Biomedical subjects

P Topf

Publications and source records attributed to P Topf.

7 recordsLinked to original sources

PubMed1995

Midforehead incision: an approach to the frontal sinus and upper face.

The coronal incision has established itself as the principal surgical approach to the forehead. It allows for a well-hidden scar and a wide field of surgical exposure. The midforehead incision, described in the brow-lift literature, is a cosmetically acceptable alternative to the coronal incision for patients with forehead wrinkles or who are at risk for male pattern baldness. In an analysis of 33 consecutive open frontal sinus procedures, we compared patients who underwent i coronal approach to a midforehead approach for operative time, blood loss, length of hospital stay, and cosmetic result. There was a trend toward decreased operative time and decreased blood loss with the midforehead approach. The cosmetic result was acceptable in all patients. We advocate the use of a midforehead approach to the frontal sinus in patients with deep forehead creases and with hairline recession and elderly or infirmed patients who cannot tolerate prolonged procedures or significant blood loss.

Esthetics↗

PubMed1991

Acute suppurative thyroiditis with bilateral piriform sinus fistulae.

Although there are many possible routes of infection in AST, the clinician must be aware of a possible fistula between the piriform sinus and the perithyroidal space--especially in patients with recurrent episodes of AST. Diagnosis of this congenital tract requires a high index of suspicion and radiographic demonstration by a barium swallow or endoscopic visualization. Effective treatment of AST with intravenous antibiotics and appropriate surgical intervention have greatly reduced the mortality and secondary complications. Complete fistulectomy, however, is required for permanent cure.

Acute Disease↗

PubMed1990

Epiglottitis in the adult.

Much attention has been directed toward the etiology, diagnosis, and management of pediatric epiglottitis. Recently, however, the otolaryngological literature has stressed the importance of recognizing epiglottitis (or supraglottitis) as an adult affliction. Two interesting cases of adult epiglottitis are presented, emphasizing the many differences between the adult and pediatric forms concerning the presentation, diagnosis, treatment, and natural course of the disease. Controversies regarding the diagnosis and management are addressed, as well as the indications for and types of airway intervention. A review of the complications of epiglottitis and their treatment is included.

Diagnosis, Differential↗

PubMed1988

Hyperlipidemia in association with childhood sensorineural hearing loss.

In adults there has been an association noted between hyperlipidemia and sensorineural hearing loss. Etiologic considerations include hyperviscosity of the serum, vascular occlusion and an increased susceptibility to noise. Until now this correlation, to our knowledge, has not been made in the pediatric population. Several children with bilateral fluctuating sensorineural hearing losses have been identified with hyperlipidemia. The fluctuations in hearing varied with lipid levels. With dietary controls, the cholesterol levels returned to what would be near the norm for the pediatric population and hearing returned to near baseline. Unexplained fluctuating sensorineural hearing losses in children warrant the consideration of hyperlipidemia. Discovering a potentially reversible etiology for hearing loss is significant but more importantly, may lead to the early detection of hyperlipidemia in the young patient.

Auditory Threshold↗

PubMed1988

Vagaries of thyroglossal duct cysts.

The thyroglossal duct cyst is the most common congenital cyst found in the neck, classically presenting as a paramidline mass in a healthy young adult. Fifty-three cases managed at the Brigham and Women's Hospital and Boston's Beth Israel Hospital over the past 10 years were reviewed. The unique presentation of papillary adenocarcinoma in TGDCs and findings in the elderly population are discussed. These cases represent both diagnostic and therapeutic challenges. The existing literature is correlated with our data, providing a treatise on management.

Adenocarcinoma, Papillary↗

PubMed1984

Single-dose treatment of uncomplicated urinary tract infections in children.

Thirty-six girls, aged two to 17 years, with culture-proven, acute, uncomplicated lower urinary tract infections and without signs or symptoms of upper urinary tract infection, were randomized to receive either single-dose amoxicillin or conventional therapy for ten days. Twenty-six patients completed the study, ten in the single-dose group and 16 in the conventional therapy group. The patients treated with single-dose therapy had cure rates (70% vs 75%), relapse rates (30% vs 25%), and reinfection rates (0% vs 12%) comparable to those of conventionally treated patients. A significant difference in the induction of resistant organisms was seen between treatment groups (P less than .05). All single-dose relapses were due to failure to clear a sensitive organism from the urinary tract. All relapses on conventional therapy resulted from an initially sensitive organism becoming resistant to amoxicillin during treatment. Single-dose antibiotic therapy of uncomplicated urinary tract infections in children is effective in patients with culture-proven infections selected by clinical criteria, and appears to be safe when combined with conscientious long-term follow up and radiographic evaluation. Single-dose therapy offers the advantage of selecting significantly fewer resistant organisms from the gut flora than do conventional antibiotic regimens.

Adolescent↗

PubMed1983

Hemophilus influenzae cellulitis.

To define the clinical features of cellulitis due to Hemophilus influenzae type B, we reviewed the records of 78 children admitted to the hospital with cellulitis during a one-year period. Fifty-two children were afebrile (T less than 38 degrees C) and none had infections due to H. influenzae. Twenty-six children were febrile, 19 with facial and seven with extremity lesions. H. influenzae type B was recovered from seven of the febrile children with facial cellulitis, and one with extremity involvement. The mean WBC count of children with disease due to this organism was 17,500/mm3. Both fever and a leukocytosis (WBC count greater than 15,000/mm3) occurred more often in children with H. influenzae type B cellulitis than among those with infections due to other organisms.

Adolescent↗