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Biomedical subjects

S D Handler

Publications and source records attributed to S D Handler.

At least 73 records · Page 4Linked to original sources
PubMed1985

Massive juvenile ossifying fibroma of maxillary sinus with orbital involvement.

A 14-year-old black girl had painless, progressive proptosis and upward displacement of the left eye for approximately six months. Computed tomography showed a massive tumour involving the maxillary sinus with extension into the sphenoid sinus, ethmoid sinus, and orbit. The mass was excised surgically and proved histopathologically to be a juvenile ossifying fibroma. The clinical and histopathological features of this uncommon orbital tumour are discussed and its place in the spectrum of fibro-osseous tumours of the orbital region is considered.

Adolescent↗
PubMed1985

Upper airway obstruction in craniofacial anomalies: diagnosis and management.

Particular attention to airway problems must be paid to any child with a craniofacial anomaly. Knowledge of the potential for upper airway obstruction in children with craniofacial anomalies, early recognition of the signs of obstruction, and prompt treatment are extremely important aspects of the treatment plan for each patient. An infant with choanal atresia or a nasal glioma will need definitive repair of his specific deformity to ensure the airway prior to consideration of any other problem. Similarly, the child with severe mandibular hypoplasia may require an early tongue-lip adhesion or tracheotomy to relieve airway distress until mandibular growth or surgical advancement enlarges the natural airway. Adenotonsillar hypertrophy may present earlier and with more severe sleep apnea in a child with an already compromised pharyngeal lumen. Early tonsillectomy and/or adenoidectomy must be considered in these patients even if this may possibly lead to velopharyngeal incompetence. Sleep apnea may also occur as a complication of the creation of a pharyngeal flap. If operative intervention for the craniofacial anomaly is contemplated, the potential for airway problems increases. The anesthetic induction and intubation are extremely difficult in the child with mandibular hypoplasia. The anesthetist and otolaryngologist must have a full range of techniques available to them to accomplish this task. If intermaxillary fixation is required postoperatively, or if the endotracheal tube is in the operative field, consideration should be given to a short-term tracheotomy to protect the airway during and after the operation. Close cooperation among the members of the craniofacial team is mandatory to prevent and/or treat any upper airway obstruction that may occur in the child with a craniofacial anomaly. Anticipation of possible airway compromise, early recognition of any existing obstruction, and prompt management of the problem are imperative to the successful diagnosis and treatment of craniofacial anomalies.

Child↗
PubMed1983

Communication development in young children with long-term tracheostomies: preliminary report.

Communication development was studied in 77 subjects with long-term tracheostomies ranging in age from two months to 7 years. Children were categorized according to tracheostomy status (cannulated or decannulated), presence of speech practice prior to cannulation, and level of language development (prelinguistic or linguistic) at the time of decannulation. All were aphonic and consequently deprived of speech experience for extended periods while tracheostomized. Twenty-three children have been studied post-decannulation. Results for the children decannulated during the prelinguistic stage revealed that speech and language skills were attained commensurate with intellectual functioning. This evidence led to the conclusion that extensive, audible prespeech practice (cooing and babbling) was not needed for later spoken language development. All children decannulated during the linguistic stage exhibited specific spoken language delays including phonological impairment at the time of decannulation. The presence of speech practice prior to cannulation did not appear to be a factor in the severity of phonological impairment. The children who were cannulated for more lengthy time periods, extending into the linguistic stage, however, demonstrated more severe phonological impairment than those who were decannulated during the prelinguistic stage. With direct speech/language therapy, 20 of the 23 decannulated children eventually compensated for these difficulties, demonstrating appropriate spoken language skills. Alternative communication modalities were felt to be crucial in reducing communicative frustrations during cannulation.

Child↗
PubMed1983

A trial of Biolite ventilation tubes in children: is further use warranted?

