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Biomedical subjects

S D Rauch

Publications and source records attributed to S D Rauch.

43 records · Page 3Linked to original sources
PubMed1985

Medial orbital blow-out fracture with entrapment.

Blow-out fracture of the medial orbital wall, concomitant with tissue entrapment, is a rare condition occurring in those sustaining blunt trauma. Clinical signs of swelling, ecchymosis, enophthalmos, or diplopia during medial or lateral gaze is suggestive of the condition. Diagnostic confirmation is obtained by forced duction testing and computed tomography. Treatment with medial orbital decompression and limited ethmoidectomy is recommended in order to obtain optimum return of function with minimal risk.

Adult↗
PubMedDate not supplied

Parotidectomy for bulimia: a dissenting view.

Bulimia nervosa is an eating disorder syndrome characterized by frequent binge-eating episodes followed by self-induced vomiting, fasting, excessive exercise, or the use of laxatives or diuretics. In addition to the psychological manifestations of this disorder, the patient may exhibit an array of physical symptoms. The major otolaryngologic finding is the presence of benign, persistent enlargement of the parotid and/or submandibular salivary glands in some patients with more severe bingeing and purging behavior. Recent reports in the otolaryngology literature have advocated superficial parotidectomy for correction of the cosmetic deformity of this sialadenomegaly. A detailed description of the psychological and behavioral manifestations and natural history of this illness is presented. The authors believe that surgical management of parotid enlargement in patients with bulimia nervosa is contraindicated by the surgical risks, the natural history of the disorder, and the patient's psychological state.

Adult↗
PubMedDate not supplied

Multivariate vestibular testing: thresholds for bilateral Ménière's disease and aminoglycoside ototoxicity.

Although patient symptoms and an audiogram can typically identify the affected ear or ears in Ménière's disease, there are some cases where this differentiation is problematic. This paper concentrates on the sole use of vestibular test data to discriminate between unilateral and bilateral Ménière's disease. Patients that were known to have peripheral unilateral vestibular hypofunction (n = 104) were used as learning groups to define a region in multidimensional measurement space consisting of four vestibular test scores which summarized data from electronystagmography, sinusoidal harmonic acceleration, and computerized dynamic posturography tests. A multivariate boundary was created from the unilateral learning group that determined thresholds for identifying bilateral vestibular hypofunction. Patients with bilateral Ménière's disease (n = 23) and with bilateral ototoxicity (n = 19) were then used as test subjects to determine the sensitivity of the multivariate boundary. Results showed up to a increase in estimated test sensitivity (specificity = 95%) from 67%(current method)to 82%(new method)in identifying bilateral vestibular hypofunction.

Aminoglycosides↗
PubMedDate not supplied

Multivariate vestibular testing: laterality of unilateral Ménière's disease.

This paper discusses the use of vestibular testing to discriminate between right (n = 29) and left (n = 27) Ménière's disease. We examined reduced vestibular response (RVR), directional preponderance, and spontaneous and positional nystagmus measurements from electronystagmography, as well as the asymmetry measurements from the sinusoidal harmonic acceleration test, to determine whether multivariate logistic regression could improve upon the discrimination performance of RVR alone. We found that patients with a spontaneous or positional nystagmus often had a "recovery nystagmus", beating in the opposite direction of that predicted for an acute lesion. When present, the direction and magnitude of such nystagmus could be used in the classification algorithm to increase the discriminatory power over RVR alone, but in these patients the rotation test asymmetry measurements were rendered useless. In the absence of spontaneous or positional nystagmus, asymmetry measurements significantly enhanced right/left discrimination. Directional preponderance was insignificant in determining the side of lesion.

Electronystagmography↗
PubMedDate not supplied

Vestibular prostheses: the engineering and biomedical issues.

Currently available data demonstrate the need for balance prostheses. Recent technological and biomedical advances now make it feasible to produce miniaturized sensors, signal processors, electric stimulators, and stimulating electrodes that are roughly analogous to a cochlear implant but which provide information about self motion, instead of sound. Many areas require work before balance prostheses become a reality. Some of these include: the development of a motion sensor array, the conversion of the sensed motion into physiologically meaningful information, the delivery of the transformed information to the CNS, the training of vestibular deficient individuals to use the prosthesis, and developing methods to evaluate the efficacy of the device. In this "white paper", we consider these issues in the context of prototype baseline prosthetic devices.

Animals↗
PubMedDate not supplied

Serum antibody to inner ear proteins in patients with progressive hearing loss. Correlation with disease activity and response to corticosteroid treatment.

OBJECTIVE: To test whether detection of serum antibody to a 68-kd inner ear protein distinguishes among different causes of sensorineural hearing loss, and identifies patients with active disease and those likely to respond to corticosteroid therapy. DESIGN: Serum samples were tested by Western blot using bovine inner ear extract as antigen, and results were correlated with patient information obtained by chart review. SETTING: Referral center. SUBJECTS OF STUDY: Serum samples were obtained from patients with idiopathic, progressive, bilateral sensorineural hearing loss (IPBSNHL) (n = 72) otosclerosis (n = 11), Cogan's syndrome (n = 8), patients with positive tests for antinuclear antibodies (n = 10), and normal controls (n = 53). MAIN OUTCOME MEASURE: Detection of serum antibody to a 68-kd inner ear protein. RESULTS: Serum from 42 to 72 patients with IPBSNHL reacted with a 68-kd protein constituent of inner ear extract. This reactivity was not detected in serum from 11 of 11 patients with otosclerosis, or in eight of eight with Cogan's syndrome. It was found in serum from one of 10 patients with a positive test for antinuclear antibody and in one of 53 normal controls. Antibody to the 68-kd protein was detected in serum from 89% of patients with actively progressing IPBSNHL and none of the 25 patients with inactive disease (P < .001). Patients who were antibody-positive responded to steroid treatment more frequently than did those who were antibody-negative (P < .001). CONCLUSIONS: These results indicate that the presence of circulating antibody to a 68-kd constituent of bovine inner ear extract serves as a marker for IPBSNHL and that its presence correlates with disease activity and responsiveness to corticosteroid treatment.

Adolescent↗