ASN » Surgery

Spinal fluid-perilymph relationships in patients with vertigo, tinnitus, pressure and hearing fluctuation

admin — Thu, 01 Jan 2004 00:00:00 +0000

Over the last 28 years the author has been fascinated with both Meniere’s disease and patients with perilymphatic fistula (PLF), two conditions which at times closely resemble each other and at times may be indistinguishable. Both conditions manifest themselves with vertigo, tinnitus, pressure or fullness and hearing fluctuation or loss. All of these entities may not be present in each case. Usually but not always there is an obvious “event” which precedes the condition of PLF. Several cases of recurrent PLF after a successful PLF repair have lead the author to perform lumbar puncture on them. As a result he has made the diagnosis of pseudotumor cerebri in eight cases and learned that removal of spinal fluid whether normal or elevated has the potential of rendering patients with an active PLF immediately asymptomatic for a period of hours to months. Therapy ranges from simple oval and round window reinforcement to ventriculo-peritoneal shunting. Several cases will be presented.

Complicaciones intracraneanas de las otitis medias. reporte de un caso

admin — Thu, 01 Jan 2004 00:00:00 +0000

En la actualidad , las complicaciones intracranealas de las afecciones supuradas del oído medio, gracias al correcto tratamiento de las otitis agudas mediante el empleo de antibióticos y la profilaxis y terapeútica adecuada de las otitis crónicas, han disminuído su frecuencia , transformándose en una rareza. Sin embargo es importante tenerlas en cuenta ya que no han desaparecido por completo.
Describiremos el caso clínico de una paciente de 16 años quien comienza con un síndrome meníngeo ,sin respuesta al tratamiento antibiótico, progresa el cuadro con parálisis del VI par, dolor neurálgico en territorio del V par, otorrea bilateral. Su evolución ,diagnóstico y terapeútica instituida

Outcomes from clarion implantation in india

admin — Wed, 01 Jan 2003 00:00:00 +0000

The results of the use of clarion implants in 30 Indian patients have been evaluated. Cases included in the study were prelingual & postlingual patients where the cochlea was normal and prelingual patients where the cochlea had a Mondini defect or was ossified. It was found that multiple speech strategies available with the Clarion implant were a distinct advantage. The postlinguals faired better with Speech discrimination in noise using HiResolution strategy and young prelinguals developed hearing and speech faster using SAS & MPS strategies. Moreover, in Mondini cases all electrodes could be inserted using the enhanced bipolar device.

Geniculate neuralgia: modern management

admin — Wed, 01 Jan 2003 00:00:00 +0000

An uncommon cause of otalgia is geniculate neuralgia. In its most typical form it is characterized by severe paroxysmal neuralgic pain centered directly in the ear. The pain may be of a gradual onset and of a dull, persistent nature, with occasional sharp, stabbing pain. When the pain becomes intractable, an operation to surgically excise the nervus intermedius and geniculate ganglion by the middle cranial fossa approach is indicated. The author has performed this surgery for 97 patients. The purpose of this paper is to review the diagnostic features of geniculate neuralgia and to describe the surgical technique for excision of the nervus intermedius and geniculate ganglion without the production of facial paralysis. This procedure is an effective, specific definitive treatment for intractable geniculate neuralgia.

How does cochlear implantation affect the contralateral vestibular system?

admin — Tue, 01 Jan 2002 00:00:00 +0000

Cochlear implantation has been performed for 16 years by investigators at Semmelweis University. During this period, different types of cochlear implants have been used and, in 30% of cases, hearing was observed to be restored in the nonimplanted ear.
In addition to contralateral hearing improvement, significant improvement was observed in the caloric responsiveness of the nonoperated labyrinth. The preoperative median value of the average slow-phase velocity of the caloric test increased, and the increase was statistically significant on the contralateral side. The reason for this caloric response improvement is unclear, although possible explanations are brain plasticity or presently obscure trophic influence on the vestibular system. Whereas the role of brainstem function in the improvement of the contralateral ear’s caloric response remains unclear, it is also possible that hearing impulses affect the labyrinth. Clearly, the influence of cochlear implants on vestibular function requires further investigation to explain the improvement of contralateral vestibular responsiveness

International Tinnitus Journal – ITJ, go to href="http://www.tinnitusjournal.com/"
target="_new">http://www.tinnitusjournal.com/

A new therapeutic procedure for treatment of objective venous pulsatile tinnitus

admin — Tue, 01 Jan 2002 00:00:00 +0000

Pulsatile tinnitus usually means a turbulent flow within the vessels. We describe a 54-year-old man with a disabling objective pulsatile tinnitus due to a diverticulum of the sigmoid sinus toward the ipsilateral mastoid. We performed a surgical intervention via the endovascular route using coils to obliterate the diverticulum and a stent to avoid coil migration. The patient had a complete and immediate remission of the pulsatile tinnitus. This procedure has been described only in arterial circulation.

International Tinnitus Journal – ITJ, go to href="http://www.tinnitusjournal.com/"
target="_new">http://www.tinnitusjournal.com/