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Biomedical subjects

C M Myer

Publications and source records attributed to C M Myer.

At least 109 records · Page 6Linked to original sources
PubMed1989

Innominate artery compression of the trachea: current concepts.

One common vascular anomaly that causes airway obstruction in neonates and infants is innominate artery compression of the trachea. A great deal of controversy exists regarding the effect of this anatomic variant on symptom production. Several cases are presented that demonstrate the unique features of innominate artery compression of the trachea: 1. Innominate artery compression can occur in adolescent patients. 2. Flow volume loops are an effective method of documenting airway compromise in this condition. 3. Exercise intolerance should be considered as a relative indication for surgical intervention in these patients. 4. Reimplantation of the innominate artery is a viable surgical alternative in the treatment of affected patients. 5. Telescopic bronchoscopy during surgical correction of this condition will ensure that there has been successful correction of the tracheal compression. 6. Urgent repair is advocated in patients who experience periods of apnea.

Adolescent↗
PubMed1989

Congenital nasal pyriform aperture stenosis.

Congenital nasal pyriform aperture stenosis is an unusual and previously undescribed cause of nasal airway obstruction in the newborn. The nasal pyriform aperture is narrowed due to bony overgrowth of the nasal process of the maxilla. This anomaly may produce signs and symptoms of nasal airway obstruction in newborns and infants similar to those seen in bilateral posterior choanal atresia. Computed tomography confirms the diagnosis and delineates the anomaly. A series of six patients with nasal pyriform aperture stenosis is presented. Four patients were treated with surgical enlargement of the nasal pyriform aperture via a sublabial approach. One patient was repaired via a transnasal approach, and one patient did not undergo surgical intervention. Follow-up reveals normal nasal airway and facial growth in all patients. Mildly symptomatic patients with congenital nasal pyriform aperture stenosis may be treated expectantly, while severely symptomatic patients benefit from repair via the sublabial approach.

Airway Obstruction↗
PubMed1989

The child with a tracheotomy: making home care work.

Successful tracheotomy home care in children includes safe care of the child; it should promote the child's normal growth and development, yet minimize deleterious effects to the family's functioning and integrity. Only through cooperation and hard work among all concerned parties can this goal be attained.

Child↗
PubMed1989

Nasal obstruction in the neonate.

At birth, the neonate is an obligate nasal breather and any compromise of the nasal passages is potentially life threatening. It is important for the otorhinolaryngologist to quickly recognize and manage even subtle constrictions or obstructions of the nasal passages in this age group. Many times the nasal airway is disregarded as the source of airway difficulty if small catheters can be passed. Conversely, the inability to pass nasal catheters is often arbitrarily diagnosed as choanal atresia or stenosis. This limited outlook can delay appropriate therapy. The differential diagnosis of nasal obstruction in the neonate is presented wit emphasis on evaluation of nasal obstruction in anatomically normal appearing noses.

Airway Obstruction↗
PubMed1988

Anterior cricoid split, 1977-1987. Evolution of a technique.

Acquired subglottic stenosis is a well-documented complication of endotracheal intubation in infants. In past years, many of these patients required a tracheotomy for a period of years prior to laryngotracheal reconstruction. The anterior cricoid split procedure was developed as a method of treatment for severe laryngeal stenosis in infants and young children without resorting to a tracheotomy. An analysis of our institution's ten-year experience with 67 patients is presented, detailing the changes in surgical technique that have taken place over that time period. This is contrasted with alternative means of cricoid decompression advocated by other surgeons. Our review supports the efficacy of this procedure when there is strict adherence to certain criteria prior to the performance of the operation. Specifically, this operation should be restricted to neonates or young infants whose pathology is limited to the glottis and subglottis or both, and in whom there is adequate pulmonary reserve.

Child, Preschool↗
PubMed1988

Flexible fiberoptic bronchoscopy in the neonatal intensive care unit.

The pediatric otolaryngologist is often asked to evaluate intubated patients in the neonatal intensive care unit (NICU) because of sudden deterioration in respiratory status unresponsive to medical management. Previously, evaluation of infants required transportation to the operating room for rigid endoscopy. At the present time, however, flexible fiberoptic bronchoscopy may be performed on such patients in the NICU as an initial diagnostic or therapeutic measure. The procedure is performed through an endotracheal tube or tracheostomy tube already in place, thereby assuring maintenance of a safe airway. Ten representative cases are presented detailing the indications, technique and potential applications in the NICU.

