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Biomedical subjects

R I Kohut

Publications and source records attributed to R I Kohut.

At least 37 records · Page 2Linked to original sources
PubMed1987

Airway obstruction in LeFort fractures.

Airway obstruction associated with fractures of the midfacial skeleton can be life-threatening if not recognized promptly and treated appropriately. One hundred seventeen patients with LeFort fractures were treated between 1978 and 1984. Of the 117 patients, 21 had a LeFort I fracture, 46 had a LeFort II fracture, 14 had a LeFort III fracture, and 36 had various combinations of the three types of LeFort fractures. Thirty-one patients (26.5%) presented with airway obstruction, decreased respiration, or both, requiring either tracheotomy or endotracheal intubation. Of the 31 patients undergoing emergent tracheotomy or endotracheal intubation, 26 (83.9%) had loss of consciousness relating to their injuries. Thirty-nine (33.3%) additional patients had an elective tracheotomy either at the time of surgical repair of their fractures or for prolonged endotracheal intubation. Age and sex of the patients played no role in the incidence of airway complications in patients with LeFort fractures. Patients with LeFort III fractures and those with associated injuries such as mandible fracture, laryngeal and pharyngeal injury, and chest or closed head injury are at greater risk for requiring emergent control of the airway.

Adolescent↗
PubMed1986

Headache and the primary empty sella syndrome.

Otolaryngologists frequently encounter patients with complaints of headaches. On occasion, normal physical examination findings may be accompanied by a roentgenographic enlargement of the sella turcica. In the process of evaluation for an intrasellar neoplasm, an "empty sella" is occasionally discovered. Patients with this condition commonly have headaches, although a cause-effect relationship is controversial. Endocrine and visual disturbances, although rare necessitate periodic evaluation of these patients.

Empty Sella Syndrome↗
PubMed1984

Appliance to protect maxillary teeth and palate during endoscopy.

To avoid traumatizing maxillary teeth and edentulous ridges during endoscopy, a device or appliance must be used to prevent direct contact of the teeth and mucosa with endoscopic instruments. Because previous appliances have been minimally protective, easily dislodged, or obstructive to the endoscopist, none have been widely accepted at our Institution. Consequently, we developed an easily fabricated protective appliance, using conventional dental technology, that has adequate strength to prevent fracture and displacement of teeth during routine endoscopy. The appliance is retentive, unobstructive, reusable, and reasonably priced for the patient. In an initial group of approximately 25 patients undergoing endoscopy, this appliance was well accepted by the otolaryngology and anesthesia staff, and there were no injuries to the teeth or oral mucosa. To verify further the usefulness of this type of appliance, a prospective study is planned.

Endoscopes↗
PubMed1984

Penetrating injuries of the larynx.

Patients with penetrating laryngeal trauma can present a wide spectrum of signs and symptoms. Severe trauma frequently leads to life-threatening airway compromise, whereas lesser injuries are often overlooked because of the subtlety of physical and roentgenographic findings or the severity of vascular and neurologic injuries. Increased suspicion should accompany the examination of patients who have sustained a penetrating neck injury, and such injuries demand examination by an experienced laryngoscopist. Early surgical repair is mandatory to avoid delayed complications, which can permanently impair airway, speech, and deglutition. In a series of 19 patients presented here, diagnosis was delayed in seven (37%). The most relevant factor determining return to normal voice appeared to be the presence or absence of vocal cord paralysis.

Adult↗
PubMed1980

Blindness following frontal sinus irrigation. Report of a case.

Visual loss is a rare and dreaded complication of surgical procedures of the paranasal sinuses. A case of sudden unilateral blindness following irrigation of the frontal sinus is presented and the presumptive pathophysiology is discussed. An awareness of this potential complication as well as early diagnosis with prompt medical and surgical management are essential.

Blindness↗
PubMed1980

Atypical mycobacterial cervical adenitis: clinical presentation.

Atypical mycobacterium cervical adenitis (AMCA) is a disease primarily of childhood and usually presents as a unilateral mass or draining sinus. The pathogens are mycobacteria which are distinct from Mycobacteria tuberculosis, leprae and bovis (the typical mycobacteria). The atypical mycobacteria are readily recovered from the environment and are generally of low virulence. They are increasingly being recognized as pathogen for man though they are probably not transmissible from human contact. Most commonly these organisms are implicated in either pulmonary disease or lymphadenopathy. Fourteen cases of AMCA occurring in childhood are presented. A review of the bacteriology of the atypical mycobacteria is included. The clinical presentation, differential diagnosis, chemotherapeutic management and role of surgical intervention are discussed.

Adolescent↗
PubMed1976

Metastatic adenocarcinoma of the temporal bone.

Metastatic carcinoma involving the temporal bone is an unusual occurrence. A review of the world literature reveals a total of 102 reported cases. Secondary cancers of the temporal bone arise most frequently from mammary, renal, and bronchogenic carcinomas, all of which show a tendency to metastasize to bone. The pathogenesis of spread to the temporal bone is most commonly by the hematogenous route, but extension from intracranial involvement has also been noted. The symptoms of facial nerve paralysis, otalgia, and aural discharge are consistently associated with patients found to have aural cancers. These symptoms are, however, most frequently indicative of mastoid infection; it is therefore, imperative to consider the possibility of a malignant neoplasm in patients with these symptoms.

Adenocarcinoma↗
PubMed1976

One-stage dermal pedicle flap reconstruction of the oropharynx (an experimental and clinical study).

A single stage dermal pedicle graft method for reconstruction of oropharyngeal defects is presented. Its successful clinical use is described. The advantages of the method include large surface-to-surface anastomosis which appears to minimize breakdown secondary to hypovascularity of an irradiated recipient bed. Other advantages include its single stage feature, persistent blood supply, avoidance of external tubed pedicles and intermediate salivary fistulas. A histologic study in pigs preceded its clinical use in humans. Findings of both aspects of the study are discussed.

Animals↗
PubMed1975

Aural abnormalities in partial DiGeorge syndrome.

DiGeorge syndrome patients frequently have multiple anomalies of the craniofacial, cardiovascular, and visceral structures in addition to thymic and parathyroid hypoplasia. Gross and microscopic aural abnormalities occurring in a patient with partial DiGeorge syndrome are presented and compared with findings from the only other known temporal bone report.

Abnormalities, Multiple↗
PubMed1975

Macular amyloidosis with localized amyloidosis of upper air passages.

A patient with primary amyloidosis of the upper air passages was found to have cutaneous macular amyloidosis. A review of the literature indicates that this may represent the first report of these two uncommon forms of amyloidosis occurring in the same individual. Biopsy material from the nasopharynx, tonsillar areas, larynx, trachea, and skin showed amyloid in the tissue sections. Special stains were used and polariscopic studies were performed, and the hyalin material met the established criteria for amyloid. Studies of tissues from other parts of the body of this patient failed to demonstrate amyloid.

Amyloidosis↗