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Biomedical subjects

M D Schloss

Publications and source records attributed to M D Schloss.

16 recordsLinked to original sources
PubMed1992

Otitis media and CNS complications.

Intracranial complications from otitis media can be quite devastating to the patient if an early diagnosis is not made. Patients may develop meningitis, venous sinus thrombosis or cranial nerve palsies, as well as intracranial abscess. The presenting features in such cases may be subtle and include headache, nausea, vomiting, personality changes and signs of increased intracranial pressure as well as focal neurological deficits. A case of intracranial brain abscess is presented in a patient with a history of chronic otitis media with cholesteatoma. Delay in the diagnosis of intracranial complications of otitis media can lead to improper treatment with increased morbidity and mortality. The etiology and treatment of complications affecting the CNS is discussed.

Brain Abscess↗
PubMed1991

Extensive upper aerodigestive tract anomalies in 'VACTERL' Association.

Extensive upper aerodigestive tract anomalies are rare in newborns. When they occur, they are often accompanied by other congenital malformations. We present a case of a newborn who presented to the Montreal (Quebec) Children's Hospital with severe tracheoesophageal abnormalities, as part of vertebral, anal, cardiac, tracheal, esophageal, renal, and limb anomalies (VACTERL) association. In spite of surgical intervention, the patient finally succumbed to other congenital abnormalities. Management of infants with such conditions usually involve complex reconstructive efforts, while prognoses remain poor due to other congenital defects and cardiopulmonary complications.

Abnormalities, Multiple↗
PubMed1991

Cholesteatoma in children.

This is a retrospective review of 71 patients charts, over a 10-year period, with the diagnosis of cholesteatoma. An analysis included the demographic data, audiological data and surgical results. The selection of the surgical technique depended on the extent of the disease. In the majority of cases the primary procedure was of the canal wall down technique, which is contrary to most recently published reports. Most of the cholesteatomas were extensive, thereby requiring a more aggressive surgical approach. It was our opinion that the extent of the disease in a child was greater than in an adult. Another feature found in children is the occurrence of the disease behind an intact tympanic membrane. In this review, 35% of the cases presented in this manner. Hearing was maintained or improved in the majority of cases. It is concluded that cholesteatoma in children may differ from that in the adult and that even with canal wall down procedures, maintenance or improvement of hearing is achieved in most patients.

Adolescent↗
PubMed1989

Antro-choanal polyp: a 10-year retrospective study in the pediatric population with a review of the literature.

Antro-choanal polyp is generally recognized to represent approximately 4-6% of all nasal polyps; however, it is much more prevalent in the pediatric population. It warrants special consideration in children because its clinical manifestations may be mimicked by other less benign conditions, such as juvenile angiofibroma, meningoencephalocele, and nasopharyngeal malignancies. Fifty patients with surgically treated nasal polyps were reviewed at the Montreal Children's Hospital, between 1976 and 1986. Fourteen (28%) were antro-choanal polyps. Our results are compared with the literature, and special emphasis was given to radiographic manifestations and the differential diagnoses.

Adolescent↗
PubMed1989

Congenital cholesteatoma of the middle ear in children.

Congenital cholesteatoma, once considered to be a rarity, has shown an exponential increase in its incidence as evidenced by numerous clinical studies over the past decade. No explanation has been offered for this phenomenon. A review of the literature indicates that the definition of "congenital cholesteatoma" has strayed from the original one formulated by Derlacki and Clemis, which included a cholesteatoma medial to an intact tympanic membrane, without prior history of aural infections. Allowing patients with recurrent otitis media into studies may have contributed to a "false positive" rise in the incidence of this condition. This article reviews 19 cases of cholesteatomas behind intact tympanic membranes, treated at the Montreal Children's Hospital over a 10-year period. They represent 22% of the entire cholesteatoma population. There appears to be two groups of patients, each with a distinct clinical presentation that correlates well with the surgical outcome. Whether this implies different pathogenetic mechanisms remains unclear.

Adolescent↗
PubMed1988

Post-tonsillectomy and adenoidectomy hemorrhage.

This is a retrospective review of 6842 tonsillectomies and adenoidectomies performed over a seven-year period at the Montreal Children's Hospital. The total incidence of postoperative bleeding was 2.5%. The incidence of primary post-tonsillectomy hemorrhage was 1.0%, with 78% of these children having developed bleeding within 12 hours of surgery. The overall incidence of secondary post-tonsillectomy hemorrhage was 1.2%. Twenty-nine percent of children with primary hemorrhage required a second general anesthetic, and 40% required blood component transfusion. Eight percent of children with secondary hemorrhage required a second general anesthetic and 24% received transfusions. Based on these findings, primary and secondary hemorrhage can be classified further into major and minor. The criteria for a major post-tonsillectomy hemorrhage are: requirements of a general anesthetic to control and repair the bleeding, or blood loss that is sufficient to require blood component transfusion therapy. The relevance of these findings with regard to outpatient adenotonsillectomies is discussed.

Adenoidectomy↗
PubMed1987

Cochlear implants in children.

This is a review of 183 children who have been implanted in various centers throughout the United States and Canada. There is a description of the surgical technical differences in the child as compared to an adult. The results discussed are the etiology of deafness, the years of profound deafness, the condition of the cochlea at the time of surgery, and the audiological results. As of January 1, 1986, the cochlear implant program in children had been functioning for three years. The results have been good. The goals of the children's implant program and future recommendations are listed.

Audiometry↗
PubMed1985

Simplified oxygen administration in tracheostomized patients with bronchopulmonary dysplasia.

The report describes a simple effective system of meeting the oxygen requirements of tracheostomized infants in the home setting. It consists of oxygen tubing which may be run under the infant's clothing and connected to the tracheostomy tube through a specially created hole. This allows a continuous administration of oxygen while minimizing the risk of accidental decannulation of disconnection by the infant grabbing the oxygen tubing. This has been used successfully in the management of infants with tracheostomies and chronic oxygen needs due to bronchopulmonary dysplasia.

Bronchopulmonary Dysplasia↗
PubMed1985

Masseteric muscle hypertrophy.

Three cases of masseteric muscle hypertrophy are reported. The clinical features of the syndrome are illustrated. The differential diagnosis of parotid mass, inflammatory or neoplastic, vs. masseter muscle hypertrophy is discussed. CT scanning is the best diagnostic tool. Expectant therapy is suggested.

Adolescent↗
PubMed1979

Acute epiglottitis: 26 years' experience at the Montreal Children's Hospital.

Two hundred and four cases of acute epiglottitis treated at the Montreal Children's Hospital between 1951 and 1978 are reviewed. The comparison of tracheostomy vs. nasotracheal intubation is discussed. Nasotracheal intubation has been found to be the treatment of choice as long as the necessary services are available in the hospital.

Acute Disease↗
PubMed1976

Hemifacial spasm: importance of a complete investigation.

The authors report the experience of the Clinique d'O.R.L. de l'Université de Bordeaux II in the management of hemifacial spasm. The recent diagnostic and therapeutic progress in otoneurology has revealed an organic etiology for many cases of hemifacial spasm. The recent diagnostic and therapeutic progress in otoneurology has revealed an organic etiology for many cases of hemifacial spasm. From their experience, they propose a complete investigation for all cases of hemifacial spasm. The disorder is labelled as being idiopathic only if the complete investigation is negative.

Adult↗