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Biomedical subjects

K T Robbins

Publications and source records attributed to K T Robbins.

At least 91 records · Page 5Linked to original sources
PubMed1986

Radiological evaluation of mid-third facial fractures.

Clinical assessment of patients with facial injuries can be difficult, particularly if there is extensive soft tissue swelling. The maxillofacial surgeon frequently must rely on radiographic images to confirm and delineate the presence of fractures. In particular, the mid-third of the face is a notoriously difficult area in which to delineate fracture lines in the severely injured patient. In this study, three radiographic techniques were compared for the evaluation of patients with mid-facial fractures treated in a major trauma center: plain films; panoramic zonography; and computed axial tomography. The results indicate that quality plain films are frequently difficult to obtain in the severely injured patient. In selected cases, panoramic zonography and computed axial tomography are important complementary methods for accurate assessment of mid-third facial fractures.

Adult↗
PubMed1985

Primary lymphomas of the nasal cavity and paranasal sinuses.

Extranodal lymphomas which present in the nasal cavity and/or the paranasal sinuses are rare. Thirty-eight patients with disease that was clinically limited to the head and neck (Ann Arbor Stages IE-IIE) were admitted between 1947 and 1983. Twenty-eight patients were treated with radiotherapy alone and 10 received combination chemotherapy in addition. The overall 5-year survival figure was 56%. The corresponding result for Stage IE was 67%. No patient with Stage IIE disease survived 5 years. Extent of the extranodal disease also influenced results for Stage IE patients who were treated with radiotherapy only. When the extranodal disease was staged using the American Joint Committee TNM system, the 5-year disease-free survival for T1 and T2 patients was 78% as compared with 19% for patients with T3 and T4 disease. The addition of combination chemotherapy improved results for patients with T3 and T4 lesions.

Adult↗
PubMed1985

Feasibility of subtotal laryngectomy based on whole-organ examination.

Subtotal (near-total) laryngectomy has recently been advocated to eradicate large laryngeal tumors. The operation, which preserves the cricoarytenoid joint and adjacent vocal fold, is based on the premise that many T3 and T4 tumors can be resected without complete sacrifice of the phonatory mechanism. The purpose of this study was to verify or disprove the assumption by examining sections of whole-organ laryngeal specimens. Twenty-four of the 64 specimens analyzed were determined to be resectable by subtotal laryngectomy. Twenty-two other specimens could have been resected by a more conventional conservation technique such as hemilaryngectomy or supraglottic laryngectomy. This study supports the concept of subtotal laryngectomy for selected large tumors. Guidelines for determining the suitability of the technique are suggested.

Epiglottis↗
PubMed1985

Inverted papilloma. Considerations in treatment.

Inverted papilloma is notorious for recurrence and occasional association with malignancy, leading most authors to recommend lateral rhinotomy as the initial surgical approach in all cases; however, conservative surgery has been reported effective in selected cases. To assess the role of conservative procedures, 90 cases of inverted papilloma were retrospectively reviewed. Associated malignancy was rare. Conservative surgery was successful in controlling some cases, but often required two or three operations. All patients with clear sinus films were cured by a single procedure. Abnormal mitotic activity was seen in some aggressive lesions and some associated with malignancy. The surgical exposure in inverted papilloma should be adequate to ensure complete excision. Selected patients with localized disease can be satisfactorily managed by conservative procedures if they are carefully followed. All tissue should be inspected for possible malignancy.

Adult↗
PubMed1985

Pilar tumor of the scalp.

An elderly woman presented with a large, fungating mass over the occipital portion of the scalp. Biopsy revealed this to be a pilar tumor of the scalp. The tumor was excised with a margin of normal tissue and the defect was closed with advancement of scalp and neck skin. Follow-up at 6 months revealed no recurrence of the lesion.

Aged↗
PubMed1985

High-resolution CT scanning and auditory brain stem response in congenital aural atresia: patient selection and surgical correlation.

