PubMed Health⌕ Search

Biomedical subjects

S D Handler

Publications and source records attributed to S D Handler.

At least 91 records · Page 5Linked to original sources
PubMed1979

Neurogenic sarcoma of the head and neck.

We discuss our experience in the diagnosis and management of seven cases of neurogenic sarcomas of the head and neck. These uncommon tumors, which affect all ages, arise most frequently from the brachial plexus, sympathetic chain, and the cranial nerves or their branches. An enlarging mass is the most common initially appearing symptom. Diagnosis may be difficult and rests heavily on gross evidence of a relationship between the tumor and its nerve of origin. Histologically, the lesions are composed of spindle cells with varying degrees of pleomorphism in a pattern that is frequently undistinguishable from fibrosarcomas. Ultrastructural studies may be helpful in establishing the neurogenic origin of these tumors. Neurogenic sarcoma of the head and neck has an extremely poor prognosis. Surgery remains the cornerstone of treatment, although radiotherapy is important for palliation.

Accessory Nerve↗
PubMed1979

Oncocytoma of the maxillary sinus.

A case of oncocytoma of minor salivary gland origin of the left maxillary sinus is presented. No previous reports of oncocytoma confined entirely to the maxillary sinus were found in an extensive computerized search (Medline and Cancerline) of the world literature. The diagnosis and management of these histologically benign but locally aggressive tumors occurring in the head and neck are discussed.

Adenoma↗
PubMed1979

Airway management in the repair of craniofacial defects.

The operative repair of craniofacial defects presents the surgeon with critical problems regarding airway management. Thirty-seven per cent of our series of 100 children operated upon for a variety of cranofacial deformities had some difficulty in airway management. Those patients with mandibular dysostoses and those requiring midface advancement (Le Fort III) had the highest incidence of airway problems. Our suggested management of the airway is described with emphasis upon the importance of close cooperation between the plastic surgeon, otolaryngologist and anesthesiologist.

Adolescent↗
PubMed1977

Management of brachial plexus tumors.

Brachial plexus neoplasms are uncommon. When this diagnosis is suspected, the functional and anatomical integrity of the brachial plexus and cervical spinal cord must be carefully assessed. A thorough search for other signs of neurofibromatosis (von Recklinghausen's disease) must also be completed. The distinction between neurilemoma and neurofibroma is an important and useful one to know. Evaluation by a pathologist who is well versed in neural tumors is mandatory for appropriate treatment of these usually benign lesions. Surgical intervention, adequately prepared on the basis of the patient's age, the amount of neural impairment, and the extent and histology of the tumor requires a surgeon who is experienced in peripheral nerve surgery and in microdissection techniques. Long-term follow-up is necessary to monitor the growth of known tumors, the detection of malignant change, and the appearance of other stigmata of von Recklinghausen's disease.

Adolescent↗
PubMed1975

Quinidine hepatitis.

Long-term administration of quinidine was associated with persistent elevation of serum concentrations of SGOT, lactic acid dehydrogenase, and alkaline phosphatase. Liver biopsy showed active hepatitis. Discontinuance of quinidine therapy led to normalization of liver function tests. A challenge dose of quinidine caused clinical symptoms and abrupt elevation of SGOT, alkaline phosphatase, and lactic acid dehydrogenase values. We concluded that this patient had quinidine hepatotoxicity and believe that this is the first case reported with liver biopsy documentation. This report also suggests that, even after long-term administration, the hepatic toxicity is reversible.

Aged↗
PubMedDate not supplied

Management of neoplasms of the head and neck in children. 1. Benign tumors.

The otolaryngologist who treats children must have knowledge of the neoplasms that can occur in childhood. Such tumors are usually mesenchymal in origin and may be benign or malignant. Diagnosis and management of the more common benign tumors are undertaken by the otolaryngologist because local excision is generally curative. The proper treatment of malignant lesions requires a more extensive, multidisciplinary team, which includes a pediatric oncologist, diagnostic and therapeutic radiologist, and pathologist, in addition to the otolaryngologist. The purposes of this paper are to outline the types of benign and malignant neoplasms that occur in childhood and to discuss current approaches to therapy.

Age Factors↗
PubMedDate not supplied

Management of neoplasms of the head and neck in children. II. Malignant tumors.

