Cochlear Implants
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Bedside Neuro-Otological Examination and Interpretation of Commonly
J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.2004.054478 on 24 November 2004. Downloaded from BEDSIDE NEURO-OTOLOGICAL EXAMINATION AND INTERPRETATION iv32 OF COMMONLY USED INVESTIGATIONS RDavies J Neurol Neurosurg Psychiatry 2004;75(Suppl IV):iv32–iv44. doi: 10.1136/jnnp.2004.054478 he assessment of the patient with a neuro-otological problem is not a complex task if approached in a logical manner. It is best addressed by taking a comprehensive history, by a Tphysical examination that is directed towards detecting abnormalities of eye movements and abnormalities of gait, and also towards identifying any associated otological or neurological problems. This examination needs to be mindful of the factors that can compromise the value of the signs elicited, and the range of investigative techniques available. The majority of patients that present with neuro-otological symptoms do not have a space occupying lesion and the over reliance on imaging techniques is likely to miss more common conditions, such as benign paroxysmal positional vertigo (BPPV), or the failure to compensate following an acute unilateral labyrinthine event. The role of the neuro-otologist is to identify the site of the lesion, gather information that may lead to an aetiological diagnosis, and from there, to formulate a management plan. c BACKGROUND Balance is maintained through the integration at the brainstem level of information from the vestibular end organs, and the visual and proprioceptive sensory modalities. This processing takes place in the vestibular nuclei, with modulating influences from higher centres including the cerebellum, the extrapyramidal system, the cerebral cortex, and the contiguous reticular formation (fig 1). -
Research Reports
ARAŞTIRMALAR (ResearchUnur, Ülger, Reports) Ekinci MORPHOMETRICAL AND MORPHOLOGICAL VARIATIONS OF MIDDLE EAR OSSICLES IN THE NEWBORN* Yeni doğanlarda orta kulak kemikciklerinin morfometrik ve morfolojik varyasyonları Erdoğan UNUR 1, Harun ÜLGER 1, Nihat EKİNCİ 2 Abstract Özet Purpose: Aim of this study was to investigate the Amaç: Yeni doğanlarda orta kulak kemikciklerinin morphometric and morphologic variations of middle ear morfometrik ve morfolojik varyasyonlarını ortaya ossicles. koymak. Materials and Methods: Middle ear of 20 newborn Gereç ve yöntem: Her iki cinse ait 20 yeni doğan cadavers from both sexes were dissected bilaterally and kadavrasının orta kulak boşluğuna girilerek elde edilen the ossicles were obtained to investigate their orta kulak kemikcikleri üzerinde morfometrik ve morphometric and morphologic characteristics. morfolojik inceleme yapıldı. Results: The average of morphometric parameters Bulgular: Morfometrik sonuçlar; malleus’un toplam showed that the malleus was 7.69 mm in total length with uzunluğu 7.69 mm, manibrium mallei’nin uzunluğu 4.70 an angle of 137 o; the manibrium mallei was 4.70 mm, mm, caput mallei ve processus lateralis arasındaki and the total length of head and neck was 4.85 mm; the uzaklık 4.85 mm, manibrium mallei’nin ekseni ve caput incus had a total length of 6.47 mm, total width of 4.88 mallei arasındaki açı 137 o, incus’un toplam uzunluğu mm , and a maximal distance of 6.12 mm between the 6.47 mm, toplam genişliği 4.88 mm, crus longum ve tops of the processes, with an angle of 99.9 o; the stapes breve’nin uçları arasındaki uzaklık 6.12 mm, cruslar had a total height of 3.22 mm, with stapedial base being arasındaki açı 99.9 o, stapesin toplam uzunluğu 2.57 mm in length and 1.29 mm in width. -
Temporal Bone, Normal Anatomy, Computed Tomography/Histology
