Wesley Krueger - Academia.edu (original) (raw)

Papers by Wesley Krueger

Otolaryngology, Sep 1, 1978

Irradiation of normal tissues at the dose/time factor employed in the treatment of solid tumors i... more Irradiation of normal tissues at the dose/time factor employed in the treatment of solid tumors impairs the subsequent healing of surgical wounds made in those tissues. Irreversible radiation damage to regional fibroblasts is one cause of impaired healing. This study was conducted to determine whether syngeneic guinea pig fibroblasts, harvested from tissue culture when injected into irradiated guinea pig skin at the time of wound closure, could improve wound healing. Breaking strength determinations indicate that irradiated wounds demonstrate enhanced wound healing if implanted with fibroblasts.

Otology & Neurotology, Feb 1, 2007

Background: Being able to resolve the symptoms associated with benign paroxysmal positional verti... more Background: Being able to resolve the symptoms associated with benign paroxysmal positional vertigo (BPPV) is imperative because of its adverse effect upon an individual's ability to perform normal activities of daily living. Although there are several effective treatments for posterior canal BPPV (PC-BPPV) and for horizontal canal BPPV (HC-BPPV), interventions for anterior canal BPPV (AC-BPPV) are less understood. Objective: The purpose of this systematic review was to evaluate the effectiveness of interventions that have been specifically designed for the treatment of AC-BPPV. Methods: A literature search in the CINAHL Plus with Full Text, ProQuest Medical Library, and MEDLINE databases was conducted using the search terms 'positional vertigo' OR 'positional nystagmus' OR 'positioning vertigo' OR 'positioning nystagmus' AND 'anterior canal' OR 'superior canal'. The evidence level (EL) of each included study was evaluated using the 2011 Oxford Centre for Evidence-Based Medicine scale, and the methodological rigor (MR) of each included study was evaluated using a scale adapted from Medlicott and Harris. Results: Through an electronic database search, 342 records were identified. Of these 342 records, four articles met the inclusion criteria and were included in the qualitative synthesis. Although the Yacovino et al. study demonstrated the best one-treatment resolution rate, the other three studies possessed different distinct advantages. Conclusions: This systematic review revealed four particle repositioning maneuvers that had been specifically developed for the treatment of AC-BPPV. In addition to their relatively high resolution rates, each maneuver was easy to administer and could be safely applied to individuals of various ages and physical abilities.

doi: 10.3389/fnint.2014.00046 The relationship between vestibular function and topographical memo... more doi: 10.3389/fnint.2014.00046 The relationship between vestibular function and topographical memory in older adults

Journal of Otolaryngology-ENT Research, 2017

Military medicine, 2015

Motion sickness (MS) can be problematic for many military operations. Some pharmaceutical counter... more Motion sickness (MS) can be problematic for many military operations. Some pharmaceutical countermeasures are effective but can lead to side effects. Non-pharmaceutical countermeasures vary in effectiveness and can require time to be beneficial (e.g., desensitization). Previous research suggests that visual fixation can alleviate MS symptoms. In the current experiment we tested the effectiveness of a user-worn device that provides a visual fixation point that moves with the user. Fourteen subjects viewed the interior of a rotating optokinetic drum (60°/s) through a visor that displayed either a clear view of the scene (control) or the scene with a fixation point (experimental). After 5 minutes of viewing, symptoms were assessed using (1) the Simulator Sickness Questionnaire that yields four scores (total, nausea, oculomotor, and disorientation) and (2) a 0 to 10 MS overall scale. Viewing the fixation point resulted in significantly lower scores for all measures. Control condition sc...

