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Biomedical subjects

J Danino

Publications and source records attributed to J Danino.

18 recordsLinked to original sources
PubMed2000

Plastipore implants in the surgical treatment of atrophic rhinitis: technique and results.

BACKGROUND: Atrophic rhinitis is a distressing and socially crippling disease. Surgical treatment has been used for patients with severe disease that is unresponsive to medical therapy. METHODS: Eight patients with primary atrophic rhinitis were treated surgically by narrowing of the nasal fossae with implantation of 2 Plastipore plates per affected side into submucosal pockets into the floor of the nose and septum, thus reducing the volume of the nasal fossae. RESULTS: Excellent results were obtained in 6 patients, with complete resolution of symptoms and good results and only minor crusting in 2 patients. One implant was extruded spontaneously 18 months after implantation and was reimplanted. Results in this patient before and after reimplantation were excellent. There were no cases of infection and no other complications. CONCLUSION: We implanted Plastipore, a high-density polyethylene sponge with micropores, which enables tissue ingrowth, anchoring the implants to the surrounding tissue. The surgical technique is performed with the patient under local anesthesia and is relatively easy and avoids complicated flap procedures, allogeneic bone harvesting, and the discomfort of nostril closure for prolonged periods.

Adult↗
PubMed2000

Tracheotomy complications: a retrospective study of 1130 cases.

BACKGROUND: Tracheotomy is one of the most frequently performed surgical procedures in the critically ill patient. It is frequently performed as an elective therapeutic procedure and only rarely as an emergency procedure. Complications occur in 5% to 40% of tracheotomies depending on study design, patient follow-up, and the definition of the different complications. The mortality rate of tracheotomy is less than 2%. Numerous studies demonstrate a greater complication and mortality rate in emergency situations, in severely ill patients, and in small children. METHODS: A retrospective study of 1130 consecutive tracheotomies performed during 1 decade (January 1987 through December 1996) is presented. We studied the indications for surgery, the major complications of tracheotomy, and their treatment and outcome. We also noted the overall mortality rate and the specific complications that led to these deaths. RESULTS: In total, 1130 tracheotomies were performed. Major complications occurred in 49 of the cases, and 8 deaths were directly attributed to the tracheotomy. The most common complication was tracheal stenosis, which occurred in 21 cases. Hemorrhage was the second most common complication, which occurred in 9 cases. CONCLUSION: This is one of the largest series of consecutive tracheotomies compiled. We found a relatively low overall complication and mortality rate compared with other large series. Tracheal stenosis was the most common complication in contrast to other series. Our opinion is that this may reflect tracheal damage originally caused by prolonged intubation before the tracheotomy. We believe that all other complications of tracheotomy may be prevented or minimized by careful surgical technique and postoperative tracheotomy care.

Female↗
PubMed2000

Inferior turbinectomy versus submucosal diathermy for inferior turbinate hypertrophy.

In order to compare and evaluate bilateral inferior turbinectomy (BIT) and submucosal diathermy (SMD), we retrospectively examined these two well-known techniques for treatment of nasal obstruction due to bilateral congestion of the inferior turbinates. One hundred patients with bilateral nasal obstruction were divided into 4 groups according to their nasal airflow patency. Forty-nine patients underwent BIT, and 51 patients underwent SMD. All 100 patients were followed for 2 months after surgery. Patients with difficult postoperative courses were followed up to 1 year after surgery, in order to decide on the necessity of operative revision. Postoperative improvement in nasal breathing after BIT was reported for 96% of patients 2 weeks after surgery, and for 88% 2 months after surgery. Only 1 BIT patient had to undergo revision operation. Diathermy showed good results in 78% of cases 2 weeks after surgery. The efficacy of the procedure was reduced to 76% 2 months after surgery. Twenty percent of SMD patients were advised to undergo operative revision. Postoperative bleeding occurred in 20% of BIT patients and in only 4% of SMD patients. We found that the extent of postoperative improvement does not depend on preoperative conditions; therefore, it is impossible to predict the extent of postoperative improvement on the basis of the results of preoperative assessment. Both procedures can be performed under local anesthesia, are relatively safe and effective, and do not need expensive instrumentation that may not be available in many medical centers.

Adolescent↗
PubMed2000

Submucosal arytenoidectomy: new surgical technique and review of the literature.

