PubMed · 11085122
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N Taguchi. 2000. [Under water exercise].. https://pubmed.ncbi.nlm.nih.gov/11085122/
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OBJECTIVE: to determine the occurrence of the unusual side effect of a reparative granuloma after the implantation of a pure gold piston in cases of otosclerosis. STUDY DESIGN: a retrospective case review study of 475 stapes operations with a pure gold piston. SETTING: Department of Otorhinolaryngology of the University of Amsterdam, The Netherlands and the HNO clinic in Luenen (Brambauer) in Germany. PATIENTS: four hundred and seventy five patients (328 women, 147 men, average age: 45.2 years), who clinically and per-operatively had otosclerosis, underwent a stapedotomy using a pure gold piston prosthesis. Therapeutic intervention: in cases of suspicion of a reparative granulomas or those cases that did not have improvement of the hearing after the stapedotomy, a re-operation by transcanal approach was performed. RESULTS: in seven cases a reparative granuloma was diagnosed by this revision surgery. The postoperative incidence of these granulomas following stapedotomy using the pure gold piston turned out to be 1.5%. CONCLUSION: reparative granulomas can occur after stapedotomy with a pure gold stapes piston although the incidence is low. The role of grafting material to seal the oval window niche and the treatment of these reparative granulomas following stapes surgery are discussed.
A case is presented of a child who initially presented with genuine aural symptoms and pathology. Over a period of time it became apparent that the persistent aural bleeding, which is an uncommon feature of Chronic Suppurative Otitis Media, was the result of trauma inflicted by its mother; a case of Munchausen syndrome by proxy (MSBP).
A novel machine learning system, Galactica, has been developed for knowledge discovery from databases. This system was applied to discover diagnostic rules from a patient database containing 564 cases with vestibular schwannoma, bening paroxysmal positional vertigo, Ménière's disease, sudden deafness, traumatic vertigo and vestibular neuritis diagnoses. The rules were evaluated using an independent testing set. The accuracy of rules for these diagnoses were 91%, 96%, 81%, 95%, 92% and 98%, respectively. Besides being accurate, the rules contained the five most important diagnostic questions identified in the earlier research. The knowledge presented with rules can be easily comprehended and verified.