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Biomedical subjects

A D Meyers

Publications and source records attributed to A D Meyers.

At least 19 recordsLinked to original sources
PubMed1991

Nasolacrimal obstruction after inferior meatus nasal antrostomy.

Transient epiphora following rhinoplasty or intranasal procedures is a common occurrence. Permanent nasolacrimal duct obstruction, however, is rare. This article documents four cases of nasolacrimal duct obstruction following intranasal antrostomy. Three patients were cured by dacryocystorhinostomy and a fourth refused surgery. The anatomy of the nasolacrimal duct in the inferior meatus has considerable variation. Although the duct typically opens in the inferior meatus immediately under the insertion of the inferior turbinate, the orifice can be a single hole, a slit, multiple holes, or a trough, and can be located anywhere from 30 to 40 mm dorsal to the anterior nares. We review the embryology and anatomy of the nasolacrimal orifice in the nose and make recommendations for safe surgery in the inferior meatus.

Adult↗
PubMed1991

Autologous fat injection for vocal cord medialization in the canine larynx.

This study examined the use of autologous fat as an alternative to Teflon and collagen as the implantable material in vocal cord medialization. Five animals underwent left recurrent laryngeal nerve sections with subsequent fat harvest and implantation into the left true vocal cords. Three animals were killed after 48 hours and 2 after 3 weeks; their larynges were examined with light microscopy. The results of the 48-hour samples show mode-rate acute inflammation and few areas of focal necrosis. The 3-week samples show no necrotic foci, minimal foreign-body reaction, and maintenance of structure and volume of the injected fat. Autologous fat may prove to be a valuable alternative to nonautologous injectable material in vocal cord augmentation.

Adipose Tissue↗
PubMed1991

The intraoperative management of the thyroid gland during laryngectomy.

The standard of care of laryngeal cancer surgery is wide field excision of the larynx combined with ipsilateral thyroid lobectomy. A retrospective review of 247 laryngectomies performed between 1979 and 1989 was undertaken to determine specific intraoperative indications for thyroid gland removal. The incidence of thyroid disease in our patients with laryngeal cancer was compared to the normal population. Eight percent of thyroid specimens removed during laryngeal cancer surgery demonstrated invasion by squamous cell carcinoma. All patients having thyroid invasion had T3 or T4 laryngeal lesions that were stage IV at the time of surgery. All these lesions were found to have transglottic growth and laryngeal cartilage invasion by the pathologist. All of these patients also had abnormal thyroid glands intraoperatively and laryngeal cartilage destruction that was evident intraoperatively. Total thyroidectomy with bilateral paratracheal and pretracheal lymph node dissection is indicated when squamous cell carcinoma of the larynx involves the thyroid gland. Prophylactic ipsilateral thyroid lobectomy and isthmusectomy is warranted for large laryngeal cancers (T3, T4) that involve the anterior commissure, the subglottic area, or extend transglottically. Routine thyroid gland removal is not indicated for the majority of laryngeal cancers that do not meet the aforementioned criteria. Finally, abnormal thyroid histopathology was diagnosed in 37% of the surgical thyroid gland specimens removed during laryngectomy.

Adenocarcinoma↗
PubMed1991

Cystic ameloblastic fibroma.

A seven-year-old white male presented with an enlarging mass in the mandible which was a cystic ameloblastic fibroma. This case, the third reported in the literature, demonstrated several unusual histopathologic findings and presented several controversies in management.

Child↗
PubMed1990

Laser reimbursement: who pays for progress?

Leland Kaiser, a noted health care futurist, asserts that, to the degree to which medical technology can improve human life, there is no limit. Likewise, there is no limit to the amount of money people will be willing to spend on this technology. The ASLMS is at the focal point of the debate and needs to make its voice heard clearly based on a well thought out plan, based on reliable data, and considerate of the various economic, social, legal, and ethical constraints placed on the practicing clinician. If we don't take hold of the process, the technological imperative will quickly overwhelm us.

Insurance, Health, Reimbursement↗
PubMed1985

A prospective study of preoperative chemotherapy and split-course irradiation for locally advanced or recurrent oral/pharyngeal squamous carcinoma.

Two courses of preoperative chemotherapy (methotrexate, bleomycin, cisplatin) were combined with split-course irradiation (2,000 rad/10 preop., 4,000 rad/20 postop.) and prospectively compared with standard therapy (surgery and/or irradiation alone) for locally advanced or recurrent oral/pharyngeal squamous cancer. The chemoradiotherapy arm (Ch-XRT) had 31 patients; the standard therapy arm 28 randomized (RC) and 20 concomitantly-treated (CC) patients. Treatment-related mortality was 17% for Ch-XRT; 10% for RC + CC. Number of patients NED at completion of treatment was 74% for Ch-XRT; 83% for RC + CC (NS). Median survival, however, was 17 months for Ch-XRT, 9 months for CC, and 12 months for RC. In addition, survival at 40 + months was 45% for Ch-XRT versus 21-22% for RC and CC (p less than 0.05). Thus, Ch-XRT seems to have promise in advanced oral/pharyngeal cancer, but needs revision to decrease toxicity.

Aged↗
PubMed1978

Hypopharyngeal perforations in neonates.

Hypopharyngeal perforations in the neonate have rarely been reported, although such a disorder may be a more common occurrence than suspected. The optimal therapy is controversial. A case is presented in which instrumentation of the upper airway led to a transmural hypopharyngeal perforation in a naonate. The infant did well with conservative therapy. The early recognition of hypopharyngeal lacerations is of great importance. When the correct diagnosis is made, the condition of infants with pseudodiverticulum of the hypopharynx can be managed successfully without surgery.

Diverticulum↗
PubMed1978

Capillary hemangioma of the tympanic membrane.

Hemangiomas of the tympanic membrane are extremely rare. We present the third reported case and, to our knowledge, the first capillary hemangioma of the tympanic membrane. These deep purple polypoid tumors are asymptomatic while small but enlarge slowly to erode adjacent structures. They arise characteristically from the lamina propria of the tympanic membrane without involving the middle ear. Early recognition permits simple excision with preservation of the lamina propria, avoiding the need for tympanic membrane resection and reconstruction.

Ear Neoplasms↗
PubMed1977

Managing cerumen impaction.

The external auditory canal is self-cleaning. Excessive cerumen accumulation usually results from misguided attempts to remove wax and may go unnoticed until a hearing loss occurs. Mechanical removal of the wax or use of a ceruminolytic agent to soften it is recommended--irrigation may contaminate the middle ear space.

Cerumen↗
PubMed1977

Olfaction.

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Humans↗