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Biomedical subjects

M Rontal

Publications and source records attributed to M Rontal.

At least 37 records · Page 2Linked to original sources
PubMed1983

Treatment of recurrent carcinoma at the base of the skull with carbon dioxide laser.

The extension of carcinoma to the cribriform plate is a poor prognostic finding. Two extremes of treatment approach have been advocated. On the one hand, patients may be abandoned to palliative chemotherapy. On the other hand, heroic and aggressive resections may be advocated including combined neurosurgical transdural and otolaryngologic facial-orbital resection. Armed with the surgical microscope and the CO2 laser there may be a place for a middle ground of therapy. We present our experience with recurrent tumor after full course radiation therapy and maxilloethmoidectomy. The biopsy proven recurrences were found at the cribriform plate but could not be shown to have crossed into the anterior cranial fossa by polytomography or high resolution CT scanning. The CO2 surgical laser delivered through the surgical microscope was used with repeated applications. Recurrent epidermoid carcinoma found to be confined to the nasal side of the cribriform plate can be controlled by careful microscopic stripping of soft tissue from the cribriform plate with a surgical laser.

Adult↗
PubMed1980

Jet insufflation anesthesia for endolaryngeal surgery.

The ideal anesthetic in endolaryngeal surgery provides a quiet completely unobstructed larynx in a patient who is comfortable and has respiratory functions maintained. Dissatisfaction with the intubation and venturi techniques has led to the use of a high pressure jet insufflation method. The results of this study have shown that anesthetically this technique is safe for a wide range of patients and endoscopic procedures. Laryngologically, the absence of glottic obstruction has broadened the scope of endoscopic procedures performed under general anesthesia.

Anesthesia↗
PubMed1977

Lesions of the vagus nerve: diagnosis, treatment and rehabilitation.

Lesions of the vagus nervous system have devastating effects on the vital functions of coughing, swallowing and phonation. A clear understanding of the vagal correlative anatomy and physiology leads to a practical organization of upper respiratory and digestive tract lesions. A reasoned and thoughtful treatment plan evolves that leads the patient to comprehensive treatment and rehabilitation.

Adolescent↗
PubMed1977

Facial injuries in hockey players.

As otolaryngologists become more involved with maxillofacial trauma, we are encountering an increasing number of athletic injuries. Ice hockey accounts for a large number of these facial injuries. The fast moving and random nature of the game, frequent body and equipment contact and lack of protective devices, predisposes the hockey player to facial injury. Because of the roughly tenfold increase in hockey participation over the last decade, the problem of facial injury prevention has become a significant public health problem in North America. Review of the medical literature shows a paucity of interest in the subject of facial injury prevention in hockey. Several articles have dealt with ocular injury, while other articles have dealt with the general subject of hockey injury with only scant attention paid to the facial area. A retrospective study was carried out to more clearly define the scope of the facial injury problem. Four levels of hockey play were examined. Individuals from the youngest and most inexperienced to seasoned professionals were studied. An individually completed questionnaire was received from players in each group. It is the purpose of this paper to indicate the rates of injury for the various types of facial trauma, present their mechanisms of occurrence and discuss means of preventing facial injury in hockey players.

Athletic Injuries↗
PubMed1977

Probocis lateralis: case report and embryologic analysis.

A child with a lateral trunk replacing one side of the external nose is presented with a detailed X-ray study of the deformed head. In the explanation of the etiology and teratogenesis of this facial anomaly, the modern embryologic development of the head is reviewed and correlated with the findings of this anomaly. It is felt that the lesion responsible for a proboscis lateralis involves the organizer tissue for the naso-face. As a secondary phenomenon, the development of the maxillary process is retarded and a spectrum of defects, common to many mid-face derangements, is identified and explained.

Embryonic Induction↗
PubMed1976

Vocal cord injection in the treatment of acute and chronic aspiration.

The problem of maintenance of proper tracheobronchial toilet is frequently a determining factor in the morbidity and mortality of patients with vocal cord paralysis. Aspiration from an incompetent glottis can cause pneumonitis and its attendant complications. Standard management of tracheobronchial toilet in patients with vocal cord paralysis has involved direct or indirect suctioning of the trachea; however, only the symptoms and not the anatomic defect are treated by these measures. Largely due to the work of Arnold and Lewy, the technique of vocal cord injection has been advocated as a method of correcting the anatomic deficiencies in patients with vocal cord paralysis, and has been advocated in the past to prevent recurrent and chronic aspiration. This study has shown that vocal cord injection increases the ability to maintain maximum peak intraluminal air pressures following injection. It has also shown that there is an increased ability to maintain air flow by glottic closure following injection. Eleven patients were studied, each of whom has been evaluated separately in this paper. The use of vocal cord injection should be more widely used by otolaryngologists and chest disease specialists for treatment of physiologic problems as well as correcting vocal disturbances.

Adolescent↗
PubMed1975

The use of spectrograms in the evaluation of vocal cord injection.

