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Biomedical subjects

S G Selkin

Publications and source records attributed to S G Selkin.

18 recordsLinked to original sources
PubMed1989

Rhinoplasty and general anesthesia. Halothane vs enflurane as agent of choice.

In 500 rhinoplasties, infiltration of 1% lidocaine (Xylocaine) hydrochloride with epinephrine chloride (Adrenalin) 1:100,000 was used in combination with inhalation of halothane (Fluothane) or enflurane (Ethrane). Three arrhythmias requiring treatment occurred when halothane was used. No arrhythmias occurred with the use of enflurane. No complications from anesthesia were observed. No patient had laryngospasm. Bleeding was comparable with that which occurs when infiltration anesthesia is used with intravenous sedation. Enflurane is therefore the inhalation agent of choice for use with 1% lidocaine with epinephrine 1:100,000 for rhinoplasty. Clinical methods and guidelines for safety are set forth with special consideration for the in-office surgical suite.

Adolescent↗
PubMed1986

Pitfalls in intranasal laser surgery and how to avoid them.

My experience with 250 intranasal laser surgical procedures performed with the carbon dioxide laser and the surgical microscope are described. Procedures include excision and vaporization of polyps, turbinates, tumors, telangiectasias, synechiae, nasal stenoses, intranasal cysts, papillomas, and septal spurs. Avoidance of technical problems is emphasized in this article since intranasal laser surgery is, in some respects, difficult to perform. Included are practical suggestions about patient positioning, use of protective devices, and patient selection.

Granuloma↗
PubMed1986

Routine use of office endoscopy in otolaryngology.

A skilled endoscopist using a flexible fiberoptic nasopharyngolaryngoscope can complete a thorough examination of the upper aerodigestive tract in less time than it takes to heat up a laryngeal mirror. The examination is accomplished with only minimal discomfort for the majority of patients. Consistently clear photographs may be made of the physical findings. The yield, in terms of disease demonstrated and documented, well justifies the routine use of the flexible fiberoptic nasopharyngolaryngoscope on virtually every patient seen for otolaryngologic evaluation. I shall present sixteen examples of pathosis of the upper aerodigestive tract that were overlooked by the traditional means of otolaryngologic examination. All were discovered by the "routine" use of flexible fiberoptic endoscopy. Seven malignant conditions are included.

Adolescent↗
PubMed1986

Photodocumentation of laser microsurgery: preoperative, intraoperative, and postoperative techniques for still and video photographs.

Photodocumentation of preoperative, intraoperative, and postoperative findings serves to enhance and complement the study of normal and pathologic anatomy and physiology. Such documentation is invaluable for the teaching of medical students, physicians in the same or in other specialties, and allied health personnel. A surgeon may review and refine surgical technique, and colleagues around the world may study the situation from the same vantage point after surgery has been completed. Referring physicians may be kept graphically informed of the findings and progress of their patients. With the development of such modern technologies as laser microsurgery, an objective means of assessing ablation of disease and healing of surgical wounds is now available, and many of the extravagant claims of "no bleeding, and no edema during or after surgery" may be confirmed or refuted. I shall describe techniques for endoscopic examination and photodocumentation of the ears, anterior and posterior nares, nasopharynx, hypopharynx, and larynx in the preoperative, intraoperative, and postoperative patient. Techniques for obtaining high-quality color transparencies and color and sound videotapes will be presented. Equipment is simple and relatively inexpensive, and no special knowledge of photography is required. Examples of benign and malignant disease of the ears, nose, nasopharynx, and larynx will be shown before, during, and at regular intervals after microsurgery with the CO2 laser.

Endoscopy↗
PubMed1985

Laser turbinectomy as an adjunct to rhinoseptoplasty.

One hundred two inferior turbinectomies were done with the carbon dioxide laser as an adjunct to rhinoseptoplasty. Indications for surgery were airway obstruction on one or both sides not relieved by medical means (42 cases), patient inability to tolerate medication (36 cases), and patient unwillingness to continue to receive medication for prolonged periods (24 cases) in patients unhappy with their appearance. Pathologic processes included allergic rhinitis (34 cases), vasomotor rhinitis (28 cases), and rhinitis medicamentosum (40 cases). A newly designed suction speculum provided easy access to the internal nose and protected the alar rim and the face from laser energy. Only a few minutes of extra operating time were required. Relief of obstruction was comparable to that obtained from cryosurgery, submucous resection of the turbinate, and partial turbinectomy. Intraoperative and postoperative bleeding was less with laser turbinectomy than with any other means.

Adolescent↗
PubMed1985

Clinical use of the pediatric flexible fiberscope.

Office examination of the ears, nose, nasopharynx, hypopharynx, and larynx of the child has been simplified with the advent of flexible fiberoptic nasopharyngolaryngoscopes. The superior optics of recent generation fiberscopes permit excellent visualization of these structures for both diagnosis and assessment of the efficacy of medical and surgical treatment. The Machida ENT-3L pediatric model has a distal tip diameter of 3.3 mm, making it the narrowest standard production fiberscope available in the U.S.A., and is totally waterproof. The author reviews a large clinical experience with the Machida ENT-3L and compares it with the Machida ENT-4L (standard adult), and the Olympus ENF-P models. Comparisons will be made of the optics, ease of passage through the upper aerodigestive tract of younger and older children, ease of handling, and ability to permit taking endoscopic photographs (both still and video).

