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Biomedical subjects

S M Parnes

Publications and source records attributed to S M Parnes.

At least 55 records · Page 3Linked to original sources
PubMed1985

Predictive value of laryngeal electromyography in patients with vocal cord paralysis of neurogenic origin.

Laryngeal electromyography can provide prognostic information when evaluating patients with vocal cord dysfunction. Twenty-four patients were studied to determine the predictive capacity of this test. Six patients had bilateral vocal cord paralysis, constituting a total of 30 vocal cords examined. Sixteen of these cords had decreased or absent motor unit potentials, fibrillations, or positive waves. None of these patients recovered function. Fourteen cords demonstrated either normal motor unit or polyphasic potentials. Return of mobility was evident in 11 of these cords. The combined total was 27 of 30 cords correctly predicted, demonstrating a 90% accuracy rate.

Action Potentials↗
PubMed1984

Sinus tumors invading the orbit.

Forty -seven of 79 patients with sinus and paranasal tumors had clinical, radiographic or operative evidence of orbital involvement. Seventy percent of those patients with orbital extension had clinical or radiographic involvement of the orbit at the time of initial presentation. Common presenting signs and symptoms included proptosis, nasal obstruction or discharge, nasal mass, facial and/or eye pain, visual loss, facial and/or lid edema and diplopia. The most common tumor seen was squamous cell carcinoma. The maxillary sinus was the most frequent site of origin. Three patients were misdiagnosed as having sinusitis on initial evaluation. A diagnosis of sinusitis is tentative and should be reevaluated early with repeat roentgenographic studies and biopsy, especially in the presence of protracted facial and eye pain. When ordering CT scans, one must specifically request cuts of the base of the sinuses and skull as routine brain CT scans do not evaluate those regions. Two of four patients with intractable pain unrelieved by narcotics obtained pain relief with cisplatinum.

Adolescent↗
PubMed1982

Alternate innervations of facial musculature.

There have been several case reports in which spontaneous return of facial function has occurred without grafting or other surgical intervention. This implies that there may be alternate pathways to explain this phenomenon. Using the technique of retrograde axonal transport with chromogens tagged to the marker enzyme horseradish peroxidase, selected facial muscles of the monkey were injected to demonstrate CNS representation. The facial nucleus was identified, exhibiting topographic arrangement in the CNS. More importantly, in several specimens, nuclear cells of the mesencephalic tract also were stained. This is part of the trigeminal system, normally associated with proprioception, whose axons travel with other fifth cranial nerve branches. The trigeminal motor nucleus did not exhibit any pickup of the enzyme marker, indicating that there was no contamination from facial musculature innervated by the fifth cranial nerve. This finding suggests that the facial musculature, normally innervated by the seventh cranial nerve, has an additional nerve supply.

Animals↗
PubMed1977

Surgical management of vagal chemodectomas.

Vagal chemodectomas (tumors of the vagal glomus body) are histologically benign and insensitive to radiation therapy. Unless properly managed, these tumors may become life-threatening because of their eventual impingement on surrounding structures, particularly contents of the cranial vault. Patients with chemodectomas of the skull base may be surgically treated without significant functional or cosmetic loss, provided the surgeon possesses the following surgical abilities: 1. temporal bone dissection capabilities; 2. microsurgical skills, including techniques of middle ear reconstruction and neurovascular anastomosis; 3. implementation of simultaneous multiple approaches to the skull base and infratemporal fossa; and 4. the capability of managing technically inherent intraoperative and postoperative problems. Experience from nine patients, all successfully treated surgically, will be summarized.

Adult↗
PubMedDate not supplied

Near-fatal complications of tracheotomy infections and their prevention.

