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Biomedical subjects

A J Reino

Publications and source records attributed to A J Reino.

13 recordsLinked to original sources
PubMed2000

Factors in the pathogenesis of tumors of the sphenoid and maxillary sinuses: a comparative study.

OBJECTIVES/HYPOTHESIS: To explain the processes that lead to the development of tumors in the maxillary and sphenoid sinuses. STUDY DESIGN: A 32-year review of the world's literature on neoplasms of these two sinuses and a randomized case-controlled study comparing the normal mucosal architecture of the maxillary to the sphenoid sinus. METHODS: Analysis of a 32-year world literature review reporting series of cases of maxillary and sphenoid sinus tumors. Tumors were classified by histological type and separated into subgroups if an individual incidence rate was reported. Histomorphometry of normal maxillary and sphenoid sinus mucosa was performed in 14 randomly selected patients (10 sphenoid and 4 maxillary specimens). Specimens were fixed in 10% formalin, embedded in paraffin, and stained with periodic acid-Schiff (PAS) and hematoxylin. Histomorphometric analysis was performed with a Zeiss Axioscope light microscope (Carl Zeiss Inc., Thornwood, NY) mounted with a Hamamatsu (Hamamatsu Photonics, Tokyo, Japan) color-chilled 3 charge coupled device digital camera. The images were captured on a 17-inch Sony (Sony Corp., Tokyo, Japan) multiscan monitor and analyzed with a Samba 4000 Image Analysis Program (Samba Corp., Los Angeles, CA). Five random areas were selected from strips of epithelium removed from each sinus, and goblet and basal cell measurements were made at magnifications x 100 and x 400. RESULTS: The literature review revealed that the number and variety of tumors in the maxillary sinus are much greater than those in the sphenoid. The incidence of metastatic lesions to each sinus is approximately equal. No recognized pattern of spread from any particular organ system could be determined. On histomorphometric study there were no statistically significant differences between the sinuses in the concentration of goblet cells, basal cells, or seromucinous glands. CONCLUSIONS: Factors involved in the pathogenesis of tumors of the maxillary and sphenoid sinuses include differences in nasal physiology, embryology, morphology, and topography. There are no significant histological differences in the epithelium and submucous glands between the two sinuses to explain the dissimilar formation of neoplasms.

Case-Control Studies↗
PubMed1999

Transverse infrahyoid approach to bilateral glottic tumors.

Glottic exposure and entry for vertical partial laryngectomy procedures has traditionally been through the subglottis. Although this approach is generally satisfactory for the resection of unilateral vocal cord lesions, it may be unsafe in cases in which tumors extend across the midline and/or subglottically. In these instances, we prefer the superior transverse infrahyoid approach to the glottis, which transects the petiole of the epiglottis and reflects the contents of the preepiglottic space posterior and superior. This improved visualization of the larynx has permitted precise tumor excision without sacrifice of uninvolved segments of the vocal cords. This procedure has been performed 35 times over a 15-year period at our institution for the resection of bilateral glottic tumors, with and without subglottic extension. In none of the cases in which it has been employed was there a positive surgical margin.

Adult↗
PubMed1997

Management of bilateral glottic tumors.

OBJECTIVE: To compare the rates of cure and complication and the time to decannulation and deglutition in patients undergoing resection of bilateral glottic tumors. DESIGN: A 22-year, nonrandomized, prospective, retrospective analysis. SETTING: Two academic tertiary care referral centers. PARTICIPANTS: Seventy-two patients with bilateral glottic carcinoma were treated using bilateral hemilaryngectomy. Depending on the size of the tumor and the extent of thyroid cartilage resection, patients underwent 1 of 3 methods of reconstruction: group 1, placement of an anterior commissure stent (34 patients); group 2, epiglottic laryngoplasty (15 patients); and group 3, staged posterior thyroid alar transposition laryngoplasty (23 patients). INTERVENTION: Resection and reconstruction of 72 larynges with bilateral glottic tumors using the bilateral hemilaryngectomy procedures. MAIN OUTCOME MEASURES: Acceptable rates of cure and complication, intervals to decannulation and deglutition, and quality of speech. RESULTS: High rates of tumor control and cure, low rates of recurrence and complication, acceptable time to decannulation and deglutition, and adequate quality and intelligibility of speech. CONCLUSIONS: Bilateral vocal cord carcinoma can be treated surgically with a high degree of tumor control and cure. The use of all 3 methods maintained laryngeal function with regard to tracheal decannulation, oral alimentation, and speech intelligibility.

Adult↗
PubMed1997

Isolated sphenoid sinus disease: an analysis of 132 cases.

Solitary involvement of the sphenoid sinus is a relatively uncommon entity. A series of 132 patients with isolated sphenoid disease accumulated over a 22-year period is reported. A retrospective chart review was performed with special attention to the patients' presenting signs, symptoms, and radiographic findings. There were 80 patients with inflammatory disease, 38 with neoplasms, four with fibroosseous disorders, and 10 with traumatic and developmental lesions. The most common presenting symptom was headache, followed by visual changes and cranial nerve palsies. Cranial nerve abnormalities were encountered in 12% of the inflammatory cases, 60% of the benign tumors, and 57% of the malignant tumors. Radiographically, bone remodeling was associated with chronic inflammatory disease, especially mucoceles. Bone erosion was found principally with neoplastic disease, occurring rarely with mucoceles. Extension was associated with malignant tumors.

