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Biomedical subjects

J W Templer

Publications and source records attributed to J W Templer.

18 recordsLinked to original sources
PubMed1992

Anaphylaxis in immunotherapy.

Although anaphylactic reactions resulting from immunotherapy rarely occur, when they do occur they can be life-threatening. The literature reveals more than 30 deaths attributed to immunotherapy but numerous reports of anaphylaxis. We reviewed a 5-year experience of immunotherapy in a University practice and their experience with systemic reactions is presented. More than 125,000 injections were given in this time period. Of the 550 patients receiving immunotherapy, 14% experienced anaphylactic reactions, the majority of which were mild.

Anaphylaxis↗
PubMed1992

Partial endoscopic middle turbinectomy augmenting functional endoscopic sinus surgery.

Endoscopic sinus surgery has gained acceptance in the otolaryngologic community as an effective and safe method of treating inflammatory disease of the paranasal sinuses. At our institution, partial endoscopic middle turbinectomy has become a standard component of the procedure and our experience is reported. Middle turbinectomy enhances surgical exposure, specific anatomic anomalies are more completely corrected, and subpopulations of patients at risk for failure because of their underlying disease enjoy decreased rates of synechiae formation and closure of the middle meatus antrostomy when followed over time. Photodocumentation of the surgical technique and a discussion regarding the impact of middle turbinectomy on normal nasal physiology are presented. It is reported that the procedure is safe, and no complications directly attributable to middle turbinectomy (including atrophic rhinitis) are reported in a series of 298 patients.

Endoscopy↗
PubMed1991

Laryngeal airway resistance. The relationships of airflow, pressure, and aperture.

In the surgical treatment of the paralyzed larynx, a compromise often needs to be made between an orifice size needed to preserve voice and that needed for adequate inspiratory airflow rates. To assess the negative pressures needed to generate normal airflows across a narrowed vocal cord aperture, we measured pressure and flow changes across cadaveric larynges while altering aperture size. Best-fit quadratic equations for each aperture area selected were derived and showed that if the aperture were 0.5 cm2 or less, the resistance to normal breathing would be significantly increased. Aperture sizes of 0.67 cm2 or greater are not associated with such an increase in resistance.

Airway Resistance↗
PubMed1991

Patency rate of endoscopic middle meatus antrostomy.

A series of 145 patients with chronic sinusitis were treated with functional endoscopic sinus surgery. Patency of the middle meatus was evaluated by actuarial life-table methods. After 24 months' follow-up, the overall patency rate of endoscopic middle meatotomy was 94.08%. Questionnaire data indicated that 91.8% of these patients were improved or asymptomatic. This preliminary study indicates that the patency rate of middle meatal antrostomy appears to be greater than that of inferior meatal antrostomy when compared to literature controls, and that a high percentage of these patients are improved by this surgery.

Actuarial Analysis↗
PubMed1991

Middle meatus anstrostomy: patency rates and risk factors.

Two hundred patients with chronic sinusitis were operated on using functional endoscopic sinus surgery (FESS) techniques. These patients were followed closely over 3 years. Patency of the endoscopic middle meatotomy was recorded using actuarial life-table methods. The overall patency rate of the endoscopic middle meatotomy was 93.55%, and the actuarial patency rate at 36 months was 87.47%. The presence of seasonal allergy with nasal polyps was the most important variable in predicting closure. Middle turbinectomy was the most important variable in predicting patency. Symptoms were evaluated by questionnaire at 1 year. Questionnaire data indicate that 96% of these patients are improved or asymptomatic.

Actuarial Analysis↗
PubMed1991

Audiology in medicine.

Among the most common complaints a physician confronts are those concerned with hearing loss and dizziness. It is essential that all practitioners acquaint themselves with the diagnostic information provided by an audiological evaluation. The authors describe the frequently used tests and present case studies to illustrate the value and scope of diagnostic audiology.

Adult↗
PubMed1979

Parotid fistula: current management.

The most common cause of parotid fistula is trauma. Other causes include operative complications, infection, and malignancy. In the acute phase of ductal injury, primary reconstruction, if possible, is the treatment of choice. Acute parenchymal injury is treated by tight closure and expectancy. When diverting or flow-blocking measures fail to correct chronic ductal fistula, the treatment of choice for this situation as well as for chronic parenchymal fistula may be tympanic neurectomy, which can be done under local anesthesia, is associated with low morbidity, is relatively uncomplicated and has given excellent results to date in our hands.

