Subject(s)
Borrelia burgdorferi/isolation & purification , Eye Infections, Bacterial/diagnosis , Inflammation/diagnosis , Lyme Disease/diagnosis , Eye Infections, Bacterial/complications , Eye Infections, Bacterial/microbiology , Humans , Inflammation/etiology , Lyme Disease/complications , Lyme Disease/microbiologyABSTRACT
We report 2 cases illustrating the use of a new technique to manage vitreous loss during phacoemulsification, which we have termed 'trimanual' anterior vitrectomy. In each case, after recognizing posterior capsule tear, the remaining nuclear pieces were removed with low-parameter phacoemulsification. The remaining cortical material was then removed using bimanual irrigation and aspiration handpieces while the assistant surgeon inserted the vitrectomy probe through a separate 1-mm limbal incision. The vitrectomy probe was held below the plane of the posterior capsule tear, used to cut the vitreous and to provide a mechanical blockade to potentially descending lens material. While this technique involves the potentially awkward simultaneous use of 3 intraocular instruments, we believe that there are several advantages over standard bimanual anterior vitrectomy.
Subject(s)
Bone Diseases, Developmental/diagnostic imaging , Bone Diseases, Developmental/therapy , Craniofacial Abnormalities/diagnostic imaging , Craniofacial Abnormalities/therapy , Hyperostosis/diagnostic imaging , Hyperostosis/therapy , Hypertelorism/diagnostic imaging , Hypertelorism/therapy , Nasal Obstruction/diagnostic imaging , Nasal Obstruction/therapy , Diagnosis, Differential , Humans , Infant , Male , Tomography, X-Ray ComputedABSTRACT
OBJECTIVES/HYPOTHESIS: To compare three different inoculation techniques for the development of cytomegalovirus (CMV)-induced sensorineural hearing loss (SNHL) in a mouse model. STUDY DESIGN: A prospective experimental animal study. METHODS: BALB/c mice underwent inoculation using green fluorescent protein-expressing mouse cytomegalovirus (mCMV-GFP) via transtympanic (TT), intraperitoneal (IP), or intracranial (IC) routes. Control mice received an equal volume of saline. Hearing thresholds were measured using both distortion product otoacoustic emissions (DPOAE) and evoked auditory brainstem response studies (ABR). Cochleas were harvested for histological examination and cytocochleogram. RESULTS: No mice in the TT or IP groups showed significant hearing loss. All infected mice in the IC group showed significantly elevated ABR and DPOAE thresholds at 4 weeks of age. Ten mice (55%) had profound hearing loss (≥80 dB) at 4 weeks of age, while the other eight mice (45%) initially showed moderate hearing loss (≤20 dB), which progressed to profound hearing loss by 6 to 8 weeks. Asymmetric hearing loss was seen in 40% of the mice. Temporal bone histology showed diffuse loss of outer hair cells (OHC). Green fluorescent protein (GFP)-labeled virus was abundant in the spiral ganglion and adjacent to the scala tympani at the basal region of the cochlea at 7 days postinjection, and devoid of GFP labeling by 14 days postinfection. CONCLUSIONS: Intracerebral injection of mCMV preferentially causes mCMV-mediated hearing loss relative to IP or TT injections. These results are consistent with the hearing loss reported in human congenital infection and may have implications for understanding the pathophysiology of CMV-mediated labyrinthitis.
