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Biomedical subjects

D C Lanza

Publications and source records attributed to D C Lanza.

7 recordsLinked to original sources
PubMed1992

Current concepts in the surgical management of chronic and recurrent acute sinusitis.

It was previously believed that sinusitis lasting longer than 3 months might lead to irreversible disease. Experience with functional endoscopic sinus surgery indicates that this is rarely the case. Functional endoscopic sinus surgery describes an approach whereby target areas of obstruction are cleared of disease, which allows for ventilation of secondarily involved sinuses and return of mucociliary function. Although endoscopic sinus surgery is one of the techniques most frequently used to manage chronic sinus disease, it is not a suitable surgical approach for every otolaryngologist or all patient settings. Success with this endoscopic approach for chronic sinus disease is based primarily on rigorous perioperative medical care and postoperative surgical debridement. The greatest advancement that the nasal endoscope has brought to patient care is the ability to diagnose disease and follow objectively the effects of different treatment modalities. This advantage is recognized by allergists and used at several centers.

Acute Disease↗
PubMed1992

Current concepts in the surgical management of nasal polyposis.

One of the most common and occasionally frustrating health care problems is that of nasal polyposis. Patient symptoms are debilitating and have a tendency to recur despite the treatment modality used. Nasal endoscopy is a significant advancement for the early diagnosis and objective assessment of treatment modalities used for nasal polyposis. Surgery used in conjunction with medical therapies offers a safe, thorough means of relieving patient symptoms. It is possible to monitor these patients closely for recurrence with nasal endoscopy as well as debride early recurrences before they become symptomatic.

Endoscopy↗
PubMed1991

Histiocytic necrotizing lymphadenitis (Kikuchi's disease).

Histiocytic necrotizing lymphandenitis (HNL), or Kikuchi's disease, is a newly recognized disease of unknown origin that causes cervical lymphadenitis, usually in young women. Initially described in Japan, cases of HNL are being reported in the United States and other western countries with increasing frequency. Symptoms of HNL include tender cervical adenopathy, fever, weight loss, and night sweats. Laboratory studies reveal leukopenia with relative granulocytopenia and lymphocytosis. Lymph node biopsy reveals areas with frank cellular necrosis, karyorrhexis, and absence of plasma cells. The histologic features of HNL are distinctive but can be confused with those of lymphoma. We describe two cases of HNL and present recommendations for diagnosis and treatment.

Adult↗
PubMed1991

Applied nasal anatomy & embryology.

The embryology & anatomy of the nose as it is applied to rhinoplasty is surveyed so that the surgeon in training can develop a basis from which to review the literature. This review demonstrates the need for the consolidation and clarification of the nomenclature associated with the complex anatomy of the nasal pyramid.

Humans↗
PubMed1990

Predictive value of the Glasgow Coma Scale for tracheotomy in head-injured patients.

Patients with severe head trauma often require prolonged intubation and subsequent tracheotomy. The Glasgow Coma Scale (GCS), an indicator of the severity of head injury, may help identify that subpopulation of trauma victims who will ultimately undergo tracheotomy. This retrospective study demonstrates through discriminant analysis that the likelihood of tracheotomy is significantly greater in patients with a GCS rating less than or equal to 7 than it is in patients with a GCS rating greater than 7 (p = .0001). Conversely, the presence of thoracoabdominal or maxillofacial injury is associated with but not predictive of eventual tracheotomy. In the hope of minimizing complications and enhancing the utilization of hospital resources, this study argues for early tracheotomy in patients with a GCS score less than or equal to 7 who do not undergo craniotomy and are otherwise stable.

Adolescent↗
PubMed1990

Early complications of airway management in head-injured patients.

Head-injured patients are frequently young, healthy individuals whose excellent medical condition is suddenly altered by trauma. The purpose of this study is to evaluate the early complications of airway management which occur in head-injured patients and to determine if these are different from what has been reported in patients with chronic illnesses (i.e., diabetes, atherosclerosis, or immunosuppression). Chart review of 52 head-injured patients reveals an early complication rate of 61% for endotracheal intubation and 20% for tracheotomy. Discriminant analysis shows that increasing duration of intubation is the most significant factor in predicting airway management complications (P less than 0.008). The incidence of complications seen in head-injured patients is similar to that of the chronically ill. Complications of endotracheal intubation are judged to be more severe than those of tracheotomy. Data from this study supports the early tracheotomy of severely head-injured patients who are likely to require prolonged airway management.

Adolescent↗