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Biomedical subjects

B Millman

Publications and source records attributed to B Millman.

17 recordsLinked to original sources
PubMed2001

Carbon dioxide laser resurfacing.

In society today there is an increasing awareness of aesthetics and youth and our desire to hold onto it. Fortunately technology is advancing as fast as we are aging. In the past decade, carbon dioxide laser resurfacing has been demonstrated to give consistent excellent results in the treatment of facial rhytidosis. We describe the history of how the laser has been used in facial rejuvenation and our conservative techniques on maximizing results while minimizing the risks for complications.

Adolescent↗
PubMed1999

Cervical thymic anomalies.

Because of its infrequent occurrence, cervical thymic tissue is rarely considered in the differential diagnosis of neck masses. Consequently, diagnosis is most often made by pathologic examination of the excised specimen. The preponderance of reported patients have been children and adolescents, typically asymptomatic. The clinical presentation, evaluation and surgical management of five new cases of cervical thymic anomalies ranging from infancy to adulthood are described. The authors also review the embryology and histopathology of these lesions and discuss their recommended approach to the evaluation and management of cervical thymic anomalies.

Adolescent↗
PubMed1998

The etiology of prolonged erythema after chemical peel.

BACKGROUND: As the number and methods of skin resurfacing procedures are increasing, there is a small number of patients that develop a prolonged inflammation during the postoperative period. OBJECTIVE: We attempted to correlate risk factors for the development of prolonged postpeel erythema (PPPE) and inflammation. A treatment regimen will be described to eliminate permanent skin changes. METHODS: A retrospective chart review is presented to define and correlate risk factors for the development of PPPE and a treatment protocol is described. The setting is a large multisurgeon aesthetic center. Two-hundred and thirty-six consecutive chemical phenol peels on 196 patients over a 2-year period were reviewed. RESULTS: Eleven percent of patients developed PPPE. Allergy to tape was the only factor significantly correlated with PPPE. All patients had complete resolution of skin changes with appropriate treatment. CONCLUSION: A small population of patients undergoing skin resurfacing procedures will develop prolonged erythema. No major risk factor could be correlated with its development. A treatment plan was devised and was successful in all cases.

Adult↗
PubMed1998

Comparison of transconjunctival versus subciliary approaches for orbital fractures: a review of 60 cases.

The increasing emphasis on open reduction in the management of orbital fractures has led to an extensive debate as to which approach provides adequate exposure for these fractures. This retrospective study compares the exposure provided and the rate of complications between transconjunctival and subciliary incisions for orbital rim and floor fractures. The charts of 55 patients with orbital fractures, treated with open reduction and internal fixation, were reviewed. A total of 30 subciliary and 30 transconjunctival incisions had been performed, and the adequacy of exposure as well as intraoperative and postoperative complication rates were compared. The authors found a higher rate of complications with the subciliary approach and, therefore, advocate the use of a transconjunctival incision for the management of orbital fractures.

Adolescent↗
PubMed1997

Isolated congenital internal auditory canal atresia with normal facial nerve function.

The internal auditory canal forms as a result of mesoderm enveloping the eighth cranial nerve in the developing embryo. The mesoderm eventually transforms into cartilage and ultimately ossifies around the nerve, forming the internal auditory canal. It is theorized that atresia or stenosis of the internal auditory canal results from altered cochleovestibular nerve development secondary to faulty chemotactic mechanisms or a lack of end organ targets. Unilateral internal auditory canal anomalies are frequently seen in conjunction with other inner ear anomalies and occasionally with middle or external ear anomalies. Infrequently, it will occur as either an isolated or bilateral finding, but rarely simultaneously. The few citations of isolated, unilateral or bilateral internal auditory canal anomalies that are reported in the literature are usually associated with other systemic developmental anomalies, such as, cardiac septal defects, polycystic kidney disease, skeletal deformities and duodenal atresia. We present a case report of a patient with bilateral, congenital, internal auditory canal atresia and cochleovestibular deficits but, normal facial nerve function. A review of the literature is discussed as well as diagnostic considerations and treatment options including audiologic and communication rehabilitation.

Child, Preschool↗
PubMed1997

Nodular thyroid disease in children and adolescents.

Thyroid nodules in children are extremely uncommon. Most thyroid nodules, both benign and malignant, present as asymptomatic neck masses. A thyroid nodule in a child is significant because of the risk of malignancy. A review of medical records at our institution demonstrated 71 patients 20 years of age and younger with surgically managed thyroid nodules, of which 45 were benign and 26 were malignant. Our diagnostic workup, including serum thyroid studies, radiologic evaluation, and fine-needle aspiration, is discussed. Because of the possibility of malignancy, we recommend that all solitary thyroid nodules be excised in children unless fine-needle aspiration definitively determines a benign histology. The extent and type of surgical management is controversial and is still subject to much debate. Partial thyroidectomy appears adequate for benign disease, but even though there is no statistical difference in survival, we recommend total thyroidectomy for the management of malignant disease.

