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Biomedical subjects

L G Close

Publications and source records attributed to L G Close.

71 records · Page 4Linked to original sources
PubMed1983

Ophthalmic manifestations of mucoceles.

Two patients with mucoceles are described. The first case had exophthalmos, and the second had visual loss suggestive of retrobulbar optic neuritis. Possible ocular manifestations of mucoceles are discussed, and the computed tomography findings of these are shown. The treatment of mucoceles is reviewed, and it is stressed that a team approach involving ophthalmology, otorhinolaryngology, and radiology is essential for accurate diagnosis and treatment. Paranasal sinus mucoceles can present with a multitude of different symptoms. The type of presentation is usually determined by the original site of the mucocele, whether it be frontal, ethmoidal, or sphenoidal.

Adult↗
PubMed1981

Laryngeal fibromatosis in the neonate.

Infants with a fibromatosis that originates in the laryngeal mucosa have uniform clinical appearances and morphologic features that identify a clinicopathologic syndrome. Based on data obtained from the two cases in the present study and from previously reported cases, the lesion may appear at birth or appear later in childhood, with symptoms referable to the degree of laryngeal obstruction. Fibroblasts and myofibroblasts make up the cytologic composition of these lesions. These lesions can be identified among the fibromatoses that occur in infants and children. Fibromatosis of the larynx in infants and children may have the same behavior as other fibromatoses, eg, local invasion and potential recurrence; this behavior should be considered in the clinical management.

Diagnosis, Differential↗
PubMed1980

Acute and chronic effects of ammonia burns on the respiratory tract.

Exposure to anhydrous ammonia can result in substantial injury to the respiratory system, eyes, and integument. In this retrospective study, we present the acute and chronic respiratory manifestations in 12 patients exposed to anhydrous ammonia as a result of the same accident. Survivors suffering significant ill effects are separated into two groups according to history and clinical course. One group of patients sustained exposure to high concentrations of ammonia over a short period of time. They manifested upper airway obstruction and required early intubation or tracheostomy. These patients recovered with few pulmonary sequelae and are presently in good pulmonary health. The second group of patients were exposed to lower concentrations of gas over a prolonged period of time and did not manifest upper airway obstruction. In this group of patients, however, significant long-term pulmonary sequelae are manifested.

Adolescent↗
PubMed1979

Malignant melanoma of the scalp.

Malignant melanoma of the scalp has a significantly worse prognosis than cutaneous melanoma arising in other head and neck sites. In this series, 125 patients were treated for Stage I invasive melanoma of the scalp and followed 3 to 19 years. Survival rates for these patients were calculated on the basis of several factors. Survival after treatment was not affected by the age and sex of the patient, size and site of the primary, or treatment of the primary lesion, although local failure was higher among those treated by primary excision and closure. Patients undergoing elective neck dissection with histologically negative nodes had significantly better survival rates than those with histologically positive nodes or patients in whom a neck dissection was not performed.

Adolescent↗
PubMed1978

Computerized tomography or paranasal sinus neoplasms.

Computerized tomography represents a new and valuable diagnostic tool to the otolaryngologist and head and neck surgeon in several ever-increasing aspects of his clinical practice. This report presents CT scans utilizing the E.M.I 5005 body scanner on patients with neoplasms of the paranasal sinuses presenting to the Head and Neck Service of The University of Texas System Center M. D. Anderson Hospital and Tumor Institute. Only patients undergoing surgical resection of such lesions are included so that actual operative and surgical pathological findings can be used for critical comparison of diagnostic information derived from polytomography and computerized tomography. Seven illustrative cases are presented. In general, computerized tomography has been found to be equal to polytomography in assessing bone destruction or involvement by tumor, and superior to polytomography in determining accurately the soft tissue extent of disease. CT scanning, however, has been found to have limitations in the delineation of soft tissue disease in areas of high contrast in tissue density, and in the evaluation of possible intracranial tumor extension in isodense, avascular lesions.

Aged↗
PubMedDate not supplied

Computed tomographic evaluation of regional lymph node involvement in cancer of the oral cavity and oropharynx.

To evaluate the efficacy of computed tomography (CT) in the identification of metastatic cervical node involvement from cancer of the oral cavity and oropharynx, 61 consecutive, previously untreated patients with T2 or greater squamous cell carcinoma of these sites were studies prospectively by CT, followed within 1 month by surgery to the primary and neck as initial treatment. The CT scan of each patient was evaluated according to the location, size, and appearance of visible nodes, and each feature was correlated with the histopathologic findings of all 83 neck specimens. A significant relationship was found between CT findings (node size, node appearance, and multiplicity of nodes) and the pathologic status of the neck using Chi-square contingency table analysis (overall chi 2 = 30.928, p less than 0.001). This data supports the role of CT in the evaluation of patients with cancer of these sites.

Adult↗
PubMedDate not supplied

Fibrous neoplasms of the adult larynx.

