摘要:

AbstractThe use of long‐term endotracheal intubation in the treatment of respiratory distress syndrome in the newborn has seen an increase in the number of cases of acquired subglottic stenosis. Multiple methods of correction have been advocated in conjunction with the use of antibiotics, corticosteroids, and indwelling stents.An animal experiment utilizing 64 dogs was undertaken in an effort to devise an endoscopic procedure using the CO2laser which might be successfully employed in the human patient. An attempt was also made to study the efficacy of antibiotics, corticosteroids, soft stents and rigid stents. Animals were divided into multiple groups, and their larynges were studied grossly and histologically some weeks after therapy was completed. Analysis of the results was undertaken, and the method with the best outcome was then employed in the human portion of the study.Twenty‐four human patients, 12 with severe stenosis and 12 with partial stenosis were evaluated, and their outcome is repor

ISSN:0023-852X    

DOI:10.1288/00005537-198910000-00001

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractSclerosis of the mastoid portion of the temporal bone is often seen on radiographs of patients who have or have had chronic otitis media. Occasionally lesions are seen that cause sclerosis of the entire temporal bone. The otolaryngologist must be alert to the fact that these findings may signify important pathology beyond that of chronic otitis media and indeed may be indicative of life threatening problems in adjacent or distant areas. In this paper the differential diagnoses of sclerotic lesions of the temporal bone will be discussed. These include fibrous dysplasia, osteopetrosis, meningioma, ossifying fibroma and metastatic lesions to the temporal bone. Three representative cases with sclerotic temporal bones are presented. The first is a patient with a conductive hearing loss secondary to stenosis of the external auditory canal. He was found to have a fibrous dysplasia of the temporal bone. The second case is an elderly male with a draining ear and a facial nerve paresis. He was found to have adenocarcinoma of the prostate gland metastatic to the temporal bone. The third case is that of a woman with a meningioma who demonstrated a sclerotic temporal bone on routine radiographs of the skull.

ISSN:0023-852X    

DOI:10.1288/00005537-198910000-00002

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractSubglottic stenosis is a recognized complication of prolonged intubation. To date, there is no uniformly successful operative procedure for severe subglottic stenosis, fulfilling the criteria of decannulation and a serviceable voice. The surgical ideals for such a procedure should include the use of autogenous grafting material, avoidance of internal stenting, and limited manipulation of the mucosa. This study was intended to assess the fate of isolated hyoid and thyroid alar grafts interposed in the posterior cricoid lamina. Additionally, anterior/posterior splits with and without anterior grafting were evaluated. Seventeen dogs were used in the determinate animal model. Vocal cord mobility was evaluated by direct laryngoscopy prior to sacrifice. Graphic gross anatomical specimens depict the effects of anterior/posterior splitting on the cricoid cartilage. Clinical correlations are suggested.

ISSN:0023-852X    

DOI:10.1288/00005537-198210000-00001

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractHaving been in use for the past couple of years, the “duckbill” valved Silastic® tube developed by Blom and Singer is well established as a device for vocal rehabilitation of the laryngectomee. The newer “voice button” prosthesis developed by Panje incorporates a similar valve in Silastic®. Neither of these devices can be used with tracheal stomal stenosis or with a deep tracheal stoma behind prominent sternomastoid muscles.The ritual of taping the Blom‐Singer prosthesis and the frequent failure of the tape to hold are other distinct disadvantages. Limitations are imposed on patient selection with the Panje prosthesis because of the rigid dimensions and the possibility of aspiration of the device, as well as the necessity for manual dexterity on the part of the patient.A new device has been fashioned utilizing the “duckbill” Silastic® tube as a valve attached to a new type of trachea stoma button. This appears to have universal application, is not difficult to change, requires no taping, and is self‐maintaining. There is no possibility of aspiration. The device is simple and appears to overcome many of the disadvantages of the other two.The tracheal esophageal puncture must be made in a cephalad direction so that the tracheal air diverted through the prosthesis will be directed toward the pharynx and not toward the esophagus. Prostheses directed caudad will not function and those patients sho

ISSN:0023-852X    

DOI:10.1288/00005537-198910000-00003

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractA review of the literature reveals that pyogenic gangrenosum (ecthyma gangrenosum) is fatal to most patients, especially infants. In this article, the authors review the differential diagnosis of facial necrosis, present two cases of infants who succumbed to the systemic manifestations of the disorder, and a third case of survival in an adult with concomitant systemic lupus erythematosus and pyogenic gangrenosum. Finally, a brief discussion of Pseudomonas gastroenteritis, Pseudomonas septicemia, and pseudomembranous enterocolitis is presented.