Adolescent↗
PubMed1996

Long-term follow-up of stapedectomy in children and adolescents.

Otosclerosis presenting in children and adolescents is uncommon. Typically, otosclerosis presents as a slowly progressive conductive hearing loss in the third to fourth decade. Many well-documented studies have demonstrated excellent long-term hearing results with stapedectomy. Although stapedectomy is highly effective, the rare complications may be devastating. Thirty-one patients, 21 years or younger, underwent 40 stapedectomies for otosclerosis at our institution. The average age at surgery was 16 years, with a range of 7 to 21 years. Postoperative results showed an average improvement in air-bone gap of 22 dB. Clinical and audiologic data were collected over a mean follow-up period of 25 years. There was no statistically significant difference in air-bone gap when comparing the immediate postoperative gap (measured 2 months after stapedectomy) with the last gap recorded (mean, 25 years after stapedectomy). Fifty percent of the ears operated on maintained an air-bone gap within 10 dB at the last follow-up, and an additional 40% maintained a 10- to 20-dB gap. There were no significant relationships between demographic or clinical factors and "success" (gap <= 10 dB) or long-term gap closure. Our data demonstrate that stapedectomy is an effective method for closing the air-bone gap in children and adolescents with otosclerosis, and long-term results parallel those of adults, showing maintenance of excellent gap closure. This review represents the largest population with the longest follow-up in children who underwent stapedectomy for the treatment of otosclerosis.

Adolescent↗
PubMed1996

The island rotation flap: a better alternative for nasal tip repair.

The use of the island rotation flap for the repair of small and medium-sized partial-thickness defects of the nasal tip and soft triangle has led to extremely favorable aesthetic results far superior to that of full-thickness skin grafts. The color and thickness match have been excellent, and the complication rate was negligible. The aesthetic results and reliability, coupled with the single stage and single operative site, make this flap an excellent option for nasal tip reconstruction. It is our procedure of choice for the reconstruction of small and medium-sized nasal tip and soft triangle defects.

Humans↗
PubMed1995

Branchio-oto-renal syndrome.

Branchio-oto-renal (BOR) syndrome is a rare, autosomal dominant genetic disorder involving branchial cleft and renal anomalies, hearing loss, and other otologic manifestations. We report a case of a family with three generations of branchial cleft anomalies and otologic anomalies with hearing loss. A review of the literature, classic clinical presentations, associated findings, and the differential diagnosis of BOR syndrome is presented. Due to BOR syndrome's variability of both penetrance and expression and a high incidence of renal the practicing otolaryngologist should consider BOR syndrome when evaluating hearing loss and branchial cleft remnants in any child.

Abnormalities, Multiple↗
PubMed1995

Thyroid carcinoma in children and adolescents.

OBJECTIVES: To categorize the clinical presentation of thyroid carcinoma in the pediatric and adolescent population and to present a philosophy of surgical management based on oncologic principles. RESULTS: Over half these children with thyroid carcinoma (55%) presented with an asymptomatic thyroid mass. Twelve of 26 patients presented with lymphatic metastasis. There were no recurrences in any patient when the neck disease was treated with cervical lymphadenectomy or when the patient received postoperative radioablative therapy. CONCLUSIONS: The prognosis is excellent even with more extensive disease in children. Total thyroidectomy along with selective neck dissection for regional metastatic disease is recommended for thyroid carcinoma. This is followed by nuclear scintigraphy with subsequent radioablation for residual or recurrent disease and thyroid suppression and/or replacement.

Adolescent↗
PubMed1994

Sinonasal hemangiopericytoma.

Sino-nasal hemangiopericytomas are rare indolent mesenchymal tumors which slowly invade local tissue. Electronmicroscopy and immunohistochemical techniques may be necessary to differentiate hemangiopericytomas from other sarcomatous tumors. Differentiation between malignant and benign tumors poses a difficult task, therefore clinical correlation as well histological confirmation is necessary to establish a diagnosis. Due to the low incidence of distant metastasis and low mortality, surgery consisting of wide local excision is usually curative.

Aged↗
PubMedDate not supplied

Analysis of methods for nasal tip reconstruction.

BACKGROUND: Numerous traditional and contemporary methods for nasal reconstruction are used today. Our investigation qualitatively analyzed different methods of nasal tip reconstruction which led to the development of an algorithm for repair based on the size, depth, and location of tissue loss. METHODS: A case series of 165 nasal tip reconstructions performed during a 2-year period followed for at least 6 months was critically analyzed with photographic documentation. RESULTS: Different methods of reconstruction exhibited varying aesthetic results. Analysis of surgical reconstructions led to the development of an algorithm based on the area of tissue defect. CONCLUSIONS: An algorithm was developed for nasal tip reconstructions based on the size and location of tissue defect. Both the recipient and donor sites were analyzed for aesthetic result and complications.

Algorithms↗