Multiple myeloma involving the cricoid cartilage.
This presents a case report of a patient with multiple myeloma who developed such a lesion in the cricoid--a circumstance which has not previously been recorded.
Aged↗
Biomedical subjects
J S Chapnik
Publications and source records attributed to J S Chapnik.
Total facial rejuvenation.
Facial rejuvenation cannot usually be effected by any one procedure. Since many interrelated operations are often required, the authors feel that this should be carried out at one sitting employing a "two team approach". Proper pre-operative evaluation and education of the patient is mandatory.
Face↗
The clinical significance of radionuclide bone and gallium scanning in osteomyelitis of the head and neck.
Osteomyelitis of the head and neck remains a difficult clinical problem both in diagnosis and treatment evaluation. The purpose of this manuscript is to review our clinical experience with 25 cases of osteomyelitis distributed evenly among the temporal bone and skull base, the paranasal sinuses, and the mandible. Radionuclide bone and gallium scan images accurately depicted the biologic activity of the disease process and permitted accurate treatment evaluation and patient monitoring. This work demonstrates the potentials and limitations of radionuclide imaging with bone and gallium scan agents and attempts to define a role for their contemporary use in the management of osteomyelitis of the head and neck.
Adult↗
Medical therapy in rhinology.
The treatment of nasal diseases is both medical and surgical. This article broadly reviews the medical treatment of the most common nasal pathologies.
Anti-Bacterial Agents↗
The controversy of Warthin's tumor.
Warthin's tumor is controversial. This controversy is multifaceted and relates to all aspects of the tumor from its historical beginnings to its pathogenesis, investigations, and treatments. In this paper, an in depth study of Warthin's tumor has been made to help clarify these controversies.
Adenolymphoma↗
Ludwig's angina following dental extraction as a cause of necrotizing mediastinitis.
A fatal case of Ludwig's angina is reported in which penicillin was used as the sole antibiotic. Bacteroides melanogenicus resistant by virtue of production of Beta-lactamase was present. It is suggested that a combination of penicillin and an antibiotic effective against anaerobes such as metronidazole is the most appropriate initial chemotherapy pending confirmation from the bacteriology laboratory.
Adult↗
Greater omentum used for carotid cover after pharyngolaryngoesophagectomy and gastric 'pull-up' or colonic 'swing'.
An excellent method of rehabilitation for swallowing after total pharyngolaryngoesophagectomy is the reconstruction of the pharyngoesophagus with an autogenous visceral transplant. The most popular and reliable methods are the gastric "pull-up" and colonic "swing." A complication of this procedure--which can result in morbidity as well as mortality--is carotid artery rupture, especially when a neck dissection is performed. This is usually the result of wound breakdown secondary to adjunctive use of radiotherapy. When we have performed a radical neck dissection in conjunction with a visceral transplantation, we have used pedicled omentum as a live, durable cover for the carotid artery. ?
Carotid Artery Diseases↗
Radionuclide salivary scan imaging of a "functioning" malignant parotid tumor (mucous-producing papillary adenocarcinoma).
To date, all "functioning" or "hot" tumors on salivary gland scan have been benign - either the not uncommon Warthin's tumor or the rare oncocytoma. A positive salivary scan was obtained in a functioning malignant tumor of the parotid gland (a mucous-producing papillary adenocarcinoma). This occurrence has not previously been reported. The pathologic findings and the radionuclide images are demonstrated in this elderly female. It is presumed that the Technetium Tc99m pertechnetate has been concentrated in the tumor. The functioning epithelial cell, however, is not the benign oncocyte associated with other previously reported benign functioning tumors. Clinical discretion is therefore suggested in interpreting the significance of a functioning salivary gland tumor if encountered in an elderly female.
Adenocarcinoma, Papillary↗
Muco-epidermoid carcinoma of the palate.
Muco-epidermoid carcinoma is the second most frequently occurring malignancy of the minor salivary glands representing 25 per cent of all malignancies, adenoid cystic being the more common tumor. It invariably presents as an asymptomatic lung without mucosal ulceration, 50 per cent of which occur on the palate. It is of great interest to the physician because it may be divided into two distinct categories dependent upon its cell composition - low grade malignancy or high grade. These have widely differing prognostic significance and require different modes of therapy. This is illustrated by five case histories which span the past seven years of the author's experience.
Adult↗
Familial Warthin's tumor. 1. Its synchronous occurrence in mother and son. 2. Its association with cystic oncocytic metaplasia of the larynx.
Warthin's tumor of the parotid gland is an unusual tumor for which a number of theories of pathogenesis have been advanced through the years, ranging from a branchiogenic origin to an embryonic lymph node origin to true neoplasia from parotid epithelial duct cells. Recently Allegra has suggested that Warthin's tumor may be a hypersensitivity disease. Presented here are two unique cases of Warthin's tumor, having both a familial relationship (synchronous occurrence in mother and son) and the association with cystic oncocytic metaplasia of the larynx. Observations lead to the conclusion that the lesion is primarily metaplastic, not neoplastic, with a secondary lymphoid reaction of the delayed hypersensitivity type.
