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Biomedical subjects

J G Neely

Publications and source records attributed to J G Neely.

At least 55 records · Page 3Linked to original sources
PubMed1981

"Onion bulb" formation associated with a solitary neoplasm of the eighth nerve sheath.

Audiometric patterns associated with retrocochlear disorders include abnormal adaptation, delay of auditory evoked potential latencies, and characteristic abnormalities of speech intelligibility functions. The anatomic substrate of these psychoacoustic and electrophysiologic abnormalities is unknown. This paper describes the incidental observation of "onion bulbs" in a solitary neoplasm involving the eighth nerve sheath and in the cochlear nerve lateral to the neoplasm. Such hypertrophic neuropathy in the eighth nerve has not been described previously. This occurrence raises the question of sequential demyelination and remyelination in a neoplasm-bearing nerve as a possible histopathologic correlate to retrocochlear dysfunction.

Cranial Nerve Neoplasms↗
PubMed1981

A retrospective analysis of the intact canal wall tympanoplasty with mastoidectomy.

A retrospective analysis of patients who underwent surgery for chronic otitis media, cholesterol granuloma, and cholesteatoma between 1971 and 1979 was performed. The prevalence of postoperative cholesteatoma was higher than that previously reported in the literature. This emphasizes the need to re-explore patients who have had intact canal wall tympanoplasty with mastoidectomy performed for the removal of cholesteatoma. The elimination of cavity problems and better functional results must be balanced against the need for a second operation when an intact canal wall procedure for cholesteatoma is considered. Cholesteatomas occurring in children appear to be more aggressive than those occurring in adults.

Adolescent↗
PubMed1981

Gross and microscopic anatomy of the eighth cranial nerve in relationship to the solitary schwannoma.

Surgical advances over the past two decades, allowing the discovery of smaller solitary schwannomas of the VIIIth cranial nerve and their extirpation with preservation of the VIIth cranial nerve, have lead to attempts to resect the tumor without completely resecting its nerve of origin. This paper reports the macroscopic and microscopic observations of 22 solitary schwannomas of the VIIIth cranial nerve as they relate to the nerve of origin. Nine tumors were removed, en bloc with the VIIIth nerve, transversely subserially sectioned and studied by light microscopy. Four of the en bloc cases and 13 additional cases were studied by biopsying the VIIIth nerve branches, lateral, and the VIIIth nerve trunk medial to the tumor. The results suggest that the VIIIth nerve is involved throughout the extent of the tumor and, in some cases, beyond the tumor limits with intraneural invasion by tumor cells. There is an immediate dispersion of VIIIth nerve fibers to extremely small aggregates dispersed peripherally about the tumor surface. These fiber aggregates are not surgically dissectable from the tumor because of the difficulty in identifying the fibers and because of tumor infiltration of normal appearing nerves. The pure tone threshold average of 500-2,000 Hz. tends to correlate more closely with the number of cochlear fibers present, lateral to the tumor, than do other auditory tests. The percent of unilateral vestibular weakness does not correlate with the number of fibers present in the superior vestibular nerve. In summary, these histologic data suggest that complete tumor resection from VIIIth nerve fibers may be beyond our present technological capabilities. They further suggest severe limits to accurate identification of candidates for this conservation surgery.

Adult↗
PubMed1980

Speech, impedance, and auditory brainstem response audiometry in brainstem tumors. Importance of a multiple-test strategy.

Speech, impedance, and auditory brainstem response audiometric data were determined for four patients with intracranial tumor. Although the results of any individual measure may be ambiguous, consideration of the overall pattern of results on all three measures, in combination with audiometric sensitivity level, can lead to relatively precise site localization of brainstem auditory disorders.

Acoustic Impedance Tests↗
PubMed1979

Reversible compression neuropathy of the eighth cranial nerve from a large jugular foramen schwannoma.

Jugular foramen schwannomas are unusual tumors occasionally resulting in neural hearing losses. Two previously reported cases document preservation of hearing following removal of a jugular foramen schwannoma. I report the third such case, in which there was progressive auditory and vestibular dysfunction seen on serial preoperative auditory tests and recovery of function seen on postoperative auditory and vestibular tests. The presumed pathophysiologic feature sub-serving this observation is compression neuropathy. I discuss experiences with compression neuropathy in animals and man under other circumstances.

Adult↗
PubMed1977

Unrelated sensorineural hearing loss in patients with otosclerosis. A report of three cases.

