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Biomedical subjects

W M Belenky

Publications and source records attributed to W M Belenky.

12 recordsLinked to original sources
PubMed1999

Congenital tracheal anomalies in the craniosynostosis syndromes.

The authors present the case of a 12-year-old girl with Pfeiffer's syndrome who underwent successful resection of a tracheal cartilaginous sleeve (TCS) for treatment of sleep apnea. There is growing recognition of the inclusion of TCS in the spectrum of congenital cartilage malformations seen in patients with craniosynostosis (CS) syndromes. This case demonstrates the difficult therapeutic challenge created by the combination of hypopharyngeal and intrinsic airway abnormalities present in CS patients. The early recognition of TCS in these patients may provide the opportunity for improved outcome in this severely affected subgroup of CS patients with otherwise high mortality.

Acrocephalosyndactylia↗
PubMed1998

Phenylephrine and the prevention of postoperative tympanostomy tube obstruction.

OBJECTIVE: To determine the efficacy of phenylephrine hydrochloride, a topical vasoconstrictor, in preventing tympanostomy tube obstruction. DESIGN: Prospective, randomized, double-blind, controlled trial of patients undergoing myringotomy with tympanostomy tube insertion. SETTING: Academic, tertiary referral medical center. PATIENTS: Two hundred eight patients were enrolled in the study; 157 patients (310 ears) returned for postoperative evaluation. INTERVENTIONS: Myringotomy with tympanostomy tube insertion was performed in all ears: 139 control ears received ototopical antibiotics and 171 treatment ears received ototopical antibiotics plus topical phenylephrine. MAIN OUTCOME MEASURE: Postoperative tympanostomy tube obstruction. RESULTS: The overall incidence of tympanostomy tube obstruction was 5.2%: 8.6% in the control group and 2.3% in the treatment group. The treatment group demonstrated an odds ratio of 0.25 (95% confidence interval, 0.08-0.78; P= .02). CONCLUSION: The use of phenylephrine following tympanostomy tube insertion greatly reduces the incidence of tube obstruction.

Adolescent↗
PubMed1997

Unilateral conductive hearing loss secondary to a high jugular bulb in a pediatric patient.

A high jugular bulb is not an uncommon otologic anomaly. It may be noted as an incidental finding on physical exam, middle ear surgery, or computed tomography of the temporal bones. Frequently the patient is asymptomatic, but a high jugular bulb can occasionally cause tinnitus or conductive hearing loss. The case of a seven-year-old black male with unilateral conductive hearing loss secondary to a high jugular bulb is presented. The diagnosis, differential diagnosis, and management of a conductive hearing loss associated with a high jugular bulb are discussed.

Child↗
PubMed1995

The incidence of gastroesophageal reflux in recurrent croup.

The incidence of gastroesophageal reflux in recurrent croup was evaluated by a retrospective analysis of patients at the Children's Hospital of Michigan from 1986 to 1991. Sixty-six patients required hospitalization for recurrent croup during this 6-year period. Of the patients evaluated, 47% with recurrent croup had an additional diagnosis established of gastroesophageal reflux. In patients with three or more hospitalizations for croup, there was a 63% association with gastroesophageal reflux. Compared to all patients with recurrent croup, the patients with gastroesophageal reflux tended to be younger and had a shorter interval between episodes of croup. A prospective series of six cases of recurrent croup was seen in consultation. The diagnostic procedures involving lipid-laden macrophage quantitation, endoscopy, and gastroesophageal reflux scintiscans were utilized to establish the diagnosis of gastroesophageal reflux with tracheal aspiration. The results of these studies and the follow-up is discussed.

Croup↗
PubMed1993

An analysis of the inferior based tracheal flap for pediatric tracheotomy.

In the past, various tracheotomy incisions have been used at the Children's Hospital of Michigan with the occurrence of complications related to accidental decannulation and immediate recannulation. Since that time the inferior based tracheal cartilage flap has been used to minimize early complications. A retrospective study of 126 pediatric tracheotomies performed at the Children's Hospital of Michigan from June 1986 to January 1991 was reviewed. Only tracheotomies performed by a staff otolaryngologist utilizing the inferior based tracheal cartilage flaps were reviewed. This study includes patients with a 6 month to 5 year follow up. The early complication rate was 4%, while the late was 50%. Stomal granulation tissue was comparatively increased in this series of patients but did not hinder decannulation. We consider the use of the inferior based tracheal cartilage flap in the pediatric population a safe and effective technique without increasing the morbidity of long-term tracheotomy.

Airway Obstruction↗
PubMed1993

The enlarged vestibular aqueduct syndrome (EVA syndrome).

The presentation to the Department of Pediatric Otolaryngology at the Children's Hospital of Michigan of a series of patients with sensorineural hearing loss and enlargement of the vestibular aqueduct prompted exploratory tympanotomy in three patients (two unilateral and one bilateral), for a total of four ears. These explorations were prompted by progression and/or fluctuation of hearing levels. The discovery of abnormal round windows in all four ears with a post-traumatic fistula present in one ear suggested the presence of a new association. A previously undescribed association of an enlarged vestibular aqueduct, sensorineural hearing loss and round window abnormality with potential fistula formation was identified. A review of the anatomy and physiology, literature review, and a prospective analysis with discussion of eight patients with enlarged vestibular aqueduct syndrome evaluated and treated at Children's Hospital of Michigan, is presented. We conclude that all children with sensorineural hearing loss should undergo extensive evaluation to determine etiology, including radiographic studies of the temporal bone. Further, the presence of an enlarged vestibular aqueduct should prompt the otolaryngologist to consider the presence of a round window abnormality and the potential for predisposition to perilymph fistula.

Child, Preschool↗
PubMed1992

Postoperative technetium scanning in patients with submandibular duct diversion.

Submandibular duct diversion is a common procedure for refractory sialorrhea in children. The procedure reroutes Wharton's ducts from the floor of the mouth to the tongue base. As the majority of saliva in the resting state is produced by the submandibular glands, rerouting markedly decreases sialorrhea. However, the procedure has been criticized in that diversion may cause fibrosis and stricture of the ducts. The gland would atrophy, and the physiologic functions of saliva would be lost. Glandular function of six patients with cerebral palsy (mean age, 14.7 years) was evaluated by technetium scanning (mean time after surgery, 43 months). Four patients had normal bilateral function; two patients had no function in one gland but normal function in the contralateral gland. We conclude that bilateral submandibular duct diversion maintains long-term function in at least one gland.

Adolescent↗
PubMed1986

Medical problems of the swimmer.

A swimmer is often faced with medical problems such as asthma, epilepsy, skin disease, and external otitis. Adequate management of these conditions is extremely important for optimal performance by the athlete.

Asthma, Exercise-Induced↗
PubMed1980

First branchial cleft anomalies.

A series of nine cases of first branchial cleft anomalies treated at Children's Hospital of Michigan from 1970-1978 is presented. A review of the literature and analysis of these cases reveals that the accepted criteria for classification of these anomalies are confusing and inadequate as they preclude the proper classification of a number of these cases. The embryogenesis of these anomalies is discussed with attention given to their relationship to the facial nerve. A proper classification is suggested.

Adolescent↗