Biomedical subjects

M S Mendelsohn

Publications and source records attributed to M S Mendelsohn.

13 recordsLinked to original sources

PubMed1998

Effect of esthetic illusions on rhinoplasty assessment.

OBJECTIVE: Esthetic assessment in rhinoplasty represents a balance between art and science. The result of surgical maneuvres in creating esthetic illusions has been alluded to, but has never been scientifically reported. This project analyzed the effect of optical illusions in esthetic assessment. METHOD: Eight rhinoplasty case studies were designed using computer imaging. Two hundred and ten judges analyzed the apparent differences in one parameter, such as tip projection, tip rotation, dorsal hump, and nasal size, when a different parameter was altered. RESULTS: This study confirms the validity of nasal esthetic illusions. These results indicate how surgical maneuvres that vary one parameter can create the illusion of a variation in tip projection or tip rotation. CONCLUSIONS: The surgeon can exploit esthetic illusions to provide greater control over rhinoplasty dynamics.

Chi-Square Distribution↗

PubMed1996

The management of dysphagia in jugular foramen surgery.

From 1985-1994, the Skull Base Unit at St. Vincent's Hospital, Sydney, operated on 61 patients with tumours involving the jugular foramen. Pre-operative assessment by a Speech Pathologist and the institution of swallowing techniques prior to surgery have improved post-operative morbidity. Ancillary procedures at the time of surgery were not required in the majority of cases. An individual assessment of each patient early in the postoperative period was found to be more important with regard to the benefits of supplementary surgery. The majority of patients with dysphagia settled with conservative management and only a few underwent ancillary surgery. It is perceived that the cortical and subcortical control of swallowing is a major factor in the rehabilitation of these patients.

Adolescent↗

PubMed1994

The Modified Barium Swallow Database.

Every center that carries out the modified barium swallow (MBS) has a potential storehouse of useful clinical and radiological information filed away in the patient's files and in the center's video library. The modified barium swallow database automates the recording, storage, and analysis of this information. This project utilizes a standardized clinical and radiological data form which provides a consistent approach to the reporting of the MBS results. The information on the data form is entered into the MBS database software program for decoding and permanent storage. This database program, designed for the computer novice, is menu driven to simplify operation. Once the patient information is verified on the computer screen, the program can generate different types of reports for clinical and research purposes. The program has routines to search for patients with any clinical or radiological findings of interest. The ability to group and recall patients with specific findings has been an aid in teaching, peer review, and research. The program has been modified based upon feedback and experience at three centers in Toronto that have used it for 9 months.

Barium Sulfate↗

PubMed1993

Airway protection during breath-holding.

Little is known about laryngeal function during breath-holding. The completeness of laryngeal closure during breath-holding is clinically relevant during the supraglottic swallow. To investigate this phenomenon, vocal cord position was studied prospectively in 10 adults during breath-holding using nasolaryngoscopy with video recording. The position of the vocal cords was not consistent during breath-holding. Some subjects closed the glottis, while others had variable amounts of glottic opening. Straining and vocalizing at the onset of breath-holding produced both glottic and supraglottic closure, increasing the number of levels of laryngeal closure during breath-holding. Nasolaryngoscopy can be used clinically to document the airway protection, the effects of various protective maneuvers, and any resulting aspiration during breath-holding and during the supraglottic swallow.

Adult↗

PubMed1991

Paranasal sinus cancer.

This is a review of 65 patients with paranasal sinus malignancies who were treated by radical surgery. Most patients received either pre- or postoperative radiotherapy. Twenty-nine tumours arose in the maxillary antrum, seventeen in the ethmoid labyrinth and the remainder from the vestibule, nasal septum, lateral nasal wall and vault. There were 58 epithelial cancers. The 5-year survival rate for patients with adenocarcinoma was 78%, and 70% for antral squamous cell cancer and esthesioneuroblastoma. None of the melanoma patients survived free of disease for 5 years. The 5-year survival rate for the 21 patients undergoing orbital exenteration was 50%, compared with 70% when the eye was spared. Twelve free flap revascularized tissue transfer flaps were used to reconstruct large cranial and sino-orbital defects.

Actuarial Analysis↗

PubMed1988

Manofluorography of deglutition after total laryngopharyngectomy.

Manofluorography is a new technique for the evaluation of swallowing that provides simultaneous display of manometry and videofluoroscopy on one video screen. Data are presented from a study of deglutition in 10 patients who had prior total laryngopharyngectomy with replacement by either jejunal graft or gastric pull-up. Factors that enhance bolus passage are the presence of a widely patent graft and an intact swallowing reflex. Factors that impair bolus transit include stricture, jejunal peristalsis, impaired lingual coordination, and stenosis at the anastomotic site. The swallowing patterns of these patients serve as models of the open and closed cavity swallow and illustrate principles of manofluorographic interpretation.