Adenolymphoma↗
Current thoughts on implants in rhinoplasty.
Since the birth of modern rhinoplastic surgery in the early 20th century, most attention has been directed to the reduction rhinoplasty with ever improving and increasingly sophisticated approaches and techniques. Augmentation procedures, on the other hand, have been used on a far lesser scale. The employment of implants, although used sporadically in the past and often with poor results, now appears to be gaining in popularity as new inert materials are being synthesized and proven safe for medical usage. It is the purpose of this paper to review the synthetic material available for nasal implantation, as well as their place in the rhinologist's armamentarium.
Bone Transplantation↗
Bacterial and fungal infections of the maxillary sinus.
Explore the source record for details and available documents.
Aspergillosis↗
Chemotherapy and palliative therapy in malignant disease of the maxillary sinus.
Explore the source record for details and available documents.
Bleomycin↗
Glomus tumours of the temporal bone.
Explore the source record for details and available documents.
Adult↗
Nasal nitric oxide is not altered by topical anesthesia.
This prospective study was undertaken to determine whether topical nasal anesthetic agents affect nasal nitric oxide (NO) output in healthy adults. Seven volunteers (aged: 29-56 (40.6 +/- 10.7) years, six male), were recruited. A topical anesthetic (4% lidocaine or 0.5% tetracaine) was sprayed into the subject's right nostril while the left nostril served as a control. Unilateral nasal NO and nasal volume were measured before administration of the anesthetic and at 15 and 30 minutes after the administration. The mean (+/- SD) unilateral nasal NO output was 307 +/- 45.9 nL/minute from the right nostril (exposure side) before the topical application of lidocaine. At 30 minutes after topical application (n = 6), it was 295.5 +/- 41.5 in the right nostril and 297.5 +/- 39.8 in the left (control side). In the tetracaine group (n = 7), the mean (+/- SD) unilateral nasal NO output was 302 +/- 53.3 before the administration and 307 +/- 39.7 at 30 minutes after the administration in the right nostril. The mean NO output in the left nostril at 30 minutes after the administration was 297.7 +/- 40.75. In neither group was there any significant difference in nasal NO output between either the pre- and postlocal anesthetic application on the exposure side (Group 1, P = 0.76; group 2, P = 0.41) or the two nostrils after topical anesthesia application (group 1, P = 0.83; group 2, P = 0.62). Topical anesthesia with either lidocaine or tetracaine does not alter nasal NO output. NO measurement should not be affected in circumstances that require topical anesthesia of the nasal cavity.
Administration, Inhalation↗
Parotid gland and parapharyngeal space imaging--the surgical significance.
Wise head and neck surgeons, for whom parotid gland surgery constitutes a substantial portion of their case load, make full use of the radiologist and cytologist in arriving at a rational pre-operative diagnosis. They utilize the skill of these allied consultants to qualify (by histology) and quantify (by staging) diffuse and mass lesions of the parotid gland (and subjacent parapharyngeal space) in order to evolve an effective surgical, radiation or other treatment plan. They understand the basic principles of diagnostic imaging and apply them to the clinical problem at hand. They minimize diagnostic and intra-operative "surprises", reduce intra-operative and post-operative complications and generally have a more "informed" patient and patient's family. The purpose of this manuscript is to discuss a contemporary role for diagnostic imaging in neoplastic (and other) diseases of the parotid gland and subjacent parapharyngeal space. Not all lesions of the parotid gland require imaging, although a pre-operative clinical photograph, including evidence of facial nerve function, is always welcome. Other lesions may need diagnostic imaging, from simple to complex and sophisticated, depending upon the problem. Properly used, effective and selective diagnostic imaging can improve the surgeon's confidence by providing a more realistic provisional diagnosis and a better pre-operative staging process and treatment plan, thereby avoiding the surgically unexpected and facilitating prognosis.
Humans↗
Decision making in thyroid and parathyroid surgery: the influence of imaging.
Surgical decision making is essentially based on experience, augmented by a management philosophy. In this manuscript we review concepts of thyroid and parathyroid surgical decision making in relation to diagnostic imaging input. These two endocrine glands have crucial anatomic associations, but very different pathologic conditions; it is the specific pathologic considerations that ultimately determine the decision-making process. For us, diagnostic imaging has enabled a more effective surgical decision-making process through thorough pre-operative planning. The strategy for parathyroid surgery is based upon the pathologic localization obtained by high resolution ultrasound. Thyroid surgical strategy is more heavily influenced by experience, and our policy is total thyroidectomy for all malignant and benign tumors with airway compression.
Adenoma↗