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Biomedical subjects

John F Kveton

Publications and source records attributed to John F Kveton.

6 recordsLinked to original sources
PubMed2006

Revision surgery for vertigo.

When confronted with vertigo after an otologic procedure, a surgeon first must identify the functional status of the inner ear by performing auditory and vestibular testing. Using this information in conjunction with knowledge of the primary disease process for which the initial procedure was performed, the surgeon can make a rational selection of the procedure required to eliminate vertigo. This article outlines a systematic approach to the selection of the appropriate revision procedure and discusses the specific advantages and disadvantages of these procedures used to control vertigo.

Ear Diseases↗
PubMed2004

Hydroxyapatite cement in temporal bone surgery: a 10 year experience.

OBJECTIVES: To describe the indications for successful use of hydroxyapatite cement (HAC) in temporal bone surgery. STUDY DESIGN: Retrospective case review. METHODS: One hundred nine temporal bone defects related to surgical approaches to the skull base, infection, neoplasms, or congenital defect in 102 adults and children were corrected using HAC over a 10-year period. The results and complications were obtained through retrospective chart review. RESULTS: Ninety-seven percent of temporal bone defects were successfully repaired using HAC, and the reconstruction remained stable over the course of this study. There was one case of postoperative cerebrospinal fluid leak. Wound infection occurred in three patients, which required reoperation and removal of the biomaterial. CONCLUSIONS: HAC is a biomaterial that should be used as the primary method to reconstruct temporal bone defects. Proper use of this biomaterial results in restoration of the integrity of the temporal bone and elimination of cerebrospinal fluid leak as a postoperative complication.

Adult↗
PubMed2003

Efficacy of the 2-staged procedure in the management of cholesteatoma.

OBJECTIVE: To demonstrate the efficacy of intact canal wall procedure coupled with a second-stage exploration for the treatment of cholesteatoma. DESIGN: Retrospective case study of patients with cholesteatomas treated with staged surgical extirpation. A minimum of 6 months' postoperative follow-up time was required for inclusion into the study. SETTING: Tertiary academic referral center. Patients A total of 35 adult and pediatric patients, ranging from 9 to 65 years of age, who underwent 2-stage procedures for removal of cholesteatomas. INTERVENTIONS: Two-stage procedures, separated by 6 months, performed with posterior tympanotomy approaches. MAIN OUTCOME MEASURES: The presence or absence of cholesteatoma on second-stage look and the subsequent surgical treatment for recurrent cholesteatoma. The overall hearing results after the completion of the 2-staged procedure were calculated. RESULTS: Disease was controlled in 26 (74%) of the patients. Residual and/or recurrent cholesteatomas were found in 9 (26%) of the patients during the second-stage operation. Of these patients, 5 (14% of the total group) ultimately required conversion to canal-wall-down procedure. Average hearing gain at the completion of the second-stage procedure was 9 dB. CONCLUSIONS: A planned 2-stage procedure that uses the posterior tympanotomy approach for the control of cholesteatoma is an effective technique. This approach offers significant potential for hearing preservation and restoration.

Adolescent↗
PubMed2002

Acoustic neuroma. Assessment and management.

Acoustic neuroma results from abnormal proliferation of Schwann cells. These tumors originate in the region of Scarpa's ganglion at the junction of peripheral and central myelin of the vestibular nerve located in the internal auditory canal (IAC). The bony confine of the IAC houses the VII and the VIII cranial nerves. The presence of tumor mass compresses these structures. The growing tumor mass may also prolapses into the cerebellopontine angle (CPA). With continued growth, the tumor eventually compresses on the brain stem and cerebellum. Despite the benign nature of these tumors, the clinical course of this disease may be fraught with complications.

Facial Nerve↗
PubMed2002

Rapid growth of acoustic neuromas after stereotactic radiotherapy in type 2 neurofibromatosis.

We describe a rare complication of stereotactic radiotherapy for large acoustic neuromas in a patient with type 2 neurofibromatosis. We retrospectively reviewed the case of a 14-year-old girl who had been referred to our tertiary care center. Prior to referral, the patient had been evaluated for hoarseness. During the work-up, magnetic resonance imaging (MRI) detected two large bilateral acoustic neuromas and two bilateral jugular foramen tumors. The patient was diagnosed with type 2 neurofibromatosis, and she underwent stereotactic radiotherapy for treatment of the two acoustic neuromas; the jugular foramen tumors were not irradiated. The patient's post-treatment course was complicated by hydrocephalus and symptoms of brainstem compression, which required urgent surgical intervention. Follow-up MRI 7 months following radiotherapy demonstrated a rapid growth of the acoustic neuromas, but no appreciable change in the size of the jugular foramen neuromas. These findings suggest that the radiotherapy might have been the cause of the rapid growth of the acoustic neuromas. To our knowledge, no such report has been published in the literature, and this phenomenon might be unique. Our findings suggest that radiotherapy might not be the optimal first-line treatment for acoustic neuromas in patients with type 2 neurofibromatosis.

Adolescent↗