Adolescent↗
PubMed1996

Management of embossment following the frontal osteoplastic operation.

The deformity in the bony contour of the forehead following the osteoplastic flap procedure on the frontal sinus, termed embossment, occurs in a small but definite number of cases. This complication arises from the combined processes of resorption and deposition of bone following disturbance of the periosteum in performing the operation. A simple and highly reliable method of cosmetic correction employing acrylic cranioplasty has been successfully utilized in a series of cases without complications. The details of the operative technique will be outlined.

Bone Cements↗
PubMed1996

The silicone columellar strut.

The placement of a silicone columellar strut serves to correct columellar retraction, to improve the nasolabial angle, and to increase tip projection by elevating the medical crura of the lower lateral cartilages. The potential complications of extrusion, infection, and migration are minimal if the implant is placed in a separate watertight compartment with a tension-free closure and no impingement of the nasal dome.

Female↗
PubMed1995

Role of the argon beam coagulator in facial rejuvenation surgery.

OBJECTIVE: To compare the hemostatic effectiveness of a new electrosurgical unit, the argon beam coagulator, with current methods of electrocoagulation. DESIGN: A nonrandomized control trial of 20 patients undergoing rhytidectomy. SETTING: Two academic tertiary referral medical centers. PARTICIPANTS: Twenty male patients having moderate to major degrees of facial ptosis. INTERVENTION: All 20 patients underwent a standard rhytidectomy with hemostasis provided by the argon beam coagulator on the right side and conventional electrocoagulation on the left side. OUTCOME MEASURES: Improved hemostasis with minimal depth of injury, length of procedure, decreased blood loss, edema, and ecchymosis, and the ability to coagulate indiscriminately around and over neural tissue without damage (all listed in the literature as advantages of the argon beam coagulator). RESULTS: Poor hemostatic ability was observed with concomitant increased incidence of blood loss, edema and ecchymosis, major hematoma, and length of surgery. Also noted were increased rates of flap compromise and the potential for damage to vital neural structures. CONCLUSION: Our results do not agree with the list of advantages attributed to the argon beam coagulator in the literature.

Aged↗
PubMed1995

Reduction columelloplasty. A new method in the management of the nasal base.

The nasal base is very complex secondary to the dynamic relationship between the skin, underlying muscle, and cartilaginous structures. Recently, we have employed a new method for refinement of the nasal base, which we name reduction columelloplasty. This procedure employs a full-thickness diamond-shaped tissue excision between the feet of the medial crura. The incision is carried down through the skin, depressor septi muscle, and adjacent soft tissue. Following en bloc removal, the defect is carefully closed in a vertical orientation, approximating the medial crura of the lower lateral cartilages. As in the open rhinoplasty approach, the scar produced by this technique is of negligible importance if it is closed using proper techniques of skin eversion and early suture removal. We have found this procedure to be an extremely reliable method for narrowing splayed medial crura, increasing the nasolabial angle, modifying the shape of the nares, and for increasing tip projection.

Cartilage↗
PubMed1994

Inflammatory pseudotumor of the maxillary sinus: CT and MR findings in six cases.

OBJECTIVE: Inflammatory pseudotumor is a chronic inflammatory lesion of unknown origin. The purpose of this study was to analyze the CT and MR findings in six cases of inflammatory pseudotumor of the maxillary sinus in order to determine if there were any imaging findings that distinguish this lesion from the more common type of pseudotumor that occurs in the orbit. MATERIALS AND METHODS: Six patients with pseudotumor of the maxillary sinus were identified retrospectively. The diagnosis was based on biopsy specimens. Their CT scans and MR images were studied by two radiologists to identify specifically the presence of soft-tissue disease and the presence and type of any bone involvement. RESULTS: CT and MR images showed some degree of involvement of the bony wall in all cases. All patients had a soft-tissue mass with mild enhancement on CT scans and intermediate signal intensity on both T1- and T2-weighted MR images. CONCLUSION: Our experience shows that inflammatory pseudotumor of the maxillary sinus causes bone changes on CT and MR images, findings that mimic a malignant tumor. Bone involvement appears to be more common in pseudotumor of the maxillary antrum than in its orbital counterpart.

Adolescent↗
PubMed1993

Traumatic pneumomediastinum in a child secondary to corn chip perforation of the esophagus.

Esophageal perforations, while an infrequent form of trauma in the pediatric population, are of concern because of their life-threatening complications. If not recognized and treated promptly, esophageal injuries can result in mediastinitis and death. An unusual case is presented, describing traumatic esophageal perforation in a child resulting from laceration by an ingested corn chip. A study is reported investigating the rigidity of three types of these popular snack chips. Stress testing and statistical analysis of the resultant measurement data indicated that the three brands of chips were equally rigid. The mean force of compression required to fracture the chips was approximately three pounds, a force great enough to damage the fragile structures of the upper aerodigestive system. Physicians and parents alike should be aware of the possible dangers of this type of snack food to avert the possibility of esophageal injury with its resultant morbidity and potential mortality.

Child↗