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At least 145 records · Page 8Linked to original sources
PubMed1986

Perilymphatic fistulas: are they exclusive to the round and oval windows?

Eleven patients suspected of having perilymphatic fistulas were evaluated. A perilymphatic fistula was demonstrable in ten of these patients. In six patients, fistulas of one of the windows, or both were found. In two patients, combined fistulas of both the round window and lateral semicircular canal were found. In two other patients, fistulas were found only in the lateral semicircular canal. The patients in whom fistulas were found and repaired improved dramatically. The patient without a demonstrable fistula remained symptomatic. We have shown that perilymphatic fistulas can occur in the lateral semicircular canal, and suggest exploring this area when indicated.

Adult↗
PubMed1992

Auditory performance of children with cochlear ossification and partial implant insertion.

The management of the profoundly deaf child with a cochlear implant poses a special challenge, particularly when total ossification of the cochlea is present. In this setting, insertion of an electrode array into a child's cochlea is often difficult. Our experience supports the feasibility of partial insertion of a multichannel implant into the basal turn of an ossified cochlea. Five children with ossified cochleae who had undergone partial implantation of a multichannel electrode were compared with the performance of matched controls who had full insertion of multichannel implants. No dramatic differences were detected during a 6- to 18-month follow-up period on selected test measures. These preliminary results suggest that active electrode number may exert a limited effect on performance with a cochlear implant. Drilling out the basal turn of an ossified cochlea in conjunction with partial insertion of a multichannel implant appears to be an acceptable surgical and rehabilitational alternative for placement of a cochlear implant prosthesis in children with complete cochlear ossification.

Adolescent↗
PubMed1993

Ossification patterns of the tympanic facial canal in the human fetus and neonate.

Dehiscences in the bony facial canal are comparatively common in the human adult. The highest incidence occurs in the tympanic segment of the facial nerve near the region of the oval window. Thirty-three fetal temporal bones, ranging from 16 to 40 weeks' gestation, and four from 1, 2, 4 and 12 weeks' postpartum neonates, were studied to evaluate the normal patterns of ossification of the fallopian canal of the tympanic facial nerve segment in the human. The tympanic facial nerve segment elongates three-fold during this period (from 1 mm to 3 mm). The ossification starts at 21 weeks' gestation anteriorly from apical otic ossification centers and at 26 weeks from canalicular ossification centers near the stapedius muscle. The ossification proceeds in an anterior-to-posterior direction as two periosteal shelves of bone surround the facial nerve. The superior periosteal bony ledge contributes 75% of the circumference of the fallopian canal. The anterior ossification center forms over 83% of the fallopian canal length. The two centers fuse post partum near the region of the oval window. The anatomic location of the facial nerve, nerve branching, and neural vasculature precede ossification. In 80% of the paired temporal bones, this ossification pattern appears to be symmetrical. The patterns and incidence of bony dehiscences within the tympanic fallopian canal segment can be explained by these observations. This study demonstrates that fallopian canal dehiscences are not congenital anomalies, but variations of normal developmental anatomic processes.

Cartilage↗
PubMedDate not supplied

Clinical and experimental studies on the incorporation of materials applied as covering for the labyrinth window.

From among the materials used for covering the labyrinth window, of the foreign materials gelfoam proved ideal from clinical and experimental points of view, while of the materials of interstitial origin, fascia, perichondrium, and periosteum seem to be suitable for covering the labyrinth window, resp. for transplantations in the tympanic cavity.

Adipose Tissue↗
PubMed1994

Postoperative recurrence of perilymphatic fistulas.

Postoperative follow-up study of perilymphatic fistulas (PLFs) showed that recurrence of PLF was not rare and revision was sometimes needed to relieve the symptoms associated with leakage of perilymph. Of the 54 PLF patients surgically treated in our clinic, some sign or symptom of recurrence was found in 9 cases (17%). Vertigo accompanied by spontaneous or positional nystagmus was noted in all 9 cases, while only 3 complained of exacerbation of the existing hearing loss. Revision was indicated in 3 patients since they had no predisposition to spontaneous healing. Various etiological and underlying factors contributed to the incidence of recurrence. Careful operative procedures together with strict postoperative management are required for surgical treatment of PLF.

Adolescent↗
PubMed1994

Endoscopic diagnosis of idiopathic perilymphatic fistula.