Otolaryngology - Head and Neck Surgery, 1998

I read the article '"Electrocochleography in Retrosigmoid Vestibular Nerve Section for Intractabl... more I read the article '"Electrocochleography in Retrosigmoid Vestibular Nerve Section for Intractable Vertigo" by Krueger and Storper (1997;116:593-6) and want to applaud the authors in their continued investigation of electrocochleography as a diagnostic and prognostic tool. In the Introduction, the authors '"queried whether section of the vestibular nerve would decrease the SP/AP ratio in patients with medically intractable Meniere's disease." They recorded electrocochleographic potentials using stainless steel transtympanic needle electrodes before any drilling of bone, during drilling, during isolation of the nerve, during cutting of the vestibular nerve, and after reapproximating the dura. In the Methods section, however, they state that '"the results were analyzed only for the baseline and closing conditions," and in the first sentence of the Discussion, they state that '"this experiment fulfilled its objectives." It appears, however, that the objectives of this experiment may not have been fulfilled because physiologic changes within the inner ear, which may have occurred as the result of subarachnoid space decompression, were not adequately addressed. Unfortunately, sUboccipital craniectomy for vestibular nerve section is associated with significant decompression of the subarachnoid space, and the effects of such cerebrospinal fluid pressure changes on cochlear function are well known and well published. 2-J6

Frontiers in Integrative Neuroscience, 2014

Research during the past two decades has demonstrated an important role of the vestibular system ... more Research during the past two decades has demonstrated an important role of the vestibular system in topographical orientation and memory and the network of neural structures associated with them. Almost all of the supporting data have come from animal or human clinical studies, however. The purpose of the present study was to investigate the link between vestibular function and topographical memory in normal elderly humans. Twenty-five participants aged 70 to 85 years who scored from mildly impaired to normal on the Montreal Cognitive Assessment (MoCA) received three topographical memory tests: the Camden Topographical Recognition Memory Test (CTMRT), a computerized topographical mental rotation test (TMRT), and a virtual pond maze (VPM). They also received six vestibular or oculomotor tests: optokinetic nystagmus (OKN), visual pursuit (VP), actively generated vestibulo-ocular reflex (VOR), the sensory orientation test (SOT) for posture, and two measures of rotational memory (error in degrees, or RM • , and correct directional recognition, or RM→). The only significant bivariate correlations were among the three vestibular measures primarily assessing horizontal canal function (VOR, RM • , and RM→). A multiple regression analysis showed significant relationships between vestibular and demographic predictors and both the TMRT (R = 0.78) and VPM (R = 0.66) measures. The significant relationship between the vestibular and topographical memory measures supports the theory that vestibular loss may contribute to topographical memory impairment in the elderly.

International Journal of Otolaryngology and Head & Neck Surgery, 2013

Electrocochleography (ECoG) has been an important tool in the diagnosis of Meniere's disease or e... more Electrocochleography (ECoG) has been an important tool in the diagnosis of Meniere's disease or endolymphatic hydrops. There are two methods employed, transtympanic and extratympanic. Many have regarded the results of these methods as being equally reliable. The purpose of this study is to determine any differences in sensitivity between the two methods. In this study patients with known endolymphatic hydrops or Meniere's disease underwent ECoG testing with both the extratympanic method and the transtympanic method on the same day in the same ear. The results show a significant difference between the two methods, with the transtympanic wave values being smaller and therefore more sensitive than the extratympanic method. In addition, transtympanic ECoG resulted in better waveform morphology and better correlation with the audiometric findings in endolymphatic hydrops and Meniere's disease. The results emphasize the superior role of transtympanic ECoG over extratympanic ECoG as a valuable component in the confirmation of Meniere's disease or endolymphatic hydrops along with history and audiometric findings characteristic of the disease. Implications of the study promote the use of transtympanic ECoG rather than extratympanic ECoG in patients with symptoms suggestive of Meniere's disease or endolymphatic hydrops.

