摘要:

AbstractA review of four cases of severe trauma to the temporal bone involving fracture of the external auditory canal indicates that adipose obliteration of the mastoid and middle‐ear cleft with closure of the external auditory canal is the optimal method of repair. In two of four patients, one‐stage repair was successful using this technique, and in the other two patients, obliteration was required as a revision operation after cholesteatoma developed from previous procedu

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00001

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA prospective comparison of the microbiologic safety of Merocel® versus NuGauze® nasal packing in 119 surgical patients is presented. Presurgical and postsurgical nasal cultures were obtained, analyzed, and compared. The importance of a preoperative nasal culture isolate of Toxic Shock Syndrome Toxin Number 1 (TSST‐1) producingStaphylococcus aureusin predicting postoperative toxigenicS. aureusisolation and Toxic Shock Syndrome symptomatology is demonstrated. An in vitro comparison of the ability of NuGauze® and Merocel® to amplify TSST‐1 production was pe

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00002

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA retrospective review of 4 years experience with over 32 epistaxis patients requiring hospitalization and using a standard medical or surgical therapy for control is presented. Medical therapy included the use of anterior nasal packing alone or in association with intranasal and nasopharyngeal balloon tamponade. Surgical therapy, for the most part, consisted of ethmoid and/or internal maxillary artery ligations.Most patients were treated initially with packing and balloons. Fifty‐two percent of the group failed this therapy and required ligations for control. The patients who did not come to operation had fewer complications, a shorter average hospital stay, and lower average cost of hospitalization without increased risk of future epistaxis. An analysis is made comparing the results, complications, and financial implications of these two approache

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00003

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractHereditary hemorrhagic telangiectasia is a challenging problem for the otolaryngologist since frequent, often severe epistaxis is the major symptom. Options for therapy in the past have included nasal packing, electrocautery, systemic estrogens, septal dermatoplasty, arterial embolization, and arterial ligation. Although successful treatment has been achieved with some of these methods, particularly septal dermatoplasty, other forms of therapy are needed prompting the use of laser photocoagulation.The neodymium yttrium‐aluminum‐garnet (Nd‐YAG) laser was used to treat a group of 19 patients with hereditary hemorrhagic telangiectasia over a 4‐year period without complications. Endonasal laser photocoagulation was effective in decreasing epistaxis in patients not requiring frequent transfusions prior to laser therapy. Three patients with the most severe epistaxis received minimal or no benefit from Nd‐YAG laser photocoagulation. In most patients Nd‐YAG photocoagulation is successful in treating epistaxis associated with hereditary hemorrhagic telangiectasia and should be a therapeutic option for this chronic disease having no ava

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00004

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractBilateral choanal atresia in newborns and infants carries significant morbidity and mortality, therefore, prompt correction is required. The transnasal route is usually preferred in the infant age group. This approach, however, carries significant incidence of restenosis. The transpalatal correction of choanal atresia has been the definitive approach in older children and adults. We are introducing a new procedure for correction of choanal atresia or stenosis that can be used at any age. The sublabial transseptal repair was performed in four infants without complications or restenosis. Two of our patients previously underwent different types of repair with persistent choanal stenosis. The sublabial transseptal approach provides wide exposure to the nasal cavity and the floor leading to the choanae. The operating microscope and various otologic micro‐instruments were used in the surgical dissection. Preservation of the anterior inferior cartilaginous septum and the maxillary crest and spine is mandatory in order not to disturb the nasal growth pattern of the nose and premaxilla. The infants were evaluated with a computed tomography (CT) scan, preoperatively. The posterior inferior portion of the vomer is uniformly wide, increasing the degree of stenosis or atresia. Removal of the vomer is an essential part of this procedure in order to open and enlarge the choanae. Both choanae were stented with polyvinyl tubes.Every attempt was made to keep the stents in position for a minimum of 8 to 10 weeks. Follow‐up has been for 2 to 4 years, and no recurrent choanal stenosis has been experien

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00005

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractA prospective analysis of 124 consecutive adult patients undergoing tracheotomy was performed to examine the incidence of resulting complications. All tracheotomies were performed by a junior otolaryngology resident under the supervision of a member of the attending staff or a chief resident. The vast majority were performed at the bedside in an intensive care unit. The complications were divided into two groups: early (within 2 days) and late (2 to 14 days). Seven patients had complications directly related to tracheotomy. Four of these complications occurred in three patients and were considered significant. There were no mortalities. Despite the fact that our tracheotomies were routinely performed by residents at the bedside, our complication rate was comparable to those reported from other centers. We believe that bedside tracheotomy, properly supervised and performed, is a safe procedure.

