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Biomedical subjects

S L Liston

Publications and source records attributed to S L Liston.

12 recordsLinked to original sources

Intracranial abscesses with behavioral changes.

Intracranial abscesses represent one of the most serious complications of ear and paranasal sinus infections. The infection may spread by bone erosion, preformed pathways, or septic thrombosis via the Haversian canals. This may result in subdural abscesses, meningitis, or intracerebral abscesses. These intracranial complications are associated with a high morbidity. The purpose of this communication is to emphasize that behavioral changes after ear or paranasal sinus infections may be a manifestation of an intracranial abscess.

Adult

Pedunculated pharyngeal lesions.

Dentists enjoy a unique position in the health care field because they examine and treat more intraoral disease than any other specialty. It is, therefore, the responsibility of the dentist to examine the entire oral cavity and not just the teeth. Thorough intraoral examination may reveal undiagnosed pathological lesions which arise outside the oral cavity but are pedunculated and present in the mouth or oropharynx. The article presents three cases of such lesions which are potentially life threatening but may be cured if detected and treated early.

Adenocarcinoma

Traumatic injuries in the parotid region.

The facial nerve, parotid duct, and external ear canal are at risk from penetrating injuries in the parotid region. The areas of the face supplied by the major branches of the facial nerve should be checked in the emergency department so that repair of a cut nerve can be performed while the distal end is able to be stimulated electronically. The parotid duct can be probed and lacerations repaired. The external ear canal should be repaired and stented to prevent stenosis.

Ear, External

Rhinolith: unusual appearance on panoramic radiograph.

This case report describes an unusual radiopaque lesion that was an incidental finding on a routine panoramic radiograph. The location of the rhinolith gave it the appearance of being within the maxillary sinus. The position of any lesion seen on a panoramic radiograph should be confirmed by other radiologic studies.

Adult

Radical neck dissection after prosthetic repair of carotid artery.

A carcinoma of the pyriform fossa developed ten years after a Teflon patch graft angioplasty of the common and internal carotid vessels. The graft was embedded in fibrous tissue and covered by pseudoadventitia, which could be dissected free without difficulty. If radiation therapy is used, it should be administered postoperatively. The Teflon graft can be protected from possible salivary fistulae by a dermal graft that is covered by a levator scapulae muscle flap, which is sutured to the prevertebral fascia to separate the carotid vessels from the pharynx, but it is not recommended that the tumor resection be staged to achieve this carotid protection.

Blood Vessel Prosthesis

Hypercalcemia and head and neck cancer. Bony metastases from tongue cancer.

Hypercalcemia causes lethargy and coma in patients with head and neck cancer. It is important to realize that coma may be due to hypercalcemia and need not be a terminal event in the progress of the tumor. Also, the development of hypercalcemia in a previously normocalcemic patient requires investigation as to the cause of the hypercalcemia. I report two cases of comatose patients, hypercalcemic from bony metastases from tongue cancer, in whom treatment by furosemide and intravenous fluid diuresis, prednisone, sodium phosphate, and mithramycin produced worthwhile remissions. Hypercalcemia may be due to (1) bony metastases, (2) pseudohyperparathyroidism, (3) unrelated associated parathyroid tumors, or (4) a second primary tumor. Even with treatment, hypercalcemia is a bad prognostic sign in patients with head and neck cancer.

Bone Neoplasms

External ear injuries.

The unique shape of the external ear depends on the underlying cartilaginous framework. Injuries of the external ear are common. In dealing with lacerations, subperichondrial hematomas, perichondritis, burns and frostbite, particular care should be taken to maintain the cartilaginous framework and to prevent infection. In this way cosmetic deformities of the external ear can be prevented.

Burns

Claudication on mastication following bilateral external carotid ligation.

Ligation of both external carotid arteries to control epistaxis can produce a decrease in the blood supply of the muscles of mastication sufficient to cause pain typical of claudication while chewing. We report 3 cases of this complication. We advocate that this procedure be used only in special circumstances.

Adult