Joel F Lehrer

Learn More
Vertigo or disequilibrium occurring in patients after concussive and nonconcussive head trauma may be due to a pathologic perilymphatic fistula from the inner ear through the oval and round window areas of the middle ear. Of 33 patients who had successful grafting of the fistulous area at middle ear exploration, 32 had resolution of vertigo, and 12 of 23(More)
Hyperinsulinism, impaired glucose tolerance, and hypertriglyceridemia may be risk factors for atherosclerotic heart disease and have also been described in patients with vertigo, whose symptoms and findings responded to appropriate dietary therapy. We studied 100 patients in an otolaryngology practice to determine the role of these abnormalities in(More)
Transcranial-cerebral sonography (TCCS) is a noninvasive technique that allows clinicians to detect nanoliter (billionths of a liter) displacements of the tympanic membrane. This technique was developed to assess cerebrospinal fluid (CSF) pressure in cases of shunted hydrocephalus; it takes advantage of the CSF connection to the inner ear through the(More)
The evidence for the existence of secondary endolymphatic hydrops in patients with perilymphatic fistulas is reviewed and the indications for treatment of such hydrops in patients with fistulas are discussed. The indications for and results of combined fistula repair by middle ear exploration and endolymphatic sac surgery in fifteen patients are presented.(More)
A new application of the glycerin test in the diagnosis of post-traumatic perilymphatic fistulas is described. Temporary disappearance of abnormal responses to the fistula and Quix tests and improvement in the hearing occurred. The glycerin test was useful in confirming the diagnosis of post-traumatic perilymphatic fistula in 13 patients in whom fistulas(More)