Temporal Bone Normal Anatomy Computed Tomography /Histology Correlation Otopathology Laboratory Department of Radiology Massachusetts Eye and Ear Eric F. Curtin Barbara J. Burgess Dianne D. Jones Jennifer T. O’Malley Hugh D. Curtin MD Otopathologylaboratory.org Facial nerve Malleus Incus Cochlea Lateral canal Oval Window Axial CT Red Arrow -Facial nerve VII Attic IAC Vest LSCC Red Arrow -Facial nerve VII M I M-Malleus I-Incus Vest Cochlea S-Stapes VII S Interscalar septum M M-Modiolus Interscalar septum M M-Modiolus Anterior epitympanic recess Cog Cochleariform process Cochlea Facial recess S-Stapes Pyramidal process S Sinus Tympani ME ME-middle ear RW-round window Cochlea RW Stapedius M Carotid TMJ plate Jugular plate Coronal CT FN 2 FN 1 Cochlea Carotid Malleus Tegmen Incus FN 2 Oval window Scutum Lateral Semicircular Canal Pyramidal process Round Window Jugular Facial Nerve Key image lateral canal facial nerve oval window .. Poschl CT Carotid Tensor tympani Eustachian tube VII1 IAC Basilar turn cochlea Apical turn cochlea Turn 2 cochlea VII1 VII2 Tensor tympani VII2 Jugular vein Tensor tympani Jugular vein Cochleariform process Superior SCC M M-malleus VII2 Oval W Round W Lateral canal Common crus TMJ Lateral SCC VII2 I S I –Incus S- Stapes Tegmen Vestibular aqueduct VII2 VII3 EAC Stenvers CT SSCC VII1 Carotid VII1 is separated from nerve to lateral canal by Bill’s bar Canal for nerve to lateral SCC VII VII1 Basilar turn cochlea LSCC SSCC VII3 Round window Styloid process Vestibule VII3 PSCC Common Crus IAC Axial CT Histology correlation Utricle Lateral Semicircular Canal Vestibule Vestibule Saccule Utricle Vestibule Saccule Utricle Vestibule Saccule Utricle Anterior Crus of the Stapes Carotid Tympanic Carotid plate membrane Middle Ear Jugular Jugular plate Coronal CT Histology correlation Saccule Otopathology Laboratory Department of Radiology Massachusetts Eye and Ear Otopathologylaboratory.org Eric F. -
The Nervous System: General and Special Senses
18 The Nervous System: General and Special Senses PowerPoint® Lecture Presentations prepared by Steven Bassett Southeast Community College Lincoln, Nebraska © 2012 Pearson Education, Inc. Introduction • Sensory information arrives at the CNS • Information is “picked up” by sensory receptors • Sensory receptors are the interface between the nervous system and the internal and external environment • General senses • Refers to temperature, pain, touch, pressure, vibration, and proprioception • Special senses • Refers to smell, taste, balance, hearing, and vision © 2012 Pearson Education, Inc. Receptors • Receptors and Receptive Fields • Free nerve endings are the simplest receptors • These respond to a variety of stimuli • Receptors of the retina (for example) are very specific and only respond to light • Receptive fields • Large receptive fields have receptors spread far apart, which makes it difficult to localize a stimulus • Small receptive fields have receptors close together, which makes it easy to localize a stimulus. © 2012 Pearson Education, Inc. Figure 18.1 Receptors and Receptive Fields Receptive Receptive field 1 field 2 Receptive fields © 2012 Pearson Education, Inc. Receptors • Interpretation of Sensory Information • Information is relayed from the receptor to a specific neuron in the CNS • The connection between a receptor and a neuron is called a labeled line • Each labeled line transmits its own specific sensation © 2012 Pearson Education, Inc. Interpretation of Sensory Information • Classification of Receptors • Tonic receptors -
Endoscopic Treatment of Middle Ear Myoclonus with Stapedius and Tensor Tympani Section: a New Minimally-Invasive Approach
British Journal of Medicine & Medical Research 4(17): 3398-3405, 2014 SCIENCEDOMAIN international www.sciencedomain.org Endoscopic Treatment of Middle Ear Myoclonus with Stapedius and Tensor Tympani Section: A New Minimally-Invasive Approach Natasha Pollak1*, Roya Azadarmaki2 and Sidrah Ahmad1 1Department of Otolaryngology–Head and Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA. 2Metropolitan NeuroEar Group, Rockville, Maryland, USA. Authors’ contributions This work was carried out in collaboration between all authors. Author NP designed study, performed surgery, literature review, writing, reviewing. Author RA literature review, writing, reviewing. Author SA performed surgery, writing, reviewing. All authors read and approved the final manuscript. Received 26th January 2014 th Case Study Accepted 11 March 2014 Published 27th March 2014 ABSTRACT Aims: We describe a new, entirely endoscopic surgical technique for treatment of middle ear myoclonus. Case Presentation: In our patient, the stapedius and tensor tympani tendons were sectioned to control chronic middle ear myoclonus. The procedure was performed using endoscopic ear surgery techniques, with the aid of rigid Hopkins rod endoscopes. Control of the pulsatile tinnitus was achieved after endoscopic tenotomy of the stapedius and