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Biomedical subjects

A B Seid

Publications and source records attributed to A B Seid.

At least 37 records · Page 2Linked to original sources
PubMed1992

Tongue gastric choristoma: failure to localize by technetium-99m pertechnetate scan.

Congenital rests of gastric epithelium have been reported in a variety of head and neck locations. Presenting symptoms of these lesions range from an asymptomatic cyst to one which is compromising the airway. The true diagnosis is rarely suspected prior to excision. A case of a gastric choristoma of the tongue is presented which was noted at birth as an intermittently bleeding ulcer. Complete excision of the mass was difficult to ascertain due to poor delineation of the tumor margins from the tongue musculature. A postoperative technetium-99m pertechnetate scan failed to demonstrate residual gastric mucosa. Conservative management resulted in only transient healing of the ulcer. Repeat excision demonstrated abundant residual gastric mucosa. Technetium-99m pertechnetate scanning may not be a reliable indicator of ectopic gastric mucosa in the head and neck region.

Choristoma↗
PubMed1992

Pediatric airway manifestations of gastroesophageal reflux.

Gastroesophageal reflux (GER) in children may be classified as physiologic or pathologic, depending on its degree and consequences. There are many head and neck complications of GER in pediatric patients, but most numerous are the airway manifestations, including stridor, recurrent croup, exacerbation of subglottic stenosis, laryngeal irritation with or without laryngospasm, chronic cough, and obstructive apnea. Diagnosis may be difficult unless there is a high index of suspicion for GER and awareness of the concept of "silent" GER. We present the common pediatric airway manifestations of GER, illustrated by case reports, and provide a paradigm to assist in the diagnosis and management of children with airway compromise associated with GER.

Airway Obstruction↗
PubMed1991

One-stage laryngotracheoplasty.

This article documents the evolution of our approach to the repair of subglottic stenosis in infants. With increasing experience in the management of subglottic stenosis using the anterior cricoid split procedure, we extended our procedure to include older children. This then led to the use of the one-stage procedure for repair of severe and mature subglottic stenosis. We present the results of surgical repair in 13 patients. Extubation was accomplished in 12 of 13 patients using one-stage laryngotracheoplasty.

Child↗
PubMed1991

The prognostic value of endotracheal tube-air leak following tracheal surgery in children.

In an effort to determine if the endotracheal tube-leak pressure has prognostic value in relation to a successful outcome after one-stage laryngotracheal reconstruction or cricoid split surgery, a retrospective analysis was performed on 17 children who had undergone such surgery. The daily leak pressures, length of intubation, and ultimate outcome of attempts at extubation were noted. One hundred percent of patients with a leak pressure of less than 20 cm H2O on the day before extubation were successfully extubated. In contrast, the failure rate was 100% in children extubated with a leak of greater than 30 mm H2O. The difference between these two groups was statistically significant (chi 2, 13.03). Sixty percent of patients with leak pressures in the range of 21 to 30 cm H2O were successfully extubated. The endotracheal tube-leak pressure is a parameter that has prognostic value, and should be considered in determining when to extubate children who have undergone tracheal reconstructive surgery.

Airway Obstruction↗
PubMed1991

Actinomycosis in obstructive tonsillar hypertrophy and recurrent tonsillitis.

A quantitative analysis of adenoid and tonsillar specimens from 460 patients was performed. The patients underwent tonsillectomy or adenotonsillectomy for either recurrent tonsillitis or obstructive tonsillar hypertrophy. Histologic preparations revealed Actinomycetes as statistically more prevalent in the obstructive population. The presence of Actinomycetes in the adenotonsillar core of this diagnostic group may indicate an etiologic role for this organism in tonsillar and adenoidal hypertrophy.

Actinomycosis↗
PubMed1991

The open surgical approach to subglottic hemangioma.

The management of subglottic hemangioma in infants remains controversial. We report two patients in whom an open surgical approach was utilized to completely excise the subglottic hemangioma. Both children have been successfully extubated and have remained symptom-free since that time.

Child, Preschool↗
PubMed1991

Closure of the soft palate for persistent otorrhea after placement of pressure equalization tubes in cleft palate infants.

Four case reports of infants with cleft palate and intractable otorrhea following the placement of pressure equalization tubes are presented. In one patient, liquids taken orally were noted to reflux through her ears. Otorrhea was refractory to medical management in all cases and was controlled only after closure of the soft palate. Persistent otorrhea may be an indication for early closure of the soft palate in these infants.

Cleft Palate↗
PubMed1991

Current concepts in pediatric adenotonsillar disease.

More objective thinking regarding the indications for adenotonsillar surgery has gained new respect for these operations. Better understanding of the implications of adenoid disease in chronic otitis and sinusitis, along with appreciation of obstructive airway problems secondary to adenotonsillar hypertrophy, has changed the scope of the operation. Research is ongoing to determine the etiology of chronic antigenic stimulation as a cause for hypertrophy of these organs.

Adenoidectomy↗
PubMed1990

The otolaryngologic manifestations of Pelizaeus-Merzbacher disease.

Pelizaeus-Merzbacher disease is a condition of central nervous system dysmyelination. We describe a familial series in which both otologic and laryngologic abnormalities were present. The diagnosis of this invariably fatal disorder can be made on a clinical and/or pathologic basis. As the otolaryngologic manifestations are often the first to appear, the consulting head and neck surgeon may be essential in the initial diagnosis of this hereditary disease.

