Bilateral acute coalescent mastoiditis in an immunocompromised infant with a rare leukocyte adhesion deficiency.
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Acute Disease↗
Biomedical subjects
W Y Adkins
Publications and source records attributed to W Y Adkins.
Gender-specific effects of medicinal drugs on hearing levels of older persons.
As part of a large-scale study of presbyacusis, responses to a medicinal drug questionnaire from 85 female and 126 male human subjects were analyzed. Medicinal drugs were divided into 35 categories based on their pharmacologic effects. Subjects' ages ranged from 60 to 82 years. At least 10% of subjects reported taking drugs in 14 of 35 categories. Results were significantly different between female and male subjects. In men, none of the 14 categories showed a statistically significant relation to the pure-tone average (PTA) of 500, 1000, 2000, and 4000 Hz. In women, 3 of the 14 categories showed a statistically significant relation to the PTA. First, the average PTA of female subjects taking beta-adrenergic medication was 20 dB higher (poorer) than those not taking beta-adrenergic medication. Second, women taking antihistamine/cold preparations had an average PTA 9 dB higher (poorer) than those not taking antihistamine/cold preparations. Third, the average PTA of women taking calcium-channel blockers (CCBs) was 12 dB lower (better) than those not taking CCBs. In men, however, these drugs produced effects on the PTA of less than 3 dB. Differences between women and men were not explainable by differences in age or hearing level.
Adrenergic beta-Agonists↗
Analysis of blood chemistry and hearing levels in a sample of older persons.
OBJECTIVE: As part of an ongoing study of presbyacusis, the relationship between blood chemistry levels and hearing levels was investigated. Previous reports often used small sets of blood chemistry measures, and results were inconclusive. This experiment examined hearing levels and 27 measures of blood chemistry using various univariate and multivariate statistical procedures. DESIGN: Blood from 89 female and 128 male human subjects was collected. Subjects' ages ranged from 60 to 82 yr, and hearing levels ranged from normal to moderate/severe. Subjects with a history of middle ear disease were excluded. Electrolyte panel (Na, K, Cl, CO2, Ca, urea nitrogen, glucose, creatinine, and Mg), hematology panel (WBC, RBC, Hgb, hematocrit, platelet, etc.), serum lipids (total cholesterol, low-density lipoprotein [LDL], and high-density lipoprotein [HDL]), immunoglobulins (IgG, IgA, IgM, and IgE), and thyroxine were analyzed using univariate and multivariate statistical procedures. RESULTS: Blood chemistry levels of most subjects were within normal ranges as defined by our laboratory. Correlation between blood chemistry measures and pure-tone averages (PTAs) ranged from minimal to low. Results of factor analysis, discriminant analysis, and canonical analysis showed that combining blood chemistry measures from the same panel still could not predict PTA effectively. One exception to this was a gender-specific effect of cholesterol. Hearing levels of women with high LDL/HDL ratios were 5 dB better than those of women with low LDL/HDL ratios. The comparable difference in men was only 1 dB. CONCLUSION: Results suggest that blood chemistry measures that are primarily within the normal range have very little value in predicting pure-tone thresholds in older subjects.
Age Factors↗
Congenital cholesteatomas in the tympanic membrane.
The etiology of congenital middle ear (ME) cholesteatomas is unclear. One etiologic possibility of ME cholesteatoma may be progression of a congenital tympanic membrane (TM) cholesteatoma. We recently have encountered three cases of congenital tympanic membrane cholesteatoma. Each child, ages 1, 3, and 14 years, presented with cholesteatoma of the tympanic membrane extending into the middle ear. These children have not had previous otologic surgery including myringotomy, nor had they had repeated middle ear infections, perforation, or trauma. Neither the 3-year-old nor 14-year-old child complained of hearing loss. Audiograms demonstrated only a mild conductive loss. Each child underwent excision with tympanoplasty. Although the middle ear component of the cholesteatoma was always more extensive than the pearl seen, the point of attachment was the TM and not the middle ear. This demonstrates one possible source for congenital cholesteatomas.
