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Biomedical subjects

D W Goin

Publications and source records attributed to D W Goin.

15 recordsLinked to original sources
PubMed1992

Hearing results from endolymphatic sac surgery.

This report examines the effect of the endolymphatic shunt on hearing. The study group was drawn from 101 shunt operations for intractable vertigo between 1983 and 1987. Thirty ears met criteria for diagnosis, level of preoperative hearing impairment, and length of follow-up. The control group consisted of 30 ears with symptoms severe enough to prompt recommendations for shunt surgery, but the patients either opted against surgery or improved. The results were analyzed using the 1985 AAO-HNS reporting criteria. When looking at worst postoperative (or worst scores after 2 years of follow-up in controls) compared to worst preoperative (or worst scores in the first 6 months of presentation in controls), we found no significant difference between the study group (average loss of 9 dB pure-tone average [PTA] and 16% speech discrimination [SD]) as compared to the control group (average loss of 3 dB PTA and 10% SD). However, when using the first and last audiograms for the control group, there was a statistically significant difference as compared to the worst preoperative and postoperative scores in the shunt group. Using the first and last scores, the control group had a better outcome (PTA improved 2 dB, SD score dropped 5%). There was no significant difference between groups for percentage of patients whose hearing improved, remained the same, or worsened. In conclusion, the endolymphatic shunt operation did not significantly effect the long-term hearing results.

Adolescent↗
PubMed1991

Prediction of behavioral threshold and comfort values for Nucleus 22-channel implant patients from electrical auditory brain stem response test results.

We have studied the prediction of behavioral threshold and comfort values for 11 patients who use the Nucleus 22-channel cochlear implant by means of the results of electrical auditory brain stem response (EABR) procedures. For prediction purposes, EABR and behavioral testing were done in the same electrode mode configuration for three specific electrodes. The results of this investigation suggest that EABR threshold current level is consistently near the behavioral comfort current level, rather than the patient's behavioral threshold level.

Adult↗
PubMed1990

Electrically evoked auditory brain stem responses (EABR) and middle latency responses (EMLR) obtained from patients with the nucleus multichannel cochlear implant.

Electrical auditory brain stem responses (EABR) and electrical middle latency responses (EMLR) were recorded from patients who had received the Nucleus multichannel cochlear implant system. Twenty-five sequential patients had either intraoperative or outpatient EABR testing. We also recorded EMLRs from several outpatients. EABR results were consistent among all patients tested. Wave V mean latencies were the shortest (3.82 msec) for the most apical electrode (E20) and increased slightly for the medial (E12) and basal (E5) electrodes (3.94 and 4.20 msec, respectively). Absolute latencies for all EABR component waves were observed to be 1 to 1.5 msec shorter than typical acoustic auditory brain stem response (ABR) mean latencies. We have examined the relationships between patients' EABR/EMLR and their behavioral responses to electrical stimulation. Generally, the behavioral threshold and comfort current levels were lower than the predicted values based on EABR/EMLR findings. This observation may be due in part to psychophysical loudness differences noted for pulse rates of 10 to 500 pulses per second in some of the patients that we have studied in greater detail.

Adolescent↗
PubMed1988

Hearing results and control of vertigo after retrolabyrinthine vestibular nerve section.

To determine the effect of retrolabyrinthine vestibular nerve section (RVNS) on hearing, vertigo, and associated symptoms, we reviewed our experience in 48 patients. Of the 48, 39 responded to a questionnaire. Although RVNS appeared to have little effect on hearing in Meniere's patients, 91% of non-Meniere's patients had significant and often delayed postoperative sensorineural hearing loss. Our results for vertigo control compared favorably to previous reports with 96% of Meniere's patients and 69% of non-Meniere's patients reporting improvement. Presently, we more frequently recommend RVNS as the primary procedure for the control of severe vertigo in Meniere's patients. Patients with vertigo from other causes must be carefully selected.

Follow-Up Studies↗
PubMed1986

Pediatric vestibular evaluation with harmonic acceleration.

A group of 101 otologically normal infants and children were evaluated with low-frequency harmonic acceleration (HA) to determine the feasibility of use of this procedure in evaluation of vestibular function in a pediatric population. Ninety-six of the subjects were successfully tested and normative data are presented. A maturational trend was noted (in the presence of nystagmus) in subjects up to 10 months of age and in the phase-lag measurement up to approximately 4 years of age.

