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Biomedical subjects

J A Kirchner

Publications and source records attributed to J A Kirchner.

At least 37 records · Page 2Linked to original sources
PubMed1984

Radiotherapy in sarcoidosis of the larynx: case report and review of the literature.

Sarcoidosis infrequently involves the larynx, but resultant airway obstruction will often prompt the need for therapeutic intervention. Systemic and intralesional corticosteroids as well as various surgical approaches have been advocated. We report a case of a 36-year-old man with biopsy proven laryngeal sarcoidosis. The patient became refractory to corticosteroids and was treated with megavoltage radiotherapy as an alternative to tracheostomy. A gradual and complete clinical recovery was observed. The radiation techniques are presented, and the literature regarding laryngeal sarcoidosis is reviewed. Megavoltage radiotherapy is a viable treatment option in this disorder.

Adrenal Cortex Hormones↗
PubMed1982

Bronchopulmonary dysplasia (or subglottic stenosis?).

Bronchopulmonary dysplasia has now become the most common chronic lung disease of early childhood, and is a sequel of neonatal intensive care. The condition is characterized by interstitial fibrosis, agenesis of pulmonary alveoli, and distension of the remaining lung tissue. The resultant stiffness of the lung leads to noisy, labored respiration with retraction of the soft tissues of the thorax during inspiration which may easily be mistaken for the signs of subglottic stenosis. Two cases which illustrate the problem are presented. The mechanism underlying the clinical picture is discussed.

Bronchopulmonary Dysplasia↗
PubMed1980

Surgical closure of the larynx for intractable aspiration.

Surgical closure of the glottis is reserved for patients who have suffered progressive loss of sphincteric and phonatory laryngeal function. In the prevention of life-threatening aspiration, a triple-layer closure is performed with use of a superiorly based sternohyoid muscle flap. Surgical closure is theoretically reversible should sufficient neuromuscular function return in any given patient.

Adult↗
PubMed1979

Clinical vs histopathologic staging in laryngeal cancer.

One hundred fourteen serially sectioned, nonirradiated, laryngeal specimens that were removed for cancer have been examined to determine the accuracy of preoperative staging. Characteristics of the primary lesion, which indicate invasion of the laryngeal framework, have been demonstrated for each region in the larynx. Pathologic findings, such as submucosal extension, growth into the preepiglottic space, infraglottic extension, and involvement of the laryngeal ventricle, have been correlated with clinical staging. The relationship between tumor size and accuracy of clinical staging has been evaluated. For multiregional lesions, the location that yielded the highest probability of metastasis was designated as the primary site. Our findings indicate inaccurate staging for 37% of glottic tumors, 38% of supraglottic tumors, 50% of transglottic tumors, and 13% of subglottic lesions. In 89% of the cases that were staged inaccurately, the error was one of underestimation. Depth of tumor invasion was the most difficult measurement to determine.

Humans↗
PubMed1978

The long tracheostomy tube. Alternative management of distal tracheal stenosis.

The incidence of tracheal strictures has greatly increased, and even in the most controlled clinical setting, the treatment of this problem requires sophisticated surgical management. We present an alternative method of management that was initially used to secure a temporary airway in young and debilitated patients. This technique has provided both immediate relief of the airway obstruction and definitive long-term correction of the stenosis, with a low complication rate.

Adult↗
PubMed1978

Pediatric tracheostomy and associated complications.

A retrospective analysis of 123 pediatric tracheostomies reveals an overall complication rate of 33%. Immediate complications were present in 12% or 15 patients. The most frequent immediate complications were pneumomediastinum and pneumothorax. Delayed complications occurred in 24% or 30 patients. The most frequent delayed complications were subglottic stenosis, fused vocal cords, and tracheal granuloma. Four patients died because of tracheostomy-related complications. Age, underlying disease, and prior endotracheal intubation had a high degree of correlation with complications. The use of a mechanical respirator following tracheostomy did not appear to be significantly related to complications. Fifty percent of the delayed complications in this series were regarded as being unrelated to the tracheostomy or the trachesotomy tube itself.

Age Factors↗
PubMed1978

Unilateral septal technique for transsphenoidal microsurgical approach to the sella turcica. Technical note.

A modification of the transseptal, transsphenoidal appraoch to the sella turcica is described; it consists of a unilateral separation of the nasal mucosa from the nasal septum. Experience with the technique in 215 cases has indicated that it is a useful, practical appraoch. The advantages are that the septum is spared, reoperation is made easier, and the procedure is quicker than the bilateral septal procedure. Asymptomatic nasal septal perforations (less than 3 mm) were seen in eight of 215 cases, and represented the only complication related to the operation.

Humans↗
PubMed1977

Two hundred laryngeal cancers: patterns of growth and spread as seen in serial section.

Whole organ serial section studies of specimens removed by partial or total laryngectomy have yielded information which the surgeon ordinarily needs in determining the suitability of the laryngeal cancer for conservation surgery. This information includes the degree to which the surface presentation of a growth reveals its margins, and the likelihood of invasion of the laryngeal framework and overlying soft tissues. The present studies indicate that in assessing these features of a growth before treatment, the surgeon can be guided by: 1. location; 2. fixation, and 3. size of the growth. These features are presented together under each location.

Glottis↗