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Biomedical subjects

C M Stiernberg

Publications and source records attributed to C M Stiernberg.

At least 37 records · Page 2Linked to original sources
PubMed1988

Osteomyelitis of the mandible.

The presenting characteristics and clinical courses of 60 patients with mandibular bone infections are described. Fifteen of the patients had posttraumatic osteomyelitis, 13 had odontogenic osteomyelitis, and 28 had osteoradionecrosis. Most infections (93%) were polymicrobial, and anaerobes played an important role. Types of surgical procedures and use of adjunctive hyperbaric oxygen are described. There were minimal differences in presentation or response to treatment between these four different groups. A clinical staging system for mandibular bone infections is proposed and results of treatment are retrospectively analyzed by stage. The results support the concept that initial treatment planning can be safely and successfully based on the stage of the disease.

Anti-Bacterial Agents↗
PubMed1988

Bacteriology of middle ear effusions.

We studied fluid obtained from middle ear effusions (MEEs) during 908 myringotomy and tube insertion procedures on 495 children aged 4 months to 12 years. Under general anesthesia the external auditory canal was sterilized with povidone-iodine (Betadine) and alcohol, and myringotomy was done. Fluid was aspirated into a Luki tube and sent for culture and sensitivity determination. The median age of patients was 3 years 5 months; 1-year-old children comprised the largest single group. Two thirds of the children were male. Effusion was present in three fourths of the ears; in about 20% of these, culture grew bacteria. Haemophilus influenzae made up almost 50% of the pathogens, with the percentage decreasing with age. Almost 90% of the H influenzae organisms were sensitive to erythromycin, and about three fourths to ampicillin and cephalosporin.

Anti-Bacterial Agents↗
PubMed1988

Laryngeal cancer without spread to the neck: treatment options and outcome.

We examined treatment and outcome variables in patients who had laryngeal cancer without clinical evidence of spread to the neck. In our patient population, there was a 24% overall recurrence rate for N0 laryngeal cancer. Initial manifestations, including stage and location of tumor, did not influence recurrence (P greater than .1). Initial treatment of the primary T3 or T4 tumor with radiotherapy alone was positively correlated with recurrence (P less than .0 for T3, P less than .0 for T4), but initial treatment of the neck did not appear to affect chance of regional or distant recurrence (P greater than .1). Approximately half of the patients who had recurrent disease were salvaged. Neither chance of salvage nor final disease-free status was significantly associated with any of the variables (P greater than .1).

Carcinoma, Squamous Cell↗
PubMed1988

Magnet extraction of frontal sinus foreign body.

We report a metallic foreign body that entered through the anterior table of the frontal sinus, and rolled down to lodge in the nasofrontal duct. An electromagnet was used to remove the foreign body through a trephination.

Adult↗
PubMed1987

The reporting of statistical techniques in otolaryngology journals.

The domain of this study is the reporting of statistical analyses in the otolaryngology literature during 1983 and 1984. Fewer than ten basic statistical procedures accounted for more than 90% of the statistical techniques reported. Implications for authors, journals, and educators are discussed. We offer suggestions for imparting statistical skills that may be helpful in curriculum design, residency training, and continuing medical education planning.

Humans↗
PubMed1987

Reconstruction of the anterior skull base following craniofacial resection.

Reconstruction of the anterior skull base (ASB) following craniofacial resection must seal off the cranial cavity from the upper respiratory tract and provide structural support for the brain. The inferiorly based pericranial flap is strong, pliable, and well vascularized and is especially suited for reconstruction of small-to moderate-sized midline defects of the ASB. Surgical technique of pericranial flap reconstruction used in three cases is described. Indications for this flap and other types of reconstruction are discussed and compared. We believe pericranial flap reconstruction of the ASB is technically easy, cosmetically acceptable, and safe.

Adult↗
PubMed1987

Tumoral calcinosis in the neck.

