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Biomedical subjects

H E Maddox

Publications and source records attributed to H E Maddox.

5 recordsLinked to original sources

Investigator differences in the cochlear implantation of children.

Eight investigational sites are involved in clinical trials of the 3M/House cochlear implant for children. Statistical analyses have been performed to examine differences between investigators in patient populations selected for implantation and in the results achieved. Important characteristics of the subjects from different investigational sites were compared for House, Maddox, and all "others" combined. There were no differences between investigators in sex, age at surgery, or duration of deafness of the children enrolled in the study. For age at onset, House and Others had higher proportions of postlingually deaf subjects than Maddox (16% for House and 18% for Others, compared with less than 2% for Maddox). However, all investigators had some subjects in every category: postlingual, prelingual, and congenital. Auditory discrimination and speech production scores for subjects from the three groups were compared using analysis of variance techniques. A few interaction effects between time interval and investigator indicated that not all investigator groups performed similarly over time for all measures. However, postimplant scores were always significantly higher than preimplant scores for all investigators. Differences that did occur appeared to be attributable to differences in subject characteristics.

Auditory Perception

Pleomorphic adenoma of the middle ear and mastoid with posterior fossa extension.

We describe the case of a pleomorphic adenoma of the middle ear and mastoid, with extension into the posterior cranial fossa. The lesion was characterized by extensive bony destruction and close proximity to the facial nerve. Ectopic or choristomatous salivary gland tissue within the middle ear cleft is the most probable origin of this tumor.

Adenoma, Pleomorphic

Educational aspects of cochlear implants in children.

An overview of deaf education as it relates to the needs of the cochlear implant child is given. More specific information concerning the developmental approach to successful listening is described. The progress of specific youngsters is discussed following application of this "approach".

Child

The lateral approach to acoustic tumors.

The surgical experience of a decade of acoustic tumor surgery is discussed. This series involves 106 operations. A plea is made to use the "lateral" approach to the cerebellopontine angle which combines the translabyrinthine and retrosinal routes when necessary. The facial nerve is preserved in 88% of the patients using this approach and the mortality rate is only 1 or 2%. The most common complication is cerebrospinal fluid leakage. The posterior, suboccipital approach in acoustic tumors is condemned. Statistics are presented that make the argument of "hearing preservation" by suboccipital surgery academic. Only 11% of the patients in this series of 106 had "good" hearing preoperatively and all of these had normal hearing in the opposite ear.

Cerebellopontine Angle

Endolymphatic sac surgery.

There is a disturbing variation in the reported success rate in Endolymphatic Sac Surgery in the literature. Relatively long-term (24 months to 10 years) follow-ups are given in a series of 66 patients in this paper. Results reveal only a 55% long-term relief of vertigo in these patients. Only 30% of this series of cases had any improvement in cochlear function. There was a definite trend towards recurrence of vertigo in the longer follow-up cases. It is concluded that Endolymphatic Sac Surgery still is important in the treatment of idiopathic endolymphatic hydrops, but is of questionable value early in the course of the disease. Total removal of the endolymphatic system remains the best single surgical approach in a large number of patients with Ménièr's disease.

Adult