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Biomedical subjects

T Haid

Publications and source records attributed to T Haid.

At least 19 recordsLinked to original sources
PubMed1992

Preservation of hearing in bilateral acoustic neurinomas by deliberate partial resection.

With the aim of preserving hearing, 20 acoustic neurinomas in 17 patients with neurofibromatosis 2 were intentionally submitted to an incomplete (80%) tumour removal. In 12 cases this was an operation on the last hearing ear with total deafness of the contralateral ear. If an auditus existed in both ears the better hearing ear was selected for the primary intervention. Early audiological controls evidenced residual hearing in 19 of the 20 cases operated on by the enlarged middle fossa approach, which was utilized inspite of the tumour diameters being between 1 and 6 cm in the cerebello-pontine angle. The oncologic and functional follow-up over 1 to 7 years showed different patterns of slow progression of hearing loss and of persistent auditory function over 2 to 7 years. Facial nerve function was excellent in 16 of the 18 controlled cases. Continued CT or MRT imaging revealed no signaling in 2 cases, constant tumour sizes in 10 cases and slow progression in 3 cases. With regard to the importance of an auditory communication in the younger adult, the described treatment modality appears to be the first choice method.

Adult↗
PubMed1991

Extended middle cranial fossa approach for acoustic neuroma surgery.

The enlarged middle cranial fossa approach was used for removal of acoustic neuromas in 209 cases. Complete tumor removal was accomplished in 96% of cases. Hearing was preserved in 51% of cases, with better results in smaller tumors. Our experience with the enlarged middle fossa approach has led us to discard the translabyrinthine approach for removal of acoustic neuromas.

Journal Article↗
PubMed1989

The enlarged middle cranial fossa approach for surgery of the temporal bone and of the cerebellopontine angle.

Due to the fact that the temporal bone has broad segments of bone anterior to and behind the internal auditory canal which are empty of functionally important structures, a broad exposure of the cerebellopontine angle may be obtained from above. This technique is adequate for the management of acoustic neurinomas up to 3 cm in diameter. A low postoperative morbidity and a high percentage of hearing preservation with total tumor removal were obtained in a series of 190 cases. This report underlines the advantages of the procedure and points to various other indications.

Cerebellopontine Angle↗
PubMed1989

[Function-saving microsurgery in suboccipital removal of large acoustic neuromas].

Various successful approaches are available for acoustic neurinoma surgery, permitting total tumor removal and preservation of cranial nerve function. In smaller and medium sized tumors excellent results can be achieved with respect to facial and cochlear nerve function using the transtemporal approach. For larger tumors similar results can be achieved by the suboccipital approach. The results of 45 completely removed large acoustic neurinomas all operated upon via the suboccipito-lateral approach with microsurgical techniques and neurophysiological monitoring are presented. The average tumor size, excluding the portion within the internal auditory canal was 3 cm. Anatomical preservation of the VIIth cranial nerve was achieved in nearly all cases. Satisfactory to excellent facial nerve function was preserved in 70% of all cases. Initial hearing was preserved in 29%. However delayed postoperative hearing loss was encountered in 13%. Therefore definite hearing preservation was achieved in 16% of the cases. Intraoperative monitoring, especially of auditory evoked potentials, was very helpful in achieving these functional results.

Adult↗
PubMed1988

[Surgical interventions for ameliorating of equilibrium disorders refractory to conservative therapy].

In cases of vertigo resistant to conservative treatment, surgery can be valuable for labyrinthine fistula, perilymphatic fistula, cupulolithiasis and Menière's disease. For instance, covering a labyrinthine fistula by a fascial graft relieves the vertigo in an amazingly short time. Perilymphatic fistula is verified and treated by tympanotomy and is used for patients with special auditory and/or vestibular features. Cupulolithiasis usually requires no surgical treatment: special postural training will speed recovery, but a few cases need neurectomy of the inferior vestibular nerve. There are several methods of surgical treatment for Menière's disease. In our experience neurectomy of the superior and inferior vestibular nerves on the diseased side together with decompression of the eighth cranial nerve via an extended transtemporal approach to the middle fossa is an excellent method of treating patients with vertigo attacks.

Fistula↗
PubMed1988

Evaluation of flunarizine in patients with Menière's disease. Subjective and vestibular findings.