OBJECTIVE: Arytenoidectomy is indicated in cases of bilateral median vocal cord paralysis (most commonly due to recurrent laryngeal nerve paralysis), ankylosis of the cricoarytenoid joint due to arthritis, and tumours of the arytenoid cartilage. We propose the use of the submucosal approach, to excise the arytenoid cartilage in cases of vocal cord paralysis. We present the surgical technique and review the history and relevant literature, as well as the pros and cons of various surgical techniques for arytenoidectomy. SETTING: Department of Otolaryngology-Head and Neck Surgery, Rambam Medical Center, Haifa, Israel. METHOD: We present six cases: five cases of bilateral vocal cord paralysis and one case of a chondroma of the arytenoid with mechanical fixation of the cord. All patients suffered from dyspnea on mild exertion. An arytenoidectomy using the submucosal approach was performed on all six patients. RESULTS: Airway results were evaluated via fibre-optic videotape laryngoscopy and direct microlaryngoscopy. Voice was evaluated subjectively by the patients and by a speech therapist before and after surgery. Following the surgery, all six patients showed clinical improvement, they no longer suffered from dyspnea at rest or upon mild exertion, and they retained reasonable voice quality. CONCLUSION: The submucosal approach is not difficult to perform and preserves an intact laryngeal mucosa, which prevents the formation of granulation tissue and scarring, which may further obstruct the lumen. The resulting airway is good, with minimal compromise of phonation. We feel that the submucosal approach to arytenoidectomy is an important addition to the arsenal of many surgical techniques for the treatment of bilateral vocal cord paralysis.

Adolescent↗
PubMed1998

Resolution of severe bronchiectasis after removal of long-standing retained foreign body.

Saccular bronchiectasis secondary to the presence of a long retained foreign body is considered irreversible and an indication for resection of the diseased segment or lobe. We describe a 3 1/2 year-old girl with a retained organic foreign body for 18 months, and who was treated conservatively after laser resection and extraction of the inflammatory mass from the bronchus intermedius followed by complete resolution of the bronchiectasis. We suggest that even severe bronchiectasis following prolonged retention of a foreign body may be reversible after removal of the obstruction and reestablishment of airway patency.

Bronchi↗
PubMed1998

Predictive value of an adherence test for acute otitis media.

The predictive value of an in vitro adherence test of the bacterium Streptococcus pneumoniae for the development of recurrent otitis media was calculated 5 years after the initial test. Nasopharyngeal cells from 56 children suffering from acute otitis media (AOM) and from healthy children were tested for adherence of a standard pneumococcal type (capsular serotype 6). The average adherence of the bacteria to epithelial cells from the group suffering from AOM was greater than the average adherence in the control group (p < 0.005), both when adherence was counted microscopically and radioactively. Subjects were followed up periodically over a 5-year period. Four out of 5 healthy children who had high mean adherence values experienced AOM during the 5 years, and 1 child classified as AOM-prone was found to be healthy. Based on the retrospective data, the positive predictive value of this test was 98.2%, and the negative predictive value was 90.7%.

Acute Disease↗
PubMed1998

Temporal bone fracture following blunt trauma caused by a flying fish.

Blunt trauma to the temporal region can cause fracture of the skull base, loss of hearing, vestibular symptoms and otorrhoea. The most common causes of blunt trauma to the ear and surrounding area are motor vehicle accidents, violent encounters, and sports-related accidents. We present an obscure case of a man who was struck in the ear by a flying fish while wading in the sea with resulting temporal bone fracture, sudden deafness, vertigo, cerebrospinal fluid otorrhoea, and pneumocephalus.

Adult↗
PubMed1997

T cell lymphoma of the ear presenting as mastoiditis.

Mastoiditis is a complication of otitis media characterized by suppuration and destruction of air cell septa in the mastoid and petrous pyramid. Diagnosis is made by clinical findings and computerized tomography (CT) of the temporal bone. We present a patient initially diagnosed by CT as having chronic mastoiditis who was subsequently shown to have an unusual large-cell malignant lymphoma of T cell type.

Adolescent↗
PubMed1993

Eustachian tube function during pregnancy.

The upper respiratory mucosa has been reported to react to sex hormones in both physiological and pathological conditions. The present study was specifically aimed to determine the influence of high levels of oestrogen on Eustachian tube function. Fifty-three healthy, pregnant women were prospectively evaluated for Eustachian tube function during pregnancy. Eustachian tube function was found to be highly variable in different women, and in the same woman at different stages of pregnancy. We did not find a specific trend in Eustachian tube function with increasing oestrogen levels as encountered during pregnancy.

