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Biomedical subjects

H P House

Publications and source records attributed to H P House.

11 recordsLinked to original sources

Otosclerosis. Treating progressive hearing loss in young adults.

When a patient presents with bilateral progressive hearing loss and has a family history of hearing loss, otosclerosis should be placed high on the list of possible causes. Primary care physicians should determined whether the hearing loss is conductive or sensorineural with otologic examination and tuning-fork evaluation. Unless there is an obvious reversible cause for the progressive hearing loss, the patient should be referred to an otolaryngologist for more intensive otologic and audiologic examination. The patient's principal concern is the ability to hear and comprehend the spoken word in normal circumstances. Fortunately, most patients can be rehabilitated with surgery or a hearing aid. Fluoride treatment may have a significant role in preventing further hearing loss from otosclerosis.

Adolescent

Calcitonin as treatment for hearing loss in Paget's disease.

Progressive hearing loss is a potential complication of Paget's disease, a metabolic disorder of accelerated bone formation and resorption. Calcitonin (Calcimar) is a recently introduced synthetic hormone used as a systemic treatment. Some studies have shown it to halt the progression of hearing loss. This is the first study of the effects of calcitonin on hearing loss to use a large number of patients with continuous use of the drug and long-term follow-up. It confirms that the drug is effective. We conducted chart reviews to compare the degree of hearing loss over time in 45 patients. Twenty-six patients have been taking salmon calcitonin for five to eight years to date and nineteen have received no treatment. Hearing loss was recorded at the initial examination (trial 1), one to four years later (trial 2), and then one to five years after the second evaluation (trial 3). Statistical analyses show a strong relationship between treatment and rate of hearing loss. The average hearing loss in the control group progressed from 47 dB in the first trial to 59 dB in the second trial to 75 dB in the third trial. Average hearing loss in the treated group remained at 47 dB over time. The difference in hearing loss over time between the two groups was less than 1 dB for the treated group and more than 28 dB for the control group. Results thus clearly show that calcitonin is effective in halting the progression of hearing loss in Paget's disease.

Aged

Stapes surgery at the Otologic Medical Group.

We reviewed the records of 498 primary stapedectomy cases in regard to duration of disease, age at surgery, oval window pathology, hearing results, dizziness, and tinnitus. Ninety percent of the cases in which a tissue graft had been used as an oval window covering obtained a postoperative hearing level within 10 dB of the preoperative bone conduction. Postoperative sensorineural hearing impairment occurred infrequently and was two to three times more common in cases in which Gelfoam had been used as an oval window covering as compared to tissue grafts. Postoperative dizziness of one degree or another persisted at four months in 2 percent of the cases and was a problem for the patient in two cases (0.4%). This dizziness was likewise more common in Gelfoam cases. We concluded that tissue grafts are a better covering for the oval window than Gelfoam both in regard to hearing improvement and lack of postoperative complications.

Adult

Cochlear reserve in otosclerosis. A long-term follow-up study of fenestration cases.

In this long-term follow-up study of fenestration cases, a remarkable stability in sensorineural hearing levels is demonstrated. Since the focus of otosclerosis was not removed at the time of fenestration surgery, this bone conduction stability is an indication that the ear can withstand the presence of an otosclerotic lesion that produces stapes fixation for long periods of time without sensorineural deterioration. It would seem that the otosclerotic lesion in ears suitable for fenestration surgery has had little tendency to invade deeply into the cochlear capsule.

Adult

Human stapes crura: surface bone architecture: scanning electron microscopic findings.

Human stapes crura obtained at the time of stapedectomy for clinical otosclerosis have been studied after removal of the mucosal and periosteal layers by treatment with hydrogen peroxide and ultrasonification. With the scanning electron microscope, four basic architectural patterns are evident: honeycomb, fibrillar, compact and pitted. The significance of these patterns is as yet unclear, but they do appear to be in intimate relationship one to another and perhaps are varying stages in a single process.

Ear Ossicles

Human stapes crura. Normal ultrastructure, scanning electron microscopical findings.

The crura of normal human stapes were studied with the scanning electron microscope. Three definite layers were seen: mucosal, periosteal, and bone. The appearance of each layer, as well as of the transition zones, has been presented. Familiarization with the scanning electron microscopic features of the normal human stapes crura should make identification and interpretation of abnormal features of diseased states apparent.

Cilia