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Biomedical subjects

E Ostfeld

Publications and source records attributed to E Ostfeld.

At least 19 recordsLinked to original sources
PubMed1994

Cervical posture and nasal breathing in infancy.

Survival of infants born with bilateral choanal atresia or pyriform aperture stenosis who breathe orally, as well as experimental data, challenge the virtually axiomatic theory of 'obligatory' nose breathing of the neonate. The anatomical parameters leading to the infant's airway patency and to airway obstruction were studied on midsagittal anatomical sections of fetal and adult necks as well as in head and neck radiographs of infants. The most important anatomical parameter found to facilitate the switch from nasal to oral ventilation in human infants is a cervical extension, creating a physiological lordosis of the neck that results in an opening of the veloglossal and veloepiglottic sphincters. This mechanism may explain the relationship between the sleeping posture of the infant and sudden infant death syndrome.

Aged↗
PubMed1991

[Primary cholesteatoma of the external auditory meatus].

Primary cholesteatoma of the external auditory meatus is a rare condition manifested by erosion of the external auditory meatus due to the development of a noncleansing pocket lined by squamous epithelium. The salient features of the disease are: unilateral protracted otalgia and purulent otorrhea in an elderly patient. 2 cases are presented, aged 64 and 80 years, both men, diagnosed by otomicroscopy and CT scan. