摘要:

AbstractSubglottic stenosis carries devastating consequences. Its pathogenesis, and therefore prevention, have thus far eluded precise definition. The following data suggest that tracheostomy results in a contaminated wound, secondarily infecting a larynx which may have been injured by prior intubation, fracture, or surgery. The interpretation of these data is based upon the tested assumption that infection prolongs healing of injured tissue and predisposes to scar and stricture formation. Therefore, the ability to control stomal contamination by the judicious use of topical or systemic antibiotics may play an important role in the prevention of complications in an organ functionally by‐passed by the tracheostomy cannul

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00001

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractThree patients with congenital subglottic stenosis are presented and whole organ serial‐section studies of their larynges are discussed. A superiorly displaced first tracheal ring is observed to form a cartilaginous subglottic stenosis in one. This “trapped first ring” is demonstrated in horizontal, sagittal and coronal planes. Subglottic stenosis is a clinical diagnosis which describes multifarious histopathological forms of narrowing within the subglottic l

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00002

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractA working protocol is presented which has been developed to help the clinician in the diagnosis and management of patients suffering from the sleep apnea syndrome associated with various types of upper airway obstruction.

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00003

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractA review is presented of 37 cerebellopontine angle tumors surgically removed between 1973 and 1978 by the author at the New York University Medical Center. A diagnostic protocol is outlined: An acoustic PEG (small volume pneumoencephalogram with polytomography) is utilized where a medium to large tumor is suspected, and a Pantopaque fossagram for the smaller tumors. Indications are given for the middle fossa, translabyrinthine and suboccipital approaches, depending on tumor size and level of hearing. Hearing was successfully preserved at or near the preoperative level in 3 of 6 extracanalicular tumors operated upon using the suboccipital microsurgical approach. Audiometric data are given, demonstrating the preservation of hearing. The surgical technique is described. There were no fatalities in the entire series. The incidence of permanent facial nerve palsy was 8%. Nerve palsy occurred in large tumors only.

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00004

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractSince 1972 we have been cautiously exploring the use of CO2laser in the management of carefully selected cases of localized carcinoma of the oral cavity. At the present time our experience is based on the treatment of 57 patients with cancer of the oral cavity.The CO2laser has been found to be an indispensable tool in the transoral management of T1carcinomas, multiple superficial carcinoma, extensive leukoplakia and verrucous carcinoma. The laser allows precise excision of the lesion and involved mucosa and provides an excellent specimen for histologic verification of the margins.The morbidity of laser excision is minimal, so that a tracheotomy is not needed and patients can almost always be discharged on the following day. (Follow‐up data on those patients at risk for 30 months indicate excellent control rates

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00005

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractIncreasingly, surgeons are using a middle fossa approach through a craniotomy to reach the labyrinthine segment of the facial nerve and geniculate ganglion in patients with intact hearing.This paper describes a transmastoid operation that provided exposure of the labyrinthine segment of the facial nerve without performance of a craniotomy. In this procedure the geniculate ganglion and labyrinthine segments of the facial nerve were exposed, while cochleovestibular function was spared; recovery of the facial nerve in patients with Bell's palsy or herpes zoster oticus (even those patients with a dry eye) was favorably influenced.

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00006

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractWe report a combined otoneurosurgical approach in the treatment of a patient with meningitis due to an arachnoid cyst, extending through the dura and petrous bone into the middle ear. The combination of mastoid surgery and temporal craniotomy including opening the dura was necessary to determine the nature of the problem, excise the disease and repair the defects.Two recent cases at our Institution of cerebrospinal otorhinorrhea and chronic ear disease illustrate the difficulty in carrying out definitive repair of dural defects from within the mastoid cavity. Case 2 had three bouts of meningitis and two brain abscesses separated by 25 years. Case 3 had eight bouts of meningitis in 19 years.The authors recommend an otoneurosurgical team approach in patients with cerebrospinal otorhinorrhea permitting treatment of the temporal bone, dura and brain.

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00007

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractMyasthenia gravis is a neuromuscular disease of insidious onset, characterized by weakness and fatigability of voluntary muscles. Most patients present with symptoms relating to the head and neck and thus may be seen first by the otolaryngologist. Predominant symptoms may be ocular (ptosis or diplopia) or related to fatigue of the oropharyngeal or laryngeal musculature (dysarthria, dysphonia, or dysphagia). Alleviation of muscular weakness and fatigability after administration of anticholinesterase drugs is pathognomonic of myasthenia gravis.

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00008

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractRelapsing polychondritis is a rare disease of unknown etiology. There are approximately 211 reported cases in the world literature. This is a report of ten cases from the Cleveland Clinic Foundation.McAdam's diagnostic criteria for R.P. were reviewed and modified. For diagnosis, all patients had to have 1. at least three or more diagnostic criteria, histologic confirmation not necessary; 2. one or more of McAdam's signs with positive histologic confirmation; or 3. chondritis in two or more separate anatomic locations with response to steroids and/or Dapsone.Chondritis of the auricles (9/10 patients) and arthropathy (8/10 patients) are the most common presenting signs. Chondritis was also seen in the nose (6/10) and the upper respiratory tract involving the larynx and trachea (4/10). Cochlear and vestibular damage and ocular inflammation were each seen in 5/10 patients.Patients were treated with steroids and/or Dapsone. Both drugs were reliable in abating episodes of activity and in decreasing recurrences. These results further support Dapsone as an alternate form of treatment for RP.

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00009

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY

摘要:

AbstractAlthough complications of sinusitis in children have lessened remarkably since the advent of antibiotics, nevertheless they still occur. In a 25‐year period at the Hospital for Sick Children, 6,770 patients with the diagnosis of sinusitis were reviewed and 159 of these had orbital‐facial complications. Surgical intervention was necessary in 17 to prevent more serious complications. Although there were no deaths in non‐malignant disease, two patients developed permanent optic atrophy, presumably because of delayed surgical drainage. On occasion, malignant disease may simulate inflammatory proc

ISSN:0023-852X    

DOI:10.1288/00005537-197906000-00010

出版商:John Wiley&Sons, Inc.    

年代:1979

数据来源: WILEY