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Biomedical subjects

S R Wullstein

Publications and source records attributed to S R Wullstein.

17 recordsLinked to original sources
PubMed1985

[The audioanalysator. A bridge between audiometry and psychoacoustics].

An analyser with a system of continous sweeping frequencies and a spectrum of strongly different control signals is described here. Including the active participation of the patient and his impaired hearing a much more accurate finding of symptoms is possible than with the standard methods of audiometry. The major factors mentioned include the continuous fine testing of the sounds heard in an unlimitated choice of frequencies ranging between 20 Hz. and 20 000 Hz. with an automated search unit as well as a test for the highest tones. After brief instruction the tests are determined by the patient himself according to choice monaurally and/or binaurally depending on comparisons and corrections right/left. This leads to highly differentiated statements on the sounds heard and to comparable qualities of tone which until today have been unknown in this wide extent of variety to audiometry and audiology and which presents totally new aspects. One of the main purposes of the audioanalyser is to detect the role played by the transients in discrimination. Obviously also the highest tones influence the character of the transients. They are apt to be easily lost e.g. by infections any kind. A vigilant patient will become aware of this loss.

Adolescent↗
PubMed1980

Cholesteatoma. Etiology, nosology and tympanoplasty.

After more than 25 years of tympanoplasty for cholesteatomata, it is time to reconsider the origin of this pathological finding. The pathogenesis has not changed, it is the aspects of the disease which have shifted. There are two reasons for this: (a) much improved conditions of living, housing, nutrition and epidemiology, especially during childhood, and (b) discontinuation of the indication for radical surgery, only in the case of threatening complications is tympanoplasty used as a prophylactic operation. In the meantime a new and numerously large group of cholesteatomata has come up which was previously unknown, namely the so-called 'iatrogenic cholesteatomata'. Under these aspects the nomenclature of the cholesteatomata has to be newly defined, according to its etiology and form of disease.

Cholesteatoma↗
PubMed1979

[Septoplasty without postoperative nasal packing. Mucosal repair of the upper airway with human biologica glue (author's transl)].

With the use of human biological adhesives in nasal septal surgery with or without extensive dissection, nasal packing can be avoided or at least its use essentially shortened. As a result, nasal breathing is not interrupted and mucociliary clearance resumes at an earlier stage of healing. In addition, infections of the sinsuses or the deep airway are prevented. The provisional high costs of the adhesive can be justified by the lessened patient morbidity. Similar favorable experiences with the adhesive were also found in various other reconstructive procedures of the head and neck, including tympanoplasty, aural atresia, skin transplantation, etc.

Fibrin↗
PubMed1978

Cholesteatoma in children: is the disease different in childhood?

During the early phase of the development of the temporal bone the correlation between the bone growth and the formation of the air-filled spaces--disturbed or undisturbed--is decisive for development of even hidden and neglected forms of middle ear cholesteatomata. The second phase of the development of the temporal bone is determined by a slower rate of bone growth when the mucociliary system has to develop its immunobiological capacities. It becomes obvious that the cholesteatoma matrix and perimatrix will find favourable requirements during this early period of life for a rapid spread since the air-filled spaces have not yet reached their final size. Also the correlation to the gas volume will be different when the ratio of the air flow changes.

Air Pressure↗
PubMed1977

[Consequences of a high-placed jugular bulb for the inferior ventilation pathway of the middle ear].

The evaluation and the correlation between the healthy and inflamed system of the mucosal folds of the middle ear demonstrate that there is a second "bottle neck" of the aeration pathways (the first being the Eustachian tube) in the region of the tympanic diaphragm with the tympanic isthmi - anterior and posterior -, the latter is more important for the ventilation of the epitympanum and antrum. Anatomical variations in this lower air-pathway as a high placed jugular bulb into the middle ear cavity endanger of course the undisturbed ventilation of the epitympanum and antrum in case of the infected and swollen mucosa and its folds.

Ear, Middle↗
PubMed1975

[Osteoplastic epitympanotomy and the pathology of the middle ear. Part 2: The microstructures of the epitympanum and their significance concerning the pathology of the retrotympanal spaces (author's transl)].

The two goals of osteoplastic trepanation of the middle ear spaces are first a direct inspection of the main areas of pathologies within the epitympanum and secondly a better understanding of the infected middle ear diseases through careful preparation and exposure of the pathologic processes. A new way of approval could be found by taking into account the anatomical and topographical realities and the possible deviations form normal cases. This opens a better understanding of all those variations. Without touching the microstructures of the tympanum their inspection and preparations are hereby made possible macro- and microscopically. This leads to the conclusion that the tympanic structures are involved in the formation and progression of infected middle ear diseases. The correlation of the "aeration pathways" and the "drainage outlets" of the middle ear as an interdepending functional unit can be seen by this new intrasurgical inspection-based on light- and electronic microscopic research of various authors-as well as through the fact that middle ear mucous membrane is a truly respiratory membrane with no difference to other aeration pathways as found in the nose. A of a summation of mucous membranes in the area of the diaphragma is that minor catarrhal inflammations will block this aeration pathway of the middle ear. At the same time an open tuba auditiva can be found in acute, subacute and chronic middle ear diseases. Our findings that the ventilation of the ear is in most cases blocked at the diaphragma and not at the tube leads to questions on the one hand regarding the function of diaphragma and to the opinion on the other that the ventilation system of the middle ear is divided in two sections by the diaphragma: An anterior section including tuba and hypomesotympanon and a posterior including epitympanon, aditus, antrum and the pneumatic cells of mastoid and pyramid. The anterior section still is ventilated through the tuba when blocked at the diaphragma, in the posterior one ventilation and drainage are blocked even by mildly infected processes. Longer lasting infections have severe consequences for these spaces and the tympanic membrane.

Acute Disease↗
PubMedDate not supplied

Histopathological alterations of the mucosal folds in chronic otitis media.

The autogenesis and evolution of the mucosal folds were studied. They play an important part in the immunological defense system of the middle ear. The anatomy and topography of these mucosal duplications together with their pathophysiological effects explain the clinical development in the various forms of middle ear infection and disturbances of the aeration of the middle ear in case of an open and well functioning Eustachian tube.

Adolescent↗