Adolescent↗
PubMed1985

Mucocele of the ethmoid sinus.

A 15-year-old female was evaluated for pain in the region of the right medial canthus and increasing exophthalmos. She had been diagnosed as having pseudo-tumor of the right orbit when she was 8 years old. The diagnosis was sustained until a second ophthalmologist requested a CT scan which demonstrated a mucocele of the right ethmoid sinus. Intranasal endoscopy revealed medial bulging of the right middle turbinate and meatus. Following a right external ethmoidectomy the eye returned to its normal position and pain disappeared. She has been asymptomatic for the past 4 years.

Adolescent↗
PubMed1984

Kinelaryngoscopy for documentation of laryngeal pathophysiology.

Viewing the larynx has been revolutionized by the advent of the flexible fiberoptic nasopharyngolaryngoscope. For the first time a subject may inspire, expire, cough, swallow, phonate sounds, words, sentences, passages, and sing in full voice as examination and photodocumentation procede. Combining the flexible fiberoptic nasopharyngolaryngoscope with a home video camera, a standard fiberoptic light source, a standard videotape recorder, and a standard color TV set, the author details a method for the production of color and sound videotapes of the larynx in action. The video images are of excellent quality, and may be made in straightforward and economical manner. In fact, the entire array of instrumentation, including the flexible fiberoptic nasopharyngolaryngoscope, light source, video camera, lens, adapter, camera mount, videotape recorder, and TV set may be purchased for significantly less than the cost of the camera that most physicians use for endoscopic photography. The concept of flexible fiberoptic examination of the larynx and videophotodocumentation of the larynx in respiratory, sphincteric, and phonatory action shall be referred to as "kinelaryngoscopy."

Adolescent↗
PubMed1984

Endoscopic photography of the ear, nose, and throat.

The ability to view and photograph the ears, nose, nasopharynx, hypopharynx, and larynx has been revolutionized by the advent of the flexible fiberoptic nasopharyngolaryngoscope. For the first time the otolaryngologist has a one-instrument capability for examination and photodocumentation of the structures with which the specialty deals. This should not imply that the conventional means of examination should be relegated to museums, but rather that a new instrument has been added to the diagnostic armamentarium. The real visual images may be readily adapted for photography. The author will detail a straightforward and inexpensive method for obtaining high quality color transparencies, and color and sound video tapes.

Adult↗
PubMed1984

Other clinical applications of flexible fiberoptic endoscopy.

The recent advent of the flexible fiberoptic nasopharyngolaryngoscope has revolutionized the ability to examine the ear, nose, nasopharynx, and larynx. Although several instruments have been available to the otolaryngologist for examination of these structures, none has been so universal in terms of ease of use and adaptability for photography. This article describes the versatility and practicality of flexible fiberoptic endoscopy with photodocumentation in clinical otolaryngologic practice.

Fiber Optic Technology↗
PubMed1983

Flexible fiberoptics and pediatric otolaryngology. A simple technique for examination and photodocumentation.

Examination of the ears, nose, nasopharynx, hypopharynx, and larynx has been dramatically altered by the advent of flexible fiberoptic devices. The stunningly clear real visual images may be readily adapted for photography. Using a standard flexible fiberoptic nasopharyngolaryngoscope and standard light sources, standard cameras, and standard photographic processing, the author details a simple method for examination and photodocumentation in pediatric otolaryngology. Color transparencies, color prints, and color and sound videotapes may be produced which are consistently clear, color balanced, and have good depth of field.

Adolescent↗
PubMed1983

The nasopharynx and serous otitis. A new technique for examination and photodocumentation.

The flexible fiberoptic nasopharyngolaryngoscope provides a one-instrument means of examining and of photodocumenting the tympanic membrane and the nasopharynx. No special knowledge of photography is required and the equipment is relatively inexpensive. No sedation, no topical anesthesia, and no palatal retraction devices are used. This allows the function of the velum and the tubal orifices to be studied in their natural state. Color transparencies of high quality may be made consistently.

Fiber Optic Technology↗
PubMed1983

The otolaryngologist and flexible fiberoptics: photographic considerations.

The ability to document normal and pathological anatomy is of paramount concern to all medical and surgical practitioners. Until recently the otolaryngologist was forced to resort to the use of clumsy and expensive procedures, frequently requiring the use of general anesthesia in order to obtain endoscopic photodocumentation. The author describes a simple technique, using standard flexible fiberoptic nasopharyngolaryngoscopes, standard light sources, and standard photographic processing which enable the otolaryngologist to obtain high quality transparencies and prints of the tympanic membrane, the internal nose (anterior and posterior), the nasopharynx, the hypopharynx, and the larynx.

Adult↗