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Biomedical subjects

V V King

Publications and source records attributed to V V King.

5 recordsLinked to original sources
PubMed1995

Management of sinusitis in cystic fibrosis by endoscopic surgery and serial antimicrobial lavage. Reduction in recurrence requiring surgery.

OBJECTIVE: An effective treatment program for refractory chronic sinusitis in patients with cystic fibrosis has not been achieved. We developed a long-term management approach by combining endoscopic surgery with serial antimicrobial lavage (ESSAL). DESIGN: In a before and after trial, results of ESSAL in 32 patients were compared with those of conventional sinus surgery without serial antimicrobial lavage in 19 patients. At least 1 year follow-up was available in all but one patient. SETTING AND PATIENTS: Patients attending the Stanford (Calif) Cystic Fibrosis Center were consecutively referred for otolaryngologic evaluation for symptoms and signs of refractory sinusitis. Those subjects who were evaluated before 1990 were treated conventionally and afterward by ESSAL. INTERVENTION: Conventionally treated patients underwent one or more of the following procedures: polypectomy, ethmoidectomy, antrostomy, or Caldwell-Luc operation. The ESSAL approach incorporated preoperative rhinosinuscopy and computed tomography, endoscopic surgery, a postoperative course of antral antimicrobial lavage, and monthly maintenance antimicrobial lavage via brief antral catheterization. MAIN OUTCOME MEASURE: Intensity and frequency of sinus surgery after initial presentation. RESULTS: The two groups were similar demographically and in clinical presentation, including the presence of nasal polyposis in 34% and 42%, respectively. The ESSAL group had fewer operations per patient, Caldwell-Luc procedures, and a decrease in repeated surgery at 1-year (10% vs 47%) and 2-year (22% vs 72%) follow-ups. CONCLUSION: The ESSAL is a successful approach to treatment of sinusitis in cystic fibrosis that reduces recurrence requiring further surgery for at least 2 years.

Adolescent↗
PubMed1991

Method for rapid evaluation of topically applied agents to cystic fibrosis airways.

The proposal is to target a single maxillary sinus for treatment with agents designed to reverse or ameliorate the cystic fibrosis (CF) defect in airway mucosa, with the opposite sinus serving as a control. Selected CF patients have undergone maxillary antrostomy and antibiotic lavage to help relieve severe pulmonary disease and chronically impacted and infected sinuses. After treatment, the mucosa in the maxillary sinuses of these patients are accessible and can be bathed with fluids introduced via the stomas with procedures that restrict the fluid to a single sinus. The ability of an agent to reverse mucosal pathology can therefore be determined easily with the mucosa of the contralateral sinus serving as a control. Electrophysiological properties, amounts and composition of fluid and mucus, immune functions, and bacterial colonization can be measured accurately and repeatedly. The consistent observation that sinus involvement in CF is near universal and bilaterally symmetric offers a unique opportunity for a simultaneous within-subject, double-blinded control paradigm. This approach should speed evaluation of any agent designed to improve airway mucosal function.

Administration, Topical↗
PubMed1990

Sinus disease in patients with severe cystic fibrosis: relation to pulmonary exacerbation.

Four adult cystic fibrosis patients were selected for aggressive surgical management of sinus disease on the basis of severe pulmonary involvement, high frequency of hospital admission, chronic headache, and wheezing unresponsive to conventional treatment. They underwent bilateral Caldwell-Luc procedure with perioperative anti-Pseudomonas antimicrobials. There were substantial improvements in headache and respiratory symptoms and a significant reduction in the frequency of hospital admission after the operation. These findings suggest that sinus disease is associated with pulmonary exacerbation in patients with cystic fibrosis, and strengthens a similar observation in patients with asthma.

Adolescent↗
PubMedDate not supplied

Alveolar soft part sarcoma of the tongue.

Alveolar soft part sarcoma is a rare malignancy. To our knowledge, 13 cases in the head and neck have been reported previously. It occurs more commonly in the extremities, where it is associated with a poor prognosis. Its clinical course resembles that of adenoid cystic adenocarcinoma in that late metastases often cause death in 10 to 15 years. A 5-year-old girl with alveolar soft part sarcoma was successfully treated with partial glossectomy and is free of disease at two-year follow-up.

Child, Preschool↗