Biomedical subjects
Publications and source records attributed to D Reiter.
Castleman disease in an 11-year-old girl appeared as a neck mass that grew despite antibiotic treatment. MR showed a well-defined solid mass, isointense with muscle on short-repetition-time/short-echo-time images, with a stellate area of central hypointensity on long-repetition-time/long-echo-time images, that did not enhance with gadolinium.
The torn earlobe is a common problem, yet no objective analysis of causation or management is found in the literature. We present a series of 68 patients with statistical data on earlobe characteristics and cleft-related historical factors. We describe three new methods of repair: two for full clefts and one for partial clefting (ie, elongation of the piercing site without penetration of the inferior rim). We report follow-up from 4 to 10 years, with a 91% success rate for lobe appearance and a 1.2% recurrence of clefting. We offer guidelines for repair and repiercing based on lobe thickness and shape. We make recommendations for earring use based on lobe characteristics and historical development of the defect.
Nasal packing is considered routine by most physicians and patients at the completion of nasal and septal surgery. Yet the rationale for this maneuver is not clearly defined by reported investigation or logical analysis. We discuss 75 consecutive nasal surgical procedures completed without packing. There were two postoperative episodes of bleeding, both from pyriform aperture incisions for lateral osteotomy and both managed in the recovery room with an absorbable gelatin sponge. Technical refinements such as scrupulous preoperative history taking, through-and-through suturing of the entire septal flaps, small-caliber osteotomy, meticulous closure of all intranasal incisions, and proper application of a conforming dressing are essential for hemostasis. We offer specific procedural guidance to minimize the risk of postoperative nasal bleeding.
Intramuscular hemangiomas make up less than 1% of all hemangiomas [1]. These invasive and aggressive lesions appear to have a predilection for large muscle masses. They can be strikingly aggressive in the head and neck, and persistence despite radical treatment is common. Spontaneous resolution in adults to our knowledge has not been reported in the literature. We present a case report of an invasive intramuscular hemangioma involving the parotid gland, the masseter and pterygoid muscles, and the infratemporal fossa after local resection of an apparently isolated lesion of the lip and the submandibular triangle. We describe a detailed course of treatment and review the literature.
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Facial trauma may result in damage to the structures of the mouth, both by direct insult and by hindering access for routine oral health and hygiene measures. Successful management must include consideration of the stomatognathic system. The four major areas of consideration are dentoalveolar response to the forces of trauma and repair, evaluation and management of changes in vitality of the dental pulp, control of infectious and inflammatory periodontal disease throughout the period of evaluation and management, and restoration of the dentition and supporting structures. Guidelines are offered for use in the management of patients with facial trauma in each specific area presented for consideration.
The auditory system responds to pulsatile energy flow from the environment. Compression and rarefaction of gaseous molecular mass is transduced into electromechanical forms, in order to produce an effect at the cortical level. For energy input to have consistent meaning, transduction must preserve information coded within the pattern of energy flow. Distortion, or alteration of the original form, occurs in many ways throughout the chain of generation/transmission/reception/interpretation. Parameters of energy flow are discussed, and distortion of each parameter is presented in a context which permits the development of a distortion-based analysis of common clinical problems in otolaryngology.
Sinuses and fistulae of the third branchial cleft or pouch are rarely encountered. We have cared for a child with a history of multiple neck masses and abscesses, in whom the causative factor seems to have been an unrecognized branchial cleft sinus. This case suggests the need for contrast radiography of the hypopharynx in children with recurrent neck abscess, and dramatizes the need to exercise all reasonable diagnostic options before proceeding with surgery of newly presenting neck masses in children.
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Audiologic and electroacoustic immittance measurements were obtained from each ear of 23 patients with rheumatoid arthritis and 13 normal control subjects. Audiologic findings revealed 14 patients with rheumatoid arthritis with hearing loss of either conductive (three patients) or sensorineural (11 patients) type, while only two control subjects demonstrated hearing loss, both of sensorineural type. Immittance data revealed abnormal findings in 59% of the patients with rheumatoid arthritis as compared to only 4% of the control subjects. The increased incidence of sensorineural hearing loss in the sample with rheumatoid arthritis could not be readily explained. The observed prevalence of abnormal immittance findings in patients with rheumatoid arthritis suggested either increased middle ear stiffness or increased stiffness associated with decreased stability of ligamentous anchorage.
The otolaryngologist frequently encounters problems related to the form and function of the stomatognathic system. Much has been published over the past 50 years regarding the "ideal occlusion," but controversy continues to rage over the relevance of various occlusal parameters to the evaluation and management of problems involving occlusal dysfunction. A review of the literature on occlusion is offered, maintaining historical perspective while expanding each theory with relevant clinical correlates. A concept of occlusion is offered that may help in the evaluation and management of otolaryngologic problems involving the stomatognathic system.
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