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Biomedical subjects

J D Osguthorpe

Publications and source records attributed to J D Osguthorpe.

At least 37 records · Page 2Linked to original sources
PubMed1997

Open surgical management of early glottic carcinoma.

Three options exist for the treatment of T1 through T3 glottic carcinomas: irradiation, transoral excision (usually with a CO2 laser) and external "conservation" laryngeal procedures. Controversy re approximately mains regarding the best therapy and, in many cases, is related to the uncertainty of tumor subclassifications not being contained in the current American Joint Committee on Cancer Union International Contra Cancer system. The evaluation of patients with early glottic carcinomas and common approaches to conservation laryngeal surgery and defect reconstructions are presented. External "conservation" approaches are preferred for T1B, T2B and early T3 glottic carcinomas.

Carbon Dioxide↗
PubMed1997

Sinusitis: bench to bedside. Current findings, future directions.

Sinusitis, an inflammatory disease of the sinus, is one of the most commonly reported diseases in the United States, affecting an estimated 14% of the population. The prevalence of sinusitis is rising. Between 1990 and 1992, persons with sinusitis reported approximately 73 million restricted activity days-an increase from the 50 million restricted activity days reported between 1986 and 1988. Because critical questions remain unanswered about its cause, pathophysiology, and optimal treatment, sinusitis continues to generate significant health care costs and affects the quality of life of a large segment of the U.S. population. To identify critical directions for research on sinus disease, the American Academy of Allergy, Asthma and Immunology and the American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc., convened a meeting in January 1996 in collaboration with the National Institutes of Allergy and Infectious Disease. This document summarizes the proceedings of that meeting and presents what is intended to be the background for future investigation of the many unanswered questions related to sinusitis.

Acute Disease↗
PubMed1997

Sinusitis: bench to bedside. Current findings, future directions.

Sinusitis, an inflammatory disease of the sinus, is one of the most commonly reported diseases in the United States, affecting an estimated 14% of the population. The prevalence of sinusitis is rising. Between 1990 and 1992, persons with sinusitis reported approximately 73 million restricted activity days--an increase from the 50 million restricted activity days reported between 1986 and 1988. Because critical questions remain unanswered about its cause, pathophysiology, and optimal treatment, sinusitis continues to generate significant health care costs and affects the quality of life of a large segment of the U.S. population. To identify critical directions for research on sinus disease, the American Academy of Allergy, Asthma and Immunology and the American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc., convened a meeting in January 1996 in collaboration with the National Institutes of Allergy and Infectious Disease. This document summarizes the proceedings of that meeting and presents what is intended to be the background for future investigation of the many unanswered questions related to sinusitis.

Acute Disease↗
PubMed1997

Concepts in orbital reconstruction.

The diagnosis and management of orbital disease often requires the interaction of several specialties. The authors have reviewed the concepts in orbital reconstruction from an ophthalmologic, oculoplastic, otolaryngologic, and plastic surgical approach. Careful attention is given to the clinical examination, radiologic studies, surgical indications, and surgical techniques for orbital disease.

Eye Diseases↗
PubMed1996

MR of nasolabial cysts.

We report the MR imaging findings in two cases of nasolabial cysts. Demonstration of their extraosseous location with cross-sectional imaging should prevent confusion with maxillary cysts and obviate unwarranted dental or maxillary surgery.

Adult↗
PubMed1995

Day care and the incidence of otitis media in young children.

OBJECTIVE: This study assesses whether day care is a significant risk variable for otitis media in children younger than 2 years in the United States after controlling for the number of children in the day care group. DESIGN: The computerized data source used is the 1988 Child Health Supplement (N = 17,110) of the National Health Interview Survey (NHIS-CH). SETTING: The NHIS-CH data is a multistage probability sample with clustering and stratification. It represents the civilian, noninstitutionalized population of the United States. PARTICIPANTS: The NHIS-CH sample consists of one randomly selected child from each NHIS household containing a child younger than 18 years. The overall response rate for the NHIS-CH was approximately 90%. For this analysis the focus is on children younger than 2 years (N = 2294). MAIN OUTCOME MEASURES: The NHIS-CH includes a direct questioning of an adult member of the household, usually the mother, about whether the child has ever had frequent or repeated ear infections. RESULTS: After controlling for the total size of the day care group for children younger than 12 months, the previously established relationship between attending a day care center and frequent ear infections is reduced from an odds ratio of 3.17 (95% confidence interval, 1.50 to 6.71) to an odds ratio of 1.34 (not significant; p = 0.60). CONCLUSION: The total size of the day care group is an important intervening variable in the relationship between attending day care and frequent ear infections for children younger than 12 months. The size of the day care group rather than the day care per se is the primary "modifiable risk variable" for many working parents.

Child Care↗
PubMed1995

Craniofacial approaches to sinus malignancy.

