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Biomedical subjects

E Rontal

Publications and source records attributed to E Rontal.

At least 19 recordsLinked to original sources
PubMed1991

Studying whole-mounted sections of the paranasal sinuses to understand the complications of endoscopic sinus surgery.

Endoscopic techniques for paranasal sinus surgery have allowed detailed and complete removal of sinus disease while promising minimum distress to the patient. The telescopic view of the operative field shows detail of the sinus anatomy and its disease, not possible in earlier transnasal techniques. Several articles document the serious complications seen with the endoscopic surgery. To understand the paranasal sinuses and their relationships to the orbit and cribriform plate, blocks of cadaver heads that included the orbit and paranasal sinuses were whole sectioned. It has been possible to see areas of the cribriform and orbital wall that are at risk to produce cerebrospinal fluid rhinorrhea and orbital complications. At the same time, landmarks for avoiding these complications can be defined to guide the surgeon during this dissection as seen through the endoscope.

Endoscopy↗
PubMed1991

A method for the treatment of abductor spasmodic dysphonia with botulinum toxin injections: a preliminary report.

A preliminary technical report of the effective treatment of abductor spasmodic dysphonia with botulinum toxin is presented. Our technique attempts to place the toxin close to the posterior cricoarytenoid muscle to allow diffusion of the material to the PCA. Our pilot study demonstrates that botulinum toxin is an effective approach for reducing or eliminating the abductor glottal spasms during phonation and, thereby, providing functional speech communication.

Adult↗
PubMed1991

Vocal cord injection techniques.

Injection techniques for the rehabilitation of paralytic dysphonia (e.g., Teflon) remain popular in the United States. This article presents a historical perspective of vocal cord paralysis, its work-up, and the indication, timing, techniques, and results of vocal cord injection.

Humans↗
PubMed1990

Endoscopic laryngeal surgery for bilateral midline vocal cord obstruction.

There are a number of treatment regimens for bilateral laryngeal paralysis, ranging from tracheostomy to external microscopic approaches. None has become the standard because of their unpredictable results and/or the need for an external approach. Recently, the use of micro-trapdoor flaps and suturing done via a laryngoscope has shown a possibility of correcting the airway problem, allowing a predictable result, with a completely endoscopic approach. This paper presents our experience with a group of 10 patients who had at least one treatment attempt that failed and were treated by endoscopic laryngoplasty. Eight have been decannulated.

Adult↗
PubMed1987

The use of sialodochoplasty in the treatment of benign inflammatory obstructive submandibular gland disease.

One of the most common causes of submandibular gland enlargement is benign inflammatory disease. The usual cause is ductal outflow obstruction due to either a calculus or stenosis allowing stasis and retrograde movement of the saliva into the acinar structures leading to an inflammatory response and gland enlargement. Faced with a submandibular mass, a work-up that will rule out neoplastic causes of submandibular enlargement is instituted. This includes clinical assessment, probing of the gland, radiocontrast sialography, and CT scanning. The treatment should reflect the obstructive nature of the disease. Plastic reconstruction of the duct allows the removal of calculi, shortening of the duct, and enlargement of the outflow opening preventing recurrence and allowing healing of the gland. The procedure is performed intraorally as an outpatient, does not disrupt oral functioning, or subject the patient to the risks of gland removal or loss of that organ's function. Our experience with 27 patients over a 7-year period is presented with a detailed description of the technique and an analysis of the results. The procedure was successful in 22 of the 27 patients.

Evaluation Studies as Topic↗
PubMed1986

Laser palliation for esophageal carcinoma.

The treatment of esophageal carcinoma presents itself or evolves into a palliative situation. The most likely symptom to distress the patient is obstruction. It is necessary to have available a means of alleviating this symptom in a way that will be effective, comfortable, and efficient in terms of time and expense. The Nd:YAG and the carbon dioxide lasers can give this type of palliation. This review of our experience in the cervical and lower two thirds of the esophagus has led us to believe that true palliation can be effected in both areas. Treatment is easier and more straight forward in the lower esophagus. The results in the upper one third require more care, but can be just as rewarding.

Adenocarcinoma↗
PubMed1985

Jet insufflation anesthesia for endolaryngeal laser surgery: a review of 318 consecutive cases.

A series of 318 patients utilizing the jet insufflation technique for laser laryngeal anesthesia was studied. The technique utilizes a foil wrapped catheter placed below the vocal cords and attached to the Sanders ventilating adapter. Two pneumothoraces in children, one dental injury and one tube ignition were noted--all without permanent sequelae. Subsequent modification in technique prevented recurrence of these complications. The results indicate that this is a safe technique for laryngeal laser surgery, providing excellent visualization of the larynx while maintaining good oxygenation and airway control.

