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Biomedical subjects

Fred F Telischi

Publications and source records attributed to Fred F Telischi.

7 recordsLinked to original sources
PubMed2003

Pediatric tympanoplasty: effect of contralateral ear status on outcomes.

OBJECTIVE: To assess the prognostic value of different variables on the outcome of pediatric type I tympanoplasty. DESIGN: Retrospective review of medical records. SETTING: An otolaryngology department in a large urban tertiary care medical center. PATIENTS: We reviewed 72 ears in 60 patients who had undergone a type I tympanoplasty from 1987 to 2000. Patient ages ranged from 3 to 18 years. INTERVENTIONS: Type I tympanoplasty. MAIN OUTCOME MEASURES: We identified the following 3 criteria for success: (1) healing of the neotympanic graft; (2) healing of the graft with a postoperative air-bone gap of no greater than 20 dB; and (3) healing of the graft with aeration of the middle ear space. RESULTS: Healing occurred in 59 (82%) of the 72 neotympanic grafts; 39 (83%) of the 47 healed ears for which a postoperative audiogram was available had an air-bone gap of no greater than 20 dB; and 49 (83%) of the 59 healed ears had a normally aerated middle ear space. A statistically significant difference in the rate of graft healing was identified for large perforations (76%), as well as for creation of an aerated middle ear space, when there was evidence of ongoing contralateral eustachian tube dysfunction (ie, otitis media with effusion or negative middle ear pressure, but not a perforation). CONCLUSIONS: Pediatric type I tympanoplasty can offer reasonably good chances for postoperative graft healing, serviceable hearing, and creation of an air-containing middle ear space if performed in carefully selected patients. Caution should be exercised in performing tympanoplasty in children with evidence of ongoing eustachian tube dysfunction, as evidenced by otitis media with effusion and negative middle ear pressure, but not perforations, in the contralateral ear.

Adolescent↗
PubMed2003

Role of mannitol in reducing postischemic changes in distortion-product otoacoustic emissions (DPOAEs): a rabbit model.

OBJECTIVES: The aim of this study was to observe the effects of mannitol, administered topically at the round window (RW), on cochlear blood flow (CBF) and distortion-product otoacoustic emission (DPOAE) after repeated episodes of cochlear ischemia. METHODS: Ten young rabbits were used for this study. Reversible ischemic episodes within the cochlea were induced by directly compressing the internal auditory artery (IAA). CBF was measured using a laser-Doppler (LD) probe positioned at the RW niche. DPOAEs were measured at 4, 8, and 12 kHz geometric mean frequency (GMF) using 60 dB sound pressure level (SPL) primary tone stimuli. In five test ears, mannitol was administered topically at the RW for 30 minutes before the IAA compressions. In five control ears, the IAA compressions were undertaken without application of RW medication. Each ear underwent three 5 minute IAA compressions with a 60 minute rest period between compressions. RESULTS: In the control animals, it was observed that a progressive reduction in DPOAE level followed each successive IAA compression at all three test frequencies. The reduction in DPOAE amplitudes was consistently greater at the higher test frequencies. In the test rabbits, the RW administration of mannitol resulted in significantly less reduction in DPOAE level measures after repeated IAA compressions. For example, 30 minutes after reperfusion at 12 kHz GMF, DPOAE levels in the control ears were reduced by 1.5, 6.0, and 16 dB, compared with 1.5, 4.0, and 6.0 dB in the mannitol test ears. CONCLUSIONS: Mannitol appears to exert a protective effect on cochlear function after periods of ischemia. The RW appears to be an efficacious route for topical administration of mannitol into the inner ear.

Acoustic Stimulation↗
PubMed2002

The prevalence of connexin 26 ( GJB2) mutations in the Chinese population.

Mutations in GJB2, encoding gap junction beta 2 protein (connexin 26), are responsible for the commonest form of non-syndromic recessive deafness in many populations. It has been reported recently that the most common 35delG mutation in GJB2 is exceptionally low in Japanese and Korean populations, but another deletion, 235delC, is relatively frequent. Since the Chinese constitute approximately one fifth of the global population, the frequency of GJB2 mutations in the population has important implications for understanding worldwide causes of genetic deafness. To determine whether GJB2 mutations are an important cause of deafness in Chinese, we conducted mutation screening for GJB2 in 118 deaf Chinese probands, including 60 from simplex and 58 from multiplex families with non-syndromic deafness, and 150 normal hearing Chinese controls. Four mutations, including 235delC, 299-300delAT, V37I, and 35delG, were found in the patients. Thirty-nine percent of the probands had a GJB2mutation. Of the 118 probands, 19 carried two definitely pathogenic mutations: three among the 58 multiplex cases (5.2%) and 16 among the 60 simplex cases (26.7%). Twenty-seven probands (22.9%) were found to carry only single GJB2 mutations. None of them had mutations in exon 1 of GJB2 and or the 342-kb deletion of GJB6. The 235delC mutation was the most prevalent mutation (20.3% of alleles), accounting for 81% of the pathologic alleles in multiplex cases and 67% in simplex cases. Analysis of the affected haplotypes in the patients with the homozygous 235delC mutation yielded evidence for a single origin of the mutation. The carrier frequency of the 235delC mutation in control subjects with normal hearing was 1.3%. The 35delG mutation was only noted as a heterozygous change in two simplex cases (1.2% of alleles). These results indicated that mutations in GJB2 are a major cause of inherited and sporadic congenital deafness in the Chinese population. The 235delC mutation, rather than 35delG, is the most common mutation found in the Chinese deaf population. Our data support the view that specific combinations of GJB2 mutation exist in different populations.

Alleles↗
PubMed2002

Distortion-product otoacoustic emissions in nonacoustic tumors of the cerebellopontine angle.

OBJECTIVES: The goal of the present study was to compare the frequencies of cochlear and non-cochlear patterns of distortion-product otoacoustic emissions (DPOAEs) in patients with nonacoustic (non-AN) tumors of the cerebellopontine angle (CPA)/internal auditory canal with those in patients with acoustic neuroma (AN). STUDY DESIGN AND SETTING: We conducted a prospective study of patients with non-AN internal auditory canal/CPA tumors treated between 1992 and 1999 in a tertiary care setting. We collected data on behavioral pure tone average, speech discrimination score, acoustic immittance tests, DPOAEs, and tumor size. DPOAEs were divided into those with a cochlear or a noncochlear pattern. Comparisons were made with a control group of patients with AN of the CPA. RESULTS: Twenty-four patients were included in the study: 12 patients in the non-AN group and 12 patients in the AN group. In the non-AN group, 5 (42%) patients had a cochlear pattern and 7 (58%) had a noncochlear pattern. In the AN group, 7 (58%) patients had a cochlear pattern and 5 (42%) had a noncochlear pattern. The differences between the non-AN and AN groups were statistically significant. In the non-AN group, patients with a cochlear-pattern DPOAE had significantly smaller tumors (P = 0.03) and a trend (P = 0.07) toward higher speech discrimination score. Age and pure tone average were not significantly different in the non-AN tumor patients. In the AN group, none of the study parameters were significantly related to the pattern of DPOAE. CONCLUSIONS: ANs appear to differ from other tumors of the CPA in their propensity to cause sensory versus neural hearing loss. A larger series of patients would be useful to confirm these preliminary findings.

Adolescent↗
PubMed2002

Sensory auricular branch of the facial nerve.

GOAL: To better describe the anatomy of the sensory auricular branch of the facial nerve. BACKGROUND: Clinical experience and the medical literature suggest that the facial nerve supplies sensory fibers to the external auditory canal and pinna. The anatomic distribution of these fibers remains poorly defined. METHODS: Ten cadaveric temporal bone dissections with photographic documentation, two clinical cases, and histologic examination of a candidate nerve fiber were collected. RESULTS: The anatomic distribution and histologic confirmation of a facial nerve branch coursing through the posterior wall of the external auditory canal is described. Mean (+/-SD) measurements along the mastoid segment of the facial nerve from the short process of the incus and chorda tympani nerve origin to the auricular branch origin were 11.6 +/- 1.4 mm (range 9-13 mm) and 3.9 +/- 3.0 mm (range 0-8 mm), respectively. Sacrifice of this nerve in a patient resulted in posterior external auditory canal and inferior conchal bowl hypesthesia. CONCLUSION: The anatomy of a facial nerve branch coursing through the external auditory canal is presented. The anatomic and functional findings of this study suggest that this nerve represents an auricular sensory branch. Understanding these anatomic details may help in identifying the main trunk of the facial nerve in surgery, preventing postoperative external auditory canal hypesthesia, as well as understanding the significance of Ramsay-Hunt Syndrome and Hitselberger's Sign.

Adult↗
PubMed2002

Effect of acoustic tumor extension into the internal auditory canal on distortion-product otoacoustic emissions.

We studied the effects on distortion-product otoacoustic emissions (DPOAEs) of internal auditory canal (IAC) extension of acoustic neuromas (ANs) with the hypothesis that cochlear patterns of DPOAEs would be more commonly observed when the IAC was completely filled with tumor because of direct tumor involvement of either the inner ear or its blood supply. In a retrospective analysis of 86 patients with surgically proven ANs, DPOAEs were classified as having cochlear or noncochlear patterns on the basis of comparisons with the behavioral pure tone thresholds. The results of behavioral audiometry and DPOAEs were compared with the extension of the tumor into the IAC, which was categorized as full or partial. Of the 86 patients, 58 had tumors with full IAC extension, and 28 had tumors with partial IAC involvement. Cochlear patterns of DPOAEs were found in 55.2% of the tumors in the full IAC group and in 71.4% of those in the partial IAC group (not statistically different). It was concluded that the extent of IAC involvement by ANs was not significantly related to the negative effects of the tumor on cochlear function as represented by DPOAEs.

Aged↗