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Biomedical subjects

J Kronenberg

Publications and source records attributed to J Kronenberg.

At least 19 recordsLinked to original sources

[Cochlear implantation].

Since the Israeli cochlear implant program was started in June 1989, 74 candidates have been evaluated for implantation. The main causes for hearing loss were meningitis (16 patients), aminoglycoside toxicity (9), congenital (6), viral (e.g. mumps) (6), and middle ear infection. Candidates were rejected mainly due to psychosocial factors (40%) and audiological parameters (30%). 16 postlingual deaf were implanted. In 7 of them (43.7%) the results were excellent, in 4 (25.0%) good, in 3 (18.7%) fair; 1 case is currently in a training program and 1 is a failure. There were 2 major complications: facial nerve palsy which necessitated surgical decompression, and insertion of the electrodes into the hypotympanic air cells, corrected by reoperation.

Cochlear Implants

Nasal ciliary motility in retinitis pigmentosa.

Normal in-vitro ciliary beat frequency is reported in a patient with retinitis pigmentosa. The significance of electromicroscopic ciliary defects in this condition is appraised.

Ciliary Motility Disorders

Vasoactive therapy versus placebo in the treatment of sudden hearing loss: a double-blind clinical study.

Twenty-seven patients suffering from sudden sensorineural hearing loss (SHL) were randomly assigned to one of two groups: a treatment group (n = 13) receiving intravenous procaine and low-molecular-weight dextran, and a placebo control group (n = 14). The effect of treatment was analyzed by means of an analysis of variance and covariance procedures. Results indicated nonsignificant differences between the groups on all outcome indices measured. Sex, age, time since the onset of symptoms to the initiation of therapy, audiogram configuration, and initial severity of hearing loss did not significantly affect the results. These findings suggest that the therapeutic effects of this vasodilator are not superior to a placebo.

Adult

Severe hypophosphataemia during binge eating in anorexia nervosa.

A patient presented with severe hypophosphataemia that had been precipitated during binge eating. It was corrected by restricting the binges, and by hyperalimentation through a duodenal tube together with intravenous supplementation with sodium phosphate for a short period. Phosphate concentrations should be monitored in patients with severe anorexia complicated by bulimic episodes.

Adolescent

Blast injury of the ear.

The course of middle ear injuries secondary to blast effect was evaluated in 147 soldier-patients (210 ears) during the years 1967-1986. All perforations were in the pars tensa of the tympanic membrane. Ossicular chain interruption (11 ears) was associated mainly with dislocation of the incudo-stapedial joint. Mixed-type hearing loss was most prevalent (37%). Spontaneous closure occurred in 155 ears (73.8%), most of them (65.5%) within a 3-month period. Seven ears (3.3%) developed simple chronic suppurative otitis media; in 10 (4.8%), an invasive cholesteatoma developed, and in 6 others (2.8%), epithelial pearls were encountered behind an intact eardrum. Thirty-two patients were treated by immediate patching of the perforated drum, with an 84% rate of spontaneous closure; no cholesteatoma developed among this group, emphasizing the need for immediate patching. Tympanoplasty is recommended 1 year following the injury, and a 4-year follow-up period for detection of late complications is also recommended.

Adolescent

[Decompression of the endolymphatic sac].

Preliminary results in 8 patients with Meniere's disease who underwent decompression of the endolymphatic sac in the past 3 years were good. There was improvement in general disability, and tinnitus control in 87.5% and stabilization of hearing in 62%. The single complication was dead ear in 1 patient. These results are in the acceptable range and encourage continuation of this operation.

Adult

Conservative management of adult epiglottitis.

A 10-year retrospective study of 30 adults suffering from acute epiglottitis is reported. Two clinical forms of onset were noted: gradual and accelerated. Abscess formation was present in 27% of cases. None of the patients required intubation or tracheotomy. In contrast to the accepted interventionist approach in children, conservative management in adults is recommended.

Abscess

[Blast injury of the ear].

147 soldiers, in whom 210 ears were blast-injured, were studied retrospectively during 1967-1986. The nature of eardrum perforations, hearing impairment, complications, changes over the course of time and different modes of treatment were reviewed. In 92.8 of the ears the perforation was up to half of the eardrum surface, most significantly of the lower part of the drum. In 75% the perforation closed spontaneously: in 40% within a month, in 59% within 2 months and in 73% within a year. Most had impaired hearing, of whom 74% had sensorineural or mixed hearing loss; 60% complained of tinnitus and/or vertigo. In 13% purulent discharge had accompanied the perforation and in 8% a cholesteatoma had developed 1-4 years after injury. The recommended treatment of blast injury is early patching of the perforation and surgical exploration a year later in cases with residual conductive hearing loss or cholesteatoma.

Blast Injuries

Sialadenoma papilliferum of the parotid gland.

Sialadenoma papilliferum is a rare, benign exophytic tumour of salivary glands. The preferred site of this tumour is usually the hard palate. A case of sialadenoma papilliferum occurring in the parotid gland of a 49-year-old man is presented; only one such case has been previously described.

Humans

Peritonsillar abscess in children and its indication for tonsillectomy.

38 children aged 1-15 years treated for peritonsillar abscess (PTA) between 1976 and 1986 have been reviewed. The patients were divided into those with a history of recurrent tonsillitis prior to developing PTA (T+) (10 patients = 26.3%) and those without such history (T-) (28 patients = 73.4%). 19 patients were surgically drained, 2 abscesses ruptured spontaneously, 2 patients were treated by repeated needle aspirations and 15 patients were treated by medication only. Neither the pre-PTA history (T+ versus T-) nor the mode of treatment during the acute event showed any significant differences in comparing the recurrency rate of PTA or tonsillitis. Therefore, it seems that a single event of PTA among pediatric population should not be considered an indication for tonsillectomy.

Adolescent

Pleomorphic adenoma arising in accessory salivary tissue with constriction of Stensen's duct.

Accessory salivary gland tissue is well recognized and is found in 21 per cent of the population. Tumours of the accessory salivary tissue are rare and comprise only 1 per cent of all parotid gland tumours. A pleomorphic adenoma of Stensen's duct is described. A circular constriction of this duct by the tumour with retention of saliva in the parotid gland was observed.

Adenoma, Pleomorphic