Biomedical subjects

R G Amedee

Publications and source records attributed to R G Amedee.

At least 19 recordsLinked to original sources

PubMed1992

Tracheomalacia repair using ceramic rings.

Tracheomalacia resulting from tracheostomy or compressive thyroid disease often represents a difficult problem in airway management. In an attempt to improve this condition, biocompatible ceramic rings were surgically implanted in 16 patients to restore normal patency of the airway by first expanding the tracheal lumen lateral, and then in an anterior dimension. Preoperatively, patients displayed moderate to severe obstruction with marked restrictions in lifestyle, as confirmed by history, physical examination, and airway resistance studies. Additionally, three of these patients were trach-dependent at the time of implantation. Postoperatively all 16 patients have normal airway resistance parameters with a dramatic improvement in lifestyle, whereas the three with tracheostomy were successfully decannulated. The routine use of these rings has alleviated the need for rib/cartilage grafts, primary resections with anastomosis, prolonged periods of cannulation, and multiple surgeries. Our experience in the use of ceramic rings for tracheomalacia repair will be presented, highlighting selection criteria for their use, intraoperative placement, perioperative complications, and post-operative followup for a minimum of 6 months.

Adult↗

PubMed1992

Ultrasonography for the diagnosis of Lyme disease in cases of acute facial paralysis.

Ultrasonography of the parotid gland was introduced in 1989 as part of the diagnostic protocol of every patient treated in our clinics with acute facial paralysis. Ten of 50 patients so tested were found to have unilateral nonpalpable enlarged lymph nodes in the caudal portion of the parotid gland around the stylomastoid foramen. All 10 patients were eventually diagnosed as having Lyme disease. It is suggested that in patients with acute facial paralysis, ultrasonography is an inexpensive tool to improve diagnosis of Lyme disease and may have a more useful purpose in monitoring therapy.

Acute Disease↗

PubMed1992

Glomus tumors of the temporal bone.

Glomus tumors represent one of the most common benign tumors of the temporal bone. The anatomy, embryology, physiology, and pathology of these lesions as well as diagnostic evaluation and current therapeutic modalities are reviewed.

Glomus Tumor↗

PubMed1992

The hard-of-hearing patient in office practice.

The hard-of-hearing patient may represent difficult evaluation and management decisions. This article will serve as a review for the primary care physician. Included will be a description of the various types of hearing losses, their causes, evaluation, and treatment.

Audiometry↗

PubMed1992

Carcinoma of the lip.

Carcinoma of the lip represents the most common malignancy of the oral cavity with an incidence in the United States of approximately 1.8/100,000. Lip cancers represent 15% to 20% of all malignancies of the oral cavity. With increasing public awareness of the harmful effects of solar radiation, physicians need to be aware of the etiological factors as well as appropriate treatment plans to ensure that patients obtain the most favorable outcome possible.

Carcinoma↗

PubMed1992

Neurotologic manifestations of von Hippel Lindau disease.

Von Hippel Lindau disease is a hereditary phakomatosis characterized by congenital angiomatosis of the retina and cerebellum. This autosomal dominant syndrome exhibits variable penetrance and expressivity. Because of the marked clinical variability and sporadic age of onset, members of affected families must be counseled and screening protocols established. It has been recommended that initial screening include appropriate laboratory work, ophthalmologic and neurologic examination, radiologic evaluation of the CNS, and when appropriate, abdominal ultrasound. Follow-up examination should be annually with acute evaluations as focal signs and symptoms develop. With the help of technological advances and screening of family members, patients with vHL disease can live long, productive lives with reduced morbidity.

Adult↗

PubMed1992

Zenker's diverticulum.

Dysphagia is a fairly common medical complaint. Zenker's diverticulum, although uncommon, is an easily diagnosed and treated cause of dysphagia. The clinical presentation, evaluation, pathophysiology, and therapeutic options will be discussed.

Aged↗

PubMed1992

Relapsing polychondritis.

Relapsing polychondritis is a rare disease of unknown etiology. It is characterized by progressive episodic recurring inflammation and degeneration of cartilaginous structures. The inflammation typically involves the cartilage of the ear, nose, trachea, and various peripheral joints. Treatment options most commonly involve the use of anti-inflammatory drugs and corticosteroids.

Biopsy↗

PubMed1992

Ocular trauma in otolaryngology.

Otolaryngologists are commonly called upon to emergently evaluate blunt trauma to the facial skeleton. These injuries are occasionally associated with serious trauma to the orbital contents. This manuscript reviews these orbital injuries by considering the pertinent eye anatomy and the extensive examination usually performed by an ophthalmologist. Anterior and posterior segment injuries along with specific trauma to the optic nerve will also be discussed.