Anastomosis, Surgical↗

PubMed1988

Manofluorographic analysis of swallowing.

A quantitative evaluation of the pharyngeal swallow is described using a new method--manofluorography. Eleven parameters have been established, and the clinical significance of the most important ones has been highlighted. The propulsive tongue action and hypopharyngeal suction pump have been designated as the major bolus driving forces.

Deglutition↗

PubMed1988

Dysphagia after total laryngectomy.

Quantitative analysis of swallowing after total laryngectomy has been compared with the data obtained in normal subjects. Lack of negative pressure production in the PE segment has been related to the dysphagia and prolonged bolus transit times. High pressures in the oropharynx may be a cause of fistulas.

Constriction, Pathologic↗

PubMed1987

Function in the pharyngoesophageal segment.

Examination of the pharyngoesophageal (PE) segment is usually limited to manometry or barium swallow. Manofluorography is a technique which allows simultaneous analysis of both manometry and videofluoroscopy of deglutition on a single video screen. Using manofluorography, the physician can see the cause of the manometric pressure waves. Understanding of the PE segment pathophysiology has been limited. Dysfunction is usually labeled as cricopharyngeal achalasia or incoordination, which may lead to cricopharyngeal myotomy. However, this approach has yielded poor results. This study demonstrates that laryngeal elevation and timing of the swallowing reflex also play an important role in controlling pressures and function in the PE segment during deglutition. These factors must also be examined in assessment of cricopharyngeal dysfunction to guide appropriate management.

Deglutition↗

PubMed1985

Pharyngocutaneous fistulae following laryngectomy.

This retrospective analysis of 100 patients revealed a postoperative pharyngocutaneous fistula rate of 15.3% following total laryngectomy, and 21.4% following partial pharyngolaryngectomy. All fistulae were benign. None resulted in mortality. The most significant risk factor for the development of fistulae is prior radiotherapy, especially high dose (greater than 5000 rads). Other factors include postoperative haemoglobin less than 12.0 g/dl, pyriform sinus tumour, and larger tumour size. Both the prior administration of radiotherapy and the site of the fistula opening most influence management problems.

Adult↗

PubMedDate not supplied

Using a computer to organize digital photographs.

A facial plastic surgeon's photographic files are a potential storehouse of learning material. Manual review of before-and-after photographs is time consuming and self-limiting. Computers can facilitate the analysis, storage, and review of photographs and thereby serve as an aid to learning from the results of our surgery. This article describes a personal approach to automating this process. The surgeon classifies the photographs, and the office staff performs the typing and filing. As the speed and resources of computers rapidly expand, this process will become faster, simpler, and more popular.

Computers↗

PubMedDate not supplied

Examination of swallowing after total laryngectomy using manofluorography.

Investigation of postlaryngectomy dysphagia is usually limited to the standard barium swallow. Manofluorography (mano, manometry; fluoro, videofluoroscopy; graphy, picture) is a new technique that permits analysis of simultaneous manometry and videofluoroscopy of deglutition. Manofluorography provides more detailed analysis of the swallowing dynamics during the pharyngeal stage of deglutition than either barium studies or manometry used alone. This study uses manofluorography to examine swallowing in two patient groups, total laryngectomees and total laryngectomees with tongue impairment, to analyze the role of various anatomic components in the swallowing process. Pharyngeal transit times were prolonged in both patient groups studied, with the tongue impairment group exhibiting the longest times. The postlaryngectomy pharynx offered greater resistance to bolus flow. The laryngectomy patients compensated by using increased lingual propulsion, whereas the patients with tongue impairment and total laryngectomy could not. This emphasizes the importance of the tongue in bolus propulsion in the pharynx. Other postoperative changes in swallowing are discussed.

Deglutition Disorders↗

PubMedDate not supplied

Manofluorography of deglutition after supraglottic laryngectomy.

Manofluorography (mano: manometry, fluoro: videofluoroscopy, graphy: picture) provides a simultaneous display of manometry and fluoroscopy on one video screen. This study uses manofluorography to analyze the swallowing patterns of nine patients who had undergone supraglottic laryngectomy. The results show that during swallowing the pharyngeal mechanism for preventing aspiration depends upon three processes: (1) tight lingual-laryngeal contact, (2) coordination of the swallowing reflex, and (3) tongue base and pharyngeal constrictor clearing of the hypopharynx and laryngeal inlet. Anterior suspension of the larynx under the tongue base serves to improve lingual-laryngeal contact. This close contact during deglutition protects the airway from the bolus and also opens the postcricoid region, aiding bolus passage into the esophagus. Impairment of the swallowing reflex, which can cause severe aspiration before the swallowing reflex is triggered, can be rehabilitated by swallowing therapy. Minor aspiration is commonly caused by impaired clearing of the superior hypopharynx after supraglottic laryngectomy.

Deglutition Disorders↗