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Cranial nerve paresis following epidural and spinal anesthesia. 硬膜外和脊髓麻醉后脑神经麻痹。
A S Whiting, L N Johnson, D E Martin

Three cases of cranial nerve paresis following epidural and spinal anesthesia are presented. One patient had combined oculomotor and abducens nerve paresis, while the other two patients had solitary abducens nerve pareses. The authors postulate that mechanical traction is the cause of cranial nerve paresis following epidural and spinal anesthesia.

本文报告硬膜外及脊髓麻醉后脑神经麻痹3例。1例合并动眼神经和外展神经麻痹,2例单纯性外展神经麻痹。作者认为机械牵引是硬膜外麻醉和脊髓麻醉后脑神经麻痹的原因。
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引用次数: 0
Re-operation following pars plana vitrectomy for the sequelae of proliferative diabetic retinopathy. 增殖性糖尿病视网膜病变后遗症玻璃体切除后再手术。
G C Brown, W E Benson, W S Tasman, J A McNamara

A review of 306 eyes undergoing pars plana vitrectomy for the complications of proliferative diabetic retinopathy revealed that 26 (8.5%) required a second vitrectomy operation. Among the eyes that required repeat vitrectomy, the eventual visual acuity ranged from 20/20 to 20/400 in 35% and was no light perception in 31%. Reasons for subsequent surgery included recurrent vitreous hemorrhage in 54% of eyes, retinal detachment in 42% and neovascular glaucoma in 4%. Twelve eyes (46%) remained with a permanent retinal detachment despite attempts at surgical repair, and eleven of these twelve eyes subsequently developed rubeosis iridis.

对306只因增殖性糖尿病视网膜病变并发症而行玻璃体切割手术的眼睛的回顾显示,26只(8.5%)需要第二次玻璃体切割手术。在需要重复玻璃体切除术的眼睛中,35%的眼睛最终视力在20/20至20/400之间,31%的眼睛没有光感。术后原因包括复发性玻璃体出血(54%)、视网膜脱离(42%)和新生血管性青光眼(4%)。尽管尝试手术修复,但仍有12只眼(46%)存在永久性视网膜脱离,其中11只眼随后发展为虹膜红肿。
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引用次数: 0
Perilymph fistula. 外淋巴瘘。
Pub Date : 1990-01-01 DOI: 10.4324/9780203450413_perilymph_fistula
T. O. Wilcox, R. A. Hendrix
Perilymph fistula, an abnormal communication between the inner ear and the middle ear, is an enigmatic otologic disorder which may present with auditory or vestibular symptoms. It is typically located at the oval or round windows, but several other locations have been suggested. It may be congenital or spontaneous, or due to trauma or surgery. It often poses a diagnostic dilemma because of the lack of a definitive test. Among the differential diagnoses of the perilymph fistula are Ménière's disease, infection, tumor and central nervous system disorders. Clinically, the definitive diagnosis of a perilymph fistula can only be made by exploratory tympanotomy. A current review of the etiology, diagnosis and management of perilymph fistula is presented.
淋巴管周围瘘是内耳和中耳之间的异常通信,是一种神秘的耳科疾病,可能表现为听觉或前庭症状。它通常位于椭圆形或圆形的窗户上,但也有人建议其他几个位置。它可能是先天性的或自发的,也可能是由于创伤或手术。由于缺乏明确的测试,它经常造成诊断困境。淋巴管周围瘘管的鉴别诊断包括msamimni病、感染、肿瘤和中枢神经系统疾病。临床上,淋巴管周围瘘管的明确诊断只能通过探索性鼓室切开术做出。现就淋巴管周围瘘管的病因、诊断及治疗作一综述。
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引用次数: 0
Treatment of retinoblastoma with photocoagulation. 光凝治疗视网膜母细胞瘤。
J A Shields, C L Shields

The authors summarize their experience and review the pertinent literature on photocoagulation in the treatment of selected patients with retinoblastoma. Photocoagulation appears to be an appropriate method of management in cases where the tumor is no greater than 3.0 mm in diameter and 2.0 mm in thickness and is confined to the sensory retina, without seeding into the adjacent vitreous. Photocoagulation alone is generally unsuccessful for tumors greater than 4.5 mm in diameter and greater than 2.5 mm in thickness and supplemental treatment with other modalities was often necessary in such cases. Based on personal observations the authors point out certain misconceptions regarding photocoagulation of retinoblastoma and define their current indications and contraindications for this treatment modality.

