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Biomedical subjects

M E Dunham

Publications and source records attributed to M E Dunham.

5 recordsLinked to original sources
PubMed1992

Bilateral choanal atresia associated with malformation of the anterior skull base: embryogenesis and clinical implications.

A number of craniofacial and systemic malformations have been described in association with choanal atresia. We report a case of bilateral choanal atresia associated with congenital absence of the cribriform plate, crista galli, and perpendicular plate of the ethmoid bone. The anterior skull base defect was detected by using high-resolution computed tomography with three-dimensional reconstructions. The findings support the mesodermal flow theory of choanal atresia, in which there is excess migration of neural crest cells into the developing nasal septum and posterior choanae. This occurs at the expense of cells that would otherwise form the rest of the ethmoid complex. Clinical implications include the need for adequate preoperative imaging of the anterior skull base and consideration of potential intracranial complications during surgical repair.

Abnormalities, Multiple↗
PubMed1990

Congenital aglossia and situs inversus.

Lingual agenesis is a rare anomaly caused by failed embryogenesis of the lateral lingual swellings during the fourth and fifth gestational weeks. Most reported cases have been part of oromandibular limb hypogenesis syndromes. A review of the literature reveals two previously reported cases of congenital aglossia and situs inversus. A case of lingual agenesis associated with micrognathia and situs inversus is reported in a newborn presenting with upper airway obstruction at birth.

Humans↗
PubMed1990

Audiologic management of bilateral external auditory canal atresia with the bone conducting implantable hearing device.

The hearing impairment associated with congenital external auditory canal atresia has been managed with early bone conduction hearing aid placement and surgical reconstruction in selected patients. However, many patients do not wear a bone conduction hearing aid because of physical or social considerations and surgical reconstruction of the external auditory canal and middle ear may be difficult or contraindicated. This report details the use of implantable bone conducting hearing devices in five children with bilateral external auditory canal atresia. Each patient had bilateral conductive hearing impairment with normal bone conduction thresholds. Four of the five patients had associated craniofacial anomalies including three cases of microtia. The average preoperative sound field speech reception threshold improved from 63 dB to 13 dB with the implant. Patients experienced a definite preference for the implanted hearing device over the bone conduction hearing aid.

Adolescent↗
PubMed1988

Post-traumatic sinusitis.

Septic complications following traumatic injury continue to be a contributing factor to morbidity and mortality. Paranasal sinusitis is being recognized as an often occult etiology of fever and sepsis in multiply injured patients. Our series of 11 patients who developed clinically important maxillary sinusitis is presented. Common features of the patients include: 1) nasal instrumentation; 2) craniofacial trauma; 3) concomitant use of steroids; and 4) severe multisystem injury (mean I.S.S., 45.5; T.S., 10.6). A high index of suspicion in patients with nasal tubes who develop unexplained fever or signs of systemic sepsis should prompt appropriate investigation of the paranasal sinuses. Removal of the tubes, antral puncture for irrigation and aspiration for microbiologic culture, topical nasal decongestants, systemic antibiotics based on sensitivity studies, and occasionally, formal surgical sinus drainage contribute to effective therapy.

Adult↗