The utilization of voice spectrography can be an important adjunct to the assessment of vocal cord function by both laryngologists and speech pathologists. It is especially useful in determining the effectiveness of vocal cord Teflon paste injection procedures. Dysphonic characteristics are made visible, and their improvement can be monitored. As such, spectrographic analysis should be considered as a useful tool for the laryngologist.

Adult↗
PubMedDate not supplied

Voice spectrography in the evaluation of myasthenia gravis of the larynx.

Myasthenia gravis is a neuromuscular disorder that affects striated muscles especially those innervated by the cranial nerves. The standard diagnostic regimen is to find a reversal of symptoms by acetylcholine esterase administration. The permanent and objective recording of this effect is the key to an accurate assessment of this test. The voice spectrograph is a noninvasive means of evaluating the voice. It has been used successfully to make a clear and specific diagnosis of myasthenia gravis as it affects the larynx. The test can be used to distinguish myasthenia gravis from other functional, anatomical and neuromuscular laryngeal disorders.

Adult↗
PubMedDate not supplied

Surgical anatomy of the orbit.

When operating in and around the orbit, the key to a successful operative result is precise, anatomic localization. This study was constructed to give pertinent anatomic measurements to which the maxillofacial surgeon may refer. The safe distances noted from this study are: 1) medially 30 mm from the anterior lacrimal crest; 2) inferiorly 25 mm from the infraorbital foramen; 3) superiorly 30 mm from the supraorbital notch; and 4) laterally 25 mm from the frontozygomatic suture.

Female↗
PubMedDate not supplied

Vocal cord dysfunction - an industrial health hazard.

Vocal cord dysfunction has a definite incidence of association with high environmental noise levels. Our study has shown roughly an 8% incidence of vocal cord dysfunction (vocal cord nodules, vocal cord polyps and chronic laryngitis) in individuals working in high noise environments. In addition, those individuals who have surgery for vocal cord nodules and who work in high noise environments will have over a 30% incidence of recurrent vocal cord dysfunction following surgery. Our study indicates that females tend to be more at risk in high noise environments than males.

Female↗
PubMedDate not supplied

Quantitative and objective evaluation of vocal cord function.

Objective and quantitative evaluation of vocal cord function is a goal that has been difficult for voice clinicians to obtain. To be useful as a clinical screening tool it must be easy to perform, it must produce numerical storable data, it must have a high degree of accuracy, and it must be cost-effective. The results of this study have shown that using the perturbation factor and the equipment described, a successful rate of greater than 93% can be obtained in evaluating vocal cord dysfunction. The results further indicate that this equipment can be used much in the same way as an audiogram to follow-up and clinically evaluate on an objective basis the function of the vocal cords.

Electrodiagnosis↗
PubMedDate not supplied

Anesthetic management for tracheobronchial laser surgery.

The use of the laser has become a well-recognized means of treating obstructing lesions of the tracheobronchial tree. Patients with lower airway compromise are in a precarious state of equilibrium. Everything done by the endoscopy-anesthesiology team tends to change this balance. Cooperation and coordination of this well-disciplined team is needed for efficient treatment of difficult cases. This paper outlines our surgical techniques, which have been tempered and modified to an anesthetic technique that provides the greatest safety with comfort. We detail the basic anesthetic methods for drug usage, pulmonary ventilation, and patient monitoring that we now use. A careful analysis of our results is presented to show that this technique does provide relatively safe anesthesia in this difficult setting.

Adolescent↗
PubMedDate not supplied

Bacteriologic findings from the nose, ethmoid, and bloodstream during endoscopic surgery for chronic rhinosinusitis: implications for antibiotic therapy.

This study addresses the bacterial flora of chronic rhinosinusitis at the time of endoscopic sinus surgery. We used the consensus definition of chronic rhinosinusitis as the presence of paranasal sinus inflammation present for greater than 12 weeks. In our patient study group, all cases of chronic rhinosinusitis had failed to respond to antibiotic therapy and had not been treated previously with surgery. By microscopic examination, chronic inflammatory changes were confirmed in the resected sinus lining of all study patients. Intraoperative cultures were obtained from the nasal vestibule, the middle meatus, ethmoid lining, and peripheral blood during and after the endoscopic procedure. We found approximately 30% of the patients with sterile sinuses, 50% with coagulase-negative staphylococci, and the remainder with a mixed group of "nonpathogenic" organisms. Anaerobes were conspicuously rare. The blood cultures were positive in 7% of cases and were consistent with an organism of the operative site. This is the first time bacteremia has been reported in association with endoscopic sinus surgery. The results suggest that chronic rhinosinusitis is not a bacterial disease, but rather the result of chronic inflammation produced by a previous acute inflammation. The incidence of positive blood cultures, while relatively low and cleared quickly, should alert the physician for the possible need for prophylactic antibiotics in patients with cardiac, prosthetic, or systemic conditions that could lead to metastatic infection.

Antibiotic Prophylaxis↗