作者总结了他们的经验,并对光凝治疗视网膜母细胞瘤的相关文献进行了综述。当肿瘤直径不大于3.0 mm,厚度不大于2.0 mm,且局限于感觉视网膜,而没有扩散到邻近的玻璃体时,光凝似乎是一种合适的治疗方法。对于直径大于4.5 mm,厚度大于2.5 mm的肿瘤,单独光凝治疗通常是不成功的,在这种情况下,通常需要其他方式的辅助治疗。基于个人观察,作者指出了一些关于光凝治疗视网膜母细胞瘤的误解,并定义了目前这种治疗方式的适应症和禁忌症。
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引用次数: 0
Branchial cleft anomalies: a five-year retrospective review. 鳃裂异常:五年回顾性回顾。
J F Kenealy, A J Torsiglieri, L W Tom

Branchial cleft cysts, sinuses and fistulas are among the most commonly encountered congenital anomalies in pediatric otolaryngic practice. They can present difficulties in differential diagnosis and surgical management. In order to study the clinical presentation and surgical management of branchial cleft anomalies, the operative records of the Children's Hospital of Philadelphia (CHOP) were reviewed for a five year period, January 1, 1982 through December 31, 1986. All patients with a pathologically-confirmed post-operative diagnosis of a branchial cleft anomaly were included in a retrospective chart review. Their case histories were studied to determine symptoms upon presentation, presence or absence of drainage, type of lesion, site of lesion, characteristics of the lesion, accuracy of pre-operative diagnosis, recurrence and complications. A total of 71 patients, 39 males and 32 females, underwent surgical excision of a branchial cleft cyst, sinus or fistula during the study period. There were 23 branchial cleft cysts, 50 sinuses and 3 fistulas. A correct pre-operative diagnosis was established in 60 (85%) of the patients, being highest for patients with branchial cleft fistulas. Incorrect pre-operative diagnoses included thyroglossal duct cyst, cervical lymphadenitis, dermoid, dermal inclusion cyst, lymphangioma and malignant neoplasm. The clinical presentation, pre-operative evaluation, pitfalls in diagnosis, surgical management and post-operative complications are discussed and strategies for the management of branchial cleft anomalies are presented.

鳃裂囊肿、鼻窦和瘘管是小儿耳鼻喉科实践中最常见的先天性异常。它们会给鉴别诊断和手术治疗带来困难。为了研究鳃裂畸形的临床表现和外科治疗,我们回顾了费城儿童医院(CHOP) 1982年1月1日至1986年12月31日的5年手术记录。所有术后病理确诊为鳃裂异常的患者均纳入回顾性图表回顾。我们研究了他们的病例史,以确定出现时的症状、有无引流、病变类型、病变部位、病变特征、术前诊断的准确性、复发和并发症。在研究期间,共有71例患者接受了鳃裂囊肿、窦或瘘的手术切除,其中男性39例,女性32例。其中鳃裂囊肿23例,窦50例,瘘管3例。60例(85%)患者的术前诊断正确,其中鳃裂瘘患者的诊断率最高。术前错误诊断包括甲状舌管囊肿、颈淋巴管炎、皮样囊肿、皮包涵囊肿、淋巴管瘤和恶性肿瘤。本文讨论了鳃裂畸形的临床表现、术前评估、诊断陷阱、手术处理和术后并发症,并提出了处理策略。
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引用次数: 0
Invasive diagnostic techniques for uveitis and simulating conditions. 葡萄膜炎的侵入性诊断技术及模拟条件。
J J Augsburger

Many patients with uveitis have such characteristic ocular signs and symptoms, associated systemic disorders, and laboratory abnormalities that a satisfactory clinical diagnosis can be established without the need for invasive intraocular studies. Most other patients with uveitis have mild, self-limited and/or readily controllable disease that does not warrant aggressive invasive testing. In contrast, some patients with uveitis have atypical ophthalmic and/or systemic features or do not respond to conventional antiinflammatory therapies. Such patients may be candidates for invasive diagnostic testing. In this paper, the author describes the techniques of aqueous aspiration, vitreous aspiration, diagnostic vitrectomy, fine-needle aspiration biopsy, controlled aspiration of subretinal fluid, incisional chorio-retinal biopsy and diagnostic enucleation employed in selected patients with uveitis or a simulating condition. The author stresses the potential risks as well as benefits of the different invasive diagnostic techniques and emphasizes the limited indications for these procedures.

