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Biomedical subjects

J Helms

Publications and source records attributed to J Helms.

At least 19 recordsLinked to original sources
PubMed1992

[Immunohistochemistry of the Scarpa's ganglion and the crista ampullaris of patients with Menière disease].

In certain long-lasting cases of Menière's disease with recurrent attacks, despite of saccotomy, the removal of the vestibular ganglion is the only procedure that relieves vertigo. During ganglionectomy of this group of patients all fresh tissues gotten and gathered from operation are frozen immediately and preserved for immunohistochemical assay with direct and indirect incubations. The positive findings such as ASMA+, AEA+ and ANA+ in tissues of patient's own as well as in control tissues further confirmed the results previously reported by us. The immune-complex mediated arteriolar and capillary vasculitis on the basis of an autoimmune disorder as a secondary autoimmune marker might play a dominant role in this patients group. The demyelination of vestibular neurons in the Ganglion Scarpae might be the cause of the Menière symptoms. To confirming the hypothesis, the research plan must be continuously carried out.

Antibodies, Antinuclear↗
PubMed1992

Hearing preservation in acoustic neurinoma surgery.

The chances of hearing conservation in patients with acoustic neurinoma increases by early diagnosis of small tumors. An early diagnosis of an acoustic neurinoma is achieved through the application of a minimal diagnostic test battery to evaluate unilateral otological complaints such as tinnitus, sensorineural hearing loss and balance disturbances. This minimal evaluation comprises puretone audiometry and ABR. Patients showing abnormal findings should be pursued with imaging evaluation such as MRI with gadolinium contrast. The choice of surgical approach for removal of an acoustic neurinoma (transtemporal, translabyrinthine or suboccipital) will depend on the size of the tumor and the patients' hearing. The possibilities should be discussed with the patients. Postponing the surgical intervention due to the possibility of facial paralysis or loss of hearing is difficult to rationalise. During the last 15 years, the development in diagnostic and surgical techniques has made it possible to conserve hearing during surgery at least in some patients suffering from acoustic neurinoma. Early diagnosis of small tumors increases the chances to conserve hearing. Therefore, all nonspecific early otologic symptoms should be thoroughly evaluated to exclude the presence of an acoustic neurinoma. Acoustic neurinomas usually arise within the internal auditory meatus and grow further into the posterior cranial fossa. The first symptoms usually are hearing loss, tinnitus and balance disturbance. These symptoms can occur in combination or individually. Accordingly, all cases presenting with one or all of these symptoms in the absence of an obvious etiology, such as posttraumatic hearing loss, require the exclusion of an acoustic neurinoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Audiometry, Pure-Tone↗
PubMed1990

Immunohistochemical findings in the vestibular ganglion from a patient with Menière's disease.

Immunofluorescent staining techniques were performed on a series of cryostat sections of the vestibular ganglion taken during ganglionectomy from a patient with Menière's disease. The direct technique using FITC-labelled antiserum proved the presence of immunoglobulins in the patient's blood vessels and endoneural connective tissue. Preincubation with unlabelled antiserum blocked this reaction. An additional positive reaction of ganglion cells was demonstrated by incubating tissue with the patient's serum. These findings prove antibodies in the patient's serum against the autologous ganglion cells. The vestibular ganglion from a patient with dizziness following a skull base fracture served as a control specimen. No autoimmune reaction was found in the ganglion cells when incubation was carried out with the patient's serum. A positive reaction in the blood vessels and connective tissue was less pronounced. The findings of the present study underline the occurrence of immunological reactions in the vestibular ganglion of patients with Menière's disease. A subsequent degeneration of ganglion cells could provoke clinical Menière's attacks.

Antigen-Antibody Complex↗
PubMed1990

Determination of cardiac output during positive end-expiratory pressure--noninvasive electrical bioimpedance compared with standard thermodilution.

Many investigators have demonstrated the accuracy and reliability of thoracic electrical bioimpedance (TEB) in spontaneously breathing patients and under mechanical intermittent positive-pressure ventilation. Most of these studies showed a good correlation between TEB and invasive methods, such as thermodilution (TD) or the Fick method. But during PEEP, contrary results occur when comparing TEB and TD. In six patients undergoing neurosurgical interventions, TEB cardiac output measurements were compared during zero end-expiratory pressure (ZEEP) and during PEEP at 8 cm H2O with a low respiratory rate. The data revealed a good correlation during ZEEP (r = .93) and during PEEP (r = .91). There was no significant statistical difference when measuring cardiac output by TEB during ventilation with PEEP. During normal or decreased cardiac output, TEB overestimated cardiac output compared with TD, whereas TEB underestimated cardiac output compared with TD during increased cardiac output, especially during PEEP.