The usefulness of endoscopic examination for the diagnosis of idiopathic perilymphatic fistula (IPLF) was investigated. Eight patients presenting with unilateral sensorineural hearing loss and vertigo underwent endoscopic examination by the transtubal or transtympanic approach. In 5 out of the 8 patients, transtubal endoscopy was carried out using a superfine flexible endoscope. With this approach, no abnormal findings were visualized. A perilymphatic leak from the round window was observed in 2 patients by means of transtympanic examination using a needle scope. These findings were confirmed in both patients by microscopic observation during tympanotomy. In one patient who was finally diagnosed with IPLF, the transtympanic endoscopy failed to detect perilymphatic leakage. Although incision of the tympanic membrane is necessary for the examination, transtympanic endoscopy is useful for the diagnosis of IPLF. Further improvement of the superfine flexible fiberscope is necessary before transtubal observation of the tympanic cavity can be effectively conducted.

Adult↗
PubMed1984

Extracochlear electrical stimulation.

Extracochlear electrical stimulation was carried out in 7 patients. We used square-wave signals. Electrode positions at the oval and round window showed the lowest current thresholds. The threshold of sound sensations elicited by electrical stimulation was higher in the high frequency than in the low frequency range. All 7 patients had hearing sensations for electrical stimulation with frequencies from 75 Hz to 1 000 Hz, 4 of them to 3 000 Hz. Varying the frequency of the electric signals gave variations of pitch sensation. A higher input amplitude gave variation in pitch sensation in some patients even if the electric frequency remained constant, at least for frequencies below 500 Hz. It seems possible to give prosodic information by transforming the speech from a microphone into electric pulses. This may be especially valuable information of the intelligibility of speech when combined with lip reading.

Auditory Threshold↗
PubMed1999

Does otosclerosis occur only in the temporal bone?

HYPOTHESIS: Otosclerosis does not occur outside the temporal bone. BACKGROUND: The widely accepted assumption that otosclerosis is confined to the temporal bone has never been tested. It is important to investigate this issue, particularly because of evidence that otosclerosis may be a systemic (genetic) disease that could affect other bones. METHODS: Biopsies from 9 to 11 skeletal sites were obtained from 2 patients with clinical otosclerosis. Two hundred forty-one nontemporal bone sections were examined by light microscopy. RESULTS: No nontemporal skeletal bone section showed histologic evidence of otosclerosis. The data indicate, with 95% confidence, that the true prevalence of otosclerosis in the extratemporal skeleton of the 2 patients examined was < 3%. CONCLUSIONS: These findings suggest that otosclerosis is unlikely to occur outside the temporal bone. Factors unique to the otic capsule that may predispose it to otosclerosis are lack of bone remodeling and the presence of globuli interossei.

Adult↗
PubMed1999

[Postoperative complication in stapedectomy: excessive introduction of the prothesis in the oval window].

Postoperative failures and complications detected in patients who undergo surgery for otosclerotic disease are not uncommon in stapes surgery. Prosthesis displacement and incus necrosis are the most common findings in review stapedectomy. We report the case of a patient who had tinnitus, vertigo, and non-recovery of air conduction thresholds without neurosensorial lesions after stapes surgery. The suspected diagnosis of excessive introduction of the prosthesis in the oval window was confirmed by computed tomography, which showed the radio-opaque image of the McGee metal prosthesis. The prosthesis replacement and literature review are discussed.

Female↗
PubMed2001

[From the concept of permanent percutaneous connections to that of permanent percutaneous electrical connections].

Percutaneous abutment of an extra-oral implant provides two main functions: support of bone anchored hearing aid (BAHA) and fixing maxillofacial prosthesis (MFP). Further developing this concept, and using available surgical strategies and materials, leads to a new application in extra-oral implantology. We analyzed the evolution of concepts in the field of permanent percutaneous connection (PPC) to the new concept of PPEC (permanent percutaneous electric connection), presenting a clinical case.

Biocompatible Materials↗
PubMed1992

Surgical management of perilymphatic fistulas: a Portland experience.

A comprehensive review of our series of surgical perilymphatic fistula (PLF) repairs, as well as a review of published results from other otologists, suggested an unacceptably high rate of postoperative PLF recurrence. Some recurrences were related to specific events (i.e., coughing, strenuous activity, Valsalva-type maneuvers). However many cases had no apparent cause. Rather, the patients' symptoms recurred spontaneously, and at reoperation the graft was seen to have not "taken," suggesting graft failure rather than "patient failure." After a critical evaluation of current PLF surgical procedures and state-of-the-art concepts of wound healing, we developed a new surgical technique for PLF closure. Combining the use of laser graft-site preparation, an autologous fibrin glue "buttress," and a program of postoperative activity restriction, the new procedure allowed us to achieve statistically significant improvements in graft retention and surgical outcome, with recurrences dropping from 27 percent to 8 percent. In addition, complete resolution or significant symptomatic improvement occurred in 89 percent of patients with vertigo and/or dizziness and in 84 percent with disequilibrium. We conclude that this new surgical technique is an important addition to the otologic surgeon's arsenal for PLF management.

Adolescent↗
PubMed2006

Oval window fistula.

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Cochlear Implantation↗