Showing papers by "William F. House published in 1980"

Menière's disease and endolymphatic hydrops: clinical-histopathological correlations.

Abstract: The clinical-histopathological correlation between Meniere's disease and endolymphatic hydrops was done to explain, as much as possible, causes of symptoms of Meniere's disease. Twenty-three temporal bones with endolymphatic hydrops from 17 patients were reviewed and clinical and histopathological findings were correlated. Histopathological examination revealed frequent, severe deformities in the labyrinthine walls and permanent changes in Reissner's membranes. Evidence of rupture was difficult to assess. Of 21 ears of patients with the clinical diagnosis of Meniere's disease, 93% had endolymphatic hydrops. A statistical correlation between increased area of the cochlear duct and hearing loss was found. Some correlation was also found between frequency of vertigo and results of electronystagmography with histopathological findings. Consequently, the mechanical effect of endolymphatic hydrops seems to have greater significance in the production of symptoms of Meniere's disease than the biochemical effect of ruptures. In a review of ten unusual cases from this series of 17 patients, traumatic neuromas or remnants of vestibular structures were found after an incomplete labyrinthectomy. Histopathological findings of four patients who had undergone endolymphatic subarachnoid shunt surgery are described.

A warning regarding the sitting position for acoustic tumor surgery.

Abstract: Recently, five cases of quadriplegia following surgery for removal of an acoustic tumor have come to our attention. Although complete details of each case are not available, all of these patients had in common being operated on in the sitting position, and awakening from anesthesia with midcervical quadriplegia. To our knowledge, this complication of acoustic tumor surgery has not previously been reported. This surgical disaster apparently is the result of direct prolonged focal pressure on the cervical spinal cord. In one case, postmortem examination showed acute diffuse infarction of the midcervical cord, possibly related to a preexisting asymptomatic spondylitic bar at the level of the infarction. There are several features of suboccipital craniectomies carried out in the sitting position that can potentiate the effects of pressure on the cervical cord. After the induction of general anesthesia and placement of the patient in the sitting position, the patient's head is

Neurotologic Manifestations of the Osteopetroses

Abstract: • Facial nerve paralysis or symptoms of audiovestibular nerve dysfunction may be the first indication of one of the group of bone diseases known as the osteopetroses We describe three such patients The pathophysiology of these diseases and the treatment of the resulting symptoms of facial and audiovestibular nerve dysfunction are discussed ( Arch Otolaryngol 106:210-214, 1980)

Scanning and transmission electron microscopy of the rugose portion of the human endolymphatic sac--a preliminary report.

Abstract: The rugose portion of two human endolymphatic sacs--one from a Meniere's disease patient, the other from a patient who underwent removal of an eighth nerve tumor and had no other evidence of inner ear disease--has been examined by scanning and transmission electron microscopy. The only morphological finding that distinguished the normal from the Meniere's disease specimen was more folds in the epithelium of the normal sac. Two types of cells have been distinguished in the two sacs through both scanning and transmission electron microscopy: cuboidal-to-columnar cells with a convex luminal surface and microvilli, and squamous cells with a flat luminal surface and microvilli. Qualitative differentiation of the two specimens according to frequency of cellular type or difference in cellular or microvillar morphology was not possible. Observations of this study on the epithelial morphology of the rugose portion did not correspond with descriptions of the epithelial morphology in animals. It is, therefore, tentatively concluded that the morphology of the rugose portion of the human endolymphatic sac is different from that of animals. This study suggests that scanning electron microscopy can be used to determine the number and location of cell types and/or the quantity of microvilli in the rugose portion of the endolymphatic sac. Comparison of measurements of normal endolymphatic sacs and those from Meniere's disease patients may demonstrate significant differences.

Pressure sensation in Meniere's disease.

Abstract: This article reports a case of Meniere's disease accompanied by a persistent feeling of pressure in the ear. The patient had undergone a series of surgical procedures to alleviate his symptoms. The pressure sensation was relieved only by translabyrinthine cochlear nerve section. The relationships of the result of translabyrinthine cochlear nerve section with the mechanism and pathway of the pressure sensation are discussed. Cochlear nerve section is recommended at the same time as vestibular nerve section for patients with unilateral Meniere's disease with severe pressure sensation in the ear.