The Laryngoscope, 2010

Objectives/Hypotheses-An eyewear mounted visual display ("User-worn see-through display") project... more Objectives/Hypotheses-An eyewear mounted visual display ("User-worn see-through display") projecting an artificial horizon aligned with the user's head and body position in space can prevent or lessen motion sickness in susceptible individuals when in a motion provocative environment as well as aid patients undergoing vestibular rehabilitation. In this project, a wearable display device, including software technology and hardware, was developed and a phase I feasibility study and phase II clinical trial for safety and efficacy were performed. Study Design-Both phase I and phase II were prospective studies funded by the NIH. The phase II study used repeated measures for motion intolerant subjects and a randomized control group (display device/no display device) pre-post test design for patients in vestibular rehabilitation. Methods-Following technology and display device development, 75 patients were evaluated by test and rating scales in the phase II study; 25 subjects with motion intolerance used the technology in the display device in provocative environments and completed subjective rating scales while 50 patients were evaluated before and after vestibular rehabilitation (25 using the display device and 25 in a control group) using established test measures. Results-All patients with motion intolerance rated the technology as helpful for nine symptoms assessed, and 96% rated the display device as simple and easy to use. Duration of symptoms significantly decreased with use of the technology displayed. In patients undergoing vestibular rehabilitation, there were no significant differences in amount of change from pre-to post-therapy on objective balance tests between display device users and controls. However, those using the technology required significantly fewer rehabilitation sessions to achieve those outcomes than the control group.

Otology & Neurotology, 2007

margins, and 11 had negative neural margins. Facial nerve function was analyzed using the House-B... more margins, and 11 had negative neural margins. Facial nerve function was analyzed using the House-Brackman scale. Results.-In the first group (8 patients), 5 had positive proximal margins and 3 had positive distal neural margins. Outcome by House-Brackman score was III (2 patients), IV (3 patients), V (1 patient), and VI (2 patients). In the second group (no evidence of neural spread, 11 patients), outcome was III (3 patients), IV (2 patients), V (2 patients), and VI (4 patients). Conclusion.-No significant difference in the outcome of facial nerve function was seen between these 2 groups. Facial nerve grafting should be considered in patients whose facial nerve is sacrificed, even when there is evidence of tumor in the perineurium at the margin of resection. : This article attempts to answer an important clinical question through a retrospective case review. Facial nerve resection is, unfortunately, often required in the treatment of malignant disease. Concomitant grafting of the facial nerve offers the best form of reconstruction. The article provides strong evidence that perineural invasion does not adversely affect nerve graft results. They further evaluate the effect of pre-and postoperative radiations on results, suggesting no adverse effect from postoperative radiation but poor results when preoperative radiation has been used. This conclusion is limited by the small sample size. The overall study suffers from this same limitation that the authors recognize, and other limitations from the retrospective design. Although local control of tumor is mentioned as excellent, the limited duration of review (mean 26 months) makes this uncertain. Further evaluation of this important question is warranted. However, this study is useful in that based upon these results it does appear that successful nerve grafting can occur even in the presence of positive neural margins and postoperative radiotherapy.

Otolaryngology - Head and Neck Surgery, 1995

Otolaryngology - Head and Neck Surgery, 2002

OBJECTIVE: We sought to compare the findings of 3 different hearing screening methods in school-a... more OBJECTIVE: We sought to compare the findings of 3 different hearing screening methods in school-aged children. STUDY DESIGN AND SETTING: Prospective testing of second- and third-grade students in their schools was carried out. METHODS: Three hundred children (599 ears) were screened by using 3 test modalities, pure-tone audiometry, distortion product otoacoustic emissions (DPOAE), and tympanometry. RESULTS: All of the tests were normal in 532 ears (89%), and all were abnormal in 12 ears (2%). Tympanometry yielded the most abnormalities (8.3%), and pure-tone testing demonstrated the fewest (3.3%), with a positive rate of 6.3% for DPOAE testing. False-positive rates were 1.2%, 4.2%, and 6.4% for pure tones, DPOAE, and tympanometry, respectively, when normal results on pure-tones or DPOAE were taken to represent true hearing. CONCLUSION/SIGNIFICANCE: We continue to recommend pure-tone testing as an effective screening method, with follow-up by using otoacoustic emissions in those who f...