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Biomedical subjects

J D Osguthorpe

Publications and source records attributed to J D Osguthorpe.

At least 73 records · Page 4Linked to original sources
PubMed1986

Management of lacrimal fossa masses.

Mass lesions of the lacrimal fossa are evenly divided between epithelial and nonepithelial diseases. Nonepithelial lesions include pseudotumor, benign lymphoid hyperplasia, lymphoma, and sarcoid. Epithelial lesions are evenly divided between benign and malignant neoplasia, and are similar to those of the salivary glands. Benign mixed tumors compose 25% of lacrimal gland tumors, and are very slow-growing, painless lesions that should be removed en bloc without a biopsy to avoid seeding the orbit. Adenoid cystic and malignant mixed carcinomas are the most common malignancies, and present with rapid growth and pain. These require incisional biopsy to establish the diagnosis, and then a radical exenteration and postoperative radiation therapy.

Carcinoma↗
PubMed1986

Effects of tympanic membrane scars on tympanometry: a study in cats.

The efficacy of tympanometry in the diagnosis of ossicular abnormalities and the differentiation of such from eardrum scarring is controversial. This paper presents a study of the tympanometric effects of specific eardrum scars and ossicular abnormalities in cats. For both normal eardrums and healed myringotomies, a normal middle ear could be differentiated from stapes fixation or incudostapedial discontinuity using static immittance parameters and tympanogram morphology. Twenty percent myringectomy scars caused abnormal 660 Hz tympanograms but this effect could be distinguished from changes caused by a concomitant ossicular abnormality. The very low impedance of a 50% myringectomy scar resulted in tympanograms which could not be differentiated from an ossicular discontinuity alone. With this neomembrane, stapes fixation could not even be differentiated from an ossicular discontinuity. This study supports the view that tympanometry should be interpreted as part of a battery of tests which includes otoscopy, audiometry, and acoustic reflex measurements.

Acoustic Impedance Tests↗
PubMed1985

Osteoblastoma.

Explore the source record for details and available documents.

Curettage↗
PubMed1985

Carotid arteriospasm.

Arteriospasm can result from manipulation or fresh blood around an artery. This myogenic reflex can spread to obliterate collateral flow and can last from minutes to days. Ischemic strokes from carotid spasm ensue neurosurgical procedures, endarterectomies, and even chiropractic manipulation. The diagnosis and prevention of arteriospasm are presented, and a patient who has carotid arteriospasm following excision of a branchial cleft cyst is detailed. If the vessel constriction is noted at surgery, topical application of a local anesthetic is effective. Transfusion, hydration, oxygenation, and maintenance of blood pressure are the cornerstones of nonoperative therapy.

Adult↗
PubMed1985

Facial plastic surgery in an otolaryngology training program.

The medical complications and unsatisfactory results of facial plastic surgery performed by residents under close supervision are compared with those of the staff who train them and the literature. In 502 rhinoplasty, rhytidectomy, browlift, blepharoplasty, otoplasty, dermabrasion, and chemical peel procedures, there were no significant differences between the resident and staff operations except that residents required more time to perform the procedure. Operations which might be combined at one sitting should be staged during a resident's early experience with cosmetic surgery.

Face↗
PubMed1985

Transethmoid decompression of the optic nerve.

Delayed visual deterioration following trauma to the head can result from injury to the optic nerve or central visual pathways. Surgical decompression of the medial optic canal is indicated when central nervous system causes are ruled out and vision fails to improve on megadose intravenous steroids.

Craniocerebral Trauma↗
PubMed1984

Transarterial carotid occlusion. Case report and review of the literature.

Postoperative carotid artery rupture occurs in 3% to 4.5% of head and neck resections involving a mucosal primary and radical neck dissection. Other indications for carotid sacrifice-ligation include en bloc removal of the artery with tumor, inadvertent injury during surgery, and hemorrhage from vessel erosion by unresectable tumor. The mortality and morbidity of unilateral carotid occlusion are significantly decreased when performed electively in a hydrated and normotensive patient with a normal serum hemoglobin level. Sequelae approximate 5% when adequate collateral cerebral blood flow is present. A transarterial catheter approach to the measurement of carotid artery back pressure and permanent obstruction of flow in an awake patient is presented.

