evaluated with electro-oculography, and the findings were analyzed with regard to the site of the lesion in the brain stem. Eye velocities generally were reduced more severely in pontine than in medullary lesions. In medullary lesions, there even was a slight enhancement of the velocities in the fast component of optokinetic and postrotatory nystagmus. In contrast to the slow-phase velocity of OKN, which often was preserved in medullary lesions, the smooth-pursuit velocity was reduced in lesions at all levels in the brian stem. This indicates that these two types of visually induced eye movements use different mechanisms.
Adolescent↗
Fractures of the temporal bone--chain incongruencies.
PURPOSE: The sequela of a temporal bone fracture include hearing loss, vestibular dysfunction, and facial nerve injury. A large series of patients with temporal bone fractures are reviewed to correlate mechanism of injury, fracture location, and outcome. PATIENTS AND METHODS: A retrospective analysis of patients evaluated between 1978 and 1987 for temporal bone fractures at two Swedish clinics was undertaken. Assessment of auditory, vestibular, and facial nerve function is reported. Follow up varied from 3 months to 12 years. RESULTS: A total of 72 temporal bone fractures were encountered. Eleven patients had chain incongruencies, nine of whom were operated on with resultant good hearing. Transverse fractures were associated with severe sensorineural hearing loss while longitudinal fractures frequently were accompanied by ossicular disruption and persistent conductive hearing loss. Patients with vertigo or dizziness frequently had a good prognosis. Facial nerve injury occurred in 14 patients, eight of whom recovered. CONCLUSIONS: Hearing loss following temporal bone fracture reflects the site and mechanism of injury. Transient conductive hearing loss may be due to blood in the middle ear, perforation of the tympanic membrane, or injury to the ossicular chain. Conductive loss persisting 6 to 7 weeks after trauma and exceeding 30 dB is an indication for surgical exploration.
Adolescent↗
Cholesteatoma surgery with the canal-wall-down technique.
This is a retrospective study of a limited group of 30 patients, children and adults, diagnosed as having cholesteatomas. Analysis includes audiological data and surgical results. Two techniques were used in surgery. In half of the cases, an obliteration technique was used, and in the remainder an open radical cavity was created. The method used was determined by the surgeon and in some measure by the extent of the disease. Our conclusions are that the obliteration technique offers better hearing results than the open-cavity technique. The number of residuals over a 4- to 5-year period was acceptable and cavity problems were avoided.
Adolescent↗
Velocity of rapid eye movements and vertigo of central origin.
Peak velocities of voluntary saccades and fast phases of different qualities of nystagmus were studied in 20 normal subjects, 5 patients with pontine lesions and 5 patients with lesions in the frontal cortex. The peak velocity of saccades was related to the amplitude of the eye movement, the alertness of the subject and whether the subject could see the target or not. The effect of the age was not significant. The quick phases of caloric, optokinetic and angular acceleration induced nystagmus were equally rapid but somewhat slower than that of vestibular nystagmus recorded in standardized visual surrounding. In the same visual condition saccades were always faster than quick phases of nystagmus. Patients with cortical lesions had normal velocities in saccades and quick phases of nystagmus. Patients with pontine disorders had significantly reduced saccadic and quick phase velocity, and some of the patients exhibited dissociations between velocity mechanisms while the somewhat higher velocity in quick phase of vestibular nystagmus recorded in light is probably related to higher attention evoked by vestibular-visual interaction.
Adolescent↗
Eye movements in cerebellar and combined cerebellobrainstem diseases.
We report a quantitative analysis of eye movement disturbances in patients with isolated cerebellar disorders and patients with cerebellar disorders and concomitant brainstem involvement. The most characteristic abnormalities in the exclusively cerebellar patients were increased velocities of the slow phases of vestibular nystagmus induced by rotation in the dark and increased peak velocities of the fast phases of optokinetic nystagmus induced by full-field optokinetic stimuli. Dysmetria of saccades was found in three of six cerebellar patients and gaze nystagmus in all six patients. The typical findings in the combined cerebellobrainstem group were reduced peak velocities of voluntary saccades, defective smooth pursuit and reduced peak velocities of the fast component of nystagmus during rotation in both the dark and light. All patients with combined cerebellobrainstem disorder had dysmetric voluntary saccades and gaze nystagmus. The numbers of superimposed saccades during smooth pursuit were uniformly increased. Release of inhibition in cerebellar disorders may explain the hyperresponsiveness and inaccuracy of eye movements found in this study. In addition, when lesions also involve the brainstem, however, integrative centers coding eye velocity are affected, leading to slow and inaccurate eye movements. These features elicited clinically may be useful in the diagnosis of cerebellar and brainstem disorders.
Adult↗
Dyspraxia of speech and of eye motility.
Five patients with a disturbance of their preprogramming of speech (dyspraxia of speech) were exposed to a comprehensive eye-motor test-battery. The saccades were found hypometric and inaccurate with irregular intervening pauses. The finding was interpreted as due to an extension of lesions from frontal cortical speech areas into visual motor cortex disturbing the normal preprogramming of voluntary saccades. The results were interpreted as supporting the assumption that voluntary saccades are initiated in the frontal cortex. An increase of vestibular nystagmus in these cases was related to a release of vestibular nystagmus due to the disappearance of cortical inhibition on brain stem acitivty.
Adult↗
Velocity patterns of rapid eye movements.
The peak velocities of saccades and fast phases of nystagmus were examined and compared in 20 healthy subjects. The peak velocities of both types of eye movements increased with increase of amplitudes. The saccades were found to be fastest in light, slower in darkness and slowest behind closed eyelids. The peak velocities of the quick phases of optokinetic and of vestibular nystagmus were found to be the same. Fast phases of optovestibular (optic as well as vestibular stimulation) nystagmus produced significantly higher peak velocities than the two others. At the same amplitude and during the same visual conditions the saccades were significantly faster than any type of fast components of nystagmus. The difference in velocity between voluntary and reflexive eye movements is possibly related to differences in antagonistic activity during these eye movements, but also to specific synaptic events during the voluntary action.
Adult↗