Biomedical subjects
G Har-el
Publications and source records attributed to G Har-el.
Turbinoplasty for concha bullosa: a non-synechiae-forming alternative to middle turbinectomy.
A large pneumatized middle turbinate (concha bullosa) may require surgical reduction. Partial middle turbinectomy, especially when done simultaneously with uncinectomy and ethmoidectomy, results in an increased risk for adhesion formation in the middle meatus. Turbinoplasty is a procedure that results in a significant reduction of the width of the middle turbinate without injuring its mucosal surfaces. A 4-year experience with this procedure showed almost complete elimination of the synechiae problem.
Acute postobstructive pulmonary edema.
Acute postobstructive pulmonary edema may occur after airway obstruction. A decrease in intrathoracic and intraalveolar pressures causes an increased blood flow into the pulmonary vasculature and favors the development of pulmonary edema. Two mechanisms for the development of acute postobstructive pulmonary edema are proposed: type 1 follows acute airway obstruction, and type 2 follows relief of chronic airway obstruction.
Telescopic extracranial approach to frontal mucoceles with intracranial extension.
Traditionally, frontal mucoceles were treated with open obliterative procedures such as collapse of the forehead soft tissues into the sinus or the more cosmetically appealing osteoplastic flap technique. When a frontal mucocele expands intracranially, these surgical procedures become difficult and with higher risk of cerebrospinal fluid leak and/or meningitis. In cases of a mucocele that extends both intracranially and anteriorly into the soft tissues, osteoplastic flap procedure may not be possible. We present our experience with telescopic intranasal surgery for the treatment of frontal mucocele with intracranial extension. The technique, which is based on intranasal marsupialization and stenting, was used in four patients with large mucoceles eroding into the cranium and the anterior soft tissues. The results were excellent and the patients are free of disease 1 to 4 1/2 years after surgery.
Kaposi's sarcoma of the head and neck in patients with acquired immunodeficiency syndrome.
Kaposi's sarcoma is the most common neoplastic process in patients infected with the human immunodeficiency virus. Moreover, the occurrence of Kaposi's sarcoma in human immunodeficiency virus-infected patients advances their classification to having the acquired immunodeficiency syndrome. We reviewed the medical records of 48 patients with human immunodeficiency virus infection who had Kaposi's sarcoma documented on their initial visit to the hospital. The onset of Kaposi's sarcoma occurred independent of the Centers for Disease Control and Prevention classification of human immunodeficiency virus infection (modified to exclude Kaposi's sarcoma). This neoplasm developed more frequently in patients who acquired human immunodeficiency virus infection by sexual contact (75% of cases), but manifestations were not significantly different in any of the risk populations for human immunodeficiency virus infection. Kaposi's sarcoma lesions were unpredictable and either showed progression, remained static, or occasionally, regressed spontaneously. Moreover, the lesions were usually multifocal at presentation, with the head and neck (62.5% of cases) as the primary site of involvement. In this region cutaneous lesions predominated (66.7%), followed by mucosal (56.7%) and deep structure (13.3%) involvement. The majority of patients with acquired immunodeficiency syndrome Kaposi's sarcoma involving head and neck structures were asymptomatic (80% of cases). Mucosal lesions were associated with symptoms in 29.3% of cases, whereas cutaneous lesions had symptoms in 5% of cases.
Persistent third branchial apparatus.
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Malignant head and neck germ cell tumours.
Malignant germ cell tumours of the head and neck are extremely rare. Their behaviour, despite aggressive surgical and adjuvant therapy, is relentless with most cases resulting in a fatal outcome. In this paper we present a case of a cervical embryonal carcinoma and review the presentation, clinical course and treatment of malignant germ cell tumours.
The use of salivary bypass for pharyngeal reconstruction.
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Pathologic quiz case 2. Plasma cell myeloma.
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Pathologic quiz case 1. Trichilemmal (pilar) cyst.
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Acute suppurative thyroiditis and the branchial apparatus.
Acute suppurative thyroiditis and thyroid abscess are rare. The finding of a sinus tract arising from the pyriform sinus in some cases highlights the possibility of a branchial apparatus origin. We present three case histories that include a left-sided lesion and radiologic or surgical-anatomic evidence of an internal sinus tract. Our discussion focuses on two considerations: first, the exact branchial pouch from which this lesion arises, and second, a proposed protocol for the work-up and management of patients with the onset or recurrence of acute suppurative thyroiditis or thyroid abscess.