Timothy R. Puls

Learn More
A case report of a large vestibular aqueduct syndrome (LVAS) as the sole radiographically detectable inner ear anomaly with a mixed hearing loss is presented. Hearing loss in LVAS is sensorineural with a conductive component in 15-27% of the cases. The hearing loss fluctuates and is progressive, resulting in the deterioration of the hearing after minor head(More)
  • T Puls
  • 1993
A retrospective analysis was performed on 130 thyroid gland operations from January 1986 to September 1992. In 69% a lobectomy and in 28% a subtotal thyroidectomy was performed for benign thyroid disorders. A total thyroidectomy for malignancy was required in only 3%. Recurrences, operated earlier elsewhere accounted for 6% of the cases. A dramatic fall in(More)
  • T Puls
  • 1996
Seventy four simple myringoplasties, 53 with xenograft and 21 with fresh temporalis fascia were reviewed. Closure rate for all cases was 90.5%. There were 3 surgical failures in xenografts and none in the fascia graft. Fifty two myringoplasties, 37 using xenograft and 15 using fascia graft, had a mean follow-up of 20 months and late perforations were seen(More)
Three hundred eight-two children were evaluated for abuse or neglect during a 30-month period in a pediatric clinic in a county hospital. Fifty-one percent presented for sexual abuse, 34% for physical abuse, and 15% for neglect. Thirteen children were hospitalized. Children examined for sexual abuse had a mean age of 5.8 years and a median age of 5 years;(More)
  • T Puls
  • 2003
Cartilage has been used successfully as a graft in middle ear surgery. It used to be reserved for advanced pathology because of its possible detrimental effect on postoperative hearing. Recent papers however failed to prove this effect. The present study describes the authors' experience in 161 cases of conchal cartilage tympanoplasty. In tympanoplasty type(More)
Effective, multifaceted, and short-term case management services can result in significant, quantifiable cost savings for managed Medicaid, Medicare, and other health care programs. Such savings clearly offset the administrative costs of support for case managers, social services departments, and utilization management services. This report reviews various(More)
  • T Puls
  • 1997
Stapes surgery: results when performing a moderate number of stapedectomies. The short term results of 40 small fenestra stapedectomies over a period of five years are presented. Closure of the air-bone gap is within 10 db in 62.5%, within 20 db in 90% of the cases, with a mean gain in air-bone gap of 27.2 db. Stapes surgery is difficult if not regularly(More)