Tumoral calcinosis manifests soft-tissue calcification, usually near major joints. It variably includes hyperphosphatemia, elevated 1,25-dihydroxycalciferol, and an affected sibling. Serum calcium, alkaline phosphatase, and parathyroid hormone are normal. Tumoral calcinosis of the head and neck is very rare, but this diagnosis should be considered when x-ray film of a poorly defined mass shows irregular soft-tissue calcification.

Adult↗
PubMed1987

Primary tracheoesophageal fistula procedure for voice restoration: the University of Texas Medical Branch experience.

Voice restoration for laryngectomees is challenging, but in recent years the tracheosophageal (TE) fistula procedure using a one-way valved prosthesis has had relatively good success. The purposes of this study were to determine the success rate for the primary TE fistula procedure, analyze failures, and study methods for selection and training of these patients. In a prospective study, 21 consecutive patients had primary TE fistula procedures performed over an 18-month period. Thirteen of 20 who had adequate follow-up developed fluent, intelligible speech using either duckbill or low-pressure one-way valves. Complications included one stomal infection and one paratracheal fistula. This experience has led to development of a protocol for selection and training of patients for this procedure and to the conclusion that the procedure can improve voice restoration success without an increase in morbidity.

Esophagus↗
PubMed1987

Endotracheal tube safety during laser surgery.

The most morbid complication of laryngeal laser surgery is an endotracheal tube fire. The purposes of this study were to determine the efficiency of saline solution-soaked cottonoid pledgets in protecting endotracheal tube cuffs from the laser beam and to evaluate the safety of four commonly used endotracheal tubes. The method involved measurement of perforation times of saline-soaked cottonoid pledgets with controlled variables of air exposure times and laser energy. The second part evaluated the safety and ignition properties of the red rubber, silicone, polyvinyl chloride, and Xomed Laser-Shield tubes by studying their perforation times and ignition properties under controlled oxygen concentrations. The results revealed that saline-soaked pledgets are very efficient in protecting endotracheal tube cuffs. The Laser-Shield tube was the safest one studied. It had the highest ignition threshold of the four tubes tested.

Accident Prevention↗
PubMed1986

Management of invasive frontoethmoidal sinus mucoceles.

Invasive frontoethmoidal sinus mucoceles extending into the anterior cranial fossa or orbits are difficult to manage and can lead to lethal complications. In the past four years, nine cases of frontoethmoidal mucoceles were treated at the University of Texas Medical Branch, Galveston. Five cases were complicated by anterior cranial fossa invasion, orbital invasion, or both. The choice of surgical procedures used to manage these cases depended on mucocele extent and location, which were best determined by computed tomography. Two cases required craniotomy, one of which required an inferior-based pericranial flap for reconstruction of the floor of the anterior cranial fossa. Two cases were managed by osteoplastic flap and fat obliteration procedures. Intranasal drainage was the procedure used in one case that had extensive orbital involvement. Surgical complications included an intracranial abscess in one patient and a cerebrospinal fluid leak in a second patient.

Adult↗
PubMed1986

Deep-neck space infections. Diagnosis and management.

Deep-neck space infections, which affect soft tissues and fascial compartments of the head and neck, can lead to lethal complications. Eight cases treated over a two-year period were reviewed, and the experience was used to formulate management guidelines. Specific clinical variables analyzed included patient presentation, work-up, treatment, complications, and length of hospital stay. Seven of eight cases required surgery for treatment, one of which was complicated by airway obstruction. Treatment of deep-neck space infections requires knowledge of the natural history of the disease and a detailed understanding of anatomy. Management guidelines include hospitalization, culture and sensitivity tests, antibiotic therapy, diagnostic radiographic procedures, and surgical intervention.

Adolescent↗
PubMed1986

Epithelial-myoepithelial carcinoma of the parotid gland.