Although it is generally accepted that 20% or more of patients with clinically manifest otosclerosis have a concomitant sensorineural hearing loss, it is still debated whether otosclerosis is the cause of the neural loss. Three cases are presented of other causes of sensorineural loss in otosclerotic patients who underwent stapes surgery. One of these cases, the Mondini malformation, is discussed in detail.

Adult↗
PubMed1977

Clinical correlates of neoplastic involvement of the eight cranial nerve in man.

This study of 25 cases of benign neoplastic involvement of the eighth nerve in man suggests: (1) Eighth nerve auditory dysfunction and minimal structural change in the internal auditory canal are the earliest reliable signs leading to tumor detection. (2) "Early" detection does not mean "small" tumor. (3) Schwannomas tend to grow more slowly in the elderly patient. (4) Compression and displacement of viable axons may be the primary pathophysiology of dysfunction.

Adult↗
PubMed1976

Homograft replacement of the tympanic membrane.

This paper presents the authors' experiences with one method of reconstruction of the tympanic membrane when it is totally absent or when there is a fixed, retracted, defective, or absent malleus. Ten patients undergoing surgery for chronic suppurative otitis media between April, 1971, and January, 1973, had homograft tympanic membranes and/or ossicles used to reconstruct the defect in the tympanic membrane or ossicular mechanism. The patients had certain clinical and surgical characteristics in common: 1. all had either an absent tympanic membrane or almost total perforation of it; 2. all were operated upon in the absence of acute infection or active drainage; cholesteatoma, if present, was totally removed; 3. all had patent eustachian tubes; 4. all had intact middle ear mucosa at the time of utilization of the homograft; 5. all patients were operated upon by the same surgeon; 6. all of the homografts were obtained within 24 hours and were used within one month after the death of the donor; 7. all of the homografts used had been preserved in 70 percent ethyl alcohol; 8. all of the homograft materials came from donors who were under 40 years of age at the time of death and who died of accidental causes. (None of the donors was known to have any pre-existing disease); 9. all homografts, after being placed in proper position in the recipient, were covered with ear canal skin; 10. all patients received homografts that were from the corresponding ear of the donor. (In other words, right ear homografts were used in the patient's right ear, etc.); 11. whenever the tympanic ring was greater than the size of the homograft, the patient's temporalis fascia was used in conjunction with the homograft tympanic membrane to bridge the defect; 12. all patients had the middle ear packed with gelfoam prior to inserting the homograft (compressed gelfoam was used also for the outer packing); 13. none of the patients had tissue-typing procedures carried out in an effort to match the donor and the recipient, nor was any attempt made to match the sex of the donor and the recipient; and 14. all patients received antibiotics postoperatively; however, none received immunosuppressive therapy postoperatively. In 3 of 10 patients receiving homografts, the malleus was normal, and only the tympanic membrane was reconstructed. In seven others there was a fixed, retracted, defective or absent malleus in addition to the tympanic membrane defect.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1976

Microscopic characteristics of the acoustic tumor in relationship of its nerve of origin.

The microscopic characteristics of a 0.9 cm vestibular schwannoma en bloc resected with its nerve of origin which occurred in a 54-year-old white woman presenting with a two-year history of a unilateral progressive sensori-neural hearing loss is described. The tumor originated in the inferior vestibular portion of the vestibular division of the VIIIth cranial nerve just medial to the internal auditory canal meatus at approximately the level of the glial-non-glial junction. The tumor demonstrated two distinctly different, yet simultaneous, modes of involvement with its nerve of origin: 1. inseparable cellular continuity; and 2. peripheral compression of the remainder of the nerve within the tumor capsule. Despite only slight microscopic continuity of the nerve histologically, electronystagmography showed no unilateral weakness on bithermal caloric testing, and pure tone and speech audiometry was only moderately depressed.

Audiometry↗
PubMed1975

Recovery of crossed acoustic reflexes in brain stem auditory disorder.

Crossed acoustic reflexes were serially monitored in a patient receiving radiotherapy for an intra-axial brain stem tumor. Analysis revealed a pattern of systematic recovery as the brain stem lesion responded to therapy. Crossed reflexes were observed at more and more test frequencies, until responses were present on both ears for all test signals. Pure-tone sensitivity and speech intelligibility remained within the normal range throughout the observation period.

Auditory Pathways↗