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Biomedical subjects

G R Holt

Publications and source records attributed to G R Holt.

At least 91 records · Page 5Linked to original sources
PubMed1982

The prosthetic management of oral commissure burns.

The complications of electrical burn to the oral cavity include microstomia and cosmetic deformity. Surgical burn excision and repair by primary closure, skin grafts, or tongue flaps have recognized disadvantages. The use of intraoral fixed or removable appliances, or the extraoral facemask prosthesis, serves to maintain adequate commissure spacing and allows normal skin and mucosal healing to occur. Secondary commissuroplasties may be required after prosthetic management of the burn.

Burns, Electric↗
PubMed1981

Peritonsillar abscesses in children.

A follow-up retrospective study was performed on 41 children who presented with peritonsillar abscesses from 1970-1980. The ages ranged from 3 to 16 years, with the mean age of 10 years. There were 26 females and 15 males. The abscesses were predominantly left-sided (28 vs. 13 right-sided) and the mean duration of symptoms was 3 days. Of the patients, 39% had been treated with antibiotics prior to the abscess development. Only 15% of the patients had a documented past history of exudative tonsillitis. Of the 41, 1 patient was lost to follow-up, and 11 underwent tonsillectomy for the abscess. Thus, 29 patients were reviewed who received no surgical therapy for their peritonsillar abscess other than incision and drainage. These patients were contacted for an interval history with a period of follow-up ranging from 6 months to 10 years. Only 2 of the 29 patients (7%) had recurrent abscesses. Two other patients (7%) had further recurrent bouts of exudative tonsillitis but not abscesses. These 4 children were in an initial group of 6 who had a prior history of documented tonsillitis. The incidence of recurrent peritonsillar abscesses reported in the literature has ranged from 7.6 to 16% in series which were comprised mainly of adults. The low incidence of recurrent abscesses (7%) in this series would indicate a need to reevaluate the indication for tonsillectomy for peritonsillar abscess in the pediatric age group. The authors recommend that tonsillectomy be performed in those children who present with a previous history of documented tonsillitis or suffer a complication at the time of the first abscess (neck abscess or airway compromise).

Adolescent↗
PubMed1981

Tympanometric changes after total maxillary osteotomy.

With the frequency of orthognathic surgery increasing each year, more is being learned about this surgical art. Although techniques are improving, more acute and chronic complications are being reported after orthognathic surgery. In our institution, it has been noticed that approximately 25% to 30% of our patients experience unilateral or bilateral otalgia after total (Le Fort I) maxillary osteotomy. Recently, two patients with maxillary osteotomies. In both patients acute otitis media developed postoperatively and myringotomies for relief of symptoms were required. This paper reports changes observed in preoperative and postoperative tympanograms of patients who undergo total maxillary osteotomy and offers a possible explanation for these middle ear changes, which are accompanied by otalgia.

Acoustic Impedance Tests↗
PubMed1981

Blepharoplasty.

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Anesthesia, Local↗
PubMed1980

Traumatic facial arteriovenous malformations.

Traumatic arteriovenous malformations (AVM) represent an abnormal communication between arteries and veins and are usually complex. They occur most commonly in the extremities and are noted most often in military casualties. In the literature there are approximately 25 cases of traumatic AVM of the facial region which are angiographically documented. To these are added five documented cases from this paper, one which was proven at surgery, and one which was suspected from classical signs and symptoms but not diagnosed. The trauma leading to the AVM may be: penetrating, blunt, postsurgical, or inflammatory. A swelling of the face, pulsatile tinnitus, throbbing headache and bleeding comprise the main presenting symptoms. A bruit and thrill are usually present. Doppler ultrasonography and selective arteriography will provide the essential diagnostic information. Embolization therapy may be a helpful preoperative adjunct or may be the total therapy if surgery cannot be performed. Proper identification of the feeder vessels, surgical control of these vessels, total excision of the AVM with functional and cosmetic reconstruction of the tissue defect remain the basic principles of therapy.

Adult↗
PubMed1980

Traumatic arteriovenous malformation of the eyelid.

Traumatic arteriovenous malformations (AVM) are formed by an abnormal and usually complex communication between arteries and veins. In contrast to congenital AVMs which occur most commonly in the head and neck, traumatic AVMs are usually reported in the extremities and are commonly the result of military conflicts. In 1757, William Hunter delivered his classical treatise on true and false aneurysms and described a traumatic fistula between the brachial artery and vein following phlebotomy. Approximately thirty cases of acquired traumatic AVMs of the facial region appear in the literature. Only two cases of acquired AVMs of the eyelid region have been reported--one of a post inflammatory origin and one which developed spontaneously. This paper presents the case of a large traumatic AVM of the right lower eyelid along with a discussion of the principles and management of these vascular lesions.

Arteriovenous Malformations↗
PubMed1980

Eyelid trauma.

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Eyelids↗
PubMed1978

Massive airway hemorrhage after transtracheal aspiration.

An instance of massive hemorrhage following transtracheal aspiration with successful resuscitation is reported. Indications for the procedure are pneumonia with poor ability to produce sputum, fever, or pulmonary infiltrate in a stuporous patient, and facial injuries which would complicate nasotracheal suction. The cricothyroid membrane is recommended as the site of entry. If airway hemorrhage does occur, immediate maintenance of the airway and tamponade of the bleeding can aid in successful resuscitation of the patient.

Aged↗
PubMed1978

E.N.T. manifestations of Von Recklinghausen's disease.

Von Recklinghausen's Disease (VRD) is a neurocutaneous, systemic disease characterized by CNS tumors and disorders, cafe-au-lait spots, generalized cutaneous neurofibromata, skeletal deformities, and somatic and endocrine abnormalities. It is an autosomal dominant, hereditary disorder found in approximately 1:2500 to 3300 births. There are many manifestations of this disease in the head and neck region of interest to the otolaryngologist. Case reports of three patients with multiple ENT involvements are detailed. A review of the literature is presented with a brief discussion of diagnosis and treatment. The most common intracranial tumor in the adult is the acoustic neuroma, usually bilateral, while in the child it is the astrocytoma. A defect in the sphenoid bone is common and may produce temporal lobe herniation into the orbit causing pulsatile exophthalmos. Involvement of the facial bones usually causes radiolucent defects secondary to neurofibromata within nerve pathways, and a variety of asymmetrical changes, especially within the mandible. "Elephantiasis" of the face is a hypertrophy of the soft tissues overlying a neurofibroma, often quite extensive and disfiguring. Laryngeal and neck involvement may compromise the airway and early and repeated surgical intervention is required. The over-all malignancy rate approaches 30%, indicating that the patient with VRD may be predisposed to developing a malignancy. There appears to be an increased surgical risk in these patients, with some demonstrating abnormal responses to neuromuscular blockade.

Adult↗