Humans↗
PubMed1978

Design and testing of a transistorized nerve stimulator.

Presently available equipment for nerve stimulation includes the relatively expensive multifunction pulse generators and the disposable dc stimulators. We have designed a semidisposable, two-transistor pulse generator that is portable, inexpensive, and capable of dynamic nerve stimulation.

Electric Stimulation↗
PubMed1978

Lymphocyte-tumor cell interaction in patients with head and neck cancer.

Peripheral lymphocytes from 12 patients with squamous cell carcinoma of the lead and neck were incubated with autologous tumor explants. Four of the 12 patients demonstrated lymphocyte induced tumor cytotoxicity. These lymphocytes adhered to the tumor cells and deposited a radioactive label from their surface onto tumor cells. The deposition of this label was associated with tumor death. Tissue sections from those patients who demonstrated lymphocyte cytotoxicity showed a marked plasmacytic infiltration. This was in contrast to non-responders where only a desmoplastic tissue response was observed with few inflammatory cells.

Autoradiography↗
PubMed1977

Parotid fistula and tympanic neurectomy.

Parotid fistula is most commonly a posttraumatic situation. In posttraumatic cases, spontaneous closure of the fistula is the general rule. Conservative approaches to the occurrence of a parotid fistula are eliminating oral intake by the patient and applying a pressure dressing while maintaining nutrition by the intravenous route. Anticholinergic drugs decrease the production of saliva and thus would appear to be beneficial. When a parotid fistula does not heal under these conditions, then more aggressive treatment is indicated. Treatment should be based on whether the fistula is ductal or glandular in origin. Several methods of treatment have been advocated in the past. Low dose radiotherapy has been mentioned by some authorities as the treatment of choice for parotid fistula. This was used in one of our patients without response. Excision of the fistulous tract with ligation of the parotid duct has been advocated by some authorities. Tympanic neurectomy appears to be a satisfactory method of dealing with selected parotid duct fistulas, and glandular fistulas are best treated by tympanic neurectomy. Suppression of parasympathetic activity by the use of tympanic neurectomy has been said on some occasions to be transient (for example, Frey's syndrome). In dealing with parotid fistulas it would not appear to matter whether the effects are transient or permanent. The suppression of activity by tympanic neurectomy lasts long enough to allow for healing of the fistulous tract and relief of symptoms.

Adult↗
PubMed1977

Immediate tonsillectomy for the treatment of peritonsillar abscess.

Our experience with 119 cases of peritonsillar abscess supports the experience of others, that immediate tonsillectomy is a safe treatment which provides prompt, complete drainage of the abscess. There was one episode of immediate postoperative hemorrhage and one of delayed bleeding, but there were no anesthetic complications. If one believes that the abscess is an indication for tonsillectomy and plans to perform the procedure at some time, we recommend that it be performed as the drainage procedure. The total hospitalization time will as a rule be shortened and a second convalescent period avoided. Its major drawback is the inconvenience of inserting a relative emergency into the schedule.

Adolescent↗
PubMed1975

Eversion of the laryngeal ventricle.

Eversion of the laryngeal ventricle is a rare lesion that presents with cough and/or voice changes. Laryngoscopy reveals a polypoid mass arising from the ventricle. Microscopically a polyp covered with ventricular mucosa and containing normal laryngeal mucous glands is seen. Chronic inflammation is usually present. Treatment in symptomatic cases consists of surgical removal endoscopically or by laryngofissure. The management of one patient is reported with a discussion of the cause, symptoms, and treatment of this condition.

Diagnosis, Differential↗
PubMed1975

Nevus sebaceous of Jadassohn.

The nevus sebaceous of Jadassohn is a little known entity to most otolaryngologists. Most of the reported cases have occurred on the face or scalp. The lesion is usually congenital. It is a hairless, yellowish-red plaque until puberty when it becomes verrucous and unsightly. Benign or malignant tumors frequently develop. Associated ocular and central nervous system defects are occasionally present. The treatment is full-thickness excision as early as is feasible for cosmetic purposes and to avert the potential development of benign or malignant tumors.

Humans↗
PubMedDate not supplied

Recurrent nerve locating system.

One recurring problem for otolaryngologists is the patient with vocal cord paralysis after thyroid surgery. We review the literature to assess the magnitude of this problem and to assess presently available techniques for sparing the recurrent laryngeal nerve. We present a new system for intraoperative recurrent laryngeal nerve location during thyroid surgery.

Adult↗