Craniofacial approaches to sinonasal malignancies that abut or penetrate the skull base allow isolation of tumor from its vascular supply, identification and preservation of neurovascular structures adjacent to tumor, and en bloc resection with meaningful margins. The transfacial access, and the adjuncts of lateral facial split and mandibular swing, have been presented. An extended frontal craniotomy, which encompasses the superior orbital rims, affords exposure of the nasal, sinus, orbital, and intracranial components of a dissection in one surgical field. The skull base team approach yields a high cure rate for aggressive but benign skull base neoplasms, such as meningiomas, and when combined with external beam irradiation the only nonpalliative regimen for sinonasal malignancies that penetrate the anterior or middle fossa.

Adult↗
PubMed1994

Sinus neoplasia.

After an overview of the epidemiology, histology, and evaluation of nasal and sinus neoplasms, this article discusses surgical advances in facial translocation, skull base dissection, and defect reconstruction. With the aforementioned, the question of what is technically resectable vs what is curable has become an important but as yet unanswered question. Radiation therapy, combined with surgery or as palliation, presents special challenges in the head and neck, and ports must be carefully defined to minimize damage to vision and adjacent cranial structures. Chemotherapy is usually reserved for palliation, though some report favorable results with induction treatment of squamous cell carcinomas with platin-based regimens.

Humans↗
PubMed1994

Orbital decompression in Graves' disease.

OBJECTIVE: The authors' experience with surgical decompression of the orbits in patients with Graves' orbitopathy is reviewed. DESIGN: One hundred twenty-six consecutive primary orbital decompressions were retrospectively studied. SETTING: Tertiary care university hospitals. PATIENTS: All patients were referred by ophthalmologists for surgical decompression after failure of a trial of oral steroid therapy, and many had had orbital irradiation. INTERVENTION: Antral-ethmoidal or transconjunctival surgical decompression was accomplished in all. MAIN OUTCOMES: Measurements of visual acuity, ocular motility, and proptosis were accomplished preoperatively and a minimum of 3 months postoperatively. Surgical complications were tallied. RESULTS: Mean reduction of proptosis by antral-ethmoidal decompression was 5.3 mm, and 3.6 mm by the transconjunctival approach. Visual acuity improved in 34 orbits, was unchanged in 91 orbits, and decreased in one orbit. In a subgroup of 30 patients in whom ocular motility was quantified by prism cover test preoperatively, motility was unchanged or improved in 21 and was decreased in nine. Complications were infrequent. CONCLUSION: The antral-ethmoidal and transconjunctival approaches to orbital decompression are safe and effective.

Adolescent↗
PubMed1993

Inflammatory sinus diseases affecting the orbit.

Paranasal infections and inflammatory processes involving the orbits have been described, as have primary orbital conditions that may mimic acute sinus disease. Most common are bacterial and fungal sinus infections with secondary orbital spread, diseases for which the otolaryngologist-head and neck surgeon must be skilled in diagnosis and management in order to minimize sequelae. Optic neuritis arising from such infections requires prompt recognition and aggressive treatment if vision is to be preserved. The most common causes of unilateral proptosis, Graves' orbitopathy, and pseudotumor may in their early stages mimic orbital spread of paranasal infections. Recognition of these entities and ophthalmologic consultation are critical to their appropriate management.

Female↗
PubMed1991

'Medial maxillectomy' for lateral nasal wall neoplasms.

Lateral rhinotomy and "medial maxillectomy," an en bloc resection of the medial maxillary sinus, ethmoid sinus with the lamina papyracea, medial orbital floor, and lacrimal fossa-duct, have been advocated for lateral nasal wall neoplasma. Experience with 35 (of 41) patients followed up at least 30 months (median, 57 months) postoperatively is reported. There was a 9% recurrence for benign tumors and 15% for malignant neoplasms, the latter only in the patients with nonmelanoma malignant neoplasms not receiving postoperative radiotherapy. The most frequent complications were cavity crusting, epicanthal scarring, and epiphora.

Adolescent↗
PubMed1991

Head and neck burns. Evaluation and current management.

More than half of the 150,000 burn patients hospitalized in the United States each year have head and neck involvement, with 3% to 7% sustaining concomitant inhalation injury. With advances in fluid replacement therapy and specialized burn care units, mortality has fallen from near 100% to 24% for burns of 75% to 90% of body surface area. The most common causes of death are respiratory complications and sepsis. Inhalation injuries can be diagnosed by laryngoscopy, and compromised airways can then be intubated (with tracheotomy for long-term management) and sloughing mucosa and inspissated mucus removed by serial bronchoscopy. Sepsis is minimized by early excision of burn eschar and autografting or, in the widely burned, temporary coverage with cadaver allograft, porcine xerograft, or skin substitutes until successive crops of autografts are available. The head and neck presents substantial reconstructive and rehabilitative challenges, which must be addressed in aesthetic units.

Burns↗