Audiometry, Evoked Response↗
PubMed1990

Do angiomas of the nasal septum exist?

Juvenile nasopharyngeal angiofibromas (JNA) by definition originate in the nasopharynx. Vascular tumors arising in the nasal cavity can easily be mistaken for JNA, when the correct diagnosis is hemangioma or angiofibromatous polyp. We present a case that illustrates this problem, an 11-year-old boy with a unilateral anterior nasal cavity mass associated with recurrent epistaxis. At surgery, the mass was found to arise from the anterior nasal septum and was removed easily with minimal bleeding. The initial pathologic interpretation was JNA. After extensive review of the specimen, however, the diagnosis of hemangioma was made. Similar tumors have been reported as being JNA that have been simple to remove with minimal blood loss. JNA is associated with more severe blood loss, is more difficult to expose surgically and has a higher risk of recurrence than other nasal tumors. Therefore, JNA needs to be distinguished from anterior nasal cavity masses.

Child↗
PubMed1990

Catheterization of branchial sinus tracts. A new method.

The complete surgical extirpation of branchial cleft abnormalities is essential in avoiding recurrent disease. The most technically difficult maneuver is often the localization and excision of associated sinus tracts and fistulae. The authors communicate a simple yet effective technique for dealing with this difficulty utilizing the Fogarty embolectomy catheter.

Branchioma↗
PubMed1990

Early home management of patients with Pierre Robin sequence.

Robin Sequence is a well-described disorder with a reported incidence of 1 in 2000 births. It is characterized by glossoptosis and micrognathia often associated with a cleft palate. Respiratory obstruction at the level of the tongue occurs in many affected children. Prior to routine intensive care unit management, it was the primary factor in the mortality reported in patients with moderately severe to severe deformity. Treatment of this obstruction is controversial and may include a long stay in an intensive care setting. We report two cases that demonstrate properly placed and constructed nasopharyngeal tubes allow a non-surgical treatment with early discharge of the patient and without the risks and morbidity of surgery or the complications of tracheostomy.

Airway Obstruction↗
PubMed1990

Fourth branchial pouch sinus: principles of diagnosis and management.

The fourth branchial pouch sinus is a congenital anomaly which most frequently manifests itself by recurrent episodes of neck abscess or acute suppurative thyroiditis. This lesion usually becomes symptomatic before the age of 10 years and is more common than has previously been suspected. It has been found on the left side in 93% of the 28 cases reported in the English literature. Barium swallow during periods of quiescence and nasopharyngoscopy have frequently been successful in identifying the presence of these embryological remnants. Definitive therapy consists of total excision of the sinus tract, which can be facilitated by direct endoscopic placement of a Fogarty catheter into the sinus lumen before surgical exploration. The embryological basis for the occurrence of these sinuses is discussed.

Branchioma↗
PubMed1990

Surgical therapy of obstructive sleep apnea in children with severe mental insufficiency.

Obstructive sleep apnea is the underlying cause of a variety of pediatric maladies, including pulmonary hypertension and failure to thrive. In children, unlike adults, obstruction secondary to lymphoid hyperplasia is often encountered; adenotonsillectomy restores airway patency. Patients who fail this procedure, such as children with cerebral palsy and associated muscular hypotonia, may face tracheotomies. We report on 10 pediatric patients with severe mental insufficiency and obstructive sleep apnea in whom palatal hypotonicity and lack of adenotonsillar hypertrophy was identified. Uvulopalatopharyngoplasty was performed in conjunction with adenotonsillectomy to enlarge the diameter of the nasopharyngeal inlet with successful resolution of the obstructive symptoms in eight patients. The remaining two children required more surgery. This procedure is presented as a possible alternative to tracheotomy in selected patients.

Child↗
PubMed1990

Cervicofacial mycobacterial adenitis in children: endemic to San Diego?

Nontuberculous mycobacteria (NTM) are an important cause of cervicofacial lymphadenitis in children. A dramatic increase has been seen in confirmed cases of NTM lymphadenitis in San Diego in the past few years. This report encompasses a span of 2 years 9 months, during which 22 children had confirmed NTM infection and another 14 had necrotizing granulomatous lymphadenitis in whom the specific diagnosis of NTM could not be made. This apparent increase in the prevalence of NTM as compared to previous reports in the literature suggests a possible endemic risk for NTM in the San Diego area. These cases are reviewed and our diagnostic and surgical approach to possible NTM infection is described. We also discuss possible explanations for the increasing occurrence of NTM in the San Diego area.

California↗
PubMed1989

Actinomycosis of the middle ear.

Actinomycosis is an uncommon infection of the middle ear. Only 21 cases of actinomycosis of the middle ear have been reported in the English literature prior to this paper. The offending organism is Actinomyces israelii, which is an anaerobic, filamentous organism that is difficult to grow in culture. The infection is chronic and is seldom diagnosed prior to tympanomastoidectomy. The identification of small, yellow, glue-like masses, which are called sulfur granules, is often the key to making the diagnosis of actinomycosis of the middle ear. Following tympanomastoidectomy, penicillin is given orally for 3-6 months.

Actinomycosis↗