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Biomedical subjects

W L Meyerhoff

Publications and source records attributed to W L Meyerhoff.

At least 73 records · Page 4Linked to original sources
PubMed1985

Surgical section of the posterior ampullary nerve.

Surgical section of the posterior ampullary nerve (PAN) has been used as a form of therapy for persistent benign paroxysmal positional vertigo (BPPV). Eighteen patients were reviewed. The PAN was identified in 16 patients, 15 of whom were completely cured and one of whom had improvement of symptoms. Severe sensorineural hearing loss (SNHL) occurred in three patients. This study suggests that surgical section of the PAN is effective. The procedure is facilitated by a postauricular incision and canalplasty.

Adult↗
PubMed1984

Inflammatory effects of otic drops on the middle ear.

Combination topical otic preparations are used to treat many infections of the external and middle ears. Despite the presence of ototoxic drugs in a number of these drops and convincing evidence of sensorineural hearing loss in humans and animal studies (Meyerhoff et al., presented at Southern Section Triological Meeting, Jan. 1983) following use of these medications, otic drops remain the cornerstone of treatment for many infectious disorders of the ear. Twelve chinchillas underwent bilateral tympanostomy tube placement and daily instillation of Cortisporin Otic Suspension (polymyxin B, neomycin, hydrocortisone, propylene glycol) in the right external auditory canal for 7 consecutive days. The animals were sacrificed 3 days later, 10 days following initiation of the Cortisporin Otic Suspension treatment. Following routine preparation of the temporal bones for light microscopy, the tissue was evaluated for evidence of inflammatory changes. All 12 animals demonstrated granulation tissue, effusion and focal hemorrhage in the ears subjected to the Cortisporin Otic Suspension. All of the contralateral control ears were normal. The present data suggest that this inflammatory response is due to a topical irritant effect of the otic preparation.

Animals↗
PubMed1984

Tympanic membrane changes secondary to tympanostomy tube insertion in chinchillas.

Tympanostomy tubes were inserted in 16 chinchillas to study the effect on tympanic membrane morphology. Tympanic membranes were examined with an operating microscope after 72 hours and at weekly intervals thereafter. Three ears developed postoperative otorrhea. Except for the ears with otorrhea, all tympanic membranes remained gray and translucent. Histologically, granulation tissue and polymorphonuclear leukocyte infiltration occurred around the tympanostomy tube by 7 days. With time this was replaced by a mature fibrous ring, which explained the tissue band observed otoscopically. In those tympanic membranes where the tympanostomy tube had extruded, healing occurred with an overly developed membrana propria. The middle ears of all experimental animals remained free of pathologic changes except for the three ears with otorrhea.

Animals↗
PubMed1984

Non-auditory presentations of cerebellopontine angle lesions.

Most patients with cerebellopontine angle (CPA) neoplasms present with asymmetric hearing loss and/or tinnitus. For this reason it is well accepted that patients with these symptoms deserve a detailed neurotologic evaluation. Non-auditory presentations of CPA neoplasms, on the other hand, are frequently handled in a more complacent manner which may delay diagnosis and, therefore, result in increased morbidity. Six patients seen in the last 18 months serve to exemplify this point, as all 6 presented with non-auditory symptoms of CPA lesions and, in all cases, the diagnosis was delayed for at least 6 months. Any cranial neuropathy, unless otherwise explained, should suggest the presence of an intracranial or skull base lesion. The practicing physician must learn to give these non-auditory symptoms respect equal to that of asymmetric hearing loss and tinnitus and, therefore, equal evaluation.

Adult↗
PubMed1983

Tympanostomy tubes and otic drops.

