PubMed Health⌕ Search

Biomedical subjects

C M Myer

Publications and source records attributed to C M Myer.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Tracheotomy in children with recurrent respiratory papillomatosis.

Fifty-eight patients with laryngeal papillomatosis were managed at Children's Hospital Medical Center, Cincinnati, OH, between January 1978 and December 1987. Twelve of these patients (21%) had tracheotomies. A retrospective review of these 12 cases was undertaken to determine the incidence, pattern, timing, and clinical risk factors for tracheal spread after tracheotomy. Six of 12 patients (50%) developed tracheal papillomas after tracheotomy. Peristomal mucosa was consistently the site of initial involvement followed by progressive distal spread along the length of the tracheotomy tube. Stomal involvement followed tracheotomy by an average of 14 weeks, occurring as early as 7 weeks postoperatively. Mid-tracheal spread followed stomal involvement by an average of 10 weeks. Risk factors for tracheal spread included the presence of subglottic disease at the time of tracheotomy and prolonged cannulation. Whenever possible, tracheotomy should be avoided in patients with recurrent respiratory papillomatosis. When unavoidable, every effort should be made to keep the duration of cannulation as short as possible.

Child↗
PubMedDate not supplied

Laryngeal cystic hygroma.

An unusual case of cervical cystic hygroma with laryngeal extension is reported. A patient with acute upper airway obstruction due to a laryngeal lesion was seen 18 years after the original cervical surgery. Maintenance of an adequate airway has required a partial laryngectomy in addition to repeated endoscopic procedures for removal of recurrent disease. The rationale for this therapy is discussed in light of the current literature.

Female↗
PubMedDate not supplied

Proliferative myositis of the mylohyoid muscle.

Proliferative myositis (PM) is a head and neck mass of rare etiology. In a review of the literature, 57 cases of PM were found. Of these, only 12 occurred in the head and neck region. Proliferative myositis is most rare in children, with only three reported cases, none of which involved the head and neck region. A case of a 9-year-old girl with PM of the mylohyoid muscle, presenting as a neck mass, is reported.

Biopsy↗
PubMedDate not supplied

Group C streptococcal sinusitis.

The group C streptococci have emerged as important human pathogens. A case of group C streptococcal sinusitis in a 6-year-old girl is reported and four cases of group C streptococcal sinusitis are reviewed. Age less than 18 years, central nervous system complications, and a delay in the institution of adequate therapy were features common to all five cases. Three patients were bacteremic with group C streptococci and two patients died. These cases suggest that when beta-hemolytic streptococci are isolated from sinus culture, serogrouping should be performed. When group C streptococci are identified, appropriate antimicrobial therapy should be instituted and one should be alert for suppurative intracranial complications.

Adolescent↗
PubMedDate not supplied

Subglottic stenosis and Down syndrome.

The possibility of subglottic stenosis in children with Down syndrome is well recognized. Nevertheless, this anomaly and its effect on laryngeal and respiratory function are frequently overlooked. When subglottic stenosis is present in a child with Down syndrome, the standard intubation technique may require modification. In these children, an endotracheal tube of a size appropriate to the patient's age may be too tight in the subglottic area. By aggravating a previously asymptomatic subglottic stenosis, long-term endotracheal intubation in this type of patient may be more likely to lead to a clinically significant subglottic stenosis. In our experience, subglottic stenosis in children with Down syndrome is more difficult to repair and is associated with a lower success rate of decannulation. Additionally, it is important in the management of these children not to create an even more severe subglottic stenosis.

Adolescent↗
PubMedDate not supplied

Anterior cricoid split. Update 1991.

The management of neonatal subglottic stenosis by the anterior cricoid split procedure (ACS) has evolved rapidly since this operation was first described by Cotton and Seid in 1980. Recent reports have specified criteria for the evaluation of patients for ACS, and adherence to these guidelines has increased the extubation rate and decreased the mortality rate in these series. Ninety-one patients have undergone anterior cricoid split at Children's Hospital Medical Center (Cincinnati, OH) since 1977. These cases were reviewed, emphasizing the 24 infants treated since January 1, 1988, and not previously reported. In comparison to our most recent report of 70% extubation and 10.4% mortality, 67% of the latest group were extubated, while mortality was reduced to 4.1%. These results were achieved despite some relaxation of strict patient-selection guidelines when this was appropriate in individual patients, emphasizing the need for careful clinical evaluation and close consultation between otolaryngologist and pediatrician in the selection of patients for ACS.

Airway Obstruction↗
PubMedDate not supplied

Atypical tracheobronchial vascular compression.

Vascular compression of the tracheobronchial tree frequently presents early in infancy with significant airway compromise. For this reason, the pediatric otolaryngologist is often consulted early in the assessment of these patients. Three unusual cases of tracheobronchial vascular compression are presented. The diagnosis and management of children with tracheobronchial vascular compression is discussed, stressing the importance of synchronous airway anomalies and associated congenital cardiac anomalies. Although surgical intervention may be corrective in most cases of vascular compression, persistent tracheomalacia may necessitate tracheotomy for a prolonged period.

Airway Obstruction↗
PubMedDate not supplied

Complications of adenotonsillectomy in children under 3 years of age.

Adenotonsillectomy in children may be performed safely on an outpatient basis in the majority of cases without an increase in complication rates. However, very young children comprise a unique patient subpopulation with regard to adenotonsillar surgery. Surgical indications in older children tend to be dominated by chronic recurrent infections, whereas younger children usually require surgery for chronic upper airway obstruction related to adenotonsillar hypertrophy. This study was undertaken to evaluate the adenotonsillectomy patient population under 3 years of age. Complication rates related to airway problems, hemorrhage, and dehydration were determined. Children under 3 years of age demonstrated an increased incidence of postoperative airway complications, manifested by oxygen desaturation and transient upper airway obstruction. It is recommended that adenotonsillectomy be performed on such patients on an inpatient basis with close postoperative monitoring including pulse oximetry.

Adenoidectomy↗