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Biomedical subjects

J D Osguthorpe

Publications and source records attributed to J D Osguthorpe.

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

The surgical approach to bilateral choanal atresia. Analysis of 14 cases.

Bilateral choanal atresia presents as neonatal respiratory distress and suckling difficulty. Definitive repair of this anomaly by both transpalatine and transnasal approaches had been effective in young children. The transnasal procedures are preferred in infants because of the shorter operative time, low morbidity, and minimal potential for damage to developing structures. Fourteen children were treated for bilateral choanal insufficiency.

Airway Obstruction↗
PubMed1982

Surgery in head and neck lymphomas.

Radiation therapy and/or chemotherapy are the treatment modalities of choice in lymphomas. Except for Burkitt's tumor, surgery is usually indicated only when percutaneous biopsy fails to establish the histologic diagnosis. We have described a patient with glomerulonephritis and anasarca secondary to an IgM-producing parapharyngeal lymphoma. After resection of all palpable tumor by an excisional biopsy, the monoclonal gammopathy and secondary nephrosis promptly cleared. With chemotherapy and mantle irradiation, the patient is in remission at three years. It is not now clear whether surgery will become useful as an adjunctive therapy for localized head and neck lymphomas. This will depend on whether local failure rates can be improved solely by using new combinations of irradiation and/or cytotoxic agents, and whether the morbidity of such therapy will outweigh the therapeutic gain.

Edema↗
PubMed1981

Management of canal stenosis with a transposition flap.

Stenosis of the external auditory canal is difficult to manage. Numerous surgical procedures have been advocated for its correction and all function to varying degrees, but repeat stenosis remains a problem. Our experience, with the use of a superiorly based preauricular transposition flap in combination with an endaural and postauricular approach in 5 patients, 8 ears, is presented. In 3 patients, 5 ears, the stenosis was congenital; in 1 patient, 1 ear, traumatic; and in 1 patient, 2 ears, secondary to chronic external otitis. With a follow-up of 1 to 9 years, the functional and cosmetic results have been satisfactory in all cases.

Chronic Disease↗
PubMed1979

Nasolacrimal obstruction after maxillary sinus and rhinoplastic surgery.

Transient nasolacrimal obstruction is a common complication of maxillary sinus, as well as rhinoplastic surgery. Permanent epiphora, however, is unusual. This communication describes 11 patients with surgical injury to the lacrimal drainage system, which necessitated dacryocystorhinostomy for correction. Seven of these cases occurred subsequent to nasoantral window procedures, three occurred after rhinoplasty, and one resulted from a partial maxillectomy. It has been shown that the two areas most vulnerable to inadvertent surgical injury are the nasolacrimal sac, located just beneath the medial canthal ligament, and the ductal ostium in the inferior meatus. We discuss the relevant anatomy of the nasolacrimal apparatus, in addition to surgical methods for avoiding injury to the system. We also describe the currently applied techniques for diagnosing and managing lacrimal obstruction and review the literature.

Adult↗
PubMedDate not supplied

Obstructing laryngeal carcinoma with a simultaneous lung lesion.

The consultants all agree to treat this patient who has a seemingly poor prognosis. However, they disagree as to the method and order of treatment. A patient's nutritional status is taken seriously by all 3 experts, although no one would delay surgery to correct a patient's weight loss. Drs. Komisar and Miller consider a weight loss of 10% significant and prefer to assess a patient with lymphocyte counts, serum albumin and transferrin levels, and creatinine/height index. Dr. Osguthorope follows serum hemoglobin, transferrin, prealbumin, and albumin levels. All the experts prefer an enteral route for weight gain. With regard to diagnosis, the experts agree that endoscopy plays an important role in tumor staging. Drs. Komisar and Osguthorpe believe that a tracheotomy should be performed prior to endoscopy. Dr. Miller would prefer intubation with an endotracheal tube but if there were any question of safety, he would proceed with a tracheotomy under local anesthesia. Confirming the histology of the pulmonary lesion is important. Dr. Komisar would proceed with flexible bronchoscopy and if tissue could not be obtained with this method he would obtain a fine-needle biopsy. He believes that if the histology matches that of the larynx, the pulmonary lesion is a metastasis. Dr. Osguthorpe would also obtain a needle biopsy of the lung lesion. If no other lesions are seen on the CT, he would consider this a second primary. Dr. Miller states that unless the histologies are different, the question of primary vs metastatic disease is unanswerable.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

Trichoepithelioma: report of an unusual case and review of the literature.

Trichoepitheliomas are benign and uncommon skin tumors presenting in the head and neck region. Although they can be solitary, they occur more frequently as multiple lesions with an autosomal dominant inheritance. To the surgeon, they often present the problem of clinical differentiation from basal-cell carcinoma. An unusual case is described, and experience in the treatment of 19 patients is reviewed.

Aged↗
PubMedDate not supplied

Benign osteoblastoma of the maxillary sinus.

Benign osteoblastoma is an uncommon fibro-osseous neoplasm with a predilection for the vertebrae and long bones, and a 2-to-1 male-to-female ratio of occurrence. Peak incidence occurs in the second decade, with 80% of all patients being under 30 years of age. The clinical, radiographic, and histologic presentation of a large maxillary sinus osteoblastoma is reviewed. Preoperative embolization of this vascular neoplasm is advocated.

Adolescent↗
PubMedDate not supplied

Acute laryngeal abscesses.

The clinical features of laryngeal abscess have changed markedly since the introduction of antibiotics and are rarely seen by clinicians today. Three cases of acute laryngeal abscess associated with malignancy, airway instrumentation and a preexisting laryngocele respectively are presented. Management of these cases included immediate tracheostomy, intravenous antibiotics and surgical drainage. Current etiological factors and modes of presentation are discussed. Laryngeal abscess remains a serious and potentially lethal problem requiring emergent treatment. Serious sequelae may result from this disease.

Abscess↗
PubMedDate not supplied

Methodologic aspects of tympanometry in cats.

The tympanometric effects of the methodologic variables of direction and rate of pressure change were studied in cats. Tympanogram morphologic findings differed between ascending and descending pressure runs, with the descending ones being simpler in configuration and less influenced by the rate of pressure change. The stability of tympanograms to repetitive testing was examined in the same cats, and five human subjects. Acoustic admittance increased sequentially during the first three pressure sweeps of a repetitive testing sequence in a majority of both groups.

Acoustic Impedance Tests↗
PubMedDate not supplied

Occult thyroid carcinoma appearing as a single mandibular metastasis.

Extraglandular well-differentiated follicular thyroid tissue in the head and neck can originate from aberrant embryologic rests, by separation from the main gland through strap muscle action, by 'benign metastatic" seeding of the cervical lymphatics, and from mixed papillary-follicular or pure follicular carcinoma. The management of this ectopic tissue is controversial. A case of occult follicular carcinoma with a sole metastasis to the mandible is presented.

Adenocarcinoma↗
PubMedDate not supplied

The radiographic evaluation of infants with stridor.

In the elective evaluation of infant stridor, inspiratory plain radiographs of the neck and chest are routinely obtained with fluoroscopy and a barium swallow when indicated. Several factors, including patient positioning, roentgenographic technique, and the phase of respiration, may significantly alter the appearance of the airway, reducing the diagnostic accuracy of this modality and leading to misinterpretation of the pathologic changes.

Airway Obstruction↗