A prospective controlled pilot study was undertaken in which Biolite (carbon-coated) ventilation tubes were placed in 44 ears and a conventional silicone tube in the contralateral ear. Long-term follow-up of these patients has revealed little difference in the incidence of tube occlusion or early extrusion. In addition, there were several disadvantages noted with the Biolite tubes: incomplete coating of the tube (especially within the lumen), shedding of the Biolite coating over time, "tattooing" of the tympanic membrane, poor otoscopic visibility, and the higher cost of these tubes. Since the Biolite tube has no documented advantages and, actually, several disadvantages, we believe its use in the treatment of middle ear disorders should be discontinued until significant benefits are demonstrated and present deficiencies are corrected.

Adolescent↗
PubMed1982

Hemophilus influenzae epiglottitis occurring concurrently in two siblings.

Epiglottis (more properly supraglottitis) is a potentially life-threatening infection of the supraglottic larynx that is most often caused by Hemophilus influenzae type B (HITB). Intrafamily spread of HITB disease has been described often for meningitis, but is rarely reported in epiglottis. We describe two siblings seen concurrently with HITB epiglottitis and discuss prophylaxis of family members and close contacts.

Child, Preschool↗
PubMed1982

Contributing generator of frequency-following response in man.

A contributing generator of the frequency-following response (FFR) was identified in a patient with severe neurological impairment, by comparing latencies and phase shifts of the FFR to the latency of the auditory brainstem evoked responses (ABR), and by comparing the duration of the FFR to that of the acoustic stimulus. In this patient, the ABR comprised only waves I and II; activity in the inferior colliculus was not identified. Both onset and offset latencies and phase shifts of the FFR were substantially shorter than the latency of the first wave of the ABR. The duration of the FFR corresponded precisely to that of the acoustic stimulus. These results are interpreted as supporting the view that the cochlear microphonic potential (CM) contributes to the scalp-recorded FFR.

Brain↗
PubMed1981

Unsuspected esophageal foreign bodies in adults with upper airway obstruction.

Esophageal foreign bodies rarely cause respiratory distress in adults. While it is well known that upper airway obstruction can occur with esophageal foreign bodies in children, the otorlaryngologic literature mentions little of this problem in older patients. Two adults with airway obstruction from unsuspected esophageal foreign bodies are described, with emphasis on the problems of diagnosis and management. The possibility of an unsuspected esophageal foreign body should be kept in mind during the evaluation of respiratory distress in an adult, especially in one who is a poor historian or has a history of a psychiatric disorder. Early endoscopic removal in the treatment of choice, although esophagotomy may be required.

Adult↗
PubMed1981

The speech pathologist and management of children with tracheostomies.

Troublesome airway problems necessitating the presence of a tracheostomy for extended periods of time are now not uncommon in children. To date, little attention has been devoted to the communication problems these young patients encounter. Experience with 44 children with tracheostomies, some of whom are ventilator-dependent, at the Children's Hospital of Philadelphia has enabled us to develop a therapy program that we feel would be useful to other speech professionals treating such patients. The speech pathologist must take an active role in the evaluation and management of these patients and the education of the family and hospital staff. The ultimate goal is to provide communicative and feeding skills to these handicapped children.

Bronchopulmonary Dysplasia↗
PubMed1980

Neonatal submandibular sialadenitis.

Abscess of the salivary glands in the neonatal period is a rare occurrence and almost always involves the parotid gland. A case of suppurative sialadenitis and abscess involving the submandibular gland in a neonate is presented. The diagnosis and management of this uncommon disease are discussed. A review of the literature revealed only three cases of isolated submandibular sialadenitis in neonates.

Female↗
PubMed1980

Hemangiomas of the head and neck in children - a guide to management.

Hemangiomas are the most common benign tumor of childhood occurring in the head and neck. The vast majority of these lesions are noted in the neonatal period and are a frequent cause for parental concern. Appropriate management requires familiarity with the varied types of lesions and syndromes, their natural histories, and their proven treatments. In general, treatment should remain conservative except when there is mechanical obstruction of the airway, hemorrhage, infection, tissue loss, or threatened cardiovascular decompensation. A review of the literature is presented with anatomic descriptions, classification, and discussion of treatment modalities. Special emphasis is placed on the diagnosis and treatment of the often life-threatening subglottic hemangioma.

Arteriovenous Malformations↗