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Biomedical subjects

D E Brackmann

Publications and source records attributed to D E Brackmann.

At least 127 records · Page 7Linked to original sources
PubMed1987

Menière's disease: results of treatment with the endolymphatic subarachnoid shunt compared with the endolymphatic mastoid shunt.

The senior author has performed 346 endolymphatic sac operations since 1971. Questionnaires were sent to these patients to evaluate the results of this surgery. One hundred ninety-six questionnaires were returned and formed the basis for this report. The results of surgery are reported by the new American Academy of Otolaryngology--Head and Neck Surgery criteria as well as by the older method of reporting. There is no significant difference in results between the endolymphatic subarachnoid shunt and the endolymphatic mastoid shunt. Because of the lower morbidity of the latter procedure the authors prefer the endolymphatic mastoid shunt. The new method of reporting is superior to the older method.

Academies and Institutes↗
PubMed1986

Glomus tumor of the facial canal. A case report.

Glomus tumors of the temporal bone are usually classified as either glomus tympanicum or glomus jugulare, depending on the site of origin. This report describes another anatomical site within the temporal bone from which glomus tumors may arise--the facial canal.

Cranial Nerve Neoplasms↗
PubMed1986

Chondrosarcoma of the skull base.

Chondrosarcoma of the skull base is an uncommon neoplasm that comprises 0.15% of all intracranial tumors and 6% of skull base lesions. Compression of vital neurologic structures by tumor expansion as well as the histologic characteristics contribute to the malignant potential of these neoplasms. Tumor recurrence has been associated with incomplete resection in this traditionally surgically inaccessible region. This review of five cases of chondrosarcoma of the skull base examines the surgical approaches to resection in a chronologic fashion to emphasize that total gross resection of these lesions has become possible through the evolution of lateral skull base techniques. The difficulty in pathologic diagnosis and the efficacy of postoperative radiotherapy in enhancing survival are also addressed.

Adult↗
PubMed1986

Magnetic resonance imaging and computerized tomography in malignant external otitis.

In malignant external otitis (MEO), determining the anatomic extent of disease and evaluating the physiologic response to therapy remain a problem. Magnetic resonance imaging (MRI) has recently become available in limited clinical settings. Four patients with MEO were evaluated using MRI, computerized tomography (CT), technetium-99 (Tc-99) bone scanning, and gallium-67 citrate (Ga-67 citrate) scanning. MRI is superior to CT, Tc-99 bone scanning, and Ga-67 citrate scanning in evaluating the anatomic extent of soft tissue changes in MEO. MRI alone cannot be relied upon to determine the physiologic response to therapy. MRI can, however, serve as a valuable guide to the interpretation of Tc-99 bone and Ga-67 citrate scans, and in this respect, MRI is extremely useful in the treatment of MEO.

Adult↗
PubMed1985

Changing concepts of acoustic neuroma diagnosis.

Three hundred five acoustic neuromas were reviewed to determine the sensitivity of combining the auditory brainstem response (ABR) and the intravenous contrast-enhanced computed tomogram (CT) as screening tests for acoustic neuroma diagnosis. The ABR detected 98% of the tumors. The enhanced CT demonstrated 97% of tumors larger than 1.5 cm, but only 48% of neuromas 1.5 cm or smaller. The combination of both ABR and enhanced CT, used as the initial screening tests, identified 99% of the neuromas. We conclude that ABR, with enhanced CT as needed, is an accurate screening protocol. This method can be used as an alternative to the traditional ABR, electronystagmography, and internal auditory canal tomograms.

Adolescent↗
PubMed1985

Congenital cholesteatoma of the petrous pyramid.

A 20-year follow-up was done on a patient with a large congenital cholesteatoma of the petrous apex. The patient was treated successfully with marsupialization through a radical mastoidectomy and sphenoid sinusotomy. Cranial computed tomography and magnetic resonance imaging demonstrated continued cholesteatoma growth. Bone-conduction thresholds remained normal despite replacement of the internal auditory canal by cholesteatoma matrix. The patient continues to have chronic otorrhea, but is otherwise asymptomatic.

Adolescent↗
PubMed1985

Speech recognition experience with multichannel cochlear implants.

