Biomedical subjects

R E Lingeman

Publications and source records attributed to R E Lingeman.

21 records · Page 2Linked to original sources

PubMedDate not supplied

Congenital tracheoesophageal fistulas in adults.

Congenital tracheoesophageal fistula without esophageal atresia is commonly known as "H" type. This is an extremely rare anomaly in infants and accounts for approximately 1 1/2-4% of all congenital tracheoesophageal malformations. An anomaly should be described by its anatomical defect, not by a number or letter. There are five main anatomical categories with 85-95% being of the esophageal atresia and distal tracheoesophageal fistula type. About 1 1/2% are of the "H" type. Although today tracheoesophageal fistula is a well-recognized entity, a few of the "H" type have passed through the pediatric period without diagnosis. Those undetected fistulas have successfully masqueraded as chronic lung disease of unknown etiology. Congenital "H" type tracheoesophageal fistulas assume an oblique orientation with the growth of the host to adulthood. This helps to explain the difficulty in diagnosis plus the ability of the host to survive to adult life. Treatment is surgical, consisting of simple ligation via cervical or thoracic approach depending upon location. The 12 previously reported cases in the English literature are reviewed, and a 13th case has been added.

Adult↗

PubMedDate not supplied

Neck dissection: radical or conservative.

Four hundred and forty-five neck dissections for epidermoid carcinoma over a 10-year period are reviewed as to local recurrence of neck disease. Three hundred and forty-seven dissections were radical en bloc procedures and in 98 a modified conservative technique was utilized. Cervical lymph node classification was applied and a comparison made of the two techniques. A review of the anatomy of cervical fascias and the technique of conservative neck dissection is given. Evaluation of this series of cases indicate that the control of local disease in the neck in the N0 and N1 groups is is accomplished as well with conservative dissection as with radical neck dissection. The number of conservative neck dissections for N2 disease was too limited for accurate comparison. There were no conservative neck dissections done for N3 disease. We suggest that conservative neck dissection be utilized for subclinical and N1 disease and that the classic en bloc dissection be reserved for N2 and N3 situations.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Primary vocal rehabilitation using the Blom-Singer and Panje voice prostheses.

Vocal rehabilitation by means of tracheoesophageal puncture and placement of either the Blom-Singer or Panje silicone prosthesis has become a standard method of speech production following total laryngectomy. The same technique has been employed primarily at the time of the laryngectomy by the Department of Otolaryngology-Head and Neck Surgery, Indiana University Medical Center, and our experience with 11 patients undergoing this technique forms the basis for this report. Of the ten patients available for evaluation, all have developed satisfactory prosthetic speech 2-12 weeks following total laryngectomy. Advantages of this technique include the utilization of standard laryngectomy without compromise of oncologic principles, elimination of a second procedure to place the tracheoesophageal puncture, elimination of the nasogastric tube, care in the pharyngeal closure to afford the maximum success of prosthetic speech production, and finally, the psychological boost. Limitations of the technique have been few but relate to limited voicing with postoperative radiotherapy and unrealistic patient expectations.

Aged↗