PubMed Health⌕ Search

Biomedical subjects

J L Pulec

Publications and source records attributed to J L Pulec.

228 records · Page 13Linked to original sources
PubMedDate not supplied

Eustachian tube lymphatics.

Serous otitis media is the most common cause of hearing impairment. The role of lymphatic obstruction in the pathogeneis of serous otitis media is significant. A method for removeal of the human Eustachian tube specimen and two techniques for identification of Eustachian tube lymphatic capillaries are described. One involves the antemorten intratympanic installation of Berlin blue. The other utilizes electron microscopy. Lymphatic capillaries cannot be reliably differentiated from blood capillaries with the light microscope. With electron microscopy, lymphatic capillaries can be differentiated from blood capillaries by differences in the basement membrane. The lymphatic capillary has gaps in the basement membrane with large nuclei in the wall. A blood capillary has a continuous basement membrane and sometimes red blood cells be be identified in the lumen. Using these methods, Eustachian tube lymphatic capillaries in the human are described for the first time in this report.

Adolescent↗
PubMedDate not supplied

Neurilemoma of the jugular foramen. Transmastoid removal.

The authors present two cases in which the palsies of the IX, X, XI and XII nerves heralded the presence of a neurilemoma within the jugular foramen. Temporary bone polytomography, retrograde jugular venography, and pantopaque posterior fossa myelography allowed the nature and extent of the tumor to be predicted accurately prior to the operation. The tumors were completely removed using a transmastoid-extended facial recess approach without labyrinthectomy, supplemented in one case by exploration of the upper cervical portion of the internal jugular vein. This technique has avoided the complications which attend removal by way of the posterior fossa. We feel that transmastoid removal merits more extensive clinical trial.

Accessory Nerve↗
PubMedDate not supplied

Tinnitus: diagnosis and treatment.

Few conditions are seen as commonly by the otologist and are more poorly understood than subjective tinnitus. Tinnitus has been reported in as high as 80% of patients seen in an otolaryngology practice. This symptom is especially marked in patients with a hearing problem and can be so severe that it becomes incapacitating. Careful diagnosis and classification of tinnitus is important for understanding of the problem. Identification of the frequency and intensity of masking, using a tinnitus analyzer, is useful in selecting the form of treatment. Analysis of the history, physical findings and the use of special electrocochleography and brain stem evoked response audiometry help to identify the site of lesion, which may be within the cochlea, cochlear nerve, cochlear nucleus, brain stem, midbrain or auditory cortex. Specific disease entities should be identified and treated. Lesions of the end-organ or cochlear nerve can be treated when necessary by translabyrinthine or middle cranial fossa section of the cochlear nerve. Tinnitus from cervical nerve lesions can be treated by rhizotomy. The use of a hearing aid or introduction of a sound with a tinnitus masker has been found to be 82% effective in suppressing tinnitus. Maskers can be combined with a hearing aid in some cases. The pathogenesis of tinnitus is discussed, but the method of action of tinnitus relief by auditory stimulation is still unclear. A thoughtful and complete examination with our new diagnostic tools and the judicious selection of therapy now makes it possible to give relief to the majority of patients suffering with disturbing tinnitus.

Adult↗
PubMedDate not supplied

A case of cysticercosis cerebri. Neurotologic implications.

Cysticercosis is an unusual disease entity in the United States. A case is reviewed in which a young Mexican-American female presented to an otologist's office with a headache and vertigo. Her symptoms were a manifestation of a single larval cysticercus cyst which had become lodged in the fourth ventricle resulting in an obstructive hydrocephalus and a fatal course. The epidemiology of this disease traces the life cycle of the pork tapeworm from man, normally the definitive host, to the pig, the intermediate host. It is noteworthy that the disease cysticercosis in humans is a deviation from the parasite's normal life cycle in which man serves as the intermediate host. The literature is reviewed. The broad clinical spectrum of this disease's presentation can extend from a single headache to multiple nerve palsies and convulsions. The importance of radiographic evaluation complement fixation testing and CSF evaluation in making a diagnosis is stressed. There is no known medical treatment for this disease. Surgical procedures such as primary excision and shunts to relieve intracranial pressure have had mixed results. The prognosis depends on the location and the number of infesting larva. Special note is made of this disease's endemic status in Mexico and other Latin American countries and the role that this may play in medicine practiced in the southwest United States considering the ever-increasing immigration from this area.

Adult↗
PubMedDate not supplied

Facial nerve biopsy for etiologic clarification of Bell's palsy.

Electron microscopic findings of biopsy specimens of the intratemporal facial nerve from four selected patients with Bell's palsy are described, and the results of clinical examinations and surgical findings are presented. In all specimens, wallerian degeneration of various degrees was demonstrated. In one specimen, extravascular erythrocytes, and in another, lymphatic infiltrations were noted. On the basis of the present investigation and reported temporal bone histopathologic evidence, the causes of Bell's palsy are concluded to be multiple and to be vascular, inflammatory, or degenerative.

Adolescent↗