Biomedical subjects

W O'Mara

Publications and source records attributed to W O'Mara.

5 recordsLinked to original sources

PubMed2001

Anatomic considerations in vestibular neuritis.

HYPOTHESIS: The authors believe that anatomic differences render the superior division of the vestibular nerve more susceptible to injury during vestibular neuritis. The purpose of the study was to investigate anatomic differences between the superior vestibular nerve and singular nerve canals. BACKGROUND: Previous studies of temporal bones have revealed vestibular nerve degeneration in patients with vestibular neuritis. Although the cause of this degeneration has not been established, it has been noted that the superior division of the vestibular nerve is preferentially affected, with sparing of the inferior division. The superior vestibular nerve and the singular nerve, a branch of the inferior vestibular nerve, both pass through canals interlaced with bony networks before reaching the peripheral receptors. METHODS: The authors performed histologic analysis of 40 normal temporal bones randomly selected from their temporal bone library. With a micrometer, measurements were taken of the individual canals. The ratio of the total bony spicule component to the total canal width was obtained for both the superior vestibular nerve and the singular nerve. The length of the canals was also measured. Arteriole:arteriolar canal ratios of the superior vestibular nerve and singular nerve were obtained. RESULTS: The bony channel of the singular nerve had an average length of 0.59 mm, and the average length of the superior vestibular nerve was 2.30 mm (p < 0.001). The ratio of total bony spicule width to total canal width was significantly smaller (p < 0.05) for the singular nerve (0.30 mm) compared with the superior vestibular nerve (0.34 mm). The arteriole: arteriolar canal ratio was significantly smaller (p < 0.05) for the singular nerve (0.45 mm) than for the superior vestibular nerve (0.54 mm). CONCLUSION: The bony canal of the superior vestibular nerve is longer than the singular nerve canal. Additionally, the superior vestibular nerve and arteriole travel through a relatively narrower passage than the singular nerve and its vascular supply. From an anatomic standpoint, this renders the superior division of the vestibular nerve more susceptible to entrapment and possible ischemic labyrinthine changes.

Humans↗

PubMed2001

Carcinomas of unknown primary in the head and neck.

In approximately 3% to 5.5% of patients presenting with squamous cell carcinoma metastasis to the cervical lymph nodes, the primary source remains elusive despite extensive evaluation and biopsy. The presenting symptom of a unilateral neck mass is initially evaluated with a complete history and physical. This is followed by flexible endoscopy, fine needle aspiration, laboratory and imaging studies and directed biopsies of the upper aerodigestive tract. While the initial attempt fails to locate the primary site, it will eventually become manifest in 20% to 40% of patients. Early identification decreases overall morbidity and mortality. This article summarizes contemporary diagnostic approaches, current imaging techniques, the role of tonsillectomy, and the management and outcomes of carcinoma of unknown primary.

Carcinoma, Squamous Cell↗

PubMed2000

External laryngeal trauma.

External laryngeal trauma, blunt or penetrating, is a rare but potentially life-threatening injury. This is frequently seen in multiple-trauma patients and can go unrecognized in the absence of astute clinical awareness. Injuries may range from small endolaryngeal hematomas or lacerations to complete laryngotracheal separation. Proper airway management is of utmost importance and is one of the most controversial aspects of treatment of laryngeal trauma. Flexible fiberoptic laryngoscopy and high resolution computed tomography scanning of the larynx has greatly enhanced the evaluation of these injuries. Treatment options range from conservative, nonsurgical observation to evaluation in the operating room. Surgical intervention may involve endoscopy, open surgical exploration, and possibly laryngeal stenting. Long-term goals are aimed at maintaining voice, airway, and swallowing ability. A systematic approach to this condition often results in predictable and acceptable outcomes.

Female↗

PubMed1999

Management of the preauricular sinus.

The preauricular sinus is a relatively common physical finding especially in the pediatric population. It is defined as a congenital lesion in which a small skin opening located in front of the external ear communicates with a subcutaneous network of cysts. The vast majority are benign in nature and require no intervention. Draining sinus tracts are prone to infection and should be excised. Complete excision of the pit and sinus tract provides the only definitive cure. To prevent problematic recurrence, we recommend wide exposure of the lesion by the technique described.

Branchial Region↗

PubMed1998

Anomalies of the branchial apparatus.

Developmental abnormalities of the branchial apparatus represent a common cause of congenital lateral neck mass. Most often this is seen in the pediatric population but certainly may present at a much later age. The branchial apparatus contributes to major development of the head and neck, and a thorough understanding of embryology and anatomy is essential in treating these patients. Branchial anomalies may present as a cyst, sinus, or fistula; infection frequently complicates successful long-term management. Most often these lesions can be diagnosed by thorough history and physical examination. Complete surgical excision is the treatment of choice; however, recurrences may be encountered especially in those patients with a history of prior surgery or local infection.

Branchial Region↗