Ear, Middle↗
PubMed1992

[An electromechanical model of the middle ear].

A dynamic model of the middle ear and mastoid system was designed in order to evaluate basic principles in tympanometry. The model allows controlled simulation of the exact changes in the ear drum's mass and in intratympanic volume and pressure. The contribution of each of these factors to acoustic impedance was measured. We found that the volume values of static, acoustic compliance were equal to the volume of air in a closed cell. There was good correlation between direct measurement of air pressure in the model cell and indirect pressure measurement by tympanometry. We also demonstrated a difference between mechanical displacement of the drum and its displacement by negative pressure. This demonstration of tympanometry using a middle-ear compatible model enables us to understand its principles and helps in the education of students.

Acoustic Impedance Tests↗
PubMed1991

Effect of estrogen on eustachian tube performance.

Changing levels of sex hormones have been previously associated with clinical symptoms due to alterations of the respiratory mucosa. Aural manifestations, however, have not yet been studied in this regard. Eustachian tube swallow test and blood levels of estrogen were evaluated daily in 25 women undergoing induction of ovulation. Most women showed a near stable eustachian tube performance over a wide range of estrogen levels, particularly in the physiologic range. However, there is a moderate decrease in eustachian tube function with increasing estrogen levels in some women, manifested mainly at levels beyond that of the normal menstrual cycle.

Acoustic Impedance Tests↗
PubMed1990

Malignant external otitis in an infant.

Ten cases of malignant external otitis in children have been reported hitherto. These are reviewe, and an eleventh case, a three-month-old infant associated with genetic granulocytopenia, is presented. On the grounds of the reported paediatric cases, the erudition in childhood is compared with the more common form in the adult, and is found to be much less linked with diabetes mellitus and to have a far better prognosis, with practically no mortality.

Agranulocytosis↗
PubMed1989

[Epistaxis caused by leeches].

Among the conditions which can cause epistaxis are intranasal or nasopharyngeal foreign bodies. A living foreign body, or parasite, in the nose or nasopharynx is rare in western countries, but in other parts of the world is a fairly common cause of epistaxis. In the past 5 years 17 cases of epistaxis due to infestation with leeches were treated in our 2 departments. In 14 patients, 9-27 years old, the complaint was of recurrent episodes of mild epistaxis and blood-spitting several days before admission. 3 patients were admitted hemorrhaging profusely from the nose and mouth. Examination showed a green-brown mass protruding from the nasopharynx behind the soft palate, which is every case was a blood-engorged leech. Treatment consisted of removing the leech by applying a forceps to the middle of the leech's body and giving a quick pull. Bleeding ceased immediately after removal of the leech. All the patients had drunk water from brooks, streams or fresh water lakes. Therefore, in areas in which leeches are present only boiled or filtered water should be drunk.

Adolescent↗
PubMedDate not supplied

Tinnitus as a prognostic factor in sudden deafness.

Recovery from idiopathic sudden hearing loss depends on many factors, some as yet unknown. This study found tinnitus to be a favorable prognostic sign, based on an analysis of symptoms and recovery rates in a series of 60 patients. Hearing improved in 80 per cent of the patients studied. Tinnitus was one of the complaints in 71 per cent of the patients who recovered, whereas it was present in only 39 per cent of those who did not recover. A possible explanation of the association between tinnitus and recovery from sudden hearing loss is suggested and discussed.

Adult↗
PubMedDate not supplied

Malignant external otitis: treatment with fluoroquinolones.

Malignant external otitis (MEO) is still a potentially lethal disease. Early treatment based on a correct diagnosis is the most important single factor in achieving a cure for the disease. The preferred treatment is long-term systemic antibiotics followed by surgical intervention. Hyperbaric oxygen therapy may be supplemented in refractory cases. A new fluoroquinolone, Ciprofloxacin, has been successfully used in four cases of MEO which did not respond to the accepted treatment. Ciprofloxacin is active against a broad spectrum of bacteria, including Pseudomonas aeruginosa, and several clinical studies have demonstrated its efficacy in the treatment of urinary tract and soft tissue infections, osteomyelitis, pneumonia, and gastroenteritis. This report is the first of which we are aware to document the use of Ciprofloxacin in the treatment of MEO.

Aged↗