tensor tympani, without any complications. Discussion and Conclusion: Endoscopic tensor tympani and stapedius tendon section is a new, minimally invasive treatment option for middle ear myoclonus that should be considered as a first line surgical approach in patients who fail medical therapy. The use of an endoscopic approach allows for easier access and vastly superior visualization of the relevant anatomy, which in turn allows the surgeon to minimize dissection of healthy tissue for exposure. The entire operation, including raising the tympanomeatal flap and tendon section can be safely completed under visualization with a rigid endoscope with good control of the pulsatile tinnitus. -
Axial Skeleton 214 7.7 Development of the Axial Skeleton 214
SKELETAL SYSTEM OUTLINE 7.1 Skull 175 7.1a Views of the Skull and Landmark Features 176 7.1b Sutures 183 7.1c Bones of the Cranium 185 7 7.1d Bones of the Face 194 7.1e Nasal Complex 198 7.1f Paranasal Sinuses 199 7.1g Orbital Complex 200 Axial 7.1h Bones Associated with the Skull 201 7.2 Sex Differences in the Skull 201 7.3 Aging of the Skull 201 Skeleton 7.4 Vertebral Column 204 7.4a Divisions of the Vertebral Column 204 7.4b Spinal Curvatures 205 7.4c Vertebral Anatomy 206 7.5 Thoracic Cage 212 7.5a Sternum 213 7.5b Ribs 213 7.6 Aging of the Axial Skeleton 214 7.7 Development of the Axial Skeleton 214 MODULE 5: SKELETAL SYSTEM mck78097_ch07_173-219.indd 173 2/14/11 4:58 PM 174 Chapter Seven Axial Skeleton he bones of the skeleton form an internal framework to support The skeletal system is divided into two parts: the axial skele- T soft tissues, protect vital organs, bear the body’s weight, and ton and the appendicular skeleton. The axial skeleton is composed help us move. Without a bony skeleton, we would collapse into a of the bones along the central axis of the body, which we com- formless mass. Typically, there are 206 bones in an adult skeleton, monly divide into three regions—the skull, the vertebral column, although this number varies in some individuals. A larger number of and the thoracic cage (figure 7.1). The appendicular skeleton bones appear to be present at birth, but the total number decreases consists of the bones of the appendages (upper and lower limbs), with growth and maturity as some separate bones fuse. -
THE OSSIFICATION of the MIDDLE and INTERNAL EAR of the GOLDEN HAMSTER (Cricetus Auratus)
THE OSSIFICATION OF THE MIDDLE AND INTERNAL EAR OF THE GOLDEN HAMSTER (Cricetus auratus) WILLIAM CAMPBELL VAN ARSDEL III A THESIS submitted to OREGON STATE COLLEGE in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE June 1951 Redacted for privacy Assistant Professor of Zoo10 In Charge of Major Redacted for privacy Head of Department of Zoolor Redacted for privacy Chair!nan of School Graduate Conittee Redacted for privacy Dean of Graduate School Date thesis is presented / If7 Typed by Mary Adams ACKNOWLEDGEMENT I wish to express my appreciation to Dr. Howard H. Hillemann for suggesting this problem and for the generous amount of time and valuable guidance which he has given during the period of this study. TABLE OF CONTENTS Page Introduction ................................................. i Materials and Methods ......................................... 2 Observations ................................................. 2 Malleus: Ossification .................................. 2 Malleus: Anatomy ....................................... 5 Mafleus: Ossiculum accessoriurn mallei .................. 6 Incus: Ossification .................................... 7 Incus: Anatomy ......................................... 8 Stapes: Ossification ................................... 8 Stapes: Anatomy ........................................ 9 Ectotympanic: Ossification and Derivatives ............ 10 Internal ear: Ossification ............................. 12 Hyold arch elements associated with the ear ............. 15 Table -
Mechanisms of High Sensitivity and Active Amplification in Sensory Hair Cells a Dissertation Presented to the Faculty of The
