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- Möller, Claes, 1950-, et al.
(författare)
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The plasticity of compensatory eye movements in bilateral vestibular loss : a study with low and high frequency rotatory tests
- 1989
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Ingår i: Acta Oto-Laryngologica. - : Informa UK Limited. - 0001-6489 .- 1651-2251. ; 108:5-6, s. 345-354
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Tidskriftsartikel (refereegranskat)abstract
- Twelve subjects with bilateral vestibular loss, with a mean age of 27 years (18-49) were studied. The loss was based on symptoms of oscillopsia and ice-water caloric tests. Nine subjects were evaluated by low-frequency sinusoidal harmonic acceleration (SHA) rotatory tests (0.01-0.32 Hz), and 3 subjects with high broad-frequency band rotatory tests (0.25-3.25 Hz). During alertness tests (darkness) all subjects had absent or very low gains. When tested with a stationary light in the middle of the swing, the SHA tests showed perfect compensatory eye movements with gains of 1 and phases of approximately 0 degrees. In the broad-frequency test, the gain was near 1 below 1 Hz, decreasing rapidly at higher frequencies. In imaginary stationary target tests (darkness), the gain was enhanced to 'normal' values (0.5) with a phase lead in the low-frequency range (SHA). This could not be replicated in the high-frequency tests. Testing with stationary acoustic guidance (darkness), further enhanced the gain in the SHA tests. A small increase of gain could also be found in the high-frequency tests. Compensatory eye movements, when tested in low-frequency rotatory tests (less than 1 Hz), are to a large extent influenced by non-vestibular mechanisms. By voluntary modifications, normal gains could be produced by patients with 'bilateral vestibular loss'. The phase lead found is proposed to be of central non-vestibular origin. Testing in higher frequency ranges (greater than 1 Hz) could not replicate these findings, thus the broad-frequency band rotatory test should be preferred for adequate vestibular quantification.
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| 2. |
- Hanner, P, et al.
(författare)
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Clinical observations of effects on central nervous system in patients with acute facial palsy.
- 1987
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Ingår i: Archives of otolaryngology--head & neck surgery. - 0886-4470. ; 113:5, s. 516-20
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-eight consecutive patients with acute unilateral facial palsy were examined with special reference to clinical signs of central nervous system involvement. The clinical investigation in the acute stage of the disease showed that only seven patients had solitary facial nerve dysfunction, while the remaining patients had evidence of more widespread disease involvement. The most frequent finding was a trigeminal dysfunction of the paretic side, as shown by paresthesia and sensibility disturbance corresponding to the sensoritrigeminal area, as well as a dysfunction of the trigeminal component of the corneal reflex of the paretic side. Three patients showed migrating symptoms that were suggestive of a brain-stem disorder. In addition, four patients had an optic neuropathy, while an abnormal brain-stem audiometry response was demonstrated in five patients. The outcome of acute facial palsy one to two years after onset, however, could not be predicted from the clinical central nervous system signs. The degree of the palsy in the acute stage of the disease still seemed to be one of the most important prognostic factors. It is concluded that acute facial palsy is not a single entity, but rather a feature of different neurologic conditions.
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| 6. |
- Söderberg, Ove, 1942-
(författare)
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Transmyringeal middle ear ventilation : an experimental approach to evaluation of its benefits and consequences
- 1985
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- A prerequisite for a functioning middle ear is an air-filled middle ear cavity. Aeration of the middle ear cavity is controlled by the Eustachian tube. Dysfunction of the Eustachian tube has long been acknowledged as a significant etiological factor in disorders of the middle ear, especially middle ear effusions. Artificial ventilation of the middle ear through the tympanic membrane has been practised for almost two centuries, but with varying degrees of success. In 1954, Armstrong reintroduced the method of inserting a transmyringeal tympanostomy tube into the ear drum. Since that time this ventilatory device has gained wide popularity and several types of tube have been designed. However, an increasing number of clinical reports have shown treatment with tympanostomy tubes to be followed by complications such as tympanosclerosis, atrophy, persistent perforations and cholesteatomas.In the present thesis, experiments were outlined in which the tympanostomy tube - tympanic membrane interaction was studied and in which tympanostomy tubes were also applied in a well-defined type of otitis media. Furthermore, alternative transmyringeal ventilatory procedures such as myringotomies with a delayed healing time were investigated. The results were evaluated with morphological and microbiological methods.Repeated tympanostomy tube insertions in ears of healthy rats caused a remarkable thickening (about 30-fold) of the tympanic membrane of the tubulated quadrants, but even the untouched quadrants were affected. The thickened areas were characterized mainly by an increase in dense connective tissue which also contained sclerotic plaques. The structural changes in the tympanic membrane were still present 3 months after the final ventilation episode.Cleavage of the rat soft palate caused an immediate accumulation of effusion material in the tympanic cavity due to disturbance of Eustachian tube function. The fluid turned purulent within one to two weeks. The microbial flora of the middle ear cavity correlated well with that of the nasopharynx, indicating an ascending infection. Insertion of a tympanostomy tube could prevent the accumulation of effusion material in the meso- and hypotympanon and significantly suppress bacterial growth in the middle ear cavity.Thermal energy-inflicted myringotomies were tested as an alternative method for establishing transmyringeal ventilation. Myringotomies performed either with a CCL-laser or by diathermy showed a delayed healing pattern, most probably due to widespread destruction of the outer keratinized squamous epithelium and damage to the vascular supply. Upon comparison, laser myringotomies appeared more favourable due to their longer closure times, whereas the perforations accomplished by diathermy were often complicated by otorrhea and showed more advanced structural changes.
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