Eye Injuries↗

PubMed1991

Auditory-evoked brain-stem responses and auditory disorders in patients with Bell's palsy.

Out of 121 patients examined with acute unilateral facial paralysis, 93 were determined to have idiopathic facial palsy (Bell's palsy). The examination included pure-tone and speech audiometry, stapedial reflex recordings, temporal bone radiography and auditory-evoked brain-stem response testing (ABR). If a retrocochlear lesion was suspected, computed tomography or magnetic resonance imaging was performed. Patients with sensorineural hearing loss affecting all frequencies were compared to one group with hearing loss affecting only high frequencies and to another group with ABR findings suggesting a cochlear lesion. No association could be made between the etiology of these pathological results and the concurrent facial paresis. Most of them were probably caused by unrelated disorders of the auditory system. In cases with prolonged inter-peak latencies representing brain-stem responses, abnormal ABRs could be caused by the same pathology as the paralysis. This might well suggest the presence of a neuropathy in both the central auditory system and the facial tracts.

Adolescent↗

PubMed1991

Selective chemical vestibulectomy: preliminary results with human application.

The involved membranous labyrinth of patients with medically intractable Meniere's disease is being accessed by means of a fenestration of the bony horizontal semicircular canal in preparation for the application of a 125 or 250 mcg flake of solid streptomycin. Sensory information originating in the affected vestibular end organ is selectively blocked from reaching the central nervous system. This uniformly results in the rapid elimination of vertiginous symptoms, and at these calculated doses yields preservation of (or in some cases improvement in) preoperative cochlear thresholds. The rationale for this procedure, as detailed in earlier investigations of animals, will be briefly reviewed before highlighting our preliminary results in adult clinical trials.

Humans↗

PubMed1991

Management of external ear trauma.

External ear trauma has been an area of continuing interest for otolaryngologists, plastic surgeons, rural-practicing general surgeons, and emergency physicians. Strict adherence to the general principles of both medical and surgical management of these injuries must be maintained to achieve optimal results. This presentation will discuss current concepts in the management of blunt, thermal, and sharp auricular injuries, and will present a logical outline in attempting to obtain optimal cosmetic and functional results.

Burns↗

PubMed1991

Vascular malformation of the sphenoid sinus.

Isolated sphenoid sinus lesions are usually inflammatory lesions or mucoceles. We report an unusual case of a thrombosed arteriovenous malformation presenting as a unilateral primary vascular malformation of the sphenoid sinus. To the best of our knowledge, no one has ever reported such an entity in the medical literature. Differential diagnosis of sphenoid sinus lesions and possible etiologies for this case will be detailed.

Adult↗

PubMed1991

Traumatic perforation of the tympanic membrane.

Traumatic perforations of the tympanic membrane are not uncommon injuries. The various etiologies of this injury along with the appropriate evaluation will be discussed. The goal of this review is to enhance the nonotolaryngologist's knowledge of this condition and its treatment.

Humans↗

PubMed1991

Neuromuscular disorders in otolaryngology.

Neuromuscular disorders pose an interesting diagnostic and therapeutic dilemma to clinicians. The initial manifestations of these disorders on physical examination are frequently subtle but may eventually progress to disabling, complex findings. Management options are varied and include pharmacologic, surgical, and other supportive modalities.

Humans↗

PubMed1991

Giant cell reparative granuloma presenting as a midline nasal mass.

Giant cell reparative granuloma (GCRG) is an uncommon entity that has been reported in all areas of the head and neck. It must be distinguished from true giant cell tumors, brown tumors of hyperparathyroidism, aneurysmal bone cysts, and fibrous dysplasia. It responds well to surgical debulking and curettage and has a benign clinical course. We describe a case report of a GCRG presenting as a midline nasal mass and review the pertinent English language literature.

Child↗

PubMed1991

Hemostasis in the surgical patient.

Hemostatic disorders present a challenging problem to the surgeon and patient alike. Many of these disorders are first discovered at the time of planned or emergent surgical procedures. This manuscript will review the normal hemostatic mechanisms and the more common congenital and acquired coagulopathies.

Blood Coagulation↗

PubMed1991

The management of otitis media with effusion.

Otitis media with effusion is one of the most common otologic diseases encountered by the clinician. This is primarily a pediatric problem although it can be seen in all age groups. The etiology, diagnosis, and treatment of this disorder will be discussed in this manuscript.

Humans↗