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Biomedical subjects

F S Herzon

Publications and source records attributed to F S Herzon.

At least 19 recordsLinked to original sources
PubMed1995

Short-stay outpatient tonsillectomy.

OBJECTIVE: To determine the risk of complications after discharge in outpatient adenotonsillectomy after a short (< 6 hours) period of postoperative observation. DESIGN: Retrospective chart review. SETTING: Outpatient surgery center at a university hospital. PATIENTS: All patients 18 years of age or less who were scheduled for adenotonsillectomy or tonsillectomy from January 1988 through December 1991. Two hundred fifty-five patient records were reviewed. Twenty-two patients were excluded from the study because of various complicating medical conditions that required planned overnight hospitalization leaving a study population of 233 patients. MAIN OUTCOME MEASURES: (1) Rate and type of complications; (2) duration of postoperative observation. RESULTS: Complication rates of bleeding, emesis, dehydration, and readmission were compared with rates deemed acceptable in the literature (< or = 10%). Power analysis demonstrated that the patient number was sufficient to establish a 95% confidence interval for a complication rate of 0% to 10%. The mean duration of postoperative observation was 136 +/- 48 minutes. Complications included bleeding, emesis, dehydration, and nonscheduled admissions. The total complication rate was 9% (95% confidence interval, 5.5% to 12.7%). The rate of primary bleeding was 1.4%, and all primary bleeding occurred within 75 minutes of arrival in the recovery room; no primary bleeding occurred after discharge from day surgery. This complication rate is comparable with rates previously described in the literature for patients who were observed for a 6- to 12-hour period. CONCLUSION: The findings in this study suggest that short periods of observation are safe for outpatient pediatric patients undergoing adenotonsillectomy after discharge criteria are met.

Adenoidectomy↗
PubMed1995

Harris P. Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines.

Currently there is no agreement on the treatment of patients who develop a peritonsillar abscess (PTA). This lack of consensus results in highly variable and possibly expensive therapeutic regimens that may not provide optimum quality patient care at reasonable cost. The present study evaluates surgical, medical, diagnostic, and cost factors that affect the management of PTA based on the following: 1. a cohort study of 123 patients with PTA treated using needle aspiration as the initial surgical drainage; 2. a national survey of the PTA management practices of otolaryngologists; and 3. meta-analyses of various components of the treatment regimen for PTA. In the cohort study, patients diagnosed with PTA were treated by both otolaryngologists and emergency medicine specialists with needle aspiration as the primary surgical modality resulting in a 96% acute resolution rate for PTA. In the national survey, questionnaires were sent to 2000 randomly selected members of the American Academy of Otolaryngology-Head and Neck Surgery regarding their management of PTA. The return rate was 73%. Ninety-six percent of the physicians who returned survey forms treated an average of seven PTAs per year using either needle aspiration, incision and drainage, or abscess tonsillectomy to drain the abscess initially. The incidence of PTA in the United States and Puerto Rico among patients 5 to 59 years of age treated by survey practitioners is 30.1 per 100,000 person years, accounting for approximately 45,000 cases per year. Four meta-analyses were completed to quantify the success rate of needle aspiration in the treatment of PTA (94%), the recurrence rate of PTA (10% to 15%), the rate at which penicillin-resistant microorganisms are found in patients with PTA (0% to 56%), and the rate of prior oropharyngeal infections associated with PTA (11% to 56%). The recurrence rate for PTA in the United States is 10%, which is significantly different from the recurrence rate of 15% reported from the rest of the world (P < .002). A clinical intervention for PTA is proposed based on the clinical series, the national survey data, and the meta-analyses. These clinical guidelines recommend that needle aspiration be used as the initial surgical drainage procedure for all patients with a PTA other than those who have indications for abscess tonsillectomy. Patients should be treated in an outpatient setting, should receive penicillin if they are not allergic to it, and should receive adequate pain medication. The evidence does not suggest that there is any benefit in examining the abscess contents for microorganisms. Approximately 30% of patients with PTA can be expected to exhibit relative indications for a tonsillectomy.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1994

Coexistent thyroid cancer and pregnancy.

OBJECTIVE: A study was performed to determine the appropriate time for the initiation of therapy for thyroid carcinoma first diagnosed during pregnancy. DATA SOURCES: Material on thyroid cancer cases was obtained from the New Mexico Tumor Registry, Albuquerque, a computerized population-based registry for the state of New Mexico, and the Indian reservation facilities in New Mexico and Arizona (a Surveillance, Epidemiology, and End Results Registry funded by the National Cancer Institute, Bethesda, Md) for the period 1970 to 1991. STUDY SELECTION: All cases of thyroid cancer, except medullary and anaplastic, in patients aged 18 to 46 years were evaluated. Subgroups were established for (1) all women who were noted to be pregnant at the time of their initial diagnosis and (2) all women with thyroid cancer in the 18- to 46-year-old age group. DATA EXTRACTION: The information was extracted by a certified tumor registrar for age, sex, thyroid cancer, specific type of thyroid cancer, period, race, year of diagnosis, accession date, last date seen, tumor status, treatment, and patient status. DATA SYNTHESIS: There have been no deaths in the pregnant group with a follow-up ranging from 0.5 to 20 years. There was no statistically significant difference in observed survival rates between the pregnant group and 465 women, aged 18 to 46 years, with comparable thyroid cancers or in the death rates of women aged 18 to 67 years in the general population. CONCLUSIONS: Surgical treatment for patients with well-differentiated thyroid cancer diagnosed during pregnancy can be delayed until after parturition.

Adolescent↗
PubMed1988

Needle aspiration of nonperitonsillar head and neck abscesses. A six-year experience.

Twenty-five patients with various head and neck abscesses have been managed with needle aspiration as the initial surgical modality over a six-year period. Twenty (83%) of 24 patients' abscesses resolved without formal surgical intervention. Patient 25 in the series whose abscess, though initially resolving, reaccumulated within two weeks requiring an incision and drainage. Recurrent cancer was then diagnosed. Eight of ten large-volume abscesses (over 10 mL) were controlled with needle aspiration. Fourteen patients required multiple aspirations, five of whom had indwelling catheters placed to facilitate abscess decompression. These data confirm that needle aspiration is an effective means of controlling nonperitonsillar abscesses of the head and neck.

Abscess↗
PubMed1985

Management of nonperitonsillar abscesses of the head and neck with needle aspiration.

Ten patients in a three-year period with various abscesses of the head and neck (nonperitonsillar) were treated with needle aspiration as the primary surgical modality. Eight were successfully managed with antibiotics and needle aspiration alone. Two required incision and drainage. Three patients had large volume abscesses (greater than 10 cc). Two of these resolved with multiple needle aspirations. These data suggest that certain nonperitonsillar abscesses of the head and neck may be successfully managed with needle aspiration and antibiotics.

Abscess↗
PubMed1984

Permucosal needle drainage of peritonsillar abscesses. A five-year experience.

Forty-one patients with proved peritonsillar abscesses were treated during a five-year period with needle aspiration as the sole initial surgical treatment. Ninety percent (37/41) of the patients' abscesses resolved without further invasive therapy. All but two of the patients were treated as outpatients. Fifty percent (21/41) of the patients were treated by nonotolaryngologists. These data indicate that outpatient needle aspiration is the simplest, most cost-effective therapy for peritonsillar abscess.

Administration, Oral↗
PubMed1984

Functional hearing loss presenting as sudden hearing loss: a case report.

A case of functional hearing loss presenting as sudden sensorineural hearing loss in the only hearing ear of a musician is presented. Pure-tone audiometric evaluation showed good intratest and intertest consistency. The pitfalls of diagnosis, ultimately made by brain stem evoked response audiometry, are discussed in light of the literature on sudden and functional hearing loss. Psychiatric evaluation revealed features consistent with hysterical conversion. It is argued that it is important to establish the exact etiologic agent of functional hearing loss despite the difficulty of diagnosis so that the patient may receive appropriate treatment.

Adult↗
PubMed1980

Electroacoustic assessment of the semipermeable tympanic ventilating tube. A physical model.

The semipermeable membrane ventilating tube has been in use for the past few years. Initial evaluation of this tube indicated that electroacoustic impedance measurements could be used to measure in situ patency. Our clinical experience seemed to question this assumption. A physical model was developed to evaluate the validity of using electroacoustic impedance measurements to test patency of membrane-type ventilating tubes. Our results indicate that volume impedance measurements cannot be used to evaluate patency. Pressure clearance studies validated the efficacy of the membrane tubes but would not appear to be a reliable method for in vivo evaluation of patency.

Acoustic Impedance Tests↗
PubMed1980

Tympanostomy tubes. Infectious complications.

Tympanostomy tube placement for a variety of indications is one of the most commonly performed surgical procedures in the United States. In the voluminous literature on the subject, little attention has been paid to the infectious complications associated with the insertion of tympanostomy tubes. A 4 1/2-year retrospective study of 140 patients to examine this problem revealed that 21.4% had otorrhea at least once during intubation. Five patients had prolonged and complicated problems associated with otorrhea. These problems are examined in detail, and the implications of the otorrhea associated with tympanostomy tubes are discussed.

Anti-Bacterial Agents↗
PubMed1978

Autotransfusion in otolaryngology.

Homologous blood transfusions have rare but serious complications that may be eliminated by using autotransfusion for elective surgery in the head and neck. With a small amount of planning, virtually all of the blood necessary for any surgical procedure in the head and neck can come from the patient.

Blood Transfusion, Autologous↗
PubMedDate not supplied

Head and neck cancer--emotional management.

The complete care of a patient with head and neck cancer should attend to the emotional as well as the physical aspects of the disease; usually the physical component of the disease is emphasized, while care of the emotional response of the patient and family is rarely addressed. There is no single, caring way to respond or cope with the emotional aspects of this disease. Nonetheless, it should be underscored that communication between the providers of health care (i.e., physician, nurse, aid, therapist, etc.) and the patient and family should be maintained during all phases of care. This article describes an approach to providing emotional support to cancer patients and their families during the phases of initial diagnosis and treatment, posttherapy, rehabilitation, recurrence, dying, and death. The emotional response of the health care provider in these circumstances is also addressed.

Death↗
PubMedDate not supplied

Normal ciliary ultrastructure in children with Kartagener's syndrome.

Kartagener's syndrome has been found to be associated with the immotile cilia syndrome (lack of dynein arms and defective radial spokes in cilia). The ultrastructure of cilia of a child with Kartagener's syndrome was examined and found to be within normal limits. The implications of this are discussed.

Cilia↗