Brain Neoplasms↗
PubMed1988

Otosurgical aspects in diagnostics and therapy of acoustic neurinomas.

136 acoustic neurinomas were operated upon by otosurgical transtemporal or translabyrinthine interventions. The otosurgical approach was used when a suboccipital craniectomy with a certain retraction of the cerebellum seemed to be avoidable. The pure otosurgical tumour removal was restricted to a tumour extension up to 2.5 cm starting from the fundus of the internal auditory meatus. The transtemporal route was used when hearing was worth saving and the translabyrinthine when the pure tone auditogram showed an average loss of 50 dB or the speech audiogram a discrimination loss of 50% or more. In larger tumours the neurosurgeon removed the intracranial part of the acoustic neurinome preserving the facial nerve and, if possible, the cochlear nerve as well. If parts of the tumour had remained within the internal auditory meatus or if some uncertainty concerning complete tumour removal persisted, an otosurgical second intervention was considered indicated. In 41 patients the cochlear nerve could be preserved at operation. 12 of these patients showed a preservation of their hearing.

Audiometry, Pure-Tone↗
PubMed1988

Inner ear surgery.

Explore the source record for details and available documents.

Ear Diseases↗
PubMed1987

[Results of microsurgery in ear malformations].

Small middle ear malformations consist of bony bridges compromising the vibration possibilities of the ossicular chain. In 17 out of 21 cases the air bone gap could be closed by microsurgery. The results in surgery of extended ear malformations with microtia, atresia of the outer ear and a malformated middle ear were not as good. In cases with aerated middle ear space the air bone gap could be reduced to 20 dB in 32 out of 45 cases (71%). When there was no air in the middle ear fenestration of the horizontal semicircular canal was performed. An improvement of hearing could be measured in 3 out of 10 cases. In 3 cases labyrinthine structures were not identified. Stenoses of the entrance of the outer ear canal and granulation in the outer ear canal could be safely prevented by using the skin-to-bone suturing technique after Zühlke and split thickness skin graft with fibrin glue in the outer ear canal.

Adolescent↗
PubMed1987

[Surgery of facial paralysis in fractures of the petrous bone].

Follow-up of 38 patients with facial nerve paralysis in fractures of the petrous bone. Transmastoidal approach was performed in 23 cases. 15 patients underwent either translabyrinthine or transtemporal approach. The clinical and intraoperative findings and procedures are demonstrated. The need for surgical treatment in facial paralysis caused by petrous bone fractures is stressed.

Adolescent↗
PubMed1987

[Clinical aspects of bilateral facial paralysis].

Facial diplegia is a rare disease. 18 patients suffering from bilateral facial palsy were examined. The clinical findings and therapeutic possibilities of ENT-surgeons are demonstrated. Common and rare causes of the lesions are discussed.

Brain Neoplasms↗
PubMed1986

[Arachnoid cysts in the internal ear canal and facial canal (Fallopius)].

We report about 3 patients with a Arachnoidal Cyst in the internal acoustic meatus. The first patient had a cyst deriving from the Falloppian Canal fundus into the cochlea reaching the internal carotic artery. The second cyst we found followed the widened Falloppian canal from the internal acoustic meatus to the region of the oval window with disturbance of the ossicular chain function. The third patient had a Arachnoidal Cyst in the borders of a enlarged internal acoustic meatus. We describe the history and the anatomic situation of the three patients.

Adult↗
PubMed1985

The bioactive glass ceramic Ceravital in ear surgery. Five years' experience.

Since 1979, various ceramics have been recommended as valuable implant materials in tympanoplasties. Such implants are used for the reconstruction of the ossicular chain or the posterior canal wall. Animal studies on bioinert and bioactive ceramics in the middle ear have been carried out to confirm their biocompatibility. Histologic and clinical findings have made it obvious that aluminum- or borum-aluminum oxide ceramics are well tolerated in the middle ear and may produce functional results, provided they are separated from the tympanic membrane or the footplate of the stapes by an interposition of cartilage. Porous tricalcium phosphate ceramics cannot be recommended for the reconstruction of the ossicular chain because they are degradable, but they may be useful for the obliteration of small mastoid cavities. Our five-year histologic and clinical experience with the bioactive glass ceramic Ceravital revealed in 1983 that this material is suitable for the reconstruction of the ossicular chain as well as of the posterior canal wall, without the need for protection by cartilage. Ceravital implants in fact behave like homologous ossicles.

Animals↗