In an open multicentre pilot study, 32 patients affected with Menière's disease were treated with the cerebrally effective calcium antagonist flunarizine for 12 weeks. By means of the so-called vestibular index, the therapeutic results could be documented in a rapid and clear manner; the vestibular index takes into account both the subjective statements of the patients and objective pathological vestibular findings in terms of figures. The mean value of this vestibular index of 32 patients with Menière's disease was 9.5 before treatment and only 4.0 at the end of the therapy, which is indicative of a positive therapeutic effect. In the final evaluation, the action of flunarizine was generally considered very beneficial both by the attending physicians and the patients.

Adult↗
PubMed1986

[Caloric evaluation of the vestibular organ in the child--an electronystagmography study for determining age dependence of the vestibulo-ocular response].

The vestibular-ocular reflex was examined after caloric stimulation on 120 healthy children, age 5 to 14 years. The different parameters of the nystagmus such as the beats during the culmination period of 30 s, the velocity of the slow phase and the amplitude and duration of the nystagmus showed a clear correlation to the child's age. The values for the duration of the nystagmus and the number of beats after caloric stimulation increased with respect to age, whereas the other parameters decreased.

Adolescent↗
PubMed1985

[Removal of acoustic neuromas of the cerebellopontile angle with transtemporal approach by the middle cranial fossa].

The enlarged transtemporal middle fossa approach to the cerebello-pontine angle is adequate for complete removal of acoustic neuromas up to 4.0 cm in diameter (sizes B and C according to Fisch). A description of the surgical technique and the results of 63 operations are presented (13, 23 and 27 tumours of sizes A, B and C respectively). 51 tumours were completely removed, 6 had a voluntary palliative incomplete resection for medical reasons or on the only remaining hearing ear. Only 6 patients (one in the last 40 consecutive cases) had an incomplete resection due to the limited exposure of the tumour. In 44 ears the cochlear nerve could be preserved, 28 of which showed postoperative hearing function (8 size A, 10 size B, 10 size C). There was no operative mortality, no severe hemorrhage nor any permanent neurological complication. The facial nerve function was well preserved in 48 of 56 patients followed up.

Adolescent↗
PubMed1985

[Experience with fibrin glue in type-III tympanoplasty with stapes elevation].

In a retrospective study, type III tympanoplasties with stapes elevation on two groups of patients were compared. In group I (101 patients) the stapes elevations, the temporalis fascia grafts for tympanic membrane reconstruction, the grafts of periosteum and cartilage used for repair defects of the posterior bony meatal wall and the Stacke-II plasty replaced in its original position after tympanoplasty were also fixed with fibrin glue (Tissucol). Group II (control group of 102 patients) was operated with fibrin glue. In group I the fascial grafts of the tympanic membrane healed faster, more securely and without fewer complications. The external auditory canal however healed equally well in both groups. Early hearing results of type III tympanoplasty could be improved by fixing the stapes elevations with fibrin glue.

Audiometry↗
PubMed1985

[Angiomatous malformation of the inner auditory canal with the leading symptoms of vertigo and tinnitus].

A case of a rare arteriovenous malformation in the internal auditory canal is reported. It caused unilateral tinnitus, facial weakness, trigeminal hypesthesia, and vertigo with lateropulsion. The audiological and otoneurological findings together with air-cisternography a CT scan had indicated an intrameatal tumor. An extended trans-temporal exposure of the internal auditory canal demonstrated an angiomatous lesion compressing the adjacent seventh and eighth cranial nerves. It could be removed safely by a second-stage lateral suboccipital approach to the cerebello-pontine angle.

Diagnosis, Differential↗
PubMed1985

[Peripheral vestibular neuropathy and a central vestibular equivalent].

The results of the initial and follow-up examinations of 217 patients with vestibular neuritis and 63 patients with a so called "vestibular neuritis syndrome" were statistically evaluated and quantified using the vestibular index. The results for patients with vestibular neuritis were compared at the different stages to those of patients after neurectomy of the vestibular nerve. The site of the lesion in patients with vestibular neuritis may therefore be in the region of Scarpa's ganglion (retrolabyrinthine). Alternatively the total peripheral end-organ may be affected. This conclusion agrees with histopathological findings. The "vestibular neuritis syndrome" included patients with the same history as patients with true vestibular neuritis but with signs of a central-vestibular disturbance or a combination of a central and peripheral lesion of the vestibular system. In these cases the lesion may be situated closer to the vestibular nuclei or its central pathways. Both disorders were similar with respect to history, etiology and the prognosis.

