Biomedical subjects

H A Milczuk

Publications and source records attributed to H A Milczuk.

5 recordsLinked to original sources

PubMed2000

Congenital laryngeal webs: surgical management and clinical embryology.

Laryngeal webs are uncommon congenital anomalies. The formation of a laryngeal web represents anomalous embryologic development of the larynx. The extent of airway involvement varies which ultimately affects surgical management. A series of five congenital laryngeal webs each with subglottic involvement is reported. One patient also had a ventral laryngeal cleft. All patients ultimately required open laryngeal reconstruction, either laryngotracheal reconstruction (LTR) or thyrotomy (laryngofissure) and silastic keel, to correct the defect and all were decannulated. Findings at surgery correlate with recent descriptions of embryonic laryngeal development though the actual mechanism by which webs develop remains unknown. The findings suggest that congenital glottic webs require accurate endoscopic diagnosis and open airway reconstruction for definitive treatment.

Female↗

PubMed2000

Effect on families and caregivers of caring for a child with laryngomalacia.

We used a retrospective chart review and telephone interviews using a standard format to 1) measure the outcome and psychosocial costs of caring for a child with upper airway obstruction due to laryngomalacia and 2) develop an epidemiologic instrument that measures the impact on the lives of families who have a child with laryngomalacia. Forty-four patients had laryngomalacia documented by endoscopy between 1993 and 1997. Complete follow-up information through 1998 was available on 26 patients. Of the 44 patients, 37 were managed expectantly and 7 (16%) required surgical intervention. Polysomnograms were obtained on 11 before neonatal discharge. Twelve patients wore an apnea monitor for at least 1 month. The quality of life analysis found that the majority of caregivers were not substantially affected by caring for the stridorous child. Loss of sleep and heightened anxiety were commonly reported by these caregivers. Younger parents or parents with fewer than 3 other children were more affected by caring for a child with laryngomalacia. There was no substantial loss of workdays, increase in doctor visits, or difficulty in obtaining day care. Caring for a child with laryngomalacia results in minor disruption of a family's lifestyle.

Apnea↗

PubMed1999

Temperature conditioning of nasal air: effects of vasoactive agents and involvement of nitric oxide.

Nitric oxide (NO) is released into nasal air, but its function is unknown. We hypothesized that nasal vascular tone and/or flow influences temperature conditioning of nasal air and that NO participates in this process. We measured nasal air temperature (via a thermocouple) and exhaled nasal NO release (by chemiluminescence) in five humans and examined the effects of an aerosolized vasoconstrictor (oxymetazoline), a vasodilator (papaverine), N(G)-nitro-L-arginine methyl ester, an inhibitor of NO synthase, or saline (control). Compared with saline (which caused no changes in nasal air temperature or exhaled NO release), oxymetazoline (0.05%) reduced nasal air temperature and NO release (130.8 +/- 15.1 to 81.3 +/- 12.8 nl. min(-1). m(-2); P < 0.01). Papaverine (0.01 M) increased nasal air temperature and NO release (131.8 +/- 13.1 to 157.2 +/- 17.4 nl. min(-1). m(-2); P < 0.03). N(G)-nitro-L-arginine methyl ester reduced nasal air temperature and NO release (123.7 +/- 14.2 to 44.2 +/- 23.7 nl. min(-1). m(-2); P < 0.01). The results suggest that vascular tone and/or flow modulates temperature conditioning and that NO may participate in that function.

Adrenergic alpha-Agonists↗

PubMed1993

Nasal and paranasal sinus anomalies in children with chronic sinusitis.

Functional endoscopic sinus surgery (FESS) is being advocated to treat children with chronic sinusitis. The surgeon performing FESS needs an intimate understanding of the anatomy to adequately treat disease and avoid complications. One hundred thirty-six patients who had endoscopic sinus surgery were reviewed. Preoperative direct coronal computed tomography scans were available for review in 114 patients. Several nasal and paranasal sinus anomalies were uncovered during this evaluation. The most common was hypoplasia of the maxillary sinuses. All hypoplastic maxillary sinuses had diseased mucosa. Eleven patients were found to have a laterally deviated uncinate process and abnormal anatomy of the maxillary ostia. Other anomalies such as concha bullosa, Haller's cells, and paradoxic curvature of the middle turbinate were found, and their respective frequencies in this population were determined.

Adolescent↗

PubMed1991

Quest for the aberrant vessel.

In most cases of posterior epistaxis, the terminal branches of the internal maxillary artery (IMA)--principally the sphenopalatine artery--are believed to be the source of hemorrhage. However, we recently treated three patients in which unexpected or aberrant vascular anatomy resulted in persistent posterior epistaxis.

Aged↗