Anesthesia, Endotracheal↗
PubMed1983

Treatment of recurrent carcinoma at the base of the skull with carbon dioxide laser.

The extension of carcinoma to the cribriform plate is a poor prognostic finding. Two extremes of treatment approach have been advocated. On the one hand, patients may be abandoned to palliative chemotherapy. On the other hand, heroic and aggressive resections may be advocated including combined neurosurgical transdural and otolaryngologic facial-orbital resection. Armed with the surgical microscope and the CO2 laser there may be a place for a middle ground of therapy. We present our experience with recurrent tumor after full course radiation therapy and maxilloethmoidectomy. The biopsy proven recurrences were found at the cribriform plate but could not be shown to have crossed into the anterior cranial fossa by polytomography or high resolution CT scanning. The CO2 surgical laser delivered through the surgical microscope was used with repeated applications. Recurrent epidermoid carcinoma found to be confined to the nasal side of the cribriform plate can be controlled by careful microscopic stripping of soft tissue from the cribriform plate with a surgical laser.

Adult↗
PubMed1980

Jet insufflation anesthesia for endolaryngeal surgery.

The ideal anesthetic in endolaryngeal surgery provides a quiet completely unobstructed larynx in a patient who is comfortable and has respiratory functions maintained. Dissatisfaction with the intubation and venturi techniques has led to the use of a high pressure jet insufflation method. The results of this study have shown that anesthetically this technique is safe for a wide range of patients and endoscopic procedures. Laryngologically, the absence of glottic obstruction has broadened the scope of endoscopic procedures performed under general anesthesia.

Anesthesia↗
PubMed1977

Lesions of the vagus nerve: diagnosis, treatment and rehabilitation.

Lesions of the vagus nervous system have devastating effects on the vital functions of coughing, swallowing and phonation. A clear understanding of the vagal correlative anatomy and physiology leads to a practical organization of upper respiratory and digestive tract lesions. A reasoned and thoughtful treatment plan evolves that leads the patient to comprehensive treatment and rehabilitation.

Adolescent↗
PubMed1977

Facial injuries in hockey players.

As otolaryngologists become more involved with maxillofacial trauma, we are encountering an increasing number of athletic injuries. Ice hockey accounts for a large number of these facial injuries. The fast moving and random nature of the game, frequent body and equipment contact and lack of protective devices, predisposes the hockey player to facial injury. Because of the roughly tenfold increase in hockey participation over the last decade, the problem of facial injury prevention has become a significant public health problem in North America. Review of the medical literature shows a paucity of interest in the subject of facial injury prevention in hockey. Several articles have dealt with ocular injury, while other articles have dealt with the general subject of hockey injury with only scant attention paid to the facial area. A retrospective study was carried out to more clearly define the scope of the facial injury problem. Four levels of hockey play were examined. Individuals from the youngest and most inexperienced to seasoned professionals were studied. An individually completed questionnaire was received from players in each group. It is the purpose of this paper to indicate the rates of injury for the various types of facial trauma, present their mechanisms of occurrence and discuss means of preventing facial injury in hockey players.

Athletic Injuries↗
PubMed1976

Vocal cord injection in the treatment of acute and chronic aspiration.

The problem of maintenance of proper tracheobronchial toilet is frequently a determining factor in the morbidity and mortality of patients with vocal cord paralysis. Aspiration from an incompetent glottis can cause pneumonitis and its attendant complications. Standard management of tracheobronchial toilet in patients with vocal cord paralysis has involved direct or indirect suctioning of the trachea; however, only the symptoms and not the anatomic defect are treated by these measures. Largely due to the work of Arnold and Lewy, the technique of vocal cord injection has been advocated as a method of correcting the anatomic deficiencies in patients with vocal cord paralysis, and has been advocated in the past to prevent recurrent and chronic aspiration. This study has shown that vocal cord injection increases the ability to maintain maximum peak intraluminal air pressures following injection. It has also shown that there is an increased ability to maintain air flow by glottic closure following injection. Eleven patients were studied, each of whom has been evaluated separately in this paper. The use of vocal cord injection should be more widely used by otolaryngologists and chest disease specialists for treatment of physiologic problems as well as correcting vocal disturbances.

Adolescent↗
PubMed1975

The use of spectrograms in the evaluation of vocal cord injection.

The utilization of voice spectrography can be an important adjunct to the assessment of vocal cord function by both laryngologists and speech pathologists. It is especially useful in determining the effectiveness of vocal cord Teflon paste injection procedures. Dysphonic characteristics are made visible, and their improvement can be monitored. As such, spectrographic analysis should be considered as a useful tool for the laryngologist.

Adult↗