Biomedical subjects

D T Cody

Publications and source records attributed to D T Cody.

At least 19 recordsLinked to original sources

PubMed1984

Mastoidectomy for acquired cholesteatoma: follow-up to 20 years.

The results of 423 mastoidectomies for acquired cholesteatoma were reanalyzed 6 years after the first analysis. The mastoidectomies were placed into three groups: open-cavity, 135 modified radical and 37 radical; obliterated-cavity, 60 modified radical and 20 radical in which the mastoid cavities were obliterated with pedicle muscle grafts; and intact-canal-wall, 69 complete and 102 complete with opening of the facial recess. The following observations were made. The cholesteatoma failure rate increased: for the open-cavity group, from 6% to 7%; obliterated-cavity group, 16% to 18%; intact-canal-wall group, 35% to 45%. The precholesteatoma (retraction pocket) failure rate in the open-cavity and obliterated-cavity groups did not change. In the intact-canal-wall group, recurrent cholesteatomas developed in 8 cases initially classified as precholesteatoma failures. In 9 initially classified as successful, retraction pockets developed and 7 of these went on to recurrent cholesteatomas. Consequently, despite the progressive increase in formation of retraction pockets, the overall incidence dropped from 20% to 16%. Failure due to chronic or frequent recurrent infection did not change in the open-cavity and intact-canal-wall groups. However, in the obliterated-cavity group, it increased from 4% to 5%. The overall failure rate increased: open-cavity group, 18% to 19%; obliterated-cavity group, 29% to 30%; intact-canal-wall group, 60% to 66%.

Cholesteatoma↗

PubMed1983

Tack operation for idiopathic endolymphatic hydrops: an update.

This paper discusses an analysis of two groups of patients who underwent a tack operation for incapacitating recurrent attacks of vertigo due to idiopathic endolymphatic hydrops. Group I consisted of the first 140 patients operated on by one of the authors (D.T.R.C.). All were followed up for at least 5 years after the operation. However, between the 63rd and 166th postoperative months, 12 patients died of unrelated causes, and an additional 26 patients were lost to follow-up between the 70th and 119th postoperative months. The analysis was based on the condition of these patients up to the time of their death or the time that they were last contacted. The mean postoperative follow-up for the 140 patients was 12 years 9 months, and the range was 63 to 197 months. Group II consisted of 150 consecutive patients who had a tack operation performed by several consultants and residents in the Department of Otorhinolaryngology at the Mayo Clinic, and the opportunity for follow-up of at least 5 years existed for all patients. The patients who were lost to follow-up in the first 56 postoperative months were excluded from the analysis unless at the time they were last seen the operation had not controlled their vertigo, in which case the results were classified as failures. On this basis, 22 patients (15%) were excluded from the study, so that 128 patients remained in the analysis. The mean postoperative follow-up for this group was 9 years 4 months, with a range of 56 to 182 months. The following conclusions were reached. Vertigo was satisfactorily controlled in 79% of the patients in the two groups. Hearing was improved or maintained in 66% of the patients in Group I and 60% of the patients in Group II. A moderate-to-profound sensorineural hearing loss occurred in 34% of the patients in Group I and 40% of the patients in Group II. We consider the tack operation the conservative operation of choice in the management of idiopathic endolymphatic hydrops.

Follow-Up Studies↗

PubMed1977

Facial palsy: unusual etiology.

This is a report of three patients who presented at the Mayo Clinic over a two-year period. All were initially diagnosed as having Bell's palsy but were later found to have a malignant neoplasm causing the paralysis. Two of the patients had breast carcinoma metastases involving the mastoid portion of the facial nerve. The third patient had an adenocarcinoma of the deep lobe of the parotid that involved the facial nerve distal to the stylomastoid foramen. The course of the facial paralysis in the two patients with the metastitic breast disease was almost identical. It consisted of episodes of pain in the mastoid area. generally in the late evening or during the night, often awakening the patient from sleep. This was then followed by peripheral facial-nerve paralysis, sometimes partial and at other times complete. These episodes lasted from 10 minutes to several hours and then resolved completely. They recurred over several months. The patients were completely asymptomatic and normal on examination in the intervals between episodes of paralysis until it became permanent. Metastatic lesions causing facial paralysis are extremely rare in the literature. In those cases that have been reported, the paralysis was progressive from the start and in the vast majority of cases was either painless or associated with other aural symptoms such as otorrhea, hearing loss, and periauricular swelling. There are two unusual features of these two cases: 1. the initial presentation of a breast metastasis as a facial paralysis; in the first case there were no other metastatic lesions present at diagnosis, whereas the second patient had other, asymptomatic, metastatic nodules; and 2. the multiple, brief, recurring episodes of facial paralysis, which have not previously been reported as a mode of presentation of metastitic disease. The third patient was diagnosed as having Bell's palsy. A facial nerve decompression was performed, and the nerve apparently looked normal. The paralysis failed to resolve. He was later found to have adenocarcinoma of the deep lobe of the parotid that involved the facial nerve distal to the stylomastoid foramen. A report of only one similar case could be found in the literature. The sequence of events in these three cases emphasizes the importance of submitting a patient suspected of having Bell's palsy to a thorough otoneurologic examination.

Adenocarcinoma↗

PubMed1974