Age Factors↗
PubMed1985

Primary CNS lymphoma in the cerebellopontine angle. Report of a case.

We report a case of primary CNS lymphoma that appeared as a cerebellopontine angle lesion, an initial observation not previously reported, to our knowledge. In general, primary CNS lymphoma remains localized to the CNS, with death occurring from localized recurrence. Radiation therapy after open biopsy is the treatment of choice, and achieves a good three-year outcome. However, five-year outcome with this treatment is poor.

Aged↗
PubMed1984

Endolymphatic sac surgery in Mondini's dysplasia: a report of 16 cases.

This paper presents 12 patients (16 ears) with radiographic evidence of Mondini's dysplasia who underwent endolymphatic sac surgery. And additional 4 patients (7 ears) on whom surgery was not performed are included. Class I or II results were obtained in 81% of the ears. Pathophysiology, as it relates to the fluctuant nature of the hearing impairment, is discussed.

Adult↗
PubMed1982

Proximal intratemporal facial nerve in Bell's palsy surgery. A study correlating anatomical and surgical findings.

This paper deals with the surgical approaches to that part of the intratemporal facial nerve lying proximal to the cochleariform process and focuses on two issues: the advisability of disarticulating the ossicular chain to reach this area and the accessibility of the labyrinthine segment via the transmastoid, extralabyrinthine, subtemporal route. Relevant anatomical features, which are based on 39 gross temporal bones, 47 histologic sections, and 10 cadaveric specimens are first considered. In the head specimens, it was possible to attempt exploration of the entire nerve with the transmastoid, extralabyrinthine, subtemporal operation and then remove the labyrinth to gauge the adequacy of this approach as an avenue to the labyrinthine segment. These anatomical findings, their bearing on the questions at hand, and the author's clinical experience are incorporated into descriptions of the operations currently in vogue for exploring the proximal nerve in patients with Bell's palsy.

Ear Ossicles↗
PubMed1982

Summating potential in Meniere's disease.

This study assesses several electrocochleographic (ECoG) duration and amplitude measures in a clinically defined Meniere's group and compares the results with those from a normal hearing control group and a hearing loss group (cochlear). The summating potential (SP)/action potential (AP) amplitude ratio was the most efficient diagnostic measure, with 62% of the Meniere's group demonstrating abnormal ratios compared to 4% of the normal control group and 17% of the cochlear group. The SP changes were then studied from three angles: 1. Comparison of SP changes with glycerol test results; 2. Comparison of ECoG results before and after shunt surgery; and 3. Recording of SP's in guinea pig ears in which hydrops had been created by obliterating the endolymphatic duct.

Action Potentials↗
PubMed1980

Facial nerve paralysis secondary to mandibular fracture.

When facial nerve paralysis complicates a mandibular fracture, it may be difficult to locate the point of injury, since the nerve may be injured in the fallopian canal by a secondary temporal bone fracture or in soft tissue by mandibular fragments. Following a review of eight previously reported cases, this paper presents two additional cases, one with bilateral, complete paralyses and the other with a unilateral paresis. In the first, the condyles were driven posteriorly, resulting in bilateral temporal bone fractures, a unilateral external canal stenosis, and a unilateral sensorineural hearing impairment. Good functional return followed decompression of the intratemporal facial nerves. In the second patient, facial function returned spontaneously. When the temporal bone is fractured, therapy follows guidelines for facial paralysis associated with basilar skull fractures from other causes. If soft tissue injury is suspected, the decision must be made whether to explore the nerve or wait for spontaneous recovery.

Adolescent↗
PubMed1979

Surgical management of petrous apex meningioma.

When centered in the petrous apex, meningiomas behave like other neoplasms occuring in that region. The petrous apex can be approached by several routes: posterior craniectomy; middle fossa craniectomy; translabyrinthine, transcochlear, and transethmoidosphenoid approaches. A patient harboring a malignant meningioma in her petrous apex is presented. A middle fossa craniectomy, coupled with posterior displacement of the facial nerve, allowed access to the entire temporal bone from above. The patient received postoperative irradiation.

Adult↗