Bronchoscopy↗
PubMed1988

Vocal cord paralysis following child abuse.

Otorhinologic manifestations of child abuse are infrequently reported in the literature. Three cases of vocal cord paralysis following child abuse are presented. The pathophysiology of vocal cord paralysis is reviewed as it relates to pediatric vocal cord paralysis. Recognition of the possibility of vocal cord paralysis in an abused child who suffers significant head trauma or a strangulation injury is necessary to insure a more rapid diagnosis and initiation of effective therapy more promptly.

Airway Obstruction↗
PubMed1988

Nasal presentation of an intracranial vascular anomaly.

Intracranial vascular anomalies uncommonly present as a nasal mass. We report the first documented intranasal extension of a venous angioma of the anterior and middle cranial fossas. The diagnostic evaluation and differential diagnosis of an intranasal vascular mass is emphasized. In addition, recommendations are offered regarding the surgical approach of such a lesion.

Diagnosis, Differential↗
PubMed1988

Airway reconstruction following laryngotracheal thermal trauma.

Care of burn patients is a complex problem for the trauma team involving management of fluid and electrolyte imbalances, infections, and ultimately reconstruction. Patients with burns of the head, neck, and upper thorax present a series of unique problems because of a high incidence of associated upper and lower airway thermal trauma necessitating intubation and ventilatory support. A series of cases requiring laryngotracheal reconstruction following severe burns to the head and neck region is reported. Methods of treatment are discussed as well as modifications of standard burn therapy to decrease the incidence of severe scarring.

Burns, Inhalation↗
PubMed1988

The role of a hearing impaired clinic in pediatric otology.

The diagnosis and management of hearing impairment in children is most effectively accomplished through the cooperative efforts of a team of skilled professionals. At Children's Hospital Medical Center, Cincinnati, Ohio, patients who are identified with a sensorineural hearing loss (SNHL) are referred to the Hearing Impaired Clinic for evaluation and therapy. The clinic functions under the supervision of a nurse coordinator and includes representatives from pediatric audiology, pediatric otolaryngology, educational audiology, social services, speech pathology and psychology. Consultative services which are frequently employed are neurotology, human genetics and neuroradiology. An overview of our institution's experience with this system is presented.

Child↗
PubMed1987

The use of a portable capnometer as a tracheostomy monitor in an animal model.

Home care of a tracheostomy patient in the pediatric age group is a challenging problem. Accidental decannulation is always a potential hazard in children with tracheostomies. The most effective monitoring system in these individuals is an experienced, alert observer. Unfortunately, caretakers cannot be expected to provide constant surveillance. Because of this, various types of mechanical monitoring systems have been developed for patients with tracheostomies. An animal model was employed to investigate the reliability of a portable capnometer in assessing the status of a tracheostomy tube under varying experimental conditions. The capnometer was found to be a reliable tool and it will now be evaluated in the clinical setting.

Animals↗
PubMed1987

Efficacy of tonsillectomy and adenoidectomy as an outpatient procedure: a preliminary report.

One of the recent trends in medical practice has been the use of ambulatory surgery for a substantial number of surgical procedures. A prospective evaluation of tonsillectomy and tonsillectomy with adenoidectomy as outpatient procedures at the Children's Hospital Medical Center in Cincinnati, OH, is reported. Patients who were felt to be inappropriate candidates for adenotonsillectomies as outpatients included patients under 3 years of age, patients who lived more than one hour from the hospital and patients who demonstrated obstructive sleep apnea or who had other significant medical problems. A review of this 9-month experience indicates that outpatient surgery for adenotonsillectomy is both safe and cost-effective in most circumstances. In an analysis of complications requiring readmission to the hospital (bleeding, dehydration, poor social situation), patients who had their original surgery performed on an ambulatory basis had no more complications than patients who were hospitalized following their surgery. Excluding the professional fees for the surgeon and anesthesiologist, a savings of approximately 50% can be expected from the performance of a tonsillectomy and adenoidectomy on an outpatient basis.

Adenoidectomy↗