Infectious complications of tracheotomy range from minor to potentially fatal. Three cases are presented: clavicular osteomyelitis; innominate artery blowout with mediastinitis; and the first reported case of necrotizing fasciitis involving the chest wall related to tracheotomy infection. All patients were debilitated, with one diabetic and another steroid-dependent. Infectious sequelae occurred as late as 8 weeks following tracheotomy. The mechanism, treatment, and prevention of tracheotomy infections are reviewed. Indications for the creation of a permanent but reversible tracheostome should be expanded to prevent infections in debilitated or immunosuppressed patients in whom decannulation is unlikely.

Fasciitis↗
PubMedDate not supplied

Pectoralis major myocutaneous flap: analysis of complications in a VA population.

Forty-five cases of head and neck reconstruction with pectoralis major myocutaneous flaps (PMMF) between 1985 and 1990 were analyzed retrospectively for complications. Thirty-two cases were done at the VA Medical Center and 13 at Albany Medical Center, a private university hospital. Total complication rate was 58%. In the VA population, complication rate was 59% as compared to 54% at the Albany Medical Center, which appears statistically not significant. It has been suggested that VA populations tend to have poorer health and socioeconomic status and are more likely to have higher complication rates. This conjecture is not borne out by this study. Complications are described and compared.

Fistula↗
PubMedDate not supplied

Psychoacoustic and electrophysiologic effects of partial eighth nerve damage.

The authors present psychoacoustic and electrophysiologic data concerning a patient with partial damage to the auditory nerve, presumably from a dilated arterial vessel. The lesion was described and documented during neurosurgery for vestibular nerve decompression. Pure tone thresholds, psychoacoustical tuning curves, speech reception ability for spondaic words, maximum word recognition performance for monosyllabic NU-6 word lists, and performance on the synthetic sentence identification test in the ipsilateral and contralateral competing message modalities were normal. Findings consistent with eighth nerve dysfunction, absent contralateral acoustic reflexes, absent or unrecognizable early evoked potentials occurring in the first 10 msec, brainstem auditory evoked potentials (BAEPs), and slight rollover of the performance intensity function for monosyllabic words were obtained on the involved side. In spite of the grossly abnormal BAEPs, two late, presumably cortical, auditory evoked potential components, which occur in the 60 to 250-msec range--vertex potential and T complex--were present and normal. The findings indicate that the perceptual processes needed for speech reception and recognition and for the appearance of later, presumably cortical-evoked potentials can be preserved despite partial damage to the auditory nerve.

Adult↗
PubMedDate not supplied

Psychological characteristics of individuals high and low in their ability to cope with tinnitus.

Seventy-seven individuals with tinnitus were assessed with a variety of standardized psychological tests and scales assessing subjective loudness, annoyance, and ability to cope with the tinnitus. Significant correlations were found between coping ability and psychological test scores. Based on their responses on the coping scale, subjects were classified as "high copers" (N = 45) or "low copers" (N = 32). For comparison purposes, the two tinnitus groups were also compared to a group of chronic pain (headache) patients (N = 34) and to a group of nonheadache/non-tinnitus controls (N = 65). Results revealed the low coping tinnitus subjects to be significantly more psychologically distressed than the high copers. Of interest, the low copers were very similar in their psychological profiles to the chronic pain patients, while the high copers were similar to the non-patient control subjects. Implications of these results are discussed.

Adaptation, Psychological↗
PubMedDate not supplied

Cutaneous-evoked tinnitus. I. Phenomenology, psychophysics and functional imaging.

DC00166e and acute unilateral deafferentation of the auditory periphery (auditory and vestibular afferents) can induce changes in the central nervous system that may result in unique forms of tinnitus. These tinnitus perceptions can be controlled (turned on and off) or modulated (changed in pitch or loudness) by performing certain overt behaviors in other sensory/motor systems. Clinical reports from our laboratory and several other independent sources indicate that static change in eye gaze, from a neutral head-referenced position, is one such behavior that can evoke, modulate and/or suppress these phantom auditory events. This report deals with a new clinical entity and a form of tinnitus that can be evoked directly by cutaneous stimulation of the upper hand and fingertip regions. In 2 adults, cutaneous-evoked tinnitus was reported following neurosurgery for space-occupying lesions at the base of the skull and posterior craniofossa, where hearing and vestibular functions were lost completely and acutely in one ear (unilateral deafferentation) and facial nerve paralysis (unilateral deefferentation) was present either immediately following neurosurgery or had occurred as a delayed-onset event. Herein, we focus on the phenomenology of this discovery, provide perceptual correlates using contemporary psychophysical methods and document in one individual cutaneous-evoked tinnitus-related neural activity using functional magnetic resonance imaging. In a companion paper, neuroanatomical and physiological interactions between auditory and somatosensory systems, possible mechanistic accounts and relevant functional neuroimaging studies are reviewed.

