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Biomedical subjects

K H Brookler

Publications and source records attributed to K H Brookler.

At least 19 recordsLinked to original sources
PubMed1991

Practical method of reporting test results in neurotologic disorders.

A more practical method of reporting the neurotologic test results became desirable in the course of preparing case reports. This need grew out of the necessity to organize neurotologic tests results in a simple, easily understandable, nonredundant manner. Tests organized in this manner were vestibular and auditory tests. Vestibular tests included electronystagmography, rotational testing, and posturography. Auditory tests included pure-tone testing, speech testing, impedance testing, and auditory brainstem responses.

Hearing Tests↗
PubMed1990

The dizzy patient: etiologic treatment.

The basis for the vestibular complaint in dizzy patients should be viewed as having an etiology rather than a description of its clinical presentation. Effective treatment of vestibular disorders is based on the stabilization of the vestibular abnormality, to allow for central vestibular compensation. While not all of the etiologies for dizziness have been described, there are effective etiologic treatments available. These fit into categories of neurotransmitters, blood sugar and blood fat control, hormones, minerals, and treatments for autoimmune dizziness.

Autoimmune Diseases↗
PubMed1990

Etiologic diagnosis in neurotologic disease.

The inner ear is a converter (transducer) of mechanical to electrical energy for both hearing and balance functions. This task is accomplished as a result of the presence of the chemicals within the perilymph and endolymph. Maintaining normal hearing and balance function is dependent upon the availability of the proper chemicals to perform this transduction task. The inner ear functions as an internal body organ and its efficiency in regard to performing its tasks related to hearing and balance function are chemically dependent upon many body systems.

Ear, Inner↗
PubMed1990

Electronystagmography 1990.

Electronystagmography in 1990 should identify a vestibular abnormality with which to associate the clinical symptoms. The vestibular test battery method and interpretation reveals its application in neurotologic diagnosis.

Electronystagmography↗
PubMed1990

Radiation injury to the temporal bone.

Osteoradionecrosis of the temporal bone is an unusual sequela of radiation therapy to the head and neck. Symptoms occur many years after the radiation is administered, and progression of the disease is insidious. Hearing loss (sensorineural, conductive, or mixed), otalgia, otorrhea, and even gross tissue extrusion herald this condition. Later, intracranial complications such as meningitis, temporal lobe or cerebellar abscess, and cranial neuropathies may occur. Reported here are five cases of this rare malady representing varying degrees of the disease process. They include a case of radiation-induced necrosis of the tympanic ring with persistent squamous debris in the external auditory canal and middle ear. Another case demonstrates the progression of radiation otitis media to mastoiditis with bony sequestration. Further progression of the disease process is seen in a third case that evolved into multiple cranial neuropathies from skull base destruction. Treatment includes systemic antibiotics, local wound care, and debridement in cases of localized tissue involvement. More extensive debridement with removal of sequestrations, abscess drainage, reconstruction with vascularized tissue from regional flaps, and mastoid obliteration may be warranted for severe cases. Hyperbaric oxygen therapy has provided limited benefit.

Adult↗
PubMed1987

Sensorineural hearing loss associated with Takayasu's disease.

This is a case report of sensorineural hearing loss associated with Takayasu's disease. Also known as "pulseless disease" and "aortic arch syndrome," Takayasu's disease involves narrowing of the aortic arch and its branches. Although the etiology is unknown, it is suspected to be an autoimmune disorder. In the case presented, steroid therapy resulted in an improvement of hearing. On one relapse the hearing loss worsened before the sedimentation rate increased. We speculate that the hearing loss is due to an autoimmune process or an ischemia involving the inner ear. We further speculate that hearing loss may indicate subsequent worsening of the disease.

Adolescent↗
PubMed1985

Middle fossa surgery. Report of 153 cases.

The principal indications for the middle cranial fossa approach to the petrous apex and internal auditory canal are section of the vestibular nerves in vertigo, management of lesions of the labyrinthine segment of the facial nerve, and removal of mass lesions of the internal auditory canal. We report 153 cases of pathosis of the temporal bone and related structures for which this approach was used.

Cranial Nerve Neoplasms↗
PubMed1979

Otosclerosis surgery: reassessment of its value in 1978.

