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Biomedical subjects

M Englender

Publications and source records attributed to M Englender.

16 recordsLinked to original sources
PubMed1996

CT of submandibular gland sialolithiasis.

We emphasise the importance of high-resolution CT with reconstruction in the demonstration of submandibular gland (SMG) sialolithiasis and its role in monitoring treatment. We studied 76 patients with swollen and tender SMG, some with fever. They underwent conventional radiography, sonography (US) and high-resolution CT with reconstructions. Conventional radiographs demonstrated single stones in 29 patients. Axial CT, before reconstructions, demonstrated single stones in 63 patients and multiple stones in another 5. Following CT reconstructions, multiple stones were demonstrated in 37 patients. On US stones were diagnosed in only 33 patients, and multiple stones in only 1. All 68 patients with stones shown on imaging and 2 without stones underwent surgery, with good clinical results. Total removal of the SMG and its duct was performed in patients with multiple stones, chronic inflammatory changes in the SMG, or a solitary stone in the SMG or deep in the duct. A small incision for removal of a solitary stone in the distal aspect of Wharton's duct was performed in 15 patients, with excellent clinical results. Another 14 patients with multiple salivary gland stones, diagnosed on CT reconstructions, did not improve following this procedure and needed further surgery; clinical improvement occurred following excision of the SMG and Wharton's duct. Histological examination in all of these confirmed the presence of additional stones. Conservative anti-inflammatory treatment was recommended for 6 patients in whom CT reconstructions did not demonstrate stones.

Adult↗
PubMed1995

CT of minor intubation trauma with clinical correlations.

Even when performed by an experienced physician, endotracheal intubation is more traumatic than previously supposed. Following emergency intubation, patients have little probability of having a normal larynx. One-hundred patients underwent CT scan of the larynx 6 months or more following endotracheal intubation of short duration (up to 8 h). Ten patients (Group 1) with respiratory arrest underwent emergency intubation; 90 surgical patients (Group 2) underwent anesthesia with endotracheal intubation. Indirect laryngoscopy was performed in 59 symptomatic patients. Abnormal CT findings were present in 86 out of 100 patients. CT irregularities, which included tears, scars and small laryngoceles, were noted on indirect laryngoscopy in 59 symptomatic patients. The laryngeal damage following endotracheal intubation is surprisingly high.

Adult↗
PubMed1995

Nasal laser mucotomy (L-mucotomy) of the interior turbinates.

Eighty-seven patients who were treated by laser mucotomy (L-mucotomy) of the inferior turbinates were followed-up for one year. Patients presented for laser surgery because of one of the three following symptoms: sneezing, rhinorrhoea, or nasal obstruction. All of them had had prior conservative or surgical treatments for their symptoms without improvement in their complaints and/or quality of life. L-mucotomy is a simple procedure performed under local anaesthesia on an ambulatory basis. A controlled amount of tissue from the inferior turbinates is ablated with improvement in the symptoms, as reported by the patients one year after laser surgery. The procedure is easy to perform, there is no bleeding, it is painless and without complications, but it requires rather expensive surgical equipment.

Adolescent↗
PubMed1995

Relation between CT axial cross-sectional area of the oropharynx and obstructive sleep apnea syndrome in adults.

PURPOSE: To look for correlation between obstructive sleep apnea syndrome (OSAS) and axial cross-sectional area of the narrowed oropharyngeal lumen. METHODS: Thirty-six men with OSAS and 10 control subjects underwent polysomnography with registration of oxygen saturation and number of sleep apnea episodes and their duration. Nine of them underwent uvulopalatopharyngoplasty and repeated polysomnography. Each polysomnography was followed by high-resolution CT scan with reconstructions in sagittal and coronal planes. Measurements of the axial cross-sectional area of the oropharyngeal lumen were taken at the level of the narrowing. RESULTS: Twenty-seven patients with severe OSAS (high number and prolonged episodes of OSAS and 22% or greater decrease in oxygen saturation) had a narrowed oropharyngeal cross-sectional area less than 50 mm2 wide. The control subjects and 6 patients who had uvulopalatopharyngoplasty without OSAS had a minimal pharyngeal cross-sectional area of 110 mm2. Eight patients with moderate OSAS and 3 patients who had uvulopalatopharyngoplasty and diagnoses of OSAS had intermediate values of the narrowest pharyngeal level--between 60 mm2 and 100 mm2. CONCLUSION: The measurement of the axial cross-sectional area of the pharyngeal lumen can play an important role in evaluation of OSAS and indications for surgery.

Adult↗
PubMed1994

CT evaluation of displaced superior cornu of ossified thyroid cartilage.

PURPOSE: To present and to demonstrate traumatic displacement of the superior cornu of the thyroid cartilage. PATIENTS AND METHODS: Four elderly patients following minor neck trauma were referred for computed tomography (CT). They complained of a feeling of a foreign body in the throat and painful swallowing. Unilateral bulging of the hypopharynx was observed in all of them on indirect laryngoscopy. The patients underwent axial CT with 3-D reconstructions. RESULTS: Axial CT demonstrated unilateral medial convexity of the ossified superior cornu of the thyroid cartilage. 3-D CT demonstrated medial convexity of the ossified complex (the lateral thyrohyoid ligament and superior cornu of the thyroid cartilage). CONCLUSION: The inflexible ossified laryngeal cartilages in elderly patients may not return to normal alignment following traumatic displacement.