Thirty patients with congenital aural atresia underwent CT scanning and/or auditory brain stem response (ABR) testing in a 20-month period. Eighteen patients had unilateral atresia and 12 had bilateral atresia. Twelve patients subsequently had surgery for repair of their atresia. CT scanning was not electively done until the patient was at least 2 years of age, while ABR testing was often performed in the first few months of life. Nineteen patients had CT scanning and 27 had ABR testing. The CT technique was found to offer specific advantages not previously observed in other methods of radiographic evaluation: (1) the course of the facial nerve was more easily traced and (2) the presence (or absence) of a stapes was more easily noted. The ABR was measured for monaural air-conduction as well as mastoid-placement bone conduction click stimuli; simultaneous multielectrode two- or four-channel recordings were employed. With this measuring technique it was not only possible to enhance wave I detection but, more important, the laterality of ABR wave I could be noted.

Acoustic Stimulation↗
PubMed1985

Nasal obstruction and pulmonary function: the role of humidification.

The function of the nose in respiration is poorly understood. This article reports on two studies of the effects of nasal obstruction on pulmonary function. First, blood gases were studied in 71 patients undergoing intranasal surgery. Patients with bilateral nasal packing had an average PO2 drop of 6.9 mm Hg. Lung disease and polyps were more prevalent in patients who showed a significant drop in PO2, and those who became most hypoxic complained of a dry throat. The second study tested the influence of humidification. Pulmonary function and blood gases were measured in 10 subjects before and after nasal occlusion. Those breathing only dry air had a drop in compliance after nasal clipping. When air was humidified, nasal occlusion had no significant effect. Humidification may be an important respiratory function of the nose. Any future studies of the nasopulmonary relationship should adequately control for humidity and bronchial reactivity.

Adult↗
PubMed1985

A comparative analysis of lymphomas involving Waldeyer's ring and the nasal cavity and paranasal sinuses.

The two major extranodal sites for malignant lymphoma of the head and neck are Waldeyer's ring and the nasal cavity and paranasal sinuses. The clinical manifestations, treatment, and survival results are presented for 137 patients with primary lymphoma of Waldeyer's ring and 38 patients with primary lymphoma of the nasal cavity and paranasal sinuses. The similarities of and differences between the two sites are discussed and compared to their more common counterparts the carcinomas. The results of this study indicate that the TNMAJCC method of staging Ann Arbor stage IE and IIE non-Hodgkin's lymphoma is a reliable prognostic indicator for these sites and should be considered when determining treatment.

Adult↗
PubMed1984

A study of whole organ cancerous larynges to determine resectability by conservation surgery.

Sixty-two extirpated whole larynges containing squamous cell carcinoma were examined by a transverse slicing method to determine whether a partial laryngeal resection would have been feasible. The epithelial origin and sites of invasion of each tumor were recorded. The observations suggested that in one third of the specimens conservation laryngeal surgery could have achieved complete removal of the cancer.

Carcinoma, Squamous Cell↗
PubMed1984

Lymphoma of the head and neck. A diagnostic dilemma.

The surgeon should remember that lymphoma may involve any tissue in the head and neck region. By maintaining a high level of suspicion when evaluating a tumor that appears to be more aggressive than expected (that is, multiple primary sites), the head and neck surgeon will expedite treatment of the patient with lymphoma. Aids in early diagnoses center around providing sufficient tissue to the pathologist by avoiding needle biopsy and piecemeal removal of the regional lymph nodes or obtaining undistorted representative tissue from extranodal sites. We stress the need for a continuing dialogue between the head and neck surgeon and the pathologist regarding early identification of the potential lymphoma patient, thereby preventing a diagnostic dilemma.

Adolescent↗
PubMed1984

Stages I and II non-Hodgkin's lymphomas of Waldeyer's ring and the neck.

