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Biomedical subjects

W J McFeely

Publications and source records attributed to W J McFeely.

3 recordsLinked to original sources

Tympanic membrane perforation repair using AlloDerm.

BACKGROUND: Some patients lack quality autologous tissue for tympanic membrane (TM) grafting. AlloDerm (LifeCell Corp, The Woodlands, TX) is a preserved allograft that has been effective in nonotologic applications. OBJECTIVE: The goal of this study was to investigate AlloDerm in the repair of chronic TM perforations. METHODS: Ten adult chinchillas underwent a controlled, 2-stage procedure for creation and repair of bilateral TM perforations. Myringoplasties were performed. The control side (left) was repaired with autologous fascia; AlloDerm was used in all right ears. Grafts were assessed at 3 to 8 weeks. RESULTS: Complete TM perforation closure was noted in 9 of 10 (90%) control ears and 8 of 10 (80%) AlloDerm-treated ears. Fascia and AlloDerm integrated consistently with host tissues. No variables demonstrated statistical significance. CONCLUSIONS: AlloDerm appeared to be an ideal substitute for grafting of the TM. It was equally effective as fascia. Clinical trials in human beings appear warranted. Potential health care savings are discussed.

Animals↗

Intratympanic gentamicin treatment for Meniere's disease.

OBJECTIVES: The purpose of this study was to evaluate the safety and efficacy of a modified intratympanic gentamicin technique in patients with intractable unilateral or bilateral Meniere's disease. METHODS: A retrospective review of 25 consecutive patients who underwent gentamicin treatment for Meniere's disease was conducted between 1992 and 1996. Two separate delivery systems were used during this study, with the last 13 subjects undergoing placement of the new system (flanged polyethylene tubing). RESULTS: Follow-up averaged 23 months. Absence of vertigo spells was reported in 88%, and substantial control was achieved in 12%. Four of five patients with bilateral disease achieved complete control. Results for the two delivery systems were not significantly different. Absence of ice-water caloric response was seen in 75% (15 of 20) patients. Clinically significant sensorineural hearing loss occurred in 5 (20%) of 25 ears. Nonserviceable hearing developed in only two (8%) patients. CONCLUSIONS: Our results support the previously reported efficacy and relative safety of gentamicin infusion therapy for intractable Meniere's disease. Polyethylene tubing may be more advantageous than T-tube delivery because of anatomic concerns in certain patients.

Administration, Topical↗

Somatosensory phenomena after multichannel cochlear implantation in prelingually deaf adults.

OBJECTIVES: Central auditory system development in thought to be dependent on normal auditory nerve excitation. Central auditory disorganization may differ between prelingual and postlingual deafness. One possible clinical manifestation of such central auditory disorganization is somatosensory perception with cochlear implant stimulation. The purpose of this study was to investigate the incidence and characteristics of somatosensory phenomena in prelingually and postlingually deafened adult cochlear implant subjects. STUDY DESIGN: The study design was a retrospective analysis. SETTING: The study was performed at an academic tertiary referral center. PATIENTS: This study included 32 adult multichannel cochlear implant recipients. MAIN OUTCOME MEASURES: Subjective patient reporting of sensory perception after cochlear implant stimulation was reviewed. RESULTS: All 10 prelingually deaf subjects noted somatosensory phenomena distant from the implanted ear (e.g., chest, abdomen) on implant stimulation. These sensations resolved gradually for all patients. No subject deafened after the age of 2 years reported somatosensory perceptions. CONCLUSIONS: Somatosensory phenomena experienced by prelingually deafened adults suggest that disorganization of central auditory system pathways is more severe in these individuals. Earlier auditory deprivation appears to produce greater central auditory alterations, and perceptible crossover between somatosensory and auditory signals may be the end result.

Adult↗