Mechanisms of High Sensitivity and Active Amplification in Sensory Hair Cells A dissertation presented to the faculty of the College of Art and Sciences of Ohio University In partial fulfillment of the requirements for the degree Doctor of Philosophy Mahvand Khamesian August 2018 © 2018 Mahvand Khamesian. All Rights Reserved. 2 This dissertation titled Mechanisms of High Sensitivity and Active Amplification in Sensory Hair Cells by MAHVAND KHAMESIAN has been approved for the Department of Physics and Astronomy and the College of Art and Sciences by Alexander B. Neiman Professor of Physics and Astronomy Joseph Shields Dean of College of Arts and Sciences 3 Abstract KHAMESIAN, MAHVAND, Ph.D., August 2018, Physics Mechanisms of High Sensitivity and Active Amplification in Sensory Hair Cells (118 pp.) Director of Dissertation: Alexander B. Neiman Hair cells mediating the senses of hearing and balance rely on active mechanisms for amplification of mechanical signals. In amphibians, hair cells exhibit spontaneous self-sustained mechanical oscillations of their hair bundles. In addition to mechanical oscillations, it is known that the electrical resonance is responsible for frequency selectivity in some inner ear organs. Furthermore, hair cells may show spontaneous electrical oscillations of their membrane potentials. In this dissertation, we study these mechanisms using a computational modeling of the bullfrog sacculus, a well-studied preparation in sensory neuroscience. In vivo, hair bundles of the bullfrog sacculus are coupled by an overlying otolithic membrane across a significant fraction of epithelium. We develop a model for coupled hair bundles in which non-identical hair cells are distributed on a regular grid and coupled mechanically via elastic springs connected to the hair bundles. -
Pathway of a Sound Wave
Pathway of a Sound Wave 1. The sound waves arrive at the pinna (auricle), the only visible part of the ear. 2. Once the sound waves have passed the pinna, they move into the auditory canal (external acoustic meatus) before hitting the tympanic membrane (eardrum). 3. Once the sound waves reach the tympanic membrane, it begins to vibrate and they enter into the middle ear. 4. The vibrations are transmitted further into the ear via three bones (ossicles): malleus (hammer), incus (anvil), and the stapes (stirrup). These three bones form a bridge from the tympanic membrane to the oval window. 5. Once sound passes through the oval window, it enters into the cochlea in the inner ear. 6. Hair cells in the organ of Corti (within the cochlea) are stimulated which in turn stimulates the cochlear branch of the vestibulocochlear nerve. 7. The cochlear nerve then transmits electrical impulses to the auditory region of the brain in the temporal lobe. Pathway of a Sound Wave 1. The sound waves arrive at the pinna (auricle), the only visible part of the ear. 2. Once the sound waves have passed the pinna, they move into the auditory canal (external acoustic meatus) before hitting the tympanic membrane (eardrum). 3. Once the sound waves reach the tympanic membrane, it begins to vibrate and they enter into the middle ear. 4. The vibrations are transmitted further into the ear via three bones (ossicles): malleus (hammer), incus (anvil), and the stapes (stirrup). These three bones form a bridge from the tympanic membrane to the oval window. -
Characterization of the Inherent Electrophysiology of Zebrafish Hair Cells and the Effect of Mutations in Met Channel Candidate Genes
CHARACTERIZATION OF THE INHERENT ELECTROPHYSIOLOGY OF ZEBRAFISH HAIR CELLS AND THE EFFECT OF MUTATIONS IN MET CHANNEL CANDIDATE GENES By KAYLA JEANNE KINDIG Submitted in partial fulfillment of the requirements for the degree of Master of Science Thesis Advisor: Dr. Brian McDermott Jr. Department of Biology CASE WESTERN RESERVE UNIVERSITY May 2019 CASE WESTERN RESERVE UNIVERSITY SCHOOL OF GRADUATE STUDIES We hereby approve the thesis/dissertation of Kayla Kindig candidate for the degree of Master of Science*. Committee Chair Nicole Crown Committee Member Brian McDermott Committee Member Ruben Stepanyan Committee Member Hillel Chiel Committee Member Susan Burden-Gulley Date of Defense March 22nd, 2019 *We also certify that written approval has been obtained for any proprietary material contained therein. 1 Table of Contents List of Tables.......................................................................................................................3 List of Figures.....................................................................................................................4 Acknowledgments..............................................................................................................5 Abstract...............................................................................................................................6 Introduction........................................................................................................................7 The Human Ear...............................................................................................................7 -
