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Biomedical subjects

S Abramovich

Publications and source records attributed to S Abramovich.

14 recordsLinked to original sources

First branchial cleft sinus presenting with cholesteatoma.

Disorders of the first branchial cleft are rare and often present difficulties in diagnosis. A case is reported that presented with the clinical and histological features of cholesteatoma. The embryology, diagnosis and treatment of branchial arch defects are also reviewed. The case highlights the fact that a high index of suspicion should be aroused for patients with a discharging ear in the presence of an intact tympanic membrane.

Adult↗

A case of malignant otitis externa following mastoidectomy.

We present a case of a 63-year-old diabetic male who developed malignant otitis externa following mastoidectomy. Extensive skull base osteomyelitis caused thrombosis of the jugular bulb and subsequent paralysis of cranial nerves VII, IX, X and XII. He was treated aggressively with intravenous antibiotics and debridement of granulation tissue in the mastoid bowl with full recovery of the cranial nerve palsies associated with recanalization of the jugular bulb. We believe this is the first reported case of malignant otitis externa to occur following mastoidectomy with complete recovery of the cranial nerve paresis.

Facial Paralysis↗

An unusual cause of cochlear implant failure.

We present a cochlear implant failure previously unidentified and unreported. Following successful implantation and activation of a Cochlear Mini 22 system, a distressing barrage of crackling noises was heard by the patient despite repeated programming with threshold and comfort level adjustment. The implant soon became nonfunctional and integrity testing showed deficient electrical responses and abnormal surface measured wave forms. Investigation of the explant, following reimplantation with an identical system, showed a defective trim capacitor, an electric component of the internal circuit in the stimulator. Paired Student's t-test showed a marginally significant increase (p = 0.047) in effective threshold level and a highly significant decrease (p = 0.0002) in maximum comfort level for the second implant compared to the first implant.

Cochlear Implants↗

Electrocochleography and brain-stem potentials in Ramsay Hunt syndrome.

Audiometric investigations and electrophysiologic recordings of cochlear and brain-stem auditory evoked potentials (BAEPs) were performed in 13 patients to elucidate further the type of hearing disorders in Ramsay Hunt syndrome. Transtympanic electrocochleography showed no enhancement of summating potential and did not suggest secondary endolymphatic hydrops. The recording of BAEPs was clearly abnormal in several of the 13 patients. The striking feature of the abnormalities in these patients was the prolongation of the latencies of waves III and V with the preservation of wave I, which clearly suggests retrocochlear involvement. In all the patients tested, abnormalities of the BAEPs were present only on the affected side. It is possible, on the basis of BAEP findings, to suggest that in Ramsay Hunt syndrome both cochlear and retrocochlear involvement may occur.

Adult↗

Naproxen in otitis media with effusion.

The levels of prostaglandin E2 (PGE2) were measured in aspirates of the effusion fluid from children suffering from secretory otitis media. The effects of naproxen 5 mg./kg. twice daily for eight weeks on the condition were studied in a placebo-controlled double-blind trial. Nineteen middle-ear aspirates from 13 children, six of whom had bilateral aspirations were examined. Detectable levels of PGE2 (greater than 1.0 ng. per ml.) were present in seven aspirates from seven children and ranged from PGE2 1.0 to 14.4 ng. per ml. In four of the six patients who had bilateral aspirations, PGE2 was detectable in the aspirate from one ear but not the other. However, the severity of otalgia and hearing loss was almost identical in the ears with detectable levels of PGE2 and those without. In a separate trial of naproxen, 11 patients received active drug and 13 received placebo. Naproxen had no significant effect on otalgia or hearing loss compared to placebo. These findings suggest that it is unlikely that non-steroidal anti-inflammatory drugs will be of therapeutic benefit in secretory otitis media.

Body Fluids↗

Assessment of the effect of chemotherapy and radiotherapy on the auditory function of children with cancer.

Forty children with malignant disease underwent full audiological assessment with pure tone audiometry, tympanometry and measurement of brain stem auditory evoked potentials in an attempt to detect auditory dysfunction resulting from treatment. Significant auditory dysfunction was observed in 8 children. Three children with evidence of a conductive or sensorineural deafness on pure tone audiometry had normal brain stem evoked potentials. One child with a high tone hearing loss and 4 children with no detectable hearing loss on audiometry showed significant differences in the interaural interpeak latencies of selected brain stem auditory evoked potentials. In 2 children these abnormalities had resolved on subsequent testing, 2 had evidence of persistent retrocochlear dysfunction and the remaining child died prior to further evaluation. Routine measurement of brain stem auditory evoked potentials is probably not necessary for the majority of children undergoing treatment for cancer, although such measurements are of value when differentiation between cochlear and retrocochlear damage is required.

Acoustic Impedance Tests↗

An evaluation of BERA for hearing screening in high-risk neonates.

Brain stem electric response audiometry (BERA) is evaluated for early detection of hearing loss in high-risk newborns selected from a general hospital population. They receive screening BERA in the nursery and detailed frequency-specific BERA in the Audiology clinic, just before discharge. Three months later, testing is repeated and recommendations are made. From 1364 assessments, 321 at-risk babies were identified; 234 received predischarge tests, and 200 had follow-up tests. Screening BERA with 40 dB nHL clicks is appropriate in the nursery. Screening sensitivity is good, and only 8% of babies failed. Several of these had mild hearing loss, resolving in the first trimester. Follow-up BERA confirmed hearing loss in 8 babies. Parental compliance is high, and the program is well-accepted. In conjunction with the high-risk register, BERA is useful both for screening and for quantitative audiometry in the infant.

Audiometry↗