ISSN:0023-852X    

DOI:10.1288/00005537-198910000-00004

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractSuccessful treatment of severe soft tissue infections of the face and neck necessitates early recognition followed by aggressive medical and surgical therapy. These infections often spreadviatissue planes, and it is essential that all areas of necrosis be exposed, debrided, or excised according to tissue planes. A classification of soft tissue infection based upon tissue plane involvement is proposed as an aid to diagnosis and treatment. In addition, a protocol for management of these infections is presented.

ISSN:0023-852X    

DOI:10.1288/00005537-198910000-00005

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractRhinocerebral mucormycosis is, with few exceptions, only reported in patients with severe metabolic or immunologic imbalances. Factors which may predispose to the development of mucormycosis are reviewed. These factors include ketoacidosis and immunologic deficiency states due either to the primary disease or to the treatment for other diseases. An appreciation for these predisposing factors is very important in order that aggressive diagnosis and therapy be undertaken without delay.

ISSN:0023-852X    

DOI:10.1288/00005537-198910000-00006

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractRaeder's syndrome consists of ipsilateral ptosis, miosis and facial pain with intact facial sweating. When not associated with other neurologic signs, the clinical course of this condition is self‐limited. Patients will have resolution of facial pain but persistence of miosis and ptosis. Treatment is symptomatic with arteriography reserved for those patients with protracted symptoms or atypical presentations. A case of Raedcr's paratrigeminal syndrome is presented with abnormal dilation of the subcavernous portion of the internal carotid artery thought to be secondary to inflammation of the adjacent sphenoid sinus. Facial pain and the abnormal dilation of the carotid artery resolved, but miosis and ptosis persisted. Because of the therapeutic indication and prognostic value, an awareness of Raeder's syndrome is stressed when evaluating patients with facial pain or possible Horner's syndrom

ISSN:0023-852X    

DOI:10.1288/00005537-198910000-00007

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractRhinosclcroma is recognized more frequently now because of the recent influx of immigrants from endemic Central America. This chronic infectious disease presents with three overlapping clinical stages and can involve any part of the respiratory tract. A review of the clinical presentation leads to a patient evaluation plan consisting of physical examination and radiographic studies. A highly sensitive and specific method is introduced for identification ofKlebsiella rhinoscleromatisin the biopsy specimen using the immunoperoxidase technique. A study of the immune status of the patient revealed general immunological competence except in effective phagocytosis of the organism by the Mikulicz cells. The choice of chronic antibiotic therapy should be guided by individual patient consideration with respect to age and sex. Repeat biopsies help determine the duration of antibiotic therapy. Relapses do occur and close observation is the key to long‐term follow‐up of the pati

ISSN:0023-852X    

DOI:10.1288/00005537-198910000-00008

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY

摘要:

AbstractA series of large, midfacial, squamous cell and basal cell carcinomas treated by the Departments of Otolaryngology and Dermatology (Cleveland Clinic Foundation) are reported. Most cases required total/partial resection of the external nose, upper lip, hard palate, nasal septum, and adjacent midfacial soft tissues. Emphasis is placed on the principles of preoperative and intraoperative management as it relates to intraoral prosthetic design and total margin control of the surgical specimen. The immediate and delayed reconstructive philosophy and techniques employed here are discussed in detail. Recurrence rates and free‐of‐disease survival times are also revie

ISSN:0023-852X    

DOI:10.1288/00005537-198910000-00009

出版商:John Wiley&Sons, Inc.    

年代:1982

数据来源: WILEY