Adolescent↗
The differential diagnosis of Meniere's disease.
The diagnosis of "classic" Meniere's disease is easy to make. Unfortunately, Meniere's disease is a diagnosis of exclusion and many disease entities can mimic Meniere's disease. Thus, it is essential to eliminate other possible etiologic agents for complaints that could be related to Meniere's disease before making this diagnosis. This article evaluates the differential diagnosis in Meniere's disease.
Audiometry, Pure-Tone↗
Reduced mastoidectomy complications with an open meatoplasty stent.
Open-tube stents were compared with standard petroleum gauze packs in meatoplasties after canal-wall-down mastoid surgery to determine whether any difference existed in postoperative complications. Tube stents were associated with much lower incidences of postoperative meatoplasty stenosis and postauricular wound complications in this series.
Adolescent↗
Intrasphenoidal encephalocele.
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Encephalocele↗
Management of trauma of the facial nerve.
The general principles of management of trauma to the facial nerve from a variety of causes are presented and the indications for and timing of surgery are reviewed. Attention is given to management techniques unique to injuries of the extracranial, intratemporal, and intracranial divisions of the nerve.
Cranial Nerve Diseases↗
Persistent stapedial artery supplying a glomus tympanicum tumor.
Vascular anomalies of the middle ear are extremely rare. The most common anomaly is a persistent stapedial artery. This artery is important clinically because of the risk of profuse bleeding during middle ear surgery. We describe a 26-year-old woman with a glomus tympanicum tumor. The blood supply to the tumor was from a persistent stapedial artery. A preoperative angiogram supported this finding by demonstrating a small vessel originating from the anterior branch of the middle meningeal artery as the major vascular supply to the tumor. To our knowledge, this is the first case report of a glomus tympanicum tumor vascularized by a persistent stapedial artery that was suggested by angiography and confirmed intraoperatively. To better understand this anomaly, we review the embryological development of the stapedial artery and discuss its clinical significance.
Adult↗
Upward spread of masking, hearing loss, and speech recognition in young and elderly listeners.
Upward spreading of masking, measured in terms of absolute masked threshold, is greater in hearing-impaired listeners than in listeners with normal hearing. The purpose of this study was to make further observations on upward-masked thresholds and speech recognition in noise in elderly listeners. Two age groups were used: One group consisted of listeners who were more than 60 years old, and the second group consisted of listeners who were less than 36 years old. Both groups had listeners with normal hearing as well as listeners with mild to moderate sensorineural loss. The masking paradigm consisted of a continuous low-pass-filtered (1000-Hz) noise, which was mixed with the output of a self-tracking, sweep-frequency Bekesy audiometer. Thresholds were measured in quiet and with maskers at 70 and 90 dB SPL. The upward-masked thresholds were similar for young and elderly hearing-impaired listeners. A few elderly listeners had lower upward-masked thresholds compared with the young control group; however, their on-frequency masked thresholds were nearly identical to the control group. A significant correlation was found between upward-masked thresholds and the Speech Perception in Noise (SPIN) test in elderly listeners.
Adolescent↗
Composite autograft for tympanoplasty and tympanomastoid surgery.
In 1982, 40 composite cartilage perichondrial autografts performed to prevent recurrent cholesteatoma secondary to canal wall defects were reviewed. A follow-up of those cases, plus 62 new cases, as well as the composite autografts for severe tympanic membrane retractions (55 cases) and selected tympanoplasties (22 cases) is presented. No recurrent cholesteatomas or retraction pockets developed at the graft sites, with one graft failure in the latter group.
Adolescent↗
The use of pentoxifylline in a pig random skin flap model.