The EME carcinoma of intercalated duct origin is now recognized as a distinct salivary gland malignancy. A case has been reported that typifies clinical and pathologic features. Both the surgeon and pathologist should learn not only to recognize its dual cellular characteristics, but also to be aware of the potential destructive nature and possibility for metastases with this tumor.

Adenoma↗
PubMed1986

Subrenal capsule assay for squamous cell carcinoma of the head and neck.

The murine subrenal capsule assay is an in vivo method for determining the responsiveness of solid tumor xenografts to chemotherapeutic agents. It was used in this study for the purposes of constructing growth curves of squamous cell carcinoma of the head and neck and collecting pilot data on the effects that indomethacin and cisplatin have on this malignant condition. Nine of the ten assays performed were evaluable. Indomethacin, cisplatin, or both were used as treatment drugs in each assay. One-millimeter fragments of viable tumor, from patients with head and neck squamous cell carcinoma, were implanted beneath the renal capsules of normal immunocompetent mice. Baseline and posttreatment measurements were made of the xenografts, and response to treatment was determined by comparing changes in tumor sizes of the test and control groups. Results indicated that reduction in tumor sizes occurred in indomethacin-treated mice in four assays and in cisplatin-treated mice in six assays. In addition, two separate growth curves were calculated by plotting the mean change in tumor size in five mice per day on days 3 through 7. In conclusion, the subrenal capsule assay is a relatively rapid and inexpensive assay in which squamous cell carcinoma remains viable and therapeutic agents can be tested. However, clinical trials that use this assay to choose treatment drugs are needed in order to correlate assay results with clinical responses.

Animals↗
PubMed1986

Influence of cisplatin on wound healing--an experimental model.

Recent clinical studies have shown that adjuvant chemotherapy may improve response rates to treatment for advanced head and neck carcinomas. Given preoperatively, some chemotherapeutic agents adversely affect wound healing. The specific purpose of this study was to evaluate the influence of cisplatin on wound healing when it is given preoperatively. Forty-four Swiss outbred mice were divided into control and treatment groups. One week before surgery, the treatment group received cisplatin (2 mg/kg body weight) by subcutaneous injections on 2 consecutive days. Each control animal was given an equal volume of normal saline. A 1.5 cm transverse incision was made in each animal, and wounds were closed with surgical staples. The mean wound-breaking strength was determined for a minimum of 5 treatment and 5 control mice on postoperative days 6, 10, 13, and 16. Serum creatinine, blood cell counts, and changes in weight were also monitored. Results showed wound strength on postoperative day 10 to be significantly reduced in mice treated with cisplatin (P less than 0.05). There was no significant difference for wound strength on any other days and all other variables were similar between both groups. In conclusion, cisplatin has an adverse effect on wound healing, the peak of which probably occurs during the proliferative stage of wound healing. Further studies are needed to determine the optimal time for surgery after preoperative chemotherapy. All new chemotherapeutic agents, particularly those being considered in a preoperative regimen, should be tested in this manner.

Analysis of Variance↗
PubMed1986

Tumor responsiveness of squamous cell carcinoma to cisplatin.

The addition of chemotherapy to planned multiple modality treatment of patients with advanced head and neck squamous cell carcinomas may improve survival rates, but individual tumor response is unpredictable. An assay for determining tumor responsiveness to specific chemotherapeutic agents would facilitate treatment selection. This study used the subrenal capsule (SRC) assay to test responsiveness of squamous cell carcinoma to cisplatin. Tumor xenografts obtained from ten patients were implanted beneath the renal capsules of control and treatment mice. Tumor responsiveness was determined by using the paired Student's t-test to compare base-line and post-treatment measurements in the cisplatin-treated mice. Results indicated six of ten tumors were sensitive to cisplatin. In conclusion, tumor sensitivity to cisplatin and other drugs may be predictable with the SRC assay, but to be clinically useful, studies will be necessary to correlate assay results with responses observed in patients.

Animals↗