Biomedical subjects
Publications and source records attributed to D F Mouney.
With the advent of the CO2 laser, the transendoscopic placement of stents and keels has become an important adjunct in the surgical treatment of laryngeal webs and stenosis. Fixation of stents, however, is often difficult and cumbersome. Here, we describe two relatively simple techniques of laryngeal stent construction, placement, and fixation.
Auditory brainstem-evoked responses (ABR) to clicks were recorded in unanesthetized restrained cats before, during, and after systemic intravenous infusion of lidocaine hydrochloride. The drug was infused continuously at varying rates. Lidocaine's major effect on ABR was to lengthen latent periods to all wave-form peaks in proportion with the infusion rate. The effect on latent periods was cumulative throughout the auditory brainstem, ie, all interpeak time intervals increased. Increases in ABR latencies were not due to reductions in effective stimulus intensity because lidocaine did not reduce ABR component amplitudes or increase thresholds. The effects of the drug were reversible. The data are consistent with the notion that lidocaine, directly or indirectly, works throughout the auditory brainstem to increase axonal and synaptic conduction times.
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An ophthalmological slit lamp argon laser was used on 8 patients with multiple cutaneous and mucosal telangiectasis; 6 patients had telangiectatic lesions of various etiologies and 2 had hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease). Bleeding from trauma was the primary symptom with cosmesis as a secondary consideration. The telangiectatic lesions were photocoagulated using the argon laser with precise microscopic control. The optimum dose was determined by varying the spot diameter, beam power, shutter speed and number of applications until the lesions were visually ablated. All treatments were accomplished on an outpatient basis with no anesthesia or sedation and minimal reported patient discomfort. No lesions have recurred over a 12 month follow-up.
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The primary clinical utility of electrocochleography at the Louisiana State University Medical Center is the detection of hearing losses in children. This frequently requires the administration of a general anesthetic. Time required for this procedure could be shortened if stimuli were presented at a more rapid rate than the customary 10/s, provided the response amplitude is not significantly diminished by adaptation. The response amplitudes of 12 subjects were studied at stimulus rates of 10, 20, 40, and 80/s. An increase of response amplitude on the order of approximately 3:1 over the 10/s rate was found for the 80/s rate when the test interval for each was equal.
Twenty-three cases of laryngeal papilloma have been treated and followed for four years utilizing laser excision and laser excision/immunotherapy. Fourteen cases responded well to laser excision alone, nine did not and immunotherapy was instituted as adjunctive treatment. To date, immunotherapy has contributed little to the relief in this group of refractory cases.
A modified American Optical (Model 100) CO2 laser was used to produce lesions in the tympanic membranes, ossicles, and cochlear capsules of guinea pigs. Even with the lowest available intensities and durations (0.4 watts, 50 msec), there was damage to the inner ear. Although laser surgery of the ear can avoid mechanical trauma and bleeding as well as increase accuracy, the use of commercial lasers in ear surgery should be avoided until a proven unit is available.
The CO2 laser has been used in a variety of lesions for two and one half years in areas other than the larynx. These lesions include viral papillomas, leukoplakias and erosive lichen planus in various otolaryngological sites. Laser therapy is compared with other modalities of treatment for similar lesions and the advantages and disadvantages of this type treatment is evaluated.
We have had the opportunity to employ the CO2 surgical laser with suspension laryngoscopy and microscopic adaptations to treat a variety of laryngeal conditions over two years. Each type of laryngeal condition is discussed, and the benefits of laser management is evaluated. This type of laryngeal management is compared with other forms of treatment such as the standard surgical approaches, electrocautery, and cryosurgery.
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Using tone burst stimuli with fixed parameters of rise time and duration, a functional relationship has been demonstrated between frequency and intensity of the stimulus and peak latency of electrocochleographic recordings. The feasibility of a "map" of the human cochlear partition has been shown for frequencies above 2 kHz.