PubMed Health⌕ Search

Biomedical subjects

Daniel G Becker

Publications and source records attributed to Daniel G Becker.

28 records · Page 2Linked to original sources
PubMed2003

Sinusitis.

Sinusitis is one of the most common health care complaints in the United States. Approximately one in eight people in the US will have sinusitis at one time in their lives. Until recently, sinusitis has been an undertreated disease. The drastic negative effect of sinusitis on patients' quality of life has been generally underappreciated and unrecognized. Recent studies show that patients score the effects of chronic sinus disease in areas such as bodily pain and social functioning as more debilitating than diseases such as angina, congestive heart failure, emphysema, chronic bronchitis, and lower back pain, to name a few. In the past, many patients were told they would just have to "live with" their sinus problem. However, there have been enormous advances in the past 15 years in the ability to diagnose and treat these problems. This is largely because of technological advances in nasal endoscopy and X-ray imaging. Also, the development of newer, more powerful medications and significant advances in surgical treatment have played a major role in improved patient care. In this article, we provide an overview of sinusitis. We describe the modern definition of sinusitis and the normal physiology of the sinuses. We discuss the causes of sinusitis with attention to the role of allergies, acid reflux, and other related disorders. Finally, we review the current approach to the diagnosis of sinusitis.

Humans↗
PubMed2003

Medical treatment of sinusitis.

Treatment of sinusitis is aimed at eliminating causative factors and controlling the inflammatory and infectious components. Ideal management includes preventative measures, including the use of specific medications in proper dose and duration. In this article, we review many of the medical treatments available for the management of sinusitis.

Anti-Bacterial Agents↗
PubMed2003

The minimally invasive, endoscopic approach to sinus surgery.

When anatomic abnormalities of the nose and sinuses contribute to sinusitis, and when medical therapy has failed, these anatomic or structural abnormalities can be surgically corrected. Examples of anatomic problems include nasal polyps, nasal septal deviations, and blockage of the osteomeatal complex--the "crossroads" of the sinuses. Endoscopic techniques allow sinus specialists to diagnose and treat these problems more easily than in the past, allowing them to be more proactive in the management of anatomic nasal abnormalities. In this article we review the minimally invasive, endoscopic approach to sinus surgery and discuss recent advances in sinus surgery. Specifically, we discuss the utility of powered instrumentation and image guidance in endoscopic sinus surgery.

Adult↗
PubMed2003

Rhinoplasty.

Rhinoplasty--surgery to reshape the nose--is a common procedure for both cosmetic and functional requests. In this article, the author provides an overview of rhinoplasty, with special emphasis on the surgical anatomy and preoperative analysis of appearance. A review of some of the surgical techniques at the disposal of the rhinoplasty surgeon is also provided and illustrated with patient examples.

Adult↗
PubMed2003

Management and prevention of tetanus.

The World Health Organization was committed to eliminating neonatal tetanus by 1995. Three years after this date, the infection killed over 400,000 babies a year, even though a safe, effective vaccine had been available for most of this century. The frequency of tetanus in the developing world epitomizes the healthcare disparity between the developed and the developing world. Consequently, the priority of the medical profession must be prevention, with the development of simpler immunization schedules with longer protection. Consequently, the purpose of this collective review is to provide an overview to the management of tetanus as well as to review the immunization strategy that will prevent this potentially deadly illness. Tetanus is caused by Cloistridium tetani, which is an obligate anaerobic, gram-positive rod that is motile and readily forms endospores. Although C. tetani is located everywhere, the disease is encountered largely in underdeveloped, overcrowded, and economically disadvantaged countries. C. tetani is widespread in the feces of domestic animals and humans, while spores of C. tetani are abundant in soil and in the environment surrounding the habitation of humans and animals. Tetanus usually follows deep penetrating wounds where anaerobic bacterial growth is facilitated. Three basic forms of tetanus may be distinguished: local, cephalic, and generalized. At least 80% of the cases are the generalized form. In the adult patient, the most characteristic sign of generalized tetanus is lockjaw, or trismus. The diagnosis of tetanus is most frequently made on clinical manifestations, rather than on bacteriologic findings. The three objectives of management of tetanus are: (1) to provide supportive care until the tetanospasmin that is fixed in tissue has been metabolized; (2) to neutralize circulating toxin; and (3) to remove the source of tetanospasmin. Because there is essentially no immunity to tetanus toxoid, the only effective way to control tetanus is by prophylactic immunization.