Pentoxifylline, the first drug in a new class of rheologic agents, has enhanced skin flap survival in previous rat models. In an attempt to find an animal model more similar to the human, a trial using a pig skin flap model was undertaken. Experimental animals received oral pentoxifylline for 21 days. Random skin flaps were elevated on the 14th day, and flap viability was determined on the 21st day. Similar flaps were raised on control animals. Serum fibrinogen levels, platelet aggregation studies, and erythrocyte flexibilities were measured in both groups. No improvement in flap viability or rheologic properties of the blood were shown in the pentoxifylline-treated animals. Although no enhancement of skin flap survival was demonstrated, future studies are warranted. Implications for future investigation and clinical application are discussed.
Animals↗
Dizziness: current evaluation.
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Dizziness↗
The use of the carbon dioxide laser in head and neck lymphangioma.
The carbon dioxide laser has been used to treat various lesions of the head and neck, ranging from carcinomas to hemangiomas, and even including tatoos. A search of the literature does not reveal any reports of the carbon dioxide laser being used to treat lymphangioma. This report discusses the efficacy of treating lymphangioma of the air and food passages with the carbon dioxide laser, and presents three patients who have been treated in this fashion-two for palliation and one for cure.
Carbon Dioxide↗
Temporal bone showing polyarteritis nodosa, otosclerosis, and occult neuroma.
The clinical and general histopathologic manifestations of systemic vasculitis of the polyarteritis nodosa type are well known. Although hearing loss associated with polyarteritis nodosa has been reported, only two temporal bone studies are available. The findings in a 60-year-old man with well-documented hearing loss who had rheumatoid arthritis, polyarteritis nodosa, and otosclerosis are presented. Polyarteritis nodosa extensively involved the subarcuate arteries and arteries of the facial canal. There were decreased nerve fibers to and sensory cells in the crista of the semicircular canals and macula of the utricle and saccule. Focal and diffuse atrophy of the stria vascularis and decreased cellularity in the spiral prominence and ligament were present. There was a loss of outer hair cells. Otosclerosis involved the left and right oval window niches (bilateral stapedectomy had been performed). There was a small Antoni type A neuroma of the superior division of the vestibular nerve on the left.
Hearing Loss, Bilateral↗
Carotid arteriospasm.
Arteriospasm can result from manipulation or fresh blood around an artery. This myogenic reflex can spread to obliterate collateral flow and can last from minutes to days. Ischemic strokes from carotid spasm ensue neurosurgical procedures, endarterectomies, and even chiropractic manipulation. The diagnosis and prevention of arteriospasm are presented, and a patient who has carotid arteriospasm following excision of a branchial cleft cyst is detailed. If the vessel constriction is noted at surgery, topical application of a local anesthetic is effective. Transfusion, hydration, oxygenation, and maintenance of blood pressure are the cornerstones of nonoperative therapy.
Adult↗
Use of a composite autograft to prevent recurrent cholesteatoma caused by canal wall defects.
Recurrent cholesteatoma following atticotomy or combined-approach tympanoplasty remains a significant problem. The importance of closing defects created by surgery or disease in the posterosuperior bony canal is recognized, and numerous materials and techniques have been advocated. Our experience with a composite autograft of tragal cartilage and perichondrium in 40 ears is presented after 1 to 6 years follow-up. The composite autograft performed satisfactorily in 38 cases. In no case did recurrent cholesteatoma develop at the site of a defect that had been obliterated by the autograft.
Adolescent↗
Type I tympanoplasty: influencing factors.
Type I tympanoplasties utilizing an underlay technique with temporalis fascia performed at the Medical University associated hospitals over a 5-year period were reviewed. Cases were excluded if follow-up was less than 18 months or if a previous tympanoplasty had been performed. The remaining 71 cases, 40 adults and 25 children, were analyzed for influencing factors. The overall success rate was 89%. The age of the patient, the length of time the ear had been dry, and the presence of infection at the time of surgery had no influence on the success rate. The two factors which adversely influenced the success rate were the presence of a near total or total perforation and the presence of bilateral perforations.
Adolescent↗