ABSTRACT
OBJECTIVES: To assess the efficacy of anterior tagging of graft material with respect to graft uptake and hearing results, in type I tympanoplasty. STUDY DESIGN: Prospective, randomised, cohort study. METHODS: Sixty patients with chronic otitis media of the mucosal type, with pars tensa perforations, were included in the study. Patients were randomly allocated to two groups: group one underwent type one tympanoplasty with anterior tagging, while group two underwent type one tympanoplasty without anterior tagging. Follow up included evaluation of graft uptake and hearing improvement. RESULTS: There were 33 patients in group one and 27 patients in group two. The overall incidence of successful graft uptake was 96.96 per cent in group one and 81.5 per cent in group two. Closure of central and posterior perforations was successful in 100 per cent of both groups. Closure of anterior and subtotal perforations was successful in 95.45 per cent of group one and 54.54 per cent of group two. CONCLUSION: Type one tympanoplasty with anterior tagging of graft material is a suitable technique for anterior and subtotal perforations.
Subject(s)
Graft Survival/physiology , Otitis Media/surgery , Tympanic Membrane Perforation/surgery , Tympanoplasty/methods , Adolescent , Adult , Bone Conduction , Chronic Disease , Fasciotomy , Female , Hearing/physiology , Humans , Male , Prospective Studies , Treatment Outcome , Young AdultABSTRACT
The caloric test response from the unaffected ear in a case of acoustic neuroma may be normal, hypoactive or hyperactive; each has a different pathophysiological connotation: a normal response is the anticipated finding; a hyperactive contralateral response is due to the presence of a large neuroma with brainstem compression; and a hypoactive response may result from several factors, such as lack of mental alertness during the test, drugs like barbiturates, raised intracranial tension, or the presence of bilateral neuromas.
Subject(s)
Ear/physiopathology , Neuroma, Acoustic/physiopathology , Caloric Tests , Female , Humans , MaleABSTRACT
The bithermal caloric test remains, four decades after its first description, the single most valuable test of vestibular function. However, there are several variations described in the exact procedure of caloric stimulation and in the method of evaluating and representing the test results. For the past 10 years, we have followed a procedure using a constant standardized stimulus and a particular system for caloric nystagmus representation, viz., the Butterfly Chart, and have found it to be very satisfactory. This paper describes our experience with the use of the Butterfly Chart and its clinical application in over 4,500 cases.
Subject(s)
Caloric Tests/methods , Vestibular Function Tests/methods , Adult , Data Display , Female , Humans , Male , Middle Aged , Nystagmus, Pathologic/diagnosisSubject(s)
Neuroma, Acoustic/diagnosis , Caloric Tests , Electronystagmography , Evaluation Studies as Topic , Female , Humans , MaleABSTRACT
It has been reported that a very commonly overlooked cause of vertigo is disorder of glucose metabolism. This may not be reflected in the glucose tolerance test alone, but becomes obvious when the insulin levels in blood are evaluated simultaneously. Thirty-one patients with Meniere's disease underwent a 5-hour glucose tolerance test with radioimmune assay of insulin. The results were compared with the normal and abnormal patterns suggested by Kraft. On this basis, it was found that 67.7% of our patients showed some abnormality in the relationship between the blood levels of glucose and insulin. These patients were put on a special diet with a limited carbohydrated content prescribed by a qualified dietitian. The effect of this diet was highly variable and the possible reasons for this are also discussed.