Fibrous neoplasms of the adult larynx are uncommon and can be benign, locally aggressive, or malignant. From January 1, 1987 to December 31, 1991, 189 adult patients underwent partial or total laryngectomy for laryngeal neoplasms at the University of Texas Southwestern Medical Center-affiliated hospitals. During this period, three (1.6%) patients were treated for fibrous neoplasms of the larynx. All three lesions arose in the true vocal fold. In one patient, a local recurrence within 6 months following partial laryngeal resection necessitated total laryngectomy. All three patients are alive and disease-free 1 to 4 years following definitive surgery. We present these cases and discuss computed tomographic (CT), histopathologic, and electron microscopic (EM) findings. Based on this experience, surgical treatment of these lesions is recommended, the extent of which is guided by clinical, radiologic, and pathologic evaluation.

Aged↗
PubMedDate not supplied

Facial reconstruction following blast injury.

The facial plastic surgeon, when treating a patient with massive loss of soft tissue and bone of the face secondary to blast injury, must carefully consider available treatment options. The choice of procedure should be dictated by the likelihood of success, donor site morbidity, and the potential for complications. Five illustrative cases of blast injury to the lower face are presented to demonstrate methods of reconstruction currently available. Local soft-tissue flaps appear to be superior to regional or distant flaps for the restoration of form and function of the lower lip. Autogenous, particulate cancellous bone is a satisfactory grafting material for the great majority of traumatic mandibular defects. Vascularized bone grafts should be considered when extensive defects of the anterior arch exist or when a sterile, supple, well-vascularized recipient bed is not available.

Adult↗
PubMedDate not supplied

Cricoarytenoid subluxation, computed tomography, and electromyography findings.

A case of cricoarytenoid subluxation secondary to endotracheal intubation and documented by computed tomography (CT) and electromyography (EMG) is reported. Successful endoscopic reduction of the displaced arytenoid is confirmed by CT. The normal anatomy and physiology of the cricoarytenoid joint is presented and the literature regarding this rarely reported injury is reviewed. Based on this review and the case reported, a treatment plan is proposed.

Arytenoid Cartilage↗
PubMedDate not supplied

Adult parapharyngeal extracardiac rhabdomyoma.

The case of a parapharyngeal adult extracardiac rhabdomyoma (ER) in a 69-year-old man is presented focusing on computed tomographic diagnosis, surgical approach, and pathologic diagnosis. Although a rare neoplasm, adult ER has a propensity for occurring in the head and neck. Systematic computed tomography evaluation with contrast serves to define the extent of the lesion and assist in the differential diagnosis of parapharyngeal masses. In this case, a transcervical extra-pharyngeal approach for excision was utilized with minimal associated morbidity and a rapid return of normal function. Careful pathologic diagnosis is required to distinguish ER from other neoplasms, especially granular cell myoblastoma.

Aged↗
PubMedDate not supplied

Computed tomography in the assessment of mandibular invasion by intraoral carcinoma.

A critical factor in the pretreatment evaluation of patients with carcinoma of the oral cavity or oropharynx is the presence or absence of bone invasion. A prospective study was performed to compare the sensitivity and specificity of plain radiographs and computed tomography in detecting mandibular invasion by cancer arising in these sites. Forty-three consecutive patients with previously untreated oral cavity or oropharyngeal carcinoma were evaluated preoperatively by intraoral radiographs (dental occlusal views and panoramic radiographs) and CT, and the results were compared with postoperative pathologic findings. Of the 11 cases in which pathologic examination confirmed bone invasion, conventional x-ray films were positive in seven (63.6%). Computed tomography confirmed bone invasion in all 11 (100%) of these patients. In addition, the CT scan was more specific than conventional x-ray films in detecting bone invasion. Based on the findings in this study, we strongly recommend CT as the only radiographic study necessary to evaluate intraoral carcinoma prior to treatment.

Aged↗
PubMedDate not supplied

Asymptomatic laryngocele: incidence and association with laryngeal cancer.

Since laryngoceles are usually asymptomatic, their incidence is probably higher than the literature suggests. With the advent of computed tomography, the incidence and significance of the asymptomatic laryngocele in a general head and neck practice can be addressed. To this end, 304 consecutive patients with a variety of otolaryngic diagnoses were studied prospectively by computed tomography of the neck from January 1983 to February 1985. Thirty-eight (12.5%) of the patients had asymptomatic laryngoceles, defined as air-containing structures in the supraglottic region extending more than 5 mm above the superior border of the thyroid cartilage during normal breathing. The incidence of laryngoceles associated with laryngeal cancer (29%) was higher than that for laryngoceles associated with other diseases (9%). No patient with an asymptomatic laryngocele not associated with laryngeal cancer showed evidence of a subsequent laryngeal neoplasm during close follow-up of 10 to 36 months.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Indications for hyperalimentation in the treatment of head and neck malignancies.

Patients with cancer of the head and neck are often malnourished when first seen by the treating physician. Often, oncologic therapeutic techniques of surgical intervention or radiotherapy or chemotherapy (or combinations thereof) compound this poor nutritional state. Proper evaluation of the patient's nutritional status and the anticipated metabolic stress of the treatment chosen can allow the physician to select the optimal method of nutritional repletion.

Enteral Nutrition↗