许多葡萄膜炎患者具有特征性的眼部体征和症状、相关的全身性疾病和实验室异常,因此无需侵入性眼内检查即可建立满意的临床诊断。大多数其他葡萄膜炎患者病情轻微,自限性和/或容易控制,不需要进行积极的侵入性检查。相反,一些葡萄膜炎患者具有不典型的眼部和/或全身特征,或对常规抗炎治疗无反应。这类患者可能需要进行侵入性诊断测试。在本文中,作者描述了水吸、玻璃体吸、诊断性玻璃体切除术、细针穿刺活检、控制视网膜下液吸、切口绒毛膜-视网膜活检和诊断性摘除术等技术在葡萄膜炎或模拟条件下的应用。作者强调了潜在的风险以及不同的侵入性诊断技术的好处,并强调了这些程序的有限适应症。
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引用次数: 0
Laser supraarytenoidectomy for laryngomalacia with apnea. 激光杓上切除术治疗喉软化伴呼吸暂停。
L I Katin, J A Tucker

Laryngomalacia, the most common congenital abnormality of the larynx, is a mild self-limiting disorder in the vast majority of cases. Severely obstructive cases do occur. In the past, these have required treatment with a tracheotomy. At St. Christopher's Hospital for Children, laryngomalacia was diagnosed in one-hundred and fifty-three infants during the three-year period from 1986 through 1988. Patients who had unusually severe symptoms, such as apneic spells, impaired ability to eat and severe choking episodes, were evaluated with four channel nasal thermister pneumocardiograms (sleep studies). Four infants with severe laryngomalacia had sleep studies which demonstrated obstructive apnea. In these infants, the carbon dioxide laser was used to vaporize excess floppy supraarytenoid tissue, a supraarytenoidectomy.

喉软化症是喉最常见的先天性畸形,在绝大多数情况下是一种轻微的自限性疾病。严重阻塞的病例也会发生。在过去,这些需要气管切开术治疗。在圣克里斯托弗儿童医院,从1986年到1988年的三年时间里,153名婴儿被诊断出患有喉软化症。有异常严重症状的患者,如呼吸暂停期、进食能力受损和严重窒息发作,用四通道鼻腔热敏器气肺心动图进行评估(睡眠研究)。四名患有严重喉软化症的婴儿进行了睡眠研究,证实了阻塞性呼吸暂停。在这些婴儿中,二氧化碳激光被用于汽化多余的松散的杓上组织,即杓上切除术。
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引用次数: 0
A new orbital implant to increase prosthetic motility following enucleation. 一种新的眶内植入物以增加假体在去核后的运动能力。
J C Flanagan
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引用次数: 0
Adenoma and adenocarcinoma of the middle ear and mastoid cavity. 中耳和乳突腔的腺瘤和腺癌。
H V Girdhar-Gopal, D O Mikaelian
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引用次数: 0
Inverted papillomas of the nasal septum. 鼻中隔内翻性乳头状瘤。
C K Bacon, R A Hendrix

The inverted papilloma is a true neoplasm of the nose and paranasal sinuses with unusual biological and clinical characteristics. It is a benign process which exhibits certain malignant features such as recurrence, localized destruction of tissues and the possibility of malignant degeneration. Inverted papillomas occur most commonly on the lateral nasal wall, but a small percentage are discovered elsewhere including the ethmoid and sphenoid sinuses, the nasopharynx and the nasal septum. Controversy exists about whether septal papillomas are true inverted papillomas or whether they represent the more commonplace squamous papillomas found in the upper respiratory tract. Two case reports of inverted papillomas of the nasal septum are presented as well as a review of the literature on these neoplasms.

内翻性乳头状瘤是一种真正的鼻和鼻窦肿瘤,具有不同寻常的生物学和临床特征。它是一种良性过程,但具有一定的恶性特征,如复发、局部组织破坏和恶性变性的可能性。内翻性乳头状瘤最常见于鼻壁外侧,但也有一小部分见于其他部位,包括筛窦、蝶窦、鼻咽和鼻中隔。关于鼻中隔乳头状瘤是真正的内翻性乳头状瘤还是代表上呼吸道常见的鳞状乳头状瘤存在争议。本文报告了两例鼻中隔内翻性乳头状瘤的病例,并对有关这些肿瘤的文献进行了综述。
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Transactions - Pennsylvania Academy of Ophthalmology and Otolaryngology
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