RESUMO
The aim of this study was to evaluate a new method to measure urethral resistance among 66 women with urinary incontinence. A stainless steel sphere attached to a guide wire was developed. The sphere is inserted into the bladder and withdrawn through the urethra at a steady rate. Serial measurements with spheres of 5, 6 and 7 mm were performed. The mean urethral resistance as measured by the largest sphere (0.07+/-0.03) was significantly greater than that measured by the medium sphere (0.06+/-0.02, p<0.0001), which was significantly larger than that measured by the smallest sphere (0.04+/-0.01, p<0.0001). There was good correlation of urethral resistance with maximum urethral closure pressure (MUCP) by this technique, but no correlation with Valsalva leak point pressure (VLPP).
Assuntos
Uretra/fisiologia , Incontinência Urinária por Estresse/diagnóstico , Urodinâmica , Adulto , Idoso , Desenho de Equipamento , Feminino , Humanos , Pessoa de Meia-Idade , Pressão , Manobra de ValsalvaRESUMO
INTRODUCTION: Vestibular nerve section is considered to be the most effective surgical procedure for control of intractable symptoms secondary to labyrinthine and eighth nerve function. This study was developed to retrospectively evaluate the efficacy of vestibular nerve section in patients treated for disabling labyrinthine dysfunction. METHODS: A retrospective review of hospital and office records was carried out on 39 patients who underwent vestibular nerve section. All patients received a comprehensive questionnaire to subjectively evaluate efficacy. RESULTS: Questionnaires were returned from 36 of 39 patients. Follow-up averaged 51 months. A decrease in vertiginous attacks was reported by 94% of patients. An improvement in activity tolerance was reported by 30% of patients. Preoperative tinnitus and ear fullness reportedly improved after surgery in 53% and 65% or patients respectively. Complications encountered included cerebrospinal fluid (CSF) leak (six patients), meningitis (two patients), and intracranial fluid collection (one patient). CONCLUSION: Vestibular nerve section is a relatively safe and effective method of treatment for intractable vertigo.
Assuntos
Doenças do Labirinto/cirurgia , Nervo Vestibular/cirurgia , Atividades Cotidianas , Otorreia de Líquido Cefalorraquidiano/etiologia , Tontura/cirurgia , Feminino , Audição , Transtornos da Audição/etiologia , Humanos , Masculino , Doença de Meniere/cirurgia , Pessoa de Meia-Idade , Satisfação do Paciente , Complicações Pós-Operatórias , Estudos Retrospectivos , Zumbido/etiologia , Vertigem/cirurgia , Doenças Vestibulares/cirurgia , Doenças do Nervo Vestibulococlear/cirurgiaRESUMO
The giant cholesterol cyst is a clinical entity distinct from cholesterol granulomas and other destructive lesions of the petrous bone. Preoperative assessment by computed tomographic scan and magnetic resonance imaging is extremely helpful. Attempts at total resection of the lesion are not necessary. Adequate surgical drainage may be established through the mastoid or middle fossa.
Assuntos
Cistos Ósseos/diagnóstico , Osso Petroso/cirurgia , Adolescente , Cistos Ósseos/complicações , Cistos Ósseos/cirurgia , Colesterol , Doenças dos Nervos Cranianos/etiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osso Petroso/diagnóstico por imagem , Osso Petroso/patologia , Tomografia Computadorizada por Raios XRESUMO
Because of unsatisfactory results in treatment of malignant conditions of the temporal bone, a technique for total en bloc resection of the temporal bone and carotid artery was reported by Graham et al. in 1984. The procedure involves resection of the internal carotid artery, cranial nerves VI through XII, and structures adjacent to the temporal bone. Experience with two additional cases led to numerous modifications in the recommended procedure, as reported by Sataloff and Myers. Additional clinical experience with this technique and its complications has resulted in further modification. Additional pitfalls and specific changes in technique from previous reports are discussed in detail, including a new procedure to assure the adequacy of contralateral venous outflow.