Blood Pressure↗
PubMed1984

Use of a composite autograft to prevent recurrent cholesteatoma caused by canal wall defects.

Recurrent cholesteatoma following atticotomy or combined-approach tympanoplasty remains a significant problem. The importance of closing defects created by surgery or disease in the posterosuperior bony canal is recognized, and numerous materials and techniques have been advocated. Our experience with a composite autograft of tragal cartilage and perichondrium in 40 ears is presented after 1 to 6 years follow-up. The composite autograft performed satisfactorily in 38 cases. In no case did recurrent cholesteatoma develop at the site of a defect that had been obliterated by the autograft.

Adolescent↗
PubMed1983

Temporary threshold shifts produced by exposure to low-frequency noises.

Groups of human subjects were exposed for 8 or 24 h to an octave-band noise centered at 63, 125, or 250 Hz. For a 24-h exposure at 84 dBA, temporary threshold shifts (TTS) increased for 8-12 h and then either decreased or remained constant. Although TTS was less than 20 dB, complete recovery for many of the subjects required as long as 48 h. Accordingly, the higher level exposure which was planned at 94 dBA for 24 h was reduced to 90 dBA for 8 h. For this condition TTS increased throughout the 8-h exposure. TTS from the 90-dBA noise for 8 h exceeded the TTS produced by the 84 dBA; however, recovery from the 24-h exposure required as long as 48 h, whereas recovery from the 8-h exposure required only 12-24 h. Thus the time required for recovery is determined in part by the duration of exposure. TTS was not always maximal 1/2-1 oct above the band of noise, but was maximal in the frequency regions of better auditory sensitivity (350 to 750 Hz). For the 250-Hz condition, TTS increased about 1.5 dB per dB increase in noise level, whereas for the 63- and 125-Hz conditions TTS increased less than 1 dB per dB increase in noise level. More data are needed to specify the relation between TTS and the level of low-frequency noises.

Adolescent↗
PubMed1983

Evaluation of and access to posterior orbital tumors.

Head and neck surgeons enter the peripheral orbit for the therapy and/or biopsy of the most common expanding lesions, i.e., thyroid ophthalmopathy, direct extension of paranasal disease, pseudotumor and metastases. It is in this space between the bony orbital walls and the extraocular muscle cone that a majority of primary orbital neoplasms occur. The four basic approaches to posterior orbital tumors are: lateral orbitotomy through the temporal fossa with a modified Kronlein procedure, medial orbitotomy utilizing a Lynch incision and lacriminal sac mobilization, superior orbitotomy via a Naffziger frontotemporal crainotomy, and inferior exposure/decompression through the maxillary sinus. Case examples of the former two approaches are presented. None of these standard procedures allows full exposure of the posterior orbit. A combined cranio-facial-orbital access to this region utilizing a modified maxillectomy and frontotemporal craniotomy is detailed.

Adolescent↗
PubMed1983

Mini-craniotomy for management of CSF otorrhea from tegmen defects.

CSF otorrhea arising from defects in the tegmen and middle fossa dura may be congenital or acquired. It may be spontaneous or secondary to trauma, chronic ear disease, tumor or surgical treatment. In the six cases presented, the tegmen defect and associated CSF leak were secondary to chronic ear disease in two cases, to mastoid surgery in two cases, to temporal bone fracture and congenital origin in one case each. The successful management of these patients utilizing a mini-craniotomy in conjunction with mastoid surgery is described. Mini-craniotomy facilitates precise extradural, intracranial placement of an autogenous graft over the tegmen defect which can be technically difficult in the transmastoid approaches, yet avoids the morbidity and potential complications of a full middle fossa craniotomy. It does not significantly add to the length of the mastoid procedure or its complications.

Cerebrospinal Fluid Otorrhea↗