This case report documents a rare case of a subgaleal pneumocele occurring more than 20 years aft... more This case report documents a rare case of a subgaleal pneumocele occurring more than 20 years after cochlear implantation. On presentation, the presence of air under the scalp followed vigorous nose blowing was observed. The patient was treated conservatively with a pressure dressing, which resulted in complete resolution of the surgical emphysema. Only a handful of such cases have been reported in the literature. Most of these cases occur early after cochlear implantation. Our case is even more unique as it occurred 24 years following implantation and presented with a painless swelling associated with deterioration in cochlear implant performance. A review of the current literature is included in the discussion. KEYWORDS: Cochlear implantation, postoperative complications, subcutaneous emphysema
It has been reported, in animal models and recently in human beings, that intravenous fluorescein... more It has been reported, in animal models and recently in human beings, that intravenous fluorescein is taken up in perilymph and may be useful as a tracer for the detection of perilymphatic fistulas. We attempted to reproduce the results of these animal experiments. Twenty-one middle ears of eight cats and four dogs were exposed. Fluorescein was given intravenously. Fluorescence was initially noted in transudates pooling in the oval and round window niches. Fistulas created with a straight pick produced a bright fluorescence in the leaking fluids, possibly from a ruptured small membrane vessel. Fistulas created with the carbon dioxide laser and with complete hemostasis demonstrated no fluorescence. We concluded that intravenously administered fluorescein causes dramatic fluorescence of vessels and transudates that may be interpreted falsely as fluorescence of perilymph. Fluorescence was not evident in perilymph when complete hemostasis was obtained.
Exostosis of the external ear canal is a disease unique to man. It has been identified in prehist... more Exostosis of the external ear canal is a disease unique to man. It has been identified in prehistoric man, affecting the aborigines of the North American continent. Aural exostoses are typically firm, sessile, multinodular bony masses which arise from the tympanic ring of the bony portion of the external auditory canal. These growths develop subsequent to prolonged irritation of the canal. The large, primitive jaw of prehistoric man placed great mechanical stress on the tympanic ring. Chronic aural suppuration seen in the preantibiotic era was soon followed by exostoses. Today, prolonged contact of the external ear canal with cold sea water is the most prevalent cause (aquatic theory). As a result the disease is now essentially limited to coastal regions. In this way we have seen exostoses appear in different stages of the evolution of man as a result of mechanical, chemical and now thermal irritation. The author is an otolaryngologist in a coastal region. In examining 11,000 patients during a ten-year period, 70 cases of symptomatic exostoses of the external auditory canal were identified. The incidence of exostoses was found to be 6.36 per 1,000 patients examined for otolaryngologic disease. It is a predominantly male disease. The development of these "irritation nodules" is painless until the tenth year of aquatic exposure to irritation, when symptoms of obstruction occur. The hearing loss associated with exostoses is usually a conductive type, secondary to occlusion of the canal by impacted cerumen or acute external otitis. The results of studying the thermal characteristics of the body of water used for such aquatic activities is presented.
Closure of the nostril in atrophic rhinitis is a simple operation. Opening the obturated nose by ... more Closure of the nostril in atrophic rhinitis is a simple operation. Opening the obturated nose by excising the obturator membrane very often causes stenosis. A new and effective method for opening the nostrils, by means of flaps, is suggested.
Transtympanic endoscopy provides a unique opportunity to view, undisturbed, the contents of the m... more Transtympanic endoscopy provides a unique opportunity to view, undisturbed, the contents of the middle ear. Flexible and rigid endoscopes with diameters of 2 mm and smaller are now available with adequate resolution to perform exploration of the middle ear. Endoscopes can be introduced through a myringotomy or an existing perforation in the tympanic membrane to examine the middle ear in
This case report documents a rare case of a subgaleal pneumocele occurring more than 20 years aft... more This case report documents a rare case of a subgaleal pneumocele occurring more than 20 years after cochlear implantation. On presentation, the presence of air under the scalp followed vigorous nose blowing was observed. The patient was treated conservatively with a pressure dressing, which resulted in complete resolution of the surgical emphysema. Only a handful of such cases have been reported in the literature. Most of these cases occur early after cochlear implantation. Our case is even more unique as it occurred 24 years following implantation and presented with a painless swelling associated with deterioration in cochlear implant performance. A review of the current literature is included in the discussion. KEYWORDS: Cochlear implantation, postoperative complications, subcutaneous emphysema
It has been reported, in animal models and recently in human beings, that intravenous fluorescein... more It has been reported, in animal models and recently in human beings, that intravenous fluorescein is taken up in perilymph and may be useful as a tracer for the detection of perilymphatic fistulas. We attempted to reproduce the results of these animal experiments. Twenty-one middle ears of eight cats and four dogs were exposed. Fluorescein was given intravenously. Fluorescence was initially noted in transudates pooling in the oval and round window niches. Fistulas created with a straight pick produced a bright fluorescence in the leaking fluids, possibly from a ruptured small membrane vessel. Fistulas created with the carbon dioxide laser and with complete hemostasis demonstrated no fluorescence. We concluded that intravenously administered fluorescein causes dramatic fluorescence of vessels and transudates that may be interpreted falsely as fluorescence of perilymph. Fluorescence was not evident in perilymph when complete hemostasis was obtained.
Exostosis of the external ear canal is a disease unique to man. It has been identified in prehist... more Exostosis of the external ear canal is a disease unique to man. It has been identified in prehistoric man, affecting the aborigines of the North American continent. Aural exostoses are typically firm, sessile, multinodular bony masses which arise from the tympanic ring of the bony portion of the external auditory canal. These growths develop subsequent to prolonged irritation of the canal. The large, primitive jaw of prehistoric man placed great mechanical stress on the tympanic ring. Chronic aural suppuration seen in the preantibiotic era was soon followed by exostoses. Today, prolonged contact of the external ear canal with cold sea water is the most prevalent cause (aquatic theory). As a result the disease is now essentially limited to coastal regions. In this way we have seen exostoses appear in different stages of the evolution of man as a result of mechanical, chemical and now thermal irritation. The author is an otolaryngologist in a coastal region. In examining 11,000 patients during a ten-year period, 70 cases of symptomatic exostoses of the external auditory canal were identified. The incidence of exostoses was found to be 6.36 per 1,000 patients examined for otolaryngologic disease. It is a predominantly male disease. The development of these "irritation nodules" is painless until the tenth year of aquatic exposure to irritation, when symptoms of obstruction occur. The hearing loss associated with exostoses is usually a conductive type, secondary to occlusion of the canal by impacted cerumen or acute external otitis. The results of studying the thermal characteristics of the body of water used for such aquatic activities is presented.
Closure of the nostril in atrophic rhinitis is a simple operation. Opening the obturated nose by ... more Closure of the nostril in atrophic rhinitis is a simple operation. Opening the obturated nose by excising the obturator membrane very often causes stenosis. A new and effective method for opening the nostrils, by means of flaps, is suggested.
Transtympanic endoscopy provides a unique opportunity to view, undisturbed, the contents of the m... more Transtympanic endoscopy provides a unique opportunity to view, undisturbed, the contents of the middle ear. Flexible and rigid endoscopes with diameters of 2 mm and smaller are now available with adequate resolution to perform exploration of the middle ear. Endoscopes can be introduced through a myringotomy or an existing perforation in the tympanic membrane to examine the middle ear in
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Papers by Arun Gadre
KEYWORDS: Cochlear implantation, postoperative complications, subcutaneous emphysema
KEYWORDS: Cochlear implantation, postoperative complications, subcutaneous emphysema