Otic drops have been proposed as a form of prophylaxis against the otitis media which follows middle ear contamination by water in patients with tympanostomy tubes. The potential adverse effects of this form of therapy were studied in chinchillas with tympanostomy tubes; 31 chinchillas underwent bilateral tympanostomy tube insertion. Seven animals had a mixture of green dye and Cortisporin otic suspension placed in both external auditory canals 24 hours following the placement of tympanostomy tubes and were sacrificed 30 minutes later for gross examination; 3 of these animals had previous eustachian tube obstruction with Silastic sponge. Twenty-one animals had Cortisporin otic suspension placed in the right external auditory canal on postoperative days 3, 4, 5, 6 and 7. No otic drops were placed in the left ear. Ten of these 20 animals had VIIIth nerve action potentials measured on postoperative day 17 and the other 11 animals had VIIIth nerve action potentials measured on postoperative day 42 followed by immediate sacrifice for histological examination and scanning electronmicroscopy. The remaining 3 animals had VIIIth nerve action potentials measured 21 days following tympanostomy tube insertion and served as electrophysiological controls. The 8 ears receiving Cortisporin otic drops mixed with green dye from animals with normal eustachian tubes showed staining of the round window membrane at sacrifice, while the 6 ears receiving Cortisporin otic suspension and green dye from animals with eustachian tube obstruction demonstrated no dye in the middle ear. All animals receiving Cortisporin otic drops in the right ear showed an intra-aural difference in action potentials with the right ear being attenuated by an average of 10.3 dB at 2,000 Hz, 12 dB at 4,000 Hz, 21 dB and 8,000 Hz, and 26 dB at 12,000 Hz. Morphological study revealed hair cell loss in the hook portion of the cochlea in those animals receiving Cortisporin otic drops. It was concluded from this study that, in patients with patent tympanostomy tubes in place, potentially ototoxic topical agents should be used with caution.

Action Potentials↗
PubMed1983

Sudden sensorineural hearing loss.

Sudden sensorineural hearing loss is a frightening experience for the patient. The patient's worse fears concern tumors or stroke. Although the physician is often frustrated by a symptom whose cause at times is not apparent, every effort should be made to identify the causes of sudden sensorineural hearing loss and possible predisposing causes of idiopathic sudden sensorineural hearing loss. Therapy includes efforts to treat known causes either medically or surgically, to keep the patient at reduced physical activity, and depending upon the treating physician's own preference, attempts to favorably alter the ultimate prognosis through medical manipulation.

Hearing Loss, Sensorineural↗
PubMed1982

Repair of complicated mandibular defects.

In most instances, the injured mandible can be successfully repaired with arch bars and intermaxillary fixation. However, it is important to identify certain potential problem situations early and apply special techniques for their treatment. Potential management problems, such as the non-compliant patient, the edentulous patient, gunshot wounds, radiated mandibles, tumors, and osteomyelitis, are reviewed. The use of special techniques, eg, the dynamic compression plate, the Morris biphase apparatus, the cobalt-chromium alloy (Vitallium) basket, a suction-irrigation apparatus, and the mandibular reconstruction plate, are described to show how they may be effectively applied to these special situations. With early recognition of these management problems and proper application of these more sophisticated techniques, the quality of care for patients, with mandibular injuries can be enhanced.

Age Factors↗
PubMed1982

Surgical treatment of orbital floor fractures.

This study retrospectively examines 551 patients with 597 orbital floor fractures for sequelae of enophthalmos and diplopia. Ocular injuries are associated with 6.9% of the fractures. Nondisplaced orbital floor fractures have been treated with observation alone, resulting in an incidence of sequelae of zero in 263 patients. Displaced fractures that had not undergone surgery have resulted in an incidence of sequelae of 18 (34%) in 53 patients. Displaced fractures that had undergone orbital floor exploration have resulted in an incidence of sequelae of 29 (10.3%) in 281 patients. Only one mild loss of visual acuity has complicated the 281 surgical procedures. It is concluded that orbital floor exploration is not indicated in patients with nondisplaced fractures of the orbital floor and that orbital floor exploration is a safe and effective means of reducing the complications associated with displaced fractures of the orbital floor.

Adolescent↗
PubMed1982

Panel discussion: pathogenesis of otitis media. Pathology and microbiology of otitis media.