Female↗
PubMed1990

Typing of Pseudomonas aeruginosa ear infections related to outcome of treatment.

Of 142 patients with Pseudomonas aeruginosa (PSA) ear infections, 88 (62 per cent) had chronic otitis media and 54 (38 per cent) external otitis. Following serotyping and pyocin typing of their bacteria, and relating the type to outcome, patients could be divided into three groups: (1) 120 patients who had no recurrence with isolation of only one PSA strain, (2) 13 patients who had recurrent infections and in whom the same PSA strain was isolated in repeated cultures, and (3) nine patients who had recurrent disease, but who had a change in their PSA strains. Most of the PSA strains isolated from patients in groups (1) and (2) were stable to pyocin, and resistent to gentamicin. Patients in the first group were all cured initially by medical management. Of the nine patients in group (3) who had a different serotype on repeated cultures, medical treatment was successful in eight (89 per cent), but of the 13 patients in group (2) who had the same Pseudomonas aeruginosa serotype cultured, medical therapy failed in six (46 per cent) and mastoid surgery was required. Serotyping of Pseudomonas aeruginosa otitis may be helpful in predicting the type of management in patients who have recurrent infections.

Adolescent↗
PubMed1990

Nasal transit time in normal subjects and pathologic conditions.

A radionuclide method using Tc-99m was used to measure the nasal transit time in 43 patients, including normal smokers and nonsmokers and those with various nasal or paranasal pathologies. The technique described was slightly modified from that already in use in various centers in order to enable more precise measurement. Measurement of transit time of a droplet of Tc-99m phytate on the nasal mucosa appears to differentiate patients with immotile cilia syndrome from normal controls. A positive test, however, can occur also in smokers and in patients with other nasal and paranasal problems. The test is reproducible, cost-effective, and noninvasive, enabling the clinician to make a more appropriate selection of patients needing further investigation.

Adolescent↗
PubMed1988

Acute acoustic trauma: dynamics of hearing loss following cessation of exposure.

The natural history of individuals with acute acoustic trauma who ceased to be exposed to impact noise was examined. Retrospective follow-up was carried out for 4 years on patients who were qualified as disabled following acoustic trauma with permanent threshold shift. Eight hundred forty-one individuals (1682 ears) were examined, of which 1514 ears with acoustic trauma were included in the study group; 150 individuals (300 ears) who continued to be exposed to impact noise even after discovery of acoustic trauma comprised the control group. In the latter, as long as exposure to gunfire continued, the severity of acoustic trauma increased. In the study group, during the first year after injury, changes were observed in hearing, whether improvement or deterioration; after this period, hearing loss appeared to be final. We suggest that, after 1 year following acute acoustic trauma, the associated hearing loss be considered as final, provided there is no further exposure to noise. This finding holds great importance from the medicolegal standpoint, an aspect that is unclear in the literature. It clarifies that beyond the period of 1 year after initial exposure, the pathologic process ceases (as long as there is no additional exposure to noise or gunfire). Further hearing deterioration beyond this period is not related to the initial acoustic trauma but rather to other factors.

Acute Disease↗
PubMed1986

Auditory brain stem responses in schizophrenic patients.

Auditory brain stem responses (ABR) were recorded from 20 schizophrenic patients, of whom ten were medicated and ten were unmedicated. A matched control group consisted of ten normal subjects. A statistically significant difference in the latencies of N3 and N5 recordings was found among the three groups. The results suggest that unmedicated schizophrenics have a delayed latency for peaks N3 and N5, and that medication (with neuroleptic drugs) shortens these delayed latencies back to the normal range.

Adult↗
PubMedDate not supplied

Myringoplasty with fascial stakes.

Myringoplasty reinforced by fascial stakes was performed in 87 ears. Small tongue-like fascial projections or "stakes" were used to keep the fascial graft in position. No foreign material was introduced into the middle ear cavity to support the graft and the drum. The technical details of this procedure are described and analysis of the results is presented.

Adolescent↗
PubMedDate not supplied

Axial CT measurements of the cross-sectional area of the oropharynx in adults with obstructive sleep apnea syndrome.

PURPOSE: To determine whether narrowing of the oropharynx increases during relaxation in patients with severe obstructive sleep apnea syndrome. MATERIALS: The study included 23 adult men in whom polysomnography had established a diagnosis of obstructive sleep apnea syndrome. Subjects had an average of 53 episodes of sleep apnea per hour, with each episode lasting 40 seconds or more. Oxygen saturation dropped an average of 22% during sleep. Hypnotic relaxation was induced in all patients, and high-resolution CT scans with sagittal and coronal reconstruction of the oropharynx were obtained in the awake state and during the relaxation state using the same parameters. The cross-sectional area of the oropharynx was measured in a minimum of 10 CT axial sections in each case. RESULTS: In all patients, the narrowest cross-sectional area of the oropharynx was smaller during hypnotic relaxation than in the awake state. The average difference between both measures was 42%. In the awake state, the measurements ranged from 15 to 55 mm2 (average, 38 mm2). During hypnotic relaxation, they ranged from 0 to 35 mm2. Oxygen saturation during hypnotic relaxation dropped in all patients from 9% to 17% (average, 14%). No episodes of sleep apnea were observed during hypnotic relaxation. CONCLUSIONS: In patients with obstructive sleep apnea, airways were demonstrably smaller in diameter during hypnotic relaxation than during the awake state.

Adult↗