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Biomedical subjects

J L Pulec

Publications and source records attributed to J L Pulec.

At least 91 records · Page 5Linked to original sources
PubMed1997

Progressive sensorineural hearing loss, subjective tinnitus and vertigo caused by elevated blood lipids.

The otologist frequently sees patients with progressive sensorineural hearing loss, subjective aural tinnitus and vertigo with no apparent cause. Elevated blood lipids may be a cause of inner ear malfunction on a biochemical basis. To establish the true incidence of this condition, all new patients (4,251) seen during an eight-year period were evaluated; of these, 2,332 patients had complaints of inner ear disease. All had a complete neurotologic examination, appropriate audiometric and vestibular studies and imaging, and blood tests including lipid phenotype studies. Hyperlipoproteinemia was found in 120 patients (5.1%). Most patients were found to be overweight and had additional coexisting conditions such as diabetes mellitus. Treatment with vasodilators and a 500-calorie, high-protein, low-carbohydrate diet yielded improvement of symptoms in 83% of patients within five months of initiation of treatment.

Adult↗
PubMed1996

Hemotympanum.

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Endoscopy↗
PubMed1996

Sinus tympani: retrofacial approach for the removal of cholesteatomas.

The epithelium basement membrane of cholesteatomas in cases of chronic otitis media often extends into the sinus tympani. In the majority of cases it can be safely and completely removed by dissection through the ear canal and tympanum. In 2% of cases, not all squamous epithelium basement membrane can be removed because the sinus tympani extends more than 3 or 4 mm posterior to the anterior edge of the facial nerve and because the membrane is adherent to the irregular bony surface. Surgical exposure of the sinus tympani through the mastoid posterior and medial to the facial nerve allows complete removal of all basement membrane with a direct view. The technique using a retrofacial approach to expose this obscure sinus is described and a series of 48 cases treated successfully by this method are reported.

Basement Membrane↗
PubMed1996

Blue ear drum.

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Endoscopy↗
PubMed1996

Labyrinthine fistula from cholesteatoma: surgical management.

Labyrinthine fistula is a complication of chronic otitis media with cholesteatoma which can result in progressive sensory hearing loss or permanent loss of inner ear function. Total surgical removal of cholesteatoma and use of the intact canal wall tympanoplasty and mastoidectomy can result in preservation or improvement of hearing and elimination of vertigo. Long-term results in a series of 63 cases are reported. The important features of surgical technique involve use of high magnification with the operating microscope, a high-speed drill, suction irrigation and thorough knowledge of temporal bone anatomy. In addition, the surgeon must avoid tearing or perforation of the squamous epithelium basement membrane during dissection. In some cases, sensory hearing returns to normal following surgery, making a successful second-stage reconstruction for hearing possible.

Adolescent↗
PubMed1996

Total facial nerve decompression: technique to avoid complications.

Exposure of the facial nerve from the brainstem to the parotid can be accomplished without injury to the nerve, tympanic membrane, external auditory canal, ossicular chain, inner ear or structures within the cerebello-pontine angle. The procedure has reliably provided good results for patients who have had the proper indications with facial paralysis from Bell's palsy, herpes zoster oticus, infection, hemi-facial spasm, temporal bone fracture and tumors. The current technique for exposure through the mastoid, middle cranial fossa and retrolabyrinthine combined approaches are described. This technique, properly performed, is a valuable treatment for facial nerve lesions.

Facial Nerve↗
PubMed1996

Retrolabyrinthine selective posterior root section of the trigeminal nerve for the treatment of trigeminal neuralgia.

Patients frequently consult otolaryngologists for the treatment of trigeminal neuralgia. Retrolabyrinthine selective posterior root section of the fifth cranial nerve effectively and permanently eliminates pain from areas supplied by this nerve without the production of annoying anesthesia dolorosa. The procedure is performed by the neurotologist and causes minimum morbidity. The results of this surgery in 106 patients are reviewed and demonstrate that the procedure provides lasting relief from intractable pain from a variety of conditions whose innervation is the Vth cranial nerve as well as trigeminal neuralgia. The surgical technique and long-term results are described.

Adult↗