Isolated Traumatic Fracture of the Malleus Handle Causing Hearing
Otology & Neurotology 40:e244–e247 ß 2019, Otology & Neurotology, Inc. Imaging Case of the Month Isolated Traumatic Fracture of the Malleus Handle Causing Hearing Fluctuation ÃMarina Neves Cavada and ÃyzNirmal Patel ÃFaculty of Medicine and Health Sciences, Macquarie University; yDepartment of Otolaryngology and Head and Neck Surgery, Royal North Shore Hospital, Sydney; and zKolling Deafness Research Centre, Macquarie University and 02/13/2019 on IJFFeEaHn1eeltApCfg9c7yVI2fguJ9PASBuFPPrq0O0PZN57Rz0eAv4YUUourz8+RIudBMJChCQDGllp3smZUOaQ90rAwYbGjJxfkIrI4yH884AvBPhiC2FCIBFobYq by http://journals.lww.com/otology-neurotology from Downloaded Downloaded University of Sydney, NSW, Australia from http://journals.lww.com/otology-neurotology Introduction: Handle of malleus fracture is a rare condition decision for surgical treatment was made based on continuing with <100 cases having been reported. The clinical presenta- symptomatology as well as audiology and CT findings. A tragal tion is conductive hearing loss following a history of trauma, composite cartilage graft was harvested and placed over the typically, during manipulation of the external auditory canal. remaining superior part of the malleus and under the inferior The diagnosis of the condition is clinical and radiological. The fragment of the malleus attached to the tympanic membrane. options for treatment are either a hearing aid or ossiculoplasty. The patient had immediate improvement of fluctuating hearing We describe an isolated case of malleus handle fracture after loss and tinnitus in the postoperative period. by trauma associated with manipulation of the external auditory Conclusion: A fracture of the malleus handle should be IJFFeEaHn1eeltApCfg9c7yVI2fguJ9PASBuFPPrq0O0PZN57Rz0eAv4YUUourz8+RIudBMJChCQDGllp3smZUOaQ90rAwYbGjJxfkIrI4yH884AvBPhiC2FCIBFobYq canal. included in the etiologies of conductive hearing loss after Case report: A 56-year-old female, reported a right ear trauma. A careful history, thorough otology examination, and trauma. -
The Malleus Maleficarum
broedel.cov 12/8/03 9:23 am Page 1 ‘Broedel has provided an excellent study, not only of the Malleus and its authors, and the construction of witchcraft The Malleus Maleficarum but just as importantly, of the intellectual context in which the Malleus must be set and the theological and folk traditions to which it is, in many ways, an heir.’ and the construction of witchcraft PETER MAXWELL-STUART, ST ANDREWS UNIVERSITY Theology and popular belief HAT WAS WITCHCRAFT? Were witches real? How should witches The HANS PETER BROEDEL be identified? How should they be judged? Towards the end of the middle ages these were serious and important questions – and completely W Malleus Maleficarum new ones. Between 1430 and 1500, a number of learned ‘witch-theorists’ attempted to answer such questions, and of these perhaps the most famous are the Dominican inquisitors Heinrich Institoris and Jacob Sprenger, the authors of the Malleus Maleficarum, or The Hammer of Witches. The Malleus is an important text and is frequently quoted by authors across a wide range of scholarly disciplines.Yet it also presents serious difficulties: it is difficult to understand out of context, and is not generally representative of late medieval learned thinking. This, the first book-length study of the original text in English, provides students and scholars with an introduction to this controversial work and to the conceptual world of its authors. Like all witch-theorists, Institoris and Sprenger constructed their witch out of a constellation of pre-existing popular beliefs and learned traditions. BROEDEL Therefore, to understand the Malleus, one must also understand the contemporary and subsequent debates over the reality and nature of witches.