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Biomedical subjects

J J Holt

Publications and source records attributed to J J Holt.

10 recordsLinked to original sources
PubMed1992

Ear canal cholesteatoma.

Although cholesteatomas are more commonly found in the middle ear and the mastoid, the disease can occur in the external ear canal. All cases of ear canal cholesteatoma treated by the author were reviewed. There were nine ears in seven patients, who had an average age of 62 years. The lesions ranged in size from a few millimeters to extensive mastoid destruction. Smaller lesions can be managed by frequent cleaning as an office procedure. Larger lesions require surgery, either canaloplasty or mastoidectomy. The otolaryngologist should suspect this disease in the elderly. Microscopic examination of the ear with meticulous cleaning of all wax, especially in elderly patients, is most useful in detecting early disease. Frequent applications of mineral oil to the canal should be used in the management of the disease and to prevent recurrence.

Adolescent↗
PubMed1985

Neck dissection and combined therapy. Study of effectiveness.

Data on 1,385 neck dissections in 1,192 patients were studied to evaluate the effectiveness of treatment with operation alone and with various forms of combined therapy in controlling cervical metastasis. Of the 1,192 patients, 837 were treated by operation (neck dissection) alone, and the remainder had preoperative or postoperative radiation to the primary site and to the entire side of the neck that was dissected. In no stage of neck disease was either form of combined therapy superior to operation alone in decreasing the rates of recurrence. In an attempt to simulate a randomized, prospective study in a clinical situation for which the end results were already known, we used a separate statistical analysis--a case-control technique to specifically address the issue of the effectiveness of postoperative radiation in decreasing the frequency of recurrences after dissection in the various stages of disease. No evidence of a relationship between recurrence and the administration of planned postoperative radiation was found.

Carcinoma, Squamous Cell↗
PubMed1982

Neck dissection: is it worthwhile?

Data on 1,048 neck dissections in 881 patients were studied to evaluate the effectiveness of treatment in controlling cervical metastasis. Of the 881 patients, 74.5% were treated by surgery alone, and most of the remainder had either planned preoperative or postoperative radiation to the primary site and the entire neck. Planned preoperative or postoperative radiation was defined as the delivery of 4,000 rads or more to the entire neck 123 days before (preoperative) or after (postoperative) neck dissection. In these groups, most patients received more than 5,000 rads. Ninety-six patients received preoperative radiation that did not satisfy these criteria and were grouped separately. The group with neck dissection alone had recurrence rates in the dissected side at 2 years of 7.5, 20.2, and 37.4%, respectively, for No, N1, and N2 staged necks. There were no differences in recurrence rates for the groups with radiated necks in the stage II (N2) necks compared with each other or with the group having surgery alone. Most recurrences, when they occurred in the neck, were manifest by 2 years. Mean follow-up in the entire study was 3.5 years. Two patients were lost to follow-up and were presumed to have died from cancer. When compared with pathologic staging, clinical staging was imprecise in one-third of the cases.

Adolescent↗
PubMedDate not supplied

Effects of large-bore middle ear ventilation tubes.

Patients with chronic otitis media that did not respond to conventional treatment were studied for the types and incidence of complications from the use of large-bore tubes inserted into their ears. The most common complication was otorrhea (41%, 50 of 123 ears). Permanent perforation occurred in 25% (17/68 ears). Use of large-bore tubes proved effective and continues to be indicated in certain conditions of chronic otitis media that are refractory to other forms of treatment.

Adolescent↗