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Biomedical subjects

J L Pulec

Publications and source records attributed to J L Pulec.

At least 127 records · Page 7Linked to original sources
PubMed1995

Acoustic neuroma surgery in patients over 65 years of age.

Patients over 65 years old develop acoustic neuromas with the same signs and symptoms as younger patients. Age limits beyond which surgery for acoustic neuroma is not offered have been suggested. Untreated vertigo in the older patient frequently results in a fall which causes a fracture of the femur followed by significant morbidity and mortality. A review of 62 cases done over a period of five years reveals that surgical removal of acoustic neuroma in eight patients over 65 years of age gave results equally good to those in younger patients. This study suggests that the patient's general medical condition, life expectancy and factors other than chronologic age should be considered in the indications for surgery of acoustic neuroma. Acoustic neuroma surgery for the older patient can provide gratifying results.

Adolescent↗
PubMed1995

Myringitis.

Explore the source record for details and available documents.

Administration, Topical↗
PubMed1994

Technique to avoid cerebrospinal fluid otorhinorrhea with translabyrinthine removal of acoustic neuroma.

A technique to avoid cerebrospinal fluid otorhinorrhea with translabyrinthine removal of acoustic neuroma is described. Its successful use in 100 consecutive cases with only one incident of cerebrospinal fluid otorhinorrhea suggests that it is an effective technique which has minimal morbidity. Intraoperative and postoperative intravenous antibiotics and the use of bacitracin irrigation during surgery are desirable additions to the technique. The procedure is accomplished in 10 minutes and involves scarifying the tubotympanum and obliteration with fibrous tissue through the facial recess approach. Coupled with obliteration of the petrous apex and mastoid with fat, postoperative CSF otorhinorrhea following translabyrinthine acoustic neuroma removal can be almost complete eliminated.

Cerebrospinal Fluid Otorrhea↗
PubMed1994

Facial nerve neuroma.

Facial nerve neuromas are uncommon, slow-growing neoplasms that may occur anywhere along the course of the facial nerve from the brainstem to the facial muscles. The signs and symptoms are characteristic and vary with the anatomic site of origin. Surgery should not be attempted until a complete and thorough diagnostic examination has been completed. The surgeon should be prepared to perform a middle-cranial fossa or translabyrinthine approach in all cases, and must expect to do a nerve graft. The results of 37 patients treated by the author reveal that, under optimal conditions, patients who have had a facial nerve graft, can be expected to regain an average of 80% facial nerve strength in almost every case. All patients who have had a facial nerve graft will have some degree of synkinesis. No graft was required in 3 patients, and a hypoglossal facial anastomosis was used for one. Facial function was completely normal in 2 patients, 16 had 80-90% return, 5 patients had 50-80% return, 4 had 20-50% return, one had no recovery at all and 9 recent patients have not reached the time for their expected recovery. Early diagnosis, prompt surgical removal and VII-VII Nerve graft for facial paralysis of ten or fewer years duration offers patients the best opportunity to avoid a permanent facial palsy.

Adult↗
PubMed1994

The relationship between vasopressin and endolymphatic hydrops in the guinea pig.

Clinical studies have shown that plasma vasopressin level is significantly elevated in patients with Meniere's disease. Other reports indicated that histamine induced a very quick and high elevation of vasopressin level and caused nystagmus in experimentally produced endolymphatic hydrops. We became interested in further investigating the details of this relationship by studying the effect of experimental endolymphatic hydrops and histamine upon plasma vasopressin level in the guinea pig. The results are as follows: 1) Histamine increased the plasma vasopressin level in normal guinea pigs. 2) There was no statistically significant difference in the plasma vasopressin level between the hydrops model and normal guinea pigs. 3) Histamine increased the plasma vasopressin level more in the hydrops model group than in normals. 4) Plasma vasopressin level was elevated in the vertiginous model caused by inner ear anesthesia. Our results support those of clinical investigators who reported that the plasma vasopressin level was elevated more in the Meniere's disease group than any other equilibrium disorder group. It is possible that vasopressin is in someway involved in the development of endolymphatic hydrops.

Animals↗