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J P Gavron

Publications and source records attributed to J P Gavron.

8 recordsLinked to original sources
PubMed1988

Otosclerosis masking coexistent acoustic neuroma.

The coexistence of an acoustic neuroma with otosclerosis can prove to be a great diagnostic dilemma. In such cases, the diagnosis of acoustic neuroma is usually delayed while more common causes of sensorineural hearing loss associated with otosclerosis or its surgery are considered. Any asymmetric progression of a sensorineural loss or shift in discrimination after stapes surgery, whether sudden or gradual, should provoke suspicion of a second pathologic process. These include perilymph fistula, labyrinthine otosclerosis or ischemia, and acoustic neuroma. The use of auditory brainstem response and acoustic reflex testing and various imaging techniques is essential for accurate diagnosis. This paper includes two cases that demonstrate this dual pathology, bringing the total to 15 such cases reported in the literature. The purposes of this paper are to alert the clinician to the diagnostic problem of acoustic neuroma coexisting with otosclerosis and to propose a means of evaluating these patients.

Adult↗
PubMed1984

Hypoglossal-facial nerve anastomosis: a review of forty cases caused by facial nerve injuries in the posterior fossa.

Hypoglossal-facial anastomosis has been our procedure of choice in the repair of the permanently injured facial nerve in the cerebellopontine cistern, when the nerve cannot be primarily repaired. Total failures are few and complications are rare. Most results are good to excellent, if assessment is based upon realistic expectations. These include: 1. normal facial symmetry in repose, 2. good midface voluntary motion, 3. no reflex or emotional facial movement, 4. some synkinesis and donor-injected mass facial movement, and 5. surprisingly little functional loss from hypoglossal paralysis. Our experience indicates better results in younger patients and in those repairs completed shortly after injury. These findings correlate well with the experience gained in peripheral nerve repair in the extremities. There appears to be no absolute time period between injury and repair beyond which this anastomosis is definitely contraindicated. Finally, this procedure does not negate adjunctive plastic surgical procedures. Most of our patients have had tarsorrhaphy or physiologic protection of the eye, but few have had corrective cosmetic surgical procedures until the past few years. We have never used cervical sympathectomy to reduce the size of the palpebral fissure. Better surgical procedures to correct both extracranial and intratemporal facial nerve injuries have significantly reduced the indication for anatomosis procedures. Additionally, over the past two decades, the improved diagnostic and surgical techniques for posterior fossa tumors have considerably reduced the incidence of facial paralysis. As these trends continue, the number of patients requiring nerve anastomosis for facial paralysis will continue to decline and what was once the only surgical procedure to repair the paralyzed face will become a rare operation.

Adult↗
PubMed1983

Necrotizing sialometaplasia.

Necrotizing sialometaplasia is a benign inflammatory disease of salivary gland origin. Because of its clinical and histologic resemblance to squamous cell carcinoma, this disease must be recognized. The cause is unknown, but it may be related to oral trauma, tobacco use or inadequate blood supply. The lesion heals spontaneously, regardless of therapy, in two to eight weeks.

Adult↗
PubMed1981

Necrotizing sialometaplasia.

Necrotizing sialometaplasia of salivary gland tissue is a benign, self-limiting disease usually confined to the minor salivary glands. To date only 49 cases have been reported. The clinical and histologic appearance may simulate squamous cell carcinoma, and unnecessary mutilating surgery may be performed if an erroneous diagnosis is made. The otolaryngologist must recognize this disease entity since it heals spontaneously and requires no treatment. Necrotizing sialometaplasia has no known premalignant potential.

Adult↗