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J J van Overbeek

Publications and source records attributed to J J van Overbeek.

At least 19 recordsLinked to original sources
PubMed1994

Meditation on the pathogenesis of hypopharyngeal (Zenker's) diverticulum and a report of endoscopic treatment in 545 patients.

Much discussion in the literature concerning Zenker's diverticulum is related to etiology. Various theories have been propounded, but no single conclusion is generally accepted. We believe that an anatomic predisposition plays a prominent role. Considerations for this conclusion will be discussed. In the otorhinolaryngology departments of University Hospital and Martini Hospital (Groningen, the Netherlands) 545 patients with a diverticulum were treated endoscopically since 1964. Initially we used the procedure described by Dohlman. With the increase in the number of patients, the technique and instruments used have improved. In 1981 we started to apply a microendoscopic procedure with a special double-lipped scope and the carbon dioxide laser. The rate of complications was very low, and 91% of the patients are highly satisfied. In view of our results, we feel justified in maintaining that endoscopic treatment is a relatively safe and effective method.

Aged↗
PubMed1992

Endoscopic treatment of the hypopharyngeal (Zenker's) diverticulum.

Over the years the techniques for endoscopic treatment of Zenker's diverticulum have been improved. Initially, in 1964, we used the electrocoagulation technique as described by Dohlman, but currently we prefer to sever the tissue bridge between the diverticulum and esophagus with the CO2 laser under microscopic control. The results of endoscopic treatment in 507 patients with a diverticulum are discussed. It is concluded that endoscopic treatment can readily be performed with good results, especially in the case of elderly patients in a poor general condition.

Adult↗
PubMed1991

Upper esophageal sphincterotomy in dysphagic patients with and without a diverticulum.

Symptoms of high dysphagia are sometimes too readily interpreted as symptoms of globus. When patients have unmistakable difficulties during meals, focused diagnostic procedures are indicated. The upper esophageal sphincter (UES) is the key structure at the transition from hypopharynx to esophagus. In many disorders presenting with dysphagia, the UES mechanism remains intact and can cause the symptoms. Especially in patients with a hypopharyngeal (Zenker's) diverticulum and in patients with a hypopharyngeal paralysis due to a neurologic disorder, sphincterotomy may be indicated. In the microendoscopic treatment of Zenker's diverticulum, a transmucosal sphincterotomy is created and at the same time a more ample overflow from diverticulum to esophagus is effected. In view of our results in 507 patients we are justified in maintaining that this procedure can be regarded as a safe and effective treatment. In patients with neurologic dysphagia, sphincterotomy by an external approach can ensure adequate passage of food from the hypopharynx to the esophagus, resulting in marked improvement of the dysphagic symptoms. Our technique and results of external approach sphincterotomy are described here.

Adult↗
PubMed1989

Laser surgery in lingual tonsil hyperplasia.

Modern techniques have reduced the long existing reluctance to perform lingual tonsillectomy. The results of treatment of hyperplasia of the lingual tonsil with the carbon dioxide laser in 32 patients are presented. After exposure with a special endoscope the lingual tonsil can be vaporized or excised under microscopic control with promising results, far superior to the results obtained with other surgical techniques. Since the success rate of the surgery depends on the diagnostic criteria for applying this therapy, a careful selection of patients is essential.

Adult↗
PubMed1985

Microendoscopic surgery of the hypopharyngeal pouch with the CO2 laser.

In 1964 we started to treat hypopharyngeal (Zenker's) diverticula endoscopically, using the procedure described by Dohlman. With the increase in the number of patients (350), the technique and the instruments used have improved. This paper describes the technique, which involves exposure of the tissue bridge between esophagus and diverticulum with the aid of a specially designed scope and subsequent severance with the CO2 laser of this bridge under microscopic control. The use of an operating microscope and the laser is a great improvement in endoscopic treatment of hypopharyngeal diverticula.

Diverticulum↗
PubMed1985

Simultaneous manometry and electromyography in the pharyngoesophageal segment.

Whether the occlusion between hypopharynx and esophagus is established by anatomical relations and tissue elasticity or by a functional resting tone of the muscle fibers is not quite clear. This study describes simultaneous electromyography (EMG) and electromanometry in the pharyngoesophageal segment to solve this problem and investigate the complex mechanism of deglutition. To register the EMG from the hypopharyngeal constrictor muscle and the upper esophageal sphincter (UES), two copper wire electrode pairs with hooked bare ends were used. These electrodes were introduced into the muscles through a rigid esophagoscope. It is demonstrated that at rest muscle activity is present in the UES. This activity disappears during the relaxation period. Simultaneous manometry and EMG is a valuable supplement to diagnostic procedures in dysphagia patients.