Aged↗
PubMedDate not supplied

Cutaneous-evoked tinnitus. II. Review Of neuroanatomical, physiological and functional imaging studies.

Cutaneous-evoked tinnitus is a clinical entity that has not been reported previously in the neurootological literature. Herein, a neuroscience framework that encompasses several distinct areas of research is used to conceptualize and help understand this phenomenon. We review normal neuroanatomical and physiological interactions between auditory and somatosensory systems in mammals. Also considered are mechanistic accounts of lesion-induced changes in the CNS following deafferentation/deefferentation of peripheral sensory or motor structures that may have a relationship to this phenomenon, as well as the role of functional imaging modalities in studying various phantom perceptions.

Brain↗
PubMedDate not supplied

Study of spastic dysphonia using videofiberoptic laryngoscopy.

Spastic dysphonia is a speech disorder, characterized by a "strangled voice quality," irregularly occuring phonatory arrests, and a jerky pattern of speech. This is often extremely disruptive to the patient's ability to communicate. Two cases are presented in which a new technique, videofiberoptic laryngoscopy, was employed in the study of these patients. The characteristic laryngeal behavior of this disorder is documented and recorded, particularly noting the increase in supraglottic activity and how different vocal maneuvers alter this activity.

Female↗
PubMedDate not supplied

Airway complications from laryngoscopy and panendoscopy.

Laryngoscopy and panendoscopy can cause airway complications. To determine the risk to the airway from reintubation following general anesthesia in otolaryngology patients, we examined recovery room and anesthesia records at the Albany Veterans Administration Medical Center covering a 10-year period. From this information we determined the incidence of recovery room reintubation and studied airway risk factors associated with otolaryngologic endoscopy. From 1975 to 1984, 10,060 surgical patients were intubated at the Albany VA Medical Center. Only 17 patients (0.17%) required reintubation. Of 1,365 otolaryngology patients intubated during the same period, 324 had laryngoscopy and 302 had panendoscopy. Significantly, four laryngoscopy patients (1.2%) and nine panendoscopy patients (3%) required recovery room intubation. Nine endoscopy patients needed reintubation within 1 hour of extubation. We conclude that the risk of postoperative airway compromise is significantly greater among patients who underwent diagnostic laryngoscopy and panendoscopy than among patients who had general anesthesia for other reasons.

Adult↗
PubMedDate not supplied

Auditory perceptual and visual-spatial characteristics of gaze-evoked tinnitus.

Auditory perceptual and visual-spatial characteristics of subjective tinnitus evoked by eye gaze were studied in two adult human subjects. This uncommon form of tinnitus occurred approximately 4-6 weeks following neurosurgery for gross total excision of space-occupying lesions of the cerebellopontine angle and hearing was lost in the operated ear. In both cases, the gaze-evoked tinnitus was characterized as being tonal in nature, with pitch and loudness percepts remaining constant as long as the same horizontal or vertical eye directions were maintained. Tinnitus was absent when the eyes were in a neutral head-referenced position with subjects looking straight ahead. The results and implications of ophthalmological, standard and modified visual-field assessment, pure-tone audiometric assessment, spontaneous otoacoustic emission testing and detailed psychophysical assessment of pitch and loudness are discussed.

Audiometry, Pure-Tone↗