In a previous communication we reported our results for patients with localized extranodal presentations of non-Hodgkin's lymphomas of the head and neck who were admitted between 1961-1969. This review describes our larger experience from 1947-1982 in treating 137 Stages I and II Waldeyer's ring patients whose slides were available for reclassification according to the modified Rappaport System. All of these patients were treated definitively as follows: radiotherapy only, 113 patients; radiotherapy and combination chemotherapy, 17 patients; chemotherapy only, seven patients. The overall 5-year survival was 50%. Significant differences were determined for specific subgroups. For patients staged after lymphangiography, the 5-year survival was 67% as compared with 32% for non-lymphangiogram staged patients (p = 0.002). Stage (Ann Arbor) also influenced results. The 5-year survival figure for Stage I was 70% as compared with 42% for Stage II (p = 0.002). The combination of extent of disease in Waldeyer's ring and the status of the neck had a major impact on survival. When the disease was staged according to the TNMAJCC System, the 5-year survivals were: 75% for T1-T2-TX N0; 53% for T1-T2-TX N+; 54% for T3-T4 N0; and 36% for T3-T4 N+. Also, results for tonsil (52%) and base of tongue (66%) disease were better than for disease involving the nasopharynx (39%) or multiple sites (25%). Treatment also influenced survivals and disease-free survivals. The best results were obtained in patients who were treated with radiotherapy and combination chemotherapy. The 5-year survival and disease-free survival figures were 78% and 69%, respectively.

Antineoplastic Agents↗
PubMed1984

Chest wall metastasis as a complication of myocutaneous flap reconstruction.

Tumor seeding of the chest wall secondary to myocutaneous flap reconstruction to our knowledge has not been previously reported. Two cases of this complication are presented, along with an analysis of possible causes. Measures for decreasing the risk of the occurrence are suggested.

Carcinoma, Squamous Cell↗
PubMed1983

Multiple laryngeal papillomatosis requiring laryngectomy.

Laryngectomy has been performed on two of the 63 cases of laryngeal papillomatosis treated at the Royal National Throat, Nose, and Ear Hospital, London, over 24 years. Their case histories are reported to illustrate the difficulties in managing extremely diffuse and recurrent forms of the disease. Whole organ laryngeal sections of one case are presented. Both patients experienced an improved life-style and fewer hospitalizations following laryngectomy. Although improved microsurgical methods are now available, the search continues for a treatment that will significantly alter the course of the disease.

Adolescent↗
PubMed1981

Occult intralabyrinthine schwannoma.

Report of a case of an intralabynrinthine schwannoma discovered unexpectedly during a labyrinthectomy for intractable vertigo, and description of the light and electron microscopic appearances. Although only 18 of these tumors have been previously reported, it is possible that some cases which are categorized as peripheral vertigo of unknown origin, may be due to an occult Schwannoma. All material removed during surgical procedures on the inner ear should therefore be submitted for histopathological examination.

Female↗
PubMed1980

Jugular foramen syndrome.

The jugular foramen syndrome (JFS) specifically refers to paralysis to the IX-XIth cranial nerves. In a more general meaning, however, any combination of palsies affecting the last four cranial nerves has been referred to as a JFS. The anatomy of the jugular foramen and the structures which traverse it are reviewed. Two cases histories of a JFS are described; the first with chronic otitis media, and the second with a glomus tumor. A variety of neoplasms, vascular insults, infections, and trauma have been reported to cause JFS. Treatment is directed toward the underlying cause. A variety of radiological techniques which are useful in the investigation of JFS are outlined.

Accessory Nerve↗
PubMed1980

Non-healing granulomas of the nose.

Our knowledge and understanding of non-healing granulomas of the nose are from complete. The classification and etiology remain in on-going controversy. This article describes an uncommon case of Wegener's granulomatosis in childhood presenting with granulomatous involvement of the nose and orbit. A review of the literature is made with regard to non-healing granulomatous disease of the nose and some of the controversies in classification are pointed out.

Child↗