Adult↗
PubMedDate not supplied

The extended columellar strut-tip graft.

The extended columellar strut-tip graft is a structural unit used in endonasal rhinoplasty that combines the attributes of the columellar strut and the tip graft. It is used to provide projection and contour to the nasal tip. Our goal with this study was to evaluate a 15-year experience with 155 patients who underwent rhinoplasty with the extended columellar strut-tip graft. Of these, 110 underwent secondary rhinoplasty, and 45 underwent primary rhinoplasty. There were 6 patients in the secondary rhinoplasty group who experienced complications: in 3, the graft became visible postoperatively, and 3 patients had graft placement asymmetry. These 6 patients underwent surgery in the initial years of graft development. One patient with graft edge visibility and 1 patient with graft asymmetry underwent revision surgery with satisfactory results. The extended columella strut-tip graft is a reliable method to provide nasal tip projection and contour. The successful use of the graft requires precise diagnosis and surgical technique.

Adult↗
PubMedDate not supplied

Intermediate crural overlay in rhinoplasty: a deprojection technique that shortens the medial leg of the tripod without lengthening the nose.

OBJECTIVE: To review the indications for, surgical techniques of, and results of intermediate crural overlay of the alar cartilages in rhinoplasty. DESIGN: Prospective study of patients undergoing intermediate crural overlay of the lower lateral cartilages. The setting was a facial plastic surgery private practice. Patients included 10 primary rhinoplasty patients and 1 revision rhinoplasty patient who underwent intermediate crural overlay of the lower lateral cartilages. The main outcome measures were postoperative photographs and patient records, which were reviewed for tip projection and rotation, preservation of the double break, bossae, and knuckling. RESULTS: Intermediate crural overlay decreased projection in all 11 patients and increased the nasolabial angle in 7 patients. One patient had no change in the nasolabial angle, and 3 patients had counterrotation of 1 degrees , 3 degrees , and 4 degrees . A postoperative physical examination revealed that no patient had developed bossae, tip asymmetries, or knuckling. In addition, the double break was maintained in all the study patients. CONCLUSIONS: Intermedial crural overlay is a reliable technique for achieving tip deprojection. Overall, the nasolabial angle is maintained (although in 3 patients, clinically insignificant counterrotation did occur). In addition, the length of the intermediate crura is reduced, but the double break is preserved. In the group of patients with thin skin and tip overprojection secondary to overdevelopment of the lower lateral cartilages, intermediate crural overlay achieves tip deprojection while controlling the nasolabial angle and preserving the natural curvature of the dome.

Adolescent↗
PubMedDate not supplied

An Internet otolaryngology referral center: a preliminary report.

BACKGROUND: The aim of this study was to review our early experience with the UPenn Otolaryngology Referral Center Website, ENTConsult.org. METHODS: ENTConsult.org is an interactive website that allows a referring physician to select a University of Pennsylvania Health System otolaryngologist and share clinical information, including uploaded pictures, radiographs, and other images via the Internet. Traditional methods of long-distance consultation involve mailing clinical information, which often is slow and unwieldy, thus discouraging consultation. ENTConsult.org seeks to take advantage of Internet functionality to facilitate efficient and timely consultation regardless of any of the participants' locations. RESULTS: In this report we reviewed our initial experience with ENTConsult.org, including an overview of the website functionality and a detailed review of critical logistical considerations. CONCLUSION: The UPenn Otolaryngology Referral Center Website ENTConsult.org offers considerable promise as an avenue for long-distance referral and consultation.

Humans↗