Four patients received multichannel intracochlear implants before 1978 as part of the University of Utah program. By 1983, sound coding strategies and electronic miniaturization were developed to allow production and use of a portable sound processor/cochlear stimulator unit. Approval for expanded clinical trials has allowed implantation of five additional patients by August 1984. Data on the earlier patients demonstrate stability of electrode thresholds and impedance, low risk of the percutaneous pedestal, and the development of speech recognition scores of greater than 60% with electrical stimulation alone and greater than 90% with electrical stimulation combined with lipreading. Data on recent recipients indicate early electrode threshold stability, lower thresholds for apical electrodes, possibility of replacing single-channel with multi-channel units, and low morbidity of the implantation. Return to function in a verbally communicating environment has been achieved by one earlier patient.

Adult↗
PubMed1985

Cholesterol granuloma of the petrous apex.

Cholesterol granuloma of the petrous apex is a newly recognized clinical entity distinct from cholesteatoma. Cholesterol granuloma usually produces symptoms of trigeminal, facial, and abducens nerve palsy and may not affect the auditory nerve. The characteristic computerized cranial tomographic (CCT) finding is a nonenhancing, smooth-walled, expansile lesion that is isodense with brain tissue in a patient with bilaterally well pneumatized mastoids and petrous apices. Treatment is limited to drainage of the cyst and insertion of a stent for permanent aeration of the petrous apex. Of ten cases of cholesterol granuloma of the petrous apex recently diagnosed at the Otologic Medical Group, the correct preoperative diagnosis was made in nine patients on the basis of CCT findings. Six of the nine patients had serviceable hearing preoperatively; serviceable hearing was maintained postoperatively in five patients.

Adult↗
PubMed1985

Recurrence rate of partially resected acoustic tumors.

Thirty-three (16.5%) of the first 200 patients who presented to the Otologic Medical Group with acoustic tumors underwent surgery for their subtotal removal. These 33 patients, operated on between 1964 and 1967, were followed for clinical evidence of recurrent tumor for a period ranging from 2 to 20 years. Twelve patients required further surgery for recurrent tumor and three of these repeat surgery patients died as a result of their tumors. Case reports of six patients who underwent partial resection are presented with recent computed cranial tomographic follow-up.

Adult↗
PubMed1984

Computed tomography with gas cisternography for detection of small acoustic tumors. A study of five false-positive results.

Cranial computed tomography (CT) with gas cisternography is reported to be the most accurate method of detection of small acoustic tumors. However, five false-positive CT results experienced in three years are now reported. This is a false-positive rate of 22% for tumors with less than 5-mm protrusion into the cerebellopontine angle, and a false-positive rate of 50% for tumors with less than 2-mm protrusion. A false-positive result is suspected if no mass protrudes at the porus or if gas enters the lateral internal auditory canal.

Adult↗
PubMed1984

Cholesterol granuloma of the petrous apex: CT diagnosis.

Cholesterol granuloma of the petrous apex is a readily recognizable and treatable entity that is more common than previously realized. Cholesterol granuloma grows slowly in the petrous apex as a mass lesion until it produces hearing loss, tinnitus, vertigo, and facial twitching. Twelve cases of cholesterol granuloma of the petrous apex are illustrated; ten of these are analyzed in detail, especially with respect to CT findings. A sharply and smoothly marginated expansile lesion in the petrous apex, isodense with brain and nonenhancing on CT, is in all probability a cholesterol granuloma. Cholesterol granuloma and cholesteatoma of the petrous apex are different lesions and treated differently. Cholesterol granuloma can be treated simply and effectively by drainage and permanent fistulization. Preoperative recognition by CT is important for planning proper treatment.

Adult↗
PubMed1984

TORPs and PORPs in tympanoplasty: a review of 1042 operations.

We reviewed 1042 operations in which a Plasti-Pore prosthesis was used for reconstruction of the sound pressure transfer mechanism. In all cases cartilage was interposed between the prosthesis and the tympanic membrane or graft. The short-term hearing results for these cases are the same as for other techniques but the hearing is more stable in the long run. Other advantages of this technique are a reduced incidence of recurrent and residual cholesteatoma. Extrusion occurred in 7% of the cases but has become less frequent with recent refinements in technique. We intend to continue using Plasti-Pore prostheses in tympanoplasty.

Cartilage↗