Corporate managed care.
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Managed Care Programs↗
Biomedical subjects
D Druker
Publications and source records attributed to D Druker.
Vocal evaluation of thyroplastic surgery in the treatment of unilateral vocal fold paralysis.
Vocal function was assessed in 15 patients who received thyroplasty type I for the rehabilitation of unilateral vocal fold paralysis. The function was assessed by perceptual evaluation, voice intensity and frequency range profiles, and questionnaire. Goals of the study were to evaluate the efficacy of thyroplasty in improving the voice, to compare postoperative thyroplasty voices to normal voices, and to correlate objective measurements to the results of the questionnaire regarding satisfaction with the voice. Perceptual evaluations were performed by randomizing normal and thyroplasty voices on a recording tape. The voices on the tape were then rated by independent, blinded, trained listeners. The perceptual qualities of pitch, intonation, and loudness were not statistically different than normals; however, voice qualities of strain, breathiness, hoarseness, harshness, and unsteadiness were different than normals. Mean frequency range and mean intensity range were moderately to severely reduced from normals with a wide variation being present in the results. The correlation between the higher threshold phonation pressures and decreased intensity ranges found in some patients is discussed. Questionnaire results indicated that a high degree of satisfaction with the surgery was present (92%). Extreme or general satisfaction with voice was present in 73%. The most difficult voicing was experienced at work, with 25% needing to adjust their employment to accommodate their voice abilities. These results indicate that thyroplasty type I is effective in partially rehabilitating unilateral voice fold paralysis. Voice function is still not normal, probably in part due to the underlying disease.
Adolescent↗
An effective cosmetic treatment for Ota's nevus.
The congenital facial melanocytic lesion Ota's nevus is reviewed, and an effective cosmetic treatment--sequential dry ice application and epidermal peeling combined with argon laser--is discussed. It is emphasized that Ota's nevus is not simply a dermal lesion and that patients should receive careful ophthalmological follow-up.
Adult↗
Benefits of the CO2 laser for verruca resistant to other modalities of treatment.
The benefits of the carbon dioxide (CO2) laser in the treatment of verruca resistant to other forms of treatment have been studied. Twenty-five patients with warts unsuccessfully treated from one to five times previously were treated with the laser, followed for a minimum of 6 months, and evaluated. Eight of these patients (32%) gained a total permanent cure. An additional five treatments resulted in a subtotal (over 75%) cure but some warts remained. Thus, 13 of 25 patients (52%) experienced complete or partially successful treatment. The CO2 laser is a valuable modality in the treatment of recalcitrant warts but cannot be expected to cure all such warts.
Adolescent↗
Granuloma faciale. Treatment with the argon laser.
Three patients with granuloma faciale were successfully treated by argon laser therapy. The intense blue-green laser light is readily absorbed by these inflammatory lesions, resulting in resolution of the clinical and microscopic abnormalities. There were no recurrences during follow-up periods of 23, 21, and 5 months, respectively. Argon laser therapy appears to be an important addition to the treatment armamentarium for this uncommon, but difficult to treat, entity.
Adult↗
CO2 laser resection for giant perineal condyloma and verrucous carcinoma.
Three cases of giant perineal condyloma are detailed and the spectrum of condylomas and verrucous carcinoma is reviewed. The benefits of the CO2 laser in treatment of these lesions include hemostatic incision, wound sterilization, and restriction of lymphatic spread.
Adult↗
Subungual osteochondroma. Differential diagnosis and treatment.
Subungual osteochondroma, a rare disorder of the fingers and toes, occurred in five patients. Clinical features of the condition include nail deformation, history of long, slow growth, and characteristic radiologic features. Surgery is directed toward total tumor resection with preservation of the nailbed to achieve normal nail growth. Differential diagnosis included bony, cartilagionous, and soft tissue tumors as well as cystic lesions. Malignant tumor should be suspected by not confused with this benign disorder. Roentgenologic examination is indicated in the differential clinical diagnosis of any subungual mass.
Adolescent↗
Treatment of colloid milium of the hand by dermabrasion.
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Dermabrasion↗