Otitis media (OM) can be subdivided into purulent, serous, mucoid, and chronic forms. It may occur in the absence of tympanic membrane changes and involve the inner ear. Purulent otitis media is characterized early by edema, hyperemia, and polymorphonuclear leukocyte infiltration in the subepithelial space (SES) and later by mucosal metaplasia, granulation tissue, and osteitis. S. pneumoniae and H. influenza are most commonly identified. Serous and mucoid OM frequently develop from eustachian tube dysfunction. Serous transudate from vessels in the SES passes to the middle ear (serous otitis media). Basal cells differentiate into goblet cells and subepithelial glandular formation occurs. This secretory activity, coupled with fluid reabsorption, results in a mucoid effusion. Bacteria can be cultured from about 30% of these effusions. Chronic otitis media denotes irreversible tissue pathology. It may be sterile although S. aureus and coliform bacteria are frequently isolated.

Animals↗
PubMed1981

Clinical evaluation of Ménière's disease.

A retrospective review of 211 consecutive patients with classic Meniere's disease was performed to determine the efficacy of diagnostic studies. The patients' ages averaged 47 years and ranged between 8 and 86 years. Females outnumbered males 1.3 to 1. Left and right ears were affected with equal frequency and, in 12% of patients, the disease was bilateral. Audiologic patterns were flat in 42%, rising in 7%, peaked in 32%, and sloping downward in the remaining 19%. Electronystagmography was normal in 21% of the patients and demonstrated canal paresis in 65% and directional preponderance in 14%. Studies of glucose metabolism were abnormal in 2 of the 204 patients tested. The 7 patients not tested had a previous diagnosis of diabetes mellitus. Thyroid function studies were abnormal in 1 of the 208 patients studied. The 3 patients not studied were known hypothyroid. FTA-abs was positive in 12 patients and special radiographic studies of the petrous apex were normal in all cases. Conclusions suggested by this study are that audiology, electronystagmography, and treponemal antigen tests for syphilis are cost effective in evaluating patients with Meniere's disease. Studies of glucose metabolism and thyroid function, however, are probably not indicated in patients without a history suggestive of a metabolic disorder and specialized radiographs of the petrous apex should be reserved for patients suspected of having acoustic neuroma.

Adolescent↗
PubMed1980

Silent otitis media.

There is a traditional view that chronic otitis media and chronic mastoiditis must exist in the presence of a tympanic membrane perforation. Based on a human histopathological study of 123 temporal bones with chronic otitis media out of 333 temporal bones with all forms of otitis media pathology, only 24 patients (36 ears) had symptoms of otological disease recorded on their charts and only 19.5% of these had an associated tympanic membrane perforation. Unsuspected findings of chronic otitis media (active or inactive) are occasionally confirmed at exploratory tympanotomy. Such quiet chronic pathological findings in the middle ear have occurred in association with endolymphatic hydrops and cochlear end organ lesions suggesting the possibility that silent chronic otitis media may help explain sensorineural hearing loss, vertigo, and tinnitus for certain patients. We put forth the hypothesis that clinically undetectable silent otitis media in neonates and infants might help explain why certain children are otitis media prone. Our otopathology laboratory includes 111 ears harvested from neonates and infants (average age 8 months). Histological analysis revealed normal findings in some, whereas significant numbers of others show all forms of otitis media, including purulent otitis media, chronic otitis media, serous otitis media, and mucoid otitis media, with occasional overlap of types. Clinical implications will be discussed with emphasis on silent otitis media and its relationship to the pathogenesis of otitis media and silent chronic otitis media and its possible role in causing insidious labyrinthine changes. A significant outcome of this study was the marked degree of unresolved mesenchyme in the clinically manifest otitis media group or silent otitis media group as compared to a control group. This association and role of mesenchyme is discussed relative to the pathogenesis of infantile otitis media.

Child, Preschool↗
PubMed1980

Cricoid chondritis.

Explore the source record for details and available documents.

Cartilage Diseases↗