The otolaryngologist who treats children must have knowledge of the neoplasms that can occur in childhood. Such tumors are usually mesenchymal in origin and may be benign or malignant. Diagnosis and management of the more common benign tumors are undertaken by the otolaryngologist because local excision is generally curative. The proper treatment of malignant lesions requires a more extensive, multidisciplinary team, which includes a pediatric oncologist, diagnostic and therapeutic radiologist, and pathologist, in addition to the otolaryngologist. This article outlines the types of malignant neoplasms that occur in childhood and discusses current approaches to therapy.

Child↗
PubMedDate not supplied

Orbital and periorbital cellulitis in children.

The proper management of patients with orbital and periorbital cellulitis represents a distinct challenge to the clinician. A retrospective study is presented of 165 patients with the diagnosis of orbital or periorbital cellulitis admitted to the Children's Hospital of Philadelphia (CHOP) from January 1975 through December 1980. Sinusitis, trauma, local skin inflammations, and otitis were the most common etiologies. Twenty-three of the patients had orbital cellulitis, all of which were secondary to sinusitis. There was one death in this series. No patients had permanent ocular sequelae related to orbital or periorbital cellulitis. A discussion of etiology and management is presented, with emphasis on the usefulness of computerized tomography (CT).

Adolescent↗
PubMedDate not supplied

Current indications for tympanostomy tubes.

Current indications for TT placement are (1) persistent SOM that has not responded to a 6 to 12-week course of medical treatment. This includes full and prophylactic doses of antimicrobials (and corticosteroids, as indicated); (2) recurrent AOM (at least three episodes in 6 months or four episodes in 12 months) that does not respond to, or recurs after, antimicrobial prophylaxis; (3) complications of AOM such as meningitis, facial nerve paralysis, coalescent mastoiditis, or brain abscess; and (4) complications of eustachian tube dysfunction such as tympanic membrane retraction with hearing loss, ossicular erosion, and/or retraction pocket formation. It must be emphasized that TT placement in children does not "cure" the condition that led to the surgical intervention. Rather, the TT maintains aeration of the middle ear until the child grows and his eustachian tube function normalizes. These recommendations for TT placement are to be regarded as guidelines, not as absolute requirements. They must be applied individually to each patient and his/her unique situation. Certain factors may influence timing of TT placement and lead to modification of the guidelines as they apply to each child.

Acute Disease↗
PubMedDate not supplied

Communication disorders in the 22Q11.2 microdeletion syndrome.

The 22q11.2 microdeletion syndrome is a genetic disorder that is being recognized with increasing frequency. Confirmation of the diagnosis can be made using fluorescence in situ hybridization. Many medical and developmental problems are present in children with this syndrome. Communication disorders are among the most common features of this syndrome and include articulation, language, resonance, and voice problems. The purpose of this paper is to provide a description of the communicative and developmental features in a sample of children with the 22q11.2 microdeletion syndrome seen for evaluation. Because communication and feeding disorders may be presenting features of this syndrome, speech and language pathologists must be familiar with this syndrome and its various characteristics. Awareness of these features and a multidisciplinary approach are necessary for the identification and treatment of the complex communicative and medical problems present in this population.

Adolescent↗
PubMedDate not supplied

Epiglottitis: evolution in management during the last decade.

In the past decade, changes have occurred in the management of epiglottis. A ten-year retrospective study of 64 patients admitted to the Children's Hospital of Philadelphia with the diagnosis of epiglottis was performed. An evolution in the management of epiglottitis was demonstrated in this series of patients. The morbidity and mortality of currently employed modes of airway management (medical observation, endotracheal intubation or tracheostomy) were complication than treatment with tracheostomy. A small, select group was conservatively managed with close observation. The use of antibiotics and steroids was analyzed. Suggested guidelines for management of epiglottitis are presented.

Airway Obstruction↗
PubMedDate not supplied

Hemoptysis in children.

Hemoptysis is uncommon in the pediatric age group. There is little mentioned regarding this problem in either the pediatric or the otolaryngologic literature. A review of the past ten years' experience at the Children's Hospital of Philadelphia identified 40 patients whose presenting symptoms included hemoptysis. Causes of the hemoptysis included tumor, infection, trauma, and foreign bodies, as well as a variety of other conditions. Based on these findings, a systematic approach to the diagnostic evaluation of the pediatric patient with hemoptysis has been developed. A thorough endoscopic examination of the upper aerodigestive tract is essential in most cases, and can have both diagnostic and therapeutic value. Particular attention is directed toward airway management in patients with massive hemorrhage. Close cooperation among the bronchoesophagologist, pediatrician, and anesthesiologist is mandatory for optimal care of the child with hemoptysis.

Adolescent↗