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00006

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractCondyloma acuminatum is one of four types of common human verrucous lesions that are of viral etiology. Also known as “moist wart,” condyloma acuminatum is most often seen on the mucosal surfaces of the anogenital area. However, occurrences in the mucosal lined areas of the head and neck region are quite rare.Since 1901, 30 cases of condylomatous lesions have been reported in the upper aerodigestive tract, occurring mainly in the various regions of the oral cavity. Eighteen of the cases were confirmed by histopathologic documentation, while the remainder were anecdotal.We have recently encountered six new cases of condyloma acuminatum, verified by histologic examination. One occurred on the tongue, another in the tonsillar fossa, one in the hypopharynx and three on the vocal cords. We present these cases and review the previously reported cases. In addition, we will discuss the differential diagnosis of these lesions, and their importance to the practicing otolaryngolog

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00007

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractOne of the most common causes of submandibular gland enlargement is benign inflammatory disease. The usual cause is ductal outflow obstruction due to either a calculus or stenosis allowing stasis and retrograde movement of the saliva into the acinar structures leading to an inflammatory response and gland enlargement.Faced with a submandibular mass, a work‐up that will rule out neoplastic causes of submandibular enlargement is instituted. This includes clinical assessment, probing of the gland, radiocontrast sialography, and CT scanning.The treatment should reflect the obstructive nature of the disease. Plastic reconstruction of the duct allows the removal of calculi, shortening of the duct, and enlargement of the outflow opening preventing recurrence and allowing healing of the gland. The procedure is performed intraorally as an outpatient, does not disrupt oral functioning, or subject the patient to the risks of gland removal or loss of that organ's function.Our experience with 27 patients over a 7‐year period is presented with a detailed description of the technique and an analysis of the results. The procedure was successful in 22 of the 27 patie

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00008

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractMedical information, diagnostic technology, and modes of therapeutic intervention available for treatment of head and neck cancer have increased exponentially. The concurrent explosion of microcomputer technology has created an ideal instrument for organizing, storing, and reporting the expanded data the head and neck oncologist must now consider.This paper presents the principles, design, and operation of a recently developed head and neck oncological database program (HNODB). Details of implementation on a microcomputer are also described. A historical review of currently used prominent cancer registration programs is presented. It defines the fundamental elements of cancer registration.A review of cancer registration in the United States shows that current systems have serious deficiencies and have not kept pace with the evolution of diagnostics, treatments, and computer technologies. The HNODB database program, however, is a valuable model for cancer data management, for it can be applied to small or extensive data collection needs, and it provides an accurate system to identify risk factors, numbers of patients treated, and types of treatment given. The program allows for rapid analysis of treatment, results, follow‐up, and survival rates of patients with carcinoma of the head and nec

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00009

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY

摘要:

AbstractIncreasing awareness of the role of adenotonsillar hypertrophy in the etiology of chronic airway obstruction and disturbed respiration during sleep has created interest in the diagnostic methods available to assess the effects of obstruction. This study evaluates and compares simultaneously‐obtained recordings of polysomnography and sleep sonography in children obstructed by adenotonsillar hypertrophy. Four hundred sixty‐five 4‐minute samples obtained from 18 patients in a clinical studies unit were analyzed and rated as to severity. Agreement between polysomnography and sleep sonography was very high in scoring the respiratory pattern (r=0.79) and detecting apnea (r=0.89). These findings demonstrate that sleep sonography is a reliable method for evaluating patients with upper airway obstruction due to adenotonsillar hypert

ISSN:0023-852X    

DOI:10.1288/00005537-198712000-00010

出版商:John Wiley&Sons, Inc.    

年代:1987

数据来源: WILEY