Today, surgical correction is the treatment of choice for the hearing loss associated with footplate otosclerosis. Experience with stapes surgery reveals this to be functionally and economically superior to the long-term use of hearing aids. There is, however, a predictable rate of surgical complications. Sensorineural hearing loss, dizziness and/or facial nerve palsy have an immense social and economic impact upon the patient, the family and the surgeon. Otosclerosis surgery will be presented in the perspective of benefits, untoward results, and alternate forms of treatment. A cost analysis of the foregoing will shed light on the future of otosclerosis surgery.

Adult↗
PubMed1979

The accuracy of the simultaneous binaural bithermal test in the diagnosis of acoustic neuroma.

Forty-three patients with a surgically confirmed unilateral acoustic neuroma were studied preoperatively with both alternate and simultaneous binaural bithermal caloric tests using horizontal lead electronystagmography. Twenty-four patients had a significant reduced vestibular response on the side of the tumor utilizing the alternate binaural bithermal calorization of Fitzgerald-Hallpike. The addition of the simultaneous binaural bithermal stimulus improved the diagnostic accuracy of caloric testing from 56% to 86%. The simultaneous test was of particular accuracy in diagnosing the inferior vestibular nerve neuroma. The simultaneous stimulus, which adds only six and one-half minutes to overall testing time, is felt to be a valuable adjunct to the alternate test of Fitzgerald-Hallpike.

Adult↗
PubMed1979

Acoustic neuroma or vascular loop?

Five patients with signs and symptoms of acoustic neuroma had a filling defect on positive contrast posterior fossa myelography. At surgical exploration they were found to have a vascular loop accounting for the space occupying lesion.

Adolescent↗
PubMed1978

Underrated neurotologic symptoms.

Patients present themselves with neurotologic symptoms which may be early and subtle indicators of active vestibular pathology. The frequently slighted complaints of light-headedness, imbalance and a floating sensation are as important as "true rotatory vertigo." Ear fullness, the most underinvestigated of neurotologic complaints may be a cardinal symptom. Occipital headaches are a frequent complaint of the dizzy patient. Blurred vision, and, in some severe peripheral disorders, diplopia are symptoms referrable to oculovestibular interaction. Visual stimulation intensifies vestibular symptoms. Stress may precipitate or increase dizziness in patients who have partially compensated for a vestibular deficit. Anxiety, fatigue and systemic illness are exemplary. Patient histories are presented to emphasize clinical relevance and therapeutic modalities.

Adolescent↗
PubMed1976

The simultaneous binaural bithermal: a caloric test utilizing electronystagmography.

The simultaneous irrigation of both external auditory canals with the bithermal stimulus of Fitzgerald and Hallpike yields responses which demonstrate a greater sensitivity than the alternate irrigation of each ear. The responses were recorded utilizing electronystagmography and were compared to the alternate or regular bithermal performed on the same paitent.

Caloric Tests↗
PubMed1976

The knotted wire in stapes surgery: one possible factor in postoperative sensori-neural hearing loss.

In four instances of revision stapedectomy in patients with sensori-neural hearing loss, with or without dizziness, a wire prosthesis was found with an extention beyond the knot which could impinge on the contents of the vestibule. Four commercially manufactured knotted wire prostheses were examined, and the end of three was found projecting beyond the knot. The wire piercing the membranous labyrinth appears to be one of the factors in causing further sensori-neural hearing loss after stapedectomy. A wire loop or piston prosthesis should be considered to eliminate the hazard of a trailing end of a knotted wire in stapes surgery.

Adult↗
PubMed1975

Etiologic factors in non-suppurative otitis media.

Two observations in non-suppurative otitis media, namely the serous fluid and the tympanic membrane retraction, may have separate explanations as to the etiologic factors. The first is the obstruction of the collecting lymphatic tubules of the middle ear and eustachian tube as they drain to the retropharyngeal lymphatics. This leads to a transudation of fluid in the middle ear or serous fluid. The second observation, retraction of the tympanic membrane, may be due to an absence or significant reduction of the surface tension lowering substance (Surface Active Membrane) of the eustachian tube, preventing the transmission of air to the middle ear from the nasopharynx.

Air Pressure↗