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Biomedical subjects

R L Mabry

Publications and source records attributed to R L Mabry.

At least 73 records · Page 4Linked to original sources
PubMed1984

Surgery of the inferior turbinates: how much and when?

Surgery of the inferior turbinates should be performed only after a trial period of medical therapy. Surgical reduction in turbinate size may be accomplished by outfracture crushing, cauterization, cryotherapy, laser vaporization, submucous resection, partial turbinate resection, turbinoplasty, or total turbinectomy. The procedure chosen should be the most conservative one consistent with obtaining a good airway.

Humans↗
PubMed1984

Office diagnosis of sinus disorders: the role of ultrasound scanning.

The accurate diagnosis of sinus disorders has traditionally depended on history-taking, physical examination, and sinus radiographs. Other helpful tools include transillumination, sinus irrigation, and direct sinoscopy. Ultrasound scanning to define and follow the course of sinus disorders, although used for years in Europe, has only recently been introduced in this country. It is characterized as an inexpensive, non-invasive diagnostic aid which does not carry the risk of ionizing radiation. This paper discusses the use of ultrasound scanning in the management of sinus disorders commonly seen in office otolaryngologic practice, comparing it to other diagnostic modalities, and pointing out its advantages and shortcomings.

Endoscopy↗
PubMed1983

Corticosteroids in the management of allergic rhinitis.

Allergic rhinitis unresponsive to conservative therapy with antihistamines, decongestants, and environmental control may require the use of corticosteroids for symptomatic relief, even while hyposensitization is being carried out. Such therapy may be given orally, intramuscularly, as a nasal aerosol, or by intraturbinal injection. This discussion deals with the characteristics and appropriate use of each modality.

Administration, Oral↗
PubMed1983

Corticosteroids in otolaryngology: intraturbinal injection.

Intranasal corticosteroid injection is not a panacea and in the usual sense never effects a "cure." However, it does effectively, rapidly, and for a prolonged period alleviate distressing symptoms that are common in rhinologic practice. It is a procedure that demands attention to patient selection for its proper use, and careful technique for its safe use. When properly employed, intranasal corticosteroid injection can be one of the most effective clinical tools available to the rhinologist today.

Adrenal Cortex Hormones↗
PubMed1982

Desensitization versus intraturbinal injection of corticosteroid for nasal allergy: indications, effectiveness, and patient acceptance.

Severe allergic nasal symptoms often require corticosteroids for control. Although I most often utilize intraturbinal injection, they may also be administered systemically (oral or intramuscular) or as nasal aerosols. I advise allergy testing and desensitization for refractory cases unresponsive to conservative management, or instances of recurrent severe symptoms requiring repeated intranasal steroid injections (eg, six or more in one year, five or more per year for two years). A survey of patients who had been treated by both allergy desensitization and intranasal steroid injection revealed a much greater patient acceptance of the latter treatment. Desensitization was judged by most patients as good to fair in providing relief, while all patients questioned in a random sampling rated intranasal steroid injection excellent to good. About half the patients had discontinued their allergy injections, generally because of lack of results or growing tired of repeated injections. Intranasal steroid injection affords good symptomatic relief for the patient with severe allergic rhinitis, while allergy desensitization offers the only "cure" possible. Both measures have a place in the management of nasal allergy. However, patients must be advised of the goals and limitations of each measure.

Administration, Intranasal↗
PubMed1982

Rhinitis medicamentosa: the forgotten factor in nasal obstruction.

Rebound nasal mucosal edema may follow the use of topical nasal vasoconstrictors for even a short time. The physician seeing a patient with nasal stuffiness should always ask about the usage of these substances. Management of patients with rhinitis medicamentosa includes making the diagnosis, reversing the mucosal changes, patient education, and appropriate follow-up. Systemic medications such as antihypertensives, beta-blockers, and antidepressants may also cause nasal stuffiness, which should resolve upon withdrawal of the offending substance.

Administration, Intranasal↗
PubMed1981

Visual loss after intranasal corticosteroid injection. Incidence, causes, and prevention.

In an attempt to establish accurately the incidence of visual abnormalities that result from an intranasal corticosteroid injection, data were obtained from published and unpublished case reports, pharmaceutical companies, and adverse-reaction reports furnished by the Food and Drug Administration. Only ten instances of visual loss associated with an intranasal steroid injection could be confirmed. Of these ten instances, five were transient and five were permanent. White steroid emboli were demonstrated in the retinal vessels in six cases. Possible factors that contribute to retinal embolization of intranasally injected steroids include a deep or forceful injection, failure to precede and injection with a topical vasoconstrictor, and clumping or precipitation of injected particles contributing to embolization.

Adrenal Cortex Hormones↗
PubMed1980

Intranasal steroid injection during pregnancy.

Nasal obstruction during pregnancy may arise from allergic or endocrine factors and often compounded by abuse of topical nasal vasoconstrictors. Severe nasal symptoms occurred in 32% of pregnant women surveyed. Despite self-medication with nose drops and proprietary remedies, as well as prescriptions of antihistamines and systemic decongestants, some instances of rhinitis of pregnancy remain refractory to treatment. Intranasal injection of corticosteroids affords rapid and lasting relief for these patients. In this series, 21 patients with severe nasal obstruction during pregnancy received 27 intranasal steroid injections. Excellent relief of symptoms was obtained, without untoward effects on the pregnancy.

Edema↗
PubMed1978

Intraturbinal steroid injection: indications, results, and complications.

Intraturbinal injection of steroid can yield rapid relief of nasal obstruction caused by severe allergic or vasomotor rhinitis, rhinitis medicamentosa, or acutely enlarged nasal polyps. This modality is not meant to replace the traditional means of therapy for these diseases. Despite previous reports of visual loss after intraturbinal steroid, thousands of such injections have been given with no such disastrous complications. The technic should include preliminary topical cocainization of the nasal mucosa, slow injection using a small gauge needle, and steps to allay apprehension and prevent a "needle reaction." In a retrospective study comparing intraturbinal triamcinolone with intramuscular betamethasone, the intraturbinal steroid was judged much more effective. Side effects reported after intranasal steroid were minor in nature. No visual complications have occurred in this series.

Airway Obstruction↗