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Biomedical subjects

D Myssiorek

Publications and source records attributed to D Myssiorek.

48 records · Page 3Linked to original sources

Laser endoscopic treatment of laryngoceles and laryngeal cysts.

The laryngocele and saccular cyst are uncommon anomalies of the larynx. Two patients, one with an internal laryngocele and one with a saccular cyst, were successfully treated by endoscopic laser marsupialization of their lesions. Since neither patient was found to be a suitable candidate for prolonged general anesthesia, the patients did not require a tracheotomy and were discharged the day after surgery. Both patients are doing well, with remarkable improvement in their voices persisting in their three year follow-up. The signs, symptoms, diagnosis, treatment, and indications for endoscopic laser treatment of internal laryngoceles and saccular cysts are discussed. Laser marsupialization of internal laryngoceles appears to be an acceptable mode of treatment.

Aged↗

Parathyroid cyst: current diagnostic and management principles.

BACKGROUND: Parathyroid (PTH) cyst is a rare lesion. Only about 200 cases have been reported to date. The diagnosis of a PTH cyst is difficult, particularly in its differentiation from thyroid cyst. It has clinical significance because PTH cysts can mimic a thyroid mass and can be associated with hyperparathyroidism. METHODS: This presentation illustrates an additional case of a PTH cyst. The importance of fine-needle aspiration (FNA) in the diagnosis of PTH cyst and its management are discussed. RESULTS: Fine-needle aspiration of clear fluid containing an elevated PTH hormone level proved to be diagnostic in the patient. Recurrence of the cyst after FNA required surgical resection. The current concepts of etiology and treatment are summarized. CONCLUSIONS: PTH cyst should be in the differential diagnosis in any patient initially seen with an anterior cystic neck mass. Radiologic imaging and FNA can accurately diagnose PTH cysts. Surgical excision may be needed for recurrent cysts after aspiration.

Adult↗

Needle aspiration biopsy of the pre-epiglottic space.

Clinical staging of supraglottic carcinoma requires evaluation of the pre-epiglottic space (PES). To explore the role of fine needle aspiration biopsy of the PES in the staging of epiglottic carcinoma, endoscopic transvallecular fine needle aspiration biopsies of the PES were performed in 16 patients with epiglottic carcinoma. The results of aspiration cytology were compared with CT scanning and postoperative histopathologic sections of the PES after total or supraglottic laryngectomy. This preliminary report shows that needle aspiration biopsy of the PES is a safe and sensitive technique, having a high correlation with histopathologic follow-up. Needle biopsy, along with CT scan, is clinically useful in staging the PES, which cannot be examined directly.

Aged↗

Recurrent pleomorphic adenomas of the parotid gland.

Twenty-seven patients with recurrent pleomorphic adenomas of the parotid gland were seen. This study confirms that superficial parotidectomy with identification and dissection of the facial nerve greatly decreases the incidence of recurrent benign pleomorphic adenoma, and, in the small number that recur, are easier to cure. All lumps in the parotid area should be approached in the same manner, with the surgeon prepared to isolate the facial nerve and perform superficial parotidectomy. This technique is successful because it avoids dissection near the tumor capsule, which is the major cause of recurrence. The procedure recommended for treatment of patients to remove the first recurrent tumor is total parotidectomy and excision of the previous scar. This vigorous approach is dictated by the increasing difficulty of removing further recurrent tumors. Only 67% of patients with recurrent tumors ultimately achieve a tumor-free status. Experienced surgeons can preserve the facial nerve even after multiple operations.

Adenoma↗

Cytogenetic analysis of tissues from patients with familial paragangliomas of the head and neck.

BACKGROUND: Paragangliomas of the head and neck are slow-growing tumors that originate from neural crest cells. Between 7% and 9% of these tumors have a familial occurrence. The suspected gene for familial paragangliomas (FP) is transmitted with an autosomal dominant mode of inheritance with incomplete penetrance, and appears to exhibit genomic imprinting. It has been demonstrated by family studies that individuals who inherit the gene(s) from their father will develop the disease. Through linkage analysis, the gene(s) for FP has been postulated to be located on the long arm of chromosome 11. The discovery of many different genes has been elucidated through the cytogenetic analysis of affected individuals who carry specific chromosome aberrations. This project was designed to look for chromosome abnormalities in several second-generation family members to further assist in the localization of the gene(s) for FP. METHODS: This study involved the cytogenetic evaluation of lymphocytes, fibroblasts, and tumor cells of several second-generation family members from a three-generation family with FP of the head and neck to look for chromosome abnormalities generally, and for abnormalities of chromosome 11 specifically. Standard cytogenetic techniques were used for lymphocyte and fibroblast cultures. Tumor cells were cultured in a collagen matrix with F12 medium supplemented with 3% L-glutamine and 10% fetal calf serum. RESULTS: There were no detectable abnormalities of chromosome 11 in any of the cells. However, nonrandom abnormalities of chromosomes 5 and 7 were seen in some of the tumor cells of one FP patient. To our knowledge, this is the first article which demonstrated the ability to successfully culture FP of the head and neck.

Adult↗

Intrasphenoidal meningoencephalocele: a case report.

A case of intrasphenoidal meningoencephalocele is presented, representing the eighth case report in English language literature. The major presenting symptom was retro-orbital headache. The patient also had cerebrospinal fluid rhinorrhea and a history of recurrent meningitis. Diagnosis was suspected on the basis of plain radiographs of the sinuses and was confirmed by computed tomography scan. The meningoencephalocele was reduced via a sublabial, transseptal sphenoidotomy approach with improvement of the patient's symptoms. Management and treatment of isolated sphenoid sinus lesions are discussed as well as the pathophysiology of intrasphenoidal meningoencephaloceles.

Aged↗