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Biomedical subjects

J Kärjä

Publications and source records attributed to J Kärjä.

9 recordsLinked to original sources
PubMed1979

Chryotherapy in the treatment of subglottic hemangioma in infants.

Congenital laryngeal hemangioma in infants is situated typically in the subglottic region and causes respiratory obstruction at the age of 1--6 months. Hitherto fewer than one hundred cases have been reported. The mortality has been high and the therapy problematic. As a primary measure, tracheotomy must be performed. In the treatment of the tumour itself, large doses of corticosteroids, sclerosing agents, radiotherapy and surgical removal have been used. The results have hardly been encouraging. In five cases we have utilized cryotherapy. The hemangioma disappeared after 3--6 sessions. No therapeutic or late complications were connected with this mode of therapy.

Cryosurgery↗
PubMed1977

Cholesteatoma in children.

The 65 cholesteatomas operated on in children showed a more expansive and rapid growth than those in adults. In one fifth of the cases cholesteatoma filled the whole air-cell area, which was wide in half of the children. Fifty-two ears of these children had an attic or a posterosuperior perforation. One case was complicated by a fistula in the horizontal semicircular canal, and the ossicular chain was unbroken in 23 cases (35%). Thus, the findings support the idea of the primary soft-tissue spread of cholesteatoma in children. Five ears (8%) discharged postoperatively, and three ears (5%) were reoperated on and showed residual tympanal cholesteatoma. Cavity obliteration with canal wall down technique proved safe, even in the cases of the most extensive and active cholesteatoma.

Adolescent↗
PubMed1976

Secretory otitis media in chronic lymphatic leukaemia. A temporal bone report of a case treated for seven months with tympanostomy tubes.

Serially sectioned temporal bones were studied from a patient with chronic lymphatic leukaemia with submucosal infiltration of the nasopharynx, the resulting secretory otitis having been treated with tympanostomy tubes for 7 months. The initially serous sterile secretion turned mucoid, and a low grade infection supervened. For the last 3 months the tympanostomy tubes were open and the ears dry. In the sections, the mastoid air cells showed leukaemic infiltrations and contained AB- and PAS-positive secretion. The drum openings were without reaction and there was no epithelial ingrowth around the margins. The posterior tympanum in both ears contained organizing fibrous tissue extending from the inner surface of the drum to the promontory. In the tympanum the mucosa was flat or columnar and without glands. Distinct AB and PAS-positive mucus film and secretory cells appeared on the promontory epithelium and the inner surface of the drum. In the tubo-tympanic recess some AB- and PAS-positive subepithelial glands appeared and in the tympanic orifice of the tube the secretory cells were prominent and the lumen full of AB-positive mucus. The case reported represents an intermediate stage in the healing of secretory otitis media, most of the glands having disappeared but the intraepithelial secretory elements being still active.

Aged↗
PubMed1976

Destruction of ossicles in chronic otitis media.

The purpose of this study is to investigate the differences in the destruction of ossicles in chronic ear disease caused solely (monoinfection) by one of the most common three bacteria, namely Staphylococcus aureus, Pseudomonas aeruginosa or Proteus strain. Material included 337 cases from 1,093 radically operated ears both with cholesteatoma and without cholesteatoma and in addition cholesteatomatous ears without signs of infection since diagnosed. In 190 ears with cholesteatoma but without discharge the ossicular chain was found damaged at the time of operation in 75 per cent and in 147 discharging ears with cholesteatoma in 79-97 per cent. In infected ears without cholesteatoma the chain was broken in 59-78 per cent. In all groups the most extensive lesions were caused by Proteus strains. This was also the fact in microscopic studies concerning extension and severity of histopathological findings. It seems to us that vascular bone erosion caused by active granulation tissue, the process triggered initially by infection, is the main mechanism for destruction of ossicles both in cholesteatomatous and in non-cholesteatomatous ears. From the histological point of view the ossicles in ears with Staphylococcus aureus and Proteus strains can be so destroyed that their use for autografts is questionable.

Bone Resorption↗
PubMed1975

Middle ear mucosa and chronic ear disease. III. Enzyme studies of thick noncholesteatomous epithelium.

Thick mucosa removed from the promontory in cases with chronic otitis media showed prominent PAS-positive glands and epithelial secretory cells. Alcian blue positivity was less pronounced, contrary to the mucosa from glue ears. Enzyme activity in the epithelium and propria was comparable to that in glue ears, with some increase in alkaline phosphatase and some decrease in proprial lactate dehydrogenase and malate dehydrogenase activity. Removal of thick, permanently altered mucoas is recommended even in the absence of squamous epithelium. Steps should be taken to allow regrowth of thin, normal middle ear epithelium on the promontory.

Acid Phosphatase↗
PubMedDate not supplied

Recruitment in conduction deafness. Observations using a midline loudness balance test.

A midline loudness balance test was made in 10 normal ears with blocked ear canals and in 104 conductively deaf ears with loss not exceeding 45 dB. The test was made by giving the tones simultaneously in the ears at 10, 60 and 80 dB sensation levels for 500 and 2 000 Hz. In the normal group the midline balance method indicated no reduction from the threshold differences at any of the three levels whereas significant reductions occurred in all groups of conduction deafness. The occurrence of true partial recruitment in conduction deafness demonstrated by ABLB (Fowler's) test was attributed to altered middle ear mechanics, loud tones stimulating the inner ear relatively more effectively than tones near the threshold level. The midline balance method is more closely dependent upon bone conducted sounds and on the altered relative movements of the labyrinthine windows.

Audiometry↗
PubMedDate not supplied

Otosclerosis surgery.

Results of otosclerosis surgery using the stapes footplate removal with various types of reconstruction are reported in 456 ears (360 patients). Primary success was obtained in around 95% while 83% retained their improvement over the years. The posterior crus on fascia has become the preferred method because of its stability and relative lack of inner ear complications. Inner ear damage is mostly due to perilymph fistulae, which should be promptly recognized and repaired, since revision after the ear has become deaf does not restore hearing. Some late inner ear losses may be due to reactions to foreign material introduced with the graft. Bilateral operations should not be done if the first operation was difficult or caused vertigo for several days.

Acoustic Stimulation↗