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Biomedical subjects

R L Steenerson

Publications and source records attributed to R L Steenerson.

At least 19 recordsLinked to original sources
PubMed2001

Vertigo after cochlear implantation.

BACKGROUND: Historically, vertigo after cochlear implantation has not been frequently documented. This differs from the authors' experience in reviewing all adults who underwent implantation at their center from 1995 through 1999. OBJECTIVE: To determine the incidence of vertigo after cochlear implantation and to describe appropriate intervention. STUDY DESIGN: A retrospective case review. PATIENTS: All adults receiving cochlear implants at the Atlanta Cochlear Implant Group from 1995 through 1999. INTERVENTION AND OUTCOME MEASURE: Vertigo was identified through subjective reports, provoked nystagmus, and static force plate evaluation. Vestibular therapy was initiated for each vertiginous patient after cochlear implant surgery. The outcome of treatment was resolution of vertigo and return to functional status. RESULTS: Approximately three-quarters of the adults with implants experienced vertigo or imbalance. Vestibular therapy was beneficial in alleviating these symptoms. CONCLUSION: A significant number of patients experienced vertigo after cochlear implant surgery. Vestibular therapy is a successful treatment of condition.

Adult↗
PubMed1999

Treatment of tinnitus with electrical stimulation.

The purpose of this study was to evaluate the treatment of tinnitus with electrical stimulation. Five hundred patients with tinnitus were treated with probe electrical stimulation. Causes of tinnitus were sensorineural hearing loss (303 patients), Meniere's disease (88), infection (25), head trauma (39), acoustic trauma (25), ototoxicity (4), and chemotherapy (2). Treatment involved 6 to 10 transcutaneous treatment electrical stimulation sessions biweekly. Fifty-three percent of patients showed decreases in their tinnitus as measured by a subjective rating scale. With a 3-month follow-up, 72% had no loss of benefit. Thirteen patients had temporary increases in their tinnitus. Two patients had permanent increases. Probe electrical stimulation seems to offer some benefit in about half the patients treated for annoying tinnitus.

Adult↗
PubMed1999

Multichannel cochlear implantation in children with cochlear ossification.

OBJECTIVE: To compare results of post-meningitic children who had cochlear implantation with partial or complete drill-out to those who had no drill-out. STUDY DESIGN: This study is a retrospective case review. SETTING: The Atlanta Cochlear Implant Group is a private, tertiary, outpatient clinic. PATIENTS: Eligibility included all our post-meningitic patients, 2-17 years, having a cochlear implant between June 1990 and July 1997. INTERVENTIONS: All subjects had a Nucleus 22 cochlear implant surgically implanted, speech processor programming and follow-up testing in our center, and aural rehabilitation in a variety of therapy settings. MAIN OUTCOME MEASURE: Open and closed set speech discrimination tests. RESULTS: Test performance for speech understanding was highest in the non-ossified group and lowest, but above chance, in the ossified group with complete drill-out. CONCLUSIONS: While children with non-ossified cochleas performed best, even children with extensive ossification requiring complete drill-out benefited from cochlear implantation.

Adolescent↗
PubMed1996

The scala vestibuli for cochlear implantation. An anatomic study.

BACKGROUND: Traditionally, cochlear implantation has used the scala tympani (ST) for electrode insertion. When faced with ST ossification, the surgeon may elect to drill out the cochlea to accomplish partial electrode insertion. Theoretically, another option in this situation is to insert the electrode into the scala vestibuli (SV). OBJECTIVE: To determine whether or not the dimensions of the SV are sufficient to accommodate an electrode array so as to assess the feasibility of SV cochlear implantation. METHODS: The study of 20 normal human temporal bones, comparing the maximum diameter and surface area of the ST with those of the combined SV and scala media. RESULTS: The dimensions of the SV and scala media were comparable to those of the ST and appeared sufficient to accommodate a cochlear implant electrode array. CONCLUSION: It appears that the combination of SV and scala media is a viable alternative route for electrode insertion, at least on the basis of anatomic dimensions, in those cases in which the ST is obliterated.

Cochlea↗
PubMed1996

Systematic approach to electrode insertion in the ossified cochlea.

Ossification of the fluid spaces of the cochlea occurs often in candidates for cochlear implantation, especially children. When noted before surgery on computerized tomography, ossification previously was thought to contraindicate cochlear implantation because of possible mechanical obstruction and uncertainty about the level of function that could be achieved by stimulating an ossified cochlea. However, during the preceding 6 years, techniques have been developed that permit implantation in ossified cochleas. We present a systematic approach that has been developed to treat the three clinically important categories of cochlear ossification: round window niche obliteration, inferior segment obstruction, and upper segment obstruction. Case reports are presented for each of these three drill-out procedures, demonstrating results often similar to those expected for implantation of the nonossified cochlea.

Adult↗
PubMed1996

Comparison of the canalith repositioning procedure and vestibular habituation training in forty patients with benign paroxysmal positional vertigo.

Forty patients with benign paroxysmal positional vertigo were treated with either the canalith repositioning procedure or vestibular habituation exercises to determine which treatment approach would be most effective. Twenty additional patients with benign paroxysmal positional vertigo were not treated and served as a control group. The intensity and duration of symptoms were monitored during a 3-month period. All patients had symptomatic relief in the treated groups. The canalith repositioning procedure seemed to give resolution of symptoms with fewer treatments, but long-term results show either treatment approach is effective in relieving positional vertigo. A significant number of patients in the control group (75%) continued to have vertigo. Advantages and disadvantages of the canalith repositioning procedure and vestibular habituation exercises are discussed.

Adaptation, Physiological↗
PubMed1994

Multichannel cochlear implantation in obliterated cochleas using the Gantz procedure.

Gantz, et al, reported two patients with extensive cochlear ossification in which cochlear implantation was done with a Nucleus 22-Channel Cochlear Implant after extensive cochlear drill-out. One of the patients did well with 20 functioning electrode pairs. We report an additional three patients with extensive cochlear ossification who received Nucleus 22-Channel Cochlear Implants. All three patients had extensive cochlear drill-out as described by Gantz, et al. All three patients have use of all 21 electrode pairs with amperages typical of conventional implantation in two of the three and slightly increased levels in the third. Extensive bilateral cochlear ossification does not seem to be an absolute contraindication for multi-channel cochlear implantation.

Adult↗
PubMed1992

Hydrocephalus in the patient with acoustic neuroma.

Hydrocephalus can occur in conjunction with large acoustic neuromas. Cerebral tentorial herniation and brainstem compression can be a complication of surgical excision. Three cases of hydrocephalus and acoustic neuroma are presented and therapeutic options are discussed. Ventriculoperitoneal shunting 1 to 2 weeks before translabyrinthine or suboccipital excision of acoustic neuroma is recommended.

Adult↗
PubMed1990

Scala vestibuli cochlear implantation for labyrinthine ossification.

Labyrinthine ossification is a common occurrence in patients with profound deafness. This may run as high as 80 percent in patients deafened by meningitis. Ossification sometimes makes cochlear implantation difficult. Two patients are presented with severe scala tympani cochlear ossification who had scala vestibuli electrode implantation. Their functional and audiologic results seem to be equal to those expected with scala tympani implantation. Scala vestibuli implantation seems to be a viable alternative in patients with scala tympani ossification.

Adult↗
PubMed1986

Ventilation tube surgery and middle ear irrigation.

Tympanostomy and insertion of ventilation tubes has become one of the most commonly performed operations in the United States. Most authors reporting complications of this procedure describe a postoperative rate of otorrhea in the range of 10%-20% with some reports much higher. This rate of presumed suppuration would generally be considered high by surgeons operating in other areas of the body. It is a commonly accepted surgical practice to follow incision and drainage of a relatively closed space effusion with irrigation of that space. This is true in the surgery for the paranasal sinuses, deep space infections of the neck, joint spaces, and abscesses in general. However, this practice is not routinely performed when incising and draining the middle ear. We have completed a prospective controlled double blind study on post-tympanostomy tube otorrhea utilizing irrigation of the middle ear. In 220 consecutive cases, the use of middle ear irrigation reduced postoperative infections in the first 6 months from 16% to 4%. Irrigation was also found to be useful in removing very thick effusions from the middle ear by displacement, including those effusions localized in the hypo or epitympanum which were not initially identified at the time of incision and suction. A soft plastic, angled irrigation catheter with radial ports was developed for this purpose.

Adolescent↗
PubMed1986

Bilateral facial paralysis.

Bilateral facial paralysis is a rare disorder, and its work-up should include a complete neurotologic assessment plus neurologic consultation and lumbar puncture. The various causes and their treatment are discussed and the treatment of longstanding facial paralysis is reviewed.

Brain Neoplasms↗
PubMed1985

Middle ear irrigation during insertion of ventilation tubes.

Tympanostomy and insertion of ventilation tubes has become one of the most commonly performed operations in the United States. Most authors reporting complications of this procedure describe a postoperative rate of otorrhea in the range of 10-20% with some reports much higher. This rate of presumed suppuration would generally be considered high by surgeons operating in other areas of the body. It is a commonly accepted surgical practice to follow incision and drainage of a relatively closed space infection with irrigation of that space. This is true in the surgery for the paranasal sinuses, deep space infections of the neck, joint spaces and abscesses in general. However, this practice is not routinely performed when incising and draining the middle ear. We have completed a prospective controlled double blind study on post tympanostomy tube otorrhea utilizing irrigation of the middle ear. In 220 consecutive cases, the use of middle ear irrigation reduced postoperative infections in the first 6 months from 16 to 4%. Irrigation was also found to be useful in removing very thick effusions from the middle ear by displacement, including those effusions localized in the hypo or epitympanum which were not initially identified at the time of incision and suction. A soft plastic, angled irrigation catheter with radial ports was developed for this purpose.

Child, Preschool↗