Adolescent↗
PubMed1983

[Microsurgical neurolysis of the 8th cranial nerve in cochleo-vestibular disorders using an extended transtemporal approach].

A series of 17 patients suffering from progressive cochleovestibular disturbances (8), severe attacks of Menière's disease (5), progressive or sudden sensori-neural deafness (2), vestibular neuronitis (1) or unbearable tinnitus (1) is reported. The eighth cranial nerve was exposed from its root at the brainstem to its exit into the fundus of the internal auditory canal (CAI), by an extended middle fossa approach. The surgical technique and the intraoperative observations are described. All cases showed morphological abnormalities such as neuro-vascular compression of the nerve by arterial or venous vessels, either at the brainstem or laterally at the CAI. Horizontal or vertical dislocations of the nerve were also noticed. Traction, compression or even strangulation of the nerve fibres or of their accompanying vessels may be co-factors of the functional disturbances. Striking improvement of the vestibular disorders was recorded following neurolysis of the eighth nerve, showing that retrolabyrinthine abnormalities may be possible causes of Menière's disease and other supposedly labyrinthine disorders. The preliminary results regarding hearing and tinnitus were hitherto unsatisfactory. This fact may be explained by the, as yet, imperfect technique of neurolysis.

Humans↗
PubMed1981

Positional test in acute vestibular disorders.

With the aid of th positiogram, a quantitative recording of th positional test, it was possible to study the intensity of nystagmus in three acute vestibular diseases (vestibular neuronitis, Meniere's disease and sudden hearing loss with vestibular involvement). Patients with vestibular neuronitis in the acute stage showed a higher intensity of nystagmus during the positional test than patients passing through the irritation stage of Menière's disease. Especially patients suffering from vestibular neuronitis complained also subjectively about such an intense vertigo that they were seized by a feeling of annihilation at the onset of the disease. Quantification of the nystagmus during the positional test allows the progress, constancy or remission of the findings to be identified during the follow-up checks. Protracted constant pathological results obtained during the positional test, or when they become progressive, constitute in the light of our experience an indication for neuroradiological clarification in order to rule out an acoustic neurinoma as a cause (especially when a unilateral sensorineural hearing impairment exists).

Aged↗
PubMed1981

Vertigo originating from inflammation of the paranasal sinuses (the so-called sinugenic vertigo).

A routine X-ray examination of the sinuses of a patient complaining of regular bouts of dizziness may provide diagnostic information about a so-called sinugenic vertigo. In addition to the pathological X-ray findings in the maxillary sinuses, the patients presented either a positioning nystagmus or a head-shaking nystagmus, with disturbed vestibular spinal reaction as a pathological vestibular condition. Out of 15 patients in whom a sinusitis-induced (sinugenic) dizziness was diagnosed and who appeared regularly for the control checks, 14 patients said that they were relieved of the dizziness as a result of sinus therapy, often immediately afterwards. Interrelationships possibly exist between pathological trigeminus reflexes via the sphenopalatine ganglion brought about by maxillary sinusitis and a reflectory labyrinthine irritation, triggering the vertigo.

Humans↗
PubMed1981

[Early diagnosis of acoustic neurinomas with computed tomography and air meatography. A comparison to meatography with lipid contrast medium (author's transl)].

Large acoustic neurinomas invading the cerebellopontine angle can be visualized in the computerized tomogram when intravenous contrast medium is used. Additionally, the filing of both the cerebellopontine angle and internal auditory canal with air has been recommended for the detection of small neurinomas which are limited to the canal. A comparative study was conducted on 54 patients using both air-meatography and cisterno-meatography with a positive lipid contrast medium (Duroliopaque). Eight tumors could be recognized by the method. Although both methods have approximately the same diagnostic value, we prefer the use of computed tomography with air-meatography because of its particular advantages as described.

Cerebellopontine Angle↗