Left tympanic segment facial nerve neuroma and hearing loss, but normal facial function.
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Biomedical subjects
Publications and source records attributed to R L Nissen.
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We reviewed records of 116 consecutive acoustic tumor surgery patients aged 65 and older during the 10 years ending in 1984. One hundred six had total removal. Ninety-four (81%) had no intraoperative complications and 66 (57%) had no postoperative complications. Only one patient, who had previously undergone partial removal elsewhere, died. Because tumors grow at 2 mm per year, and because elderly patients can expect to live up to 18 more years, we recommend planned total removal of an acoustic tumor as the management of choice for senior citizens in good health. We feel that the advantages of immediate surgery outweigh the risks of delayed surgery when age is advanced, the tumor is enlarged, and general health may be declining.
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The senior author has performed 346 endolymphatic sac operations since 1971. Questionnaires were sent to these patients to evaluate the results of this surgery. One hundred ninety-six questionnaires were returned and formed the basis for this report. The results of surgery are reported by the new American Academy of Otolaryngology--Head and Neck Surgery criteria as well as by the older method of reporting. There is no significant difference in results between the endolymphatic subarachnoid shunt and the endolymphatic mastoid shunt. Because of the lower morbidity of the latter procedure the authors prefer the endolymphatic mastoid shunt. The new method of reporting is superior to the older method.
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The true incidence of malignant hyperthermia is unknown, but the frequency has been estimated as high as 1/14,000 anesthetic events. Review of the literature reports mortality rates up to 70%. Without prompt medical intervention, it is a uniformly fatal disease. Thus, it behooves the physician to have an awareness of the syndrome and its features, so that early recognition and adequate treatment take place. This paper presents a review of the literature on the occurrence, pathology, symptoms and treatment of malignant hyperthermia.
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