Deglutition↗
PubMed1985

Endoscopic treatment of a whistling middle-lobe bronchus.

A 32-year old man presented with dyspnea and a loud inspiratory wheeze. Examination revealed a nonfibrous, fissure-shaped entrance to the middle-lobe bronchus. The cause of this stenosis was unclear. Endoscopic treatment consisted of splitting the spur and resulted in complete disappearance of the wheeze.

Adult↗
PubMed1982

Renal involvement in Wegener's granulomatosis. Report of three unusual cases.

Three patients with rapidly progressive glomerulonephritis due to Wegener's granulomatosis are described. In one patient, acute renal failure was initially the sole manifestation of the disease. Treatment of the two other patients with prednisone and cyclophosphamide resulted in a remarkable recovery of renal function even after a prolonged period of hemodialysis. These cases illustrate that early and sustained treatment with prednisone and cyclophosphamide can restore an adequate renal function in patients with anuria or severe glomerulonephritis due to Wegener's disease.

Acute Kidney Injury↗
PubMed1982

Endoscopic treatment of the hypopharyngeal diverticulum: 211 cases.

It is somewhat surprising that endoscopic treatment of hypopharyngeal diverticula has failed to become as widely known as the method merits in our opinion. In principle we use the Dohlman procedure. The septum between diverticulum and esophageal lumen is divided with a diathermic knife after electrocoagulation. In larger diverticula we prefer to divide the tissue bridge in several sessions. Endoscopic treatment (under local anesthesia, if necessary) can be carried out in patients whose general condition is poor. From 1964 until 1980 we have endoscopically treated 211 patients, including 6 patients with a recurrent diverticulum after transcutaneous surgery. The complication rate is low and the complications were successfully controlled except in 1 patient, who died from cardiac failure 2 days after operation. Ultimately 193 patients (91.5%) are very satisfied and 17 patients (8%) are fairly satisfied with the therapeutic result. We feel justified in maintaining that endoscopic treatment of hypopharyngeal diverticula can be regarded as a good method of treatment.

Adult↗
PubMed1982

Continuous intravenous anesthesia with etomidate for carbon dioxide laser surgery of the larynx.

Twenty-five adult patients undergoing carbon dioxide laser surgery for benign and malignant disease of the larynx were given continuous infusion of etomidate at 60 micrograms . kg-1 . min-1 for induction of anesthesia. Maintenance anesthesia was continued using one of three infusion rates: 20 micrograms . kg-1 . min-1 (n = 5), 30 micrograms . kg-1 . min-1 (n = 10), and 40 micrograms . kg-1 . min-1 (n = 10) of etomidate in air-oxygen mixture. Muscular relaxation was achieved by continuous infusion of succinylcholine, and fentanyl was used for analgesia. Continuous etomidate infusion for induction of anesthesia resulted in a significant decrease in the incidence of pain along the injection site to 8% and involuntary muscular movements to 12% compared with 35% and 44%, respectively, in a group of 25 adult patients undergoing endoscopic procedure who received intravenously a single volus injection of etomidate (0.3 mg .g kg-1). However, a prolonged recovery time was observed after 30 minutes of continuous etomidate infusion.

Adolescent↗
PubMed1981

[The CO2 laser in laryngeal diseases].

At present the CO2-laser is employed in almost every surgical specialism. If it is right to prefer laser treatment for special operations to conventional surgical methods, is not yet decided. However, the use of laser beam energy for laryngeal conditions offers undeniable advantages as: -- No direct instrumental contact. Involuntary movements which can occur when using long-reach instruments during conventional microlaryngeal surgery do not play a role. -- Little bleeding. The treating area stays all the time under good visual control. --Outmost precision by which an intended operation is to perform. Exact on the desired place with an adjust quantity of energy tissue can be vaporized as well with very limited amount as extensive, or be removed by cutting round. -- No postoperative edema. No or hardly any edema means that tracheotomy often needed for some conditions in another way of treatment usually is unnecessary. On account of experience during 4 years is shown which possibilities laser-microlarynx surgery offers.

Evaluation Studies as Topic↗
PubMed1978

Intramural diverticulosis of the esophagus.

A description is given of the etiology and pathology of intramural esophageal diverticulosis as so far discussed in the literature. In view of the course and the clinical findings in two young patients in whom this diagnosis was established, it is suggested that intramural diverticulosis develops as a result of a devolopmental disorder in the autonomic nervous system.

Adolescent↗