Biomedical subjects
G Har-El
Publications and source records attributed to G Har-El.
The transcervical approach to the superior mediastinum.
We describe our experience with the transcervical approach for the surgical treatment of nonthyroidal superior mediastinal masses. With careful patient selection, proper preoperative workup, and proper operative positioning and technique, the entire superior mediastinum may be explored, thus avoiding the significant morbidity associated with the transsternal route. The transcervical approach requires a thorough knowledge of the surgical anatomy. Nine patients underwent transcervical exploration of the superior mediastinum. The indications included parathyroid adenoma, thymoma, congenital cyst, hemangioma, adenocarcinoma, and thymectomy for myasthenia gravis. We specifically discuss the role of thymectomy in the treatment of myasthenia gravis.
Giant cell variant of malignant fibrous histiocytoma of the head and neck.
The giant cell variant of malignant fibrous histiocytoma is a rare entity in head and neck. Only eight well documented cases of this type are reported in the English literature. These tumours affect the superficial and deep structures of the neck most often and are best treated with prompt radical surgery. The prognosis of the giant cell type of malignant fibrous histiocytoma is dependent on the location of the tumour, with superficial tumours having a much better outlook.
Merkel's cell carcinoma.
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Choanal atresia and lymphedema.
The coexistence of bilateral bony choanal atresia and lower-extremity lymphedema was observed in a family with several consanguineous marriages. The combination of these two rare anomalies, in a hereditary form, has not been described before.
Multiple branchiogenic anomalies.
A family with three generations of male-to-male transmission of a rare syndrome is presented. The syndrome includes bilateral cervical branchial sinuses, bilateral preauricular sinuses, bilateral malformed auricles and bilateral hearing impairment. Two important aspects of this syndrome are discussed. First, male-to-male transmission rules out a sex-linked mode of inheritance. Second, the finding of both conductive and sensorineural hearing loss is puzzling since the middle and inner ear differ in embryogenesis as to both origin and timing. Few explanatory mechanisms are discussed.
Haemangioma in a cervical lymph node.
Haemangiomas of the head and neck are mainly cutaneous or mucosal; rarely, they may be found in bone or soft tissue. Haemangiomas of lymph nodes are extremely rare; here we present such a case in a cervical lymph node. This is, to the best of our knowledge, only the second report of such an entity.
Infectious mononucleosis complicated by lingual tonsillitis.
Although upper airway obstruction and superimposed infection are well-known complications of infectious mononucleosis, lingual tonsillitis in this context has not been mentioned in the literature. We describe a case of acute bacterial lingual tonsillitis with airway obstruction complicating infectious mononucleosis. The role of the base of tongue region in the pathophysiology of infectious mononucleosis is discussed.
Melanosis of the larynx.
A case of laryngeal melanosis is presented. This is followed by the analysis of the total of nine cases reported in the English literature. Patients are men in their sixth to eighth decade of life who present with hoarseness. Histopathologic findings include pigment deposits in the basal layer of the laryngeal epithelium. The possible relation of this lesion to carcinoma of the larynx is discussed.
Purpura fulminans of the head and neck.
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The combined use of muscle flaps and alloplasts for tracheal reconstruction.
This report documents our experience with a different concept in reconstructive head and neck surgery. This concept, we hoped, would enable us to reconstruct anatomic regions with a special contour that is otherwise difficult to achieve with conventional flaps and grafts. The first stage of this method includes implantation of a preshaped alloplastic material in a donor site of a commonly used myocutaneous flap and waiting 4 to 6 weeks for the implant to "take." The second stage includes raising the pedicled flap with the implant and transferring it to reconstruct the defect. As a model for this approach, tracheal defects in dogs were created and reconstructed. The technique used in this study can be specifically applied to reconstruction of tracheal defects, ie, subglottic stenosis, and also can be used for other defects in the head and neck region.
Laser lingual tonsillectomy.
Diseases of the lingual tonsils are generally overlooked in both clinical practice and medical literature. Infections of the lingual tonsils are usually treated medically, although in patients with symptomatic chronic inflammation or hyperplasia of the lingual tonsils, surgical intervention may be indicated. Eighty-two patients with benign inflammatory problems of the lingual tonsils, who were not improved by medical management, underwent laser lingual tonsillectomy at four different medical centers, between 1984 and 1987. The procedure was tolerated well by all of the patients, with no significant operative complications. Short- and long-term results were satisfactory. Laser surgery is an effective method for the treatment of benign hyperplastic and inflammatory diseases of the lingual tonsils.
Surgery of the clivus and anterior cervical spine.
Traumatic, degenerative, benign, and malignant lesions of the clivus and cervical spine were treated by three basic surgical procedures. Midline skull base lesions in the nasopharynx, clivus, and C-1 were approached via the transmandibular and transcervical route. Lesions of C-2 and C-3 were operated on through a high transcervical route (above the hypoglossal nerve). A low transcervical route was used for lesions at the level of C-4 to C-7.
The treatment of facial haemangioma by percutaneous injections of sodium tetradecyl sulfate.
Sotradecol--sodium tetradecyl sulfate--is a sclerosing agent which has been used for years in the treatment of varicose veins, haemorrhoids and haemangiomata. Two cases of large haemangioma of the cheek are presented. Because surgical treatment posed many difficulties we decided to treat with sodium tetradecyl sulfate. Treatment was successful.
An analysis of staging systems for carcinoma of the maxillary sinus.
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Temporal arteritis.
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Clinical experiences with carcinoma of the maxillary sinus.
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Angioblastic meningioma presenting as a pain in the temporomandibular joint.
A case of angioblastic meningioma is presented where the presenting symptom was severe TM pain. Theories based on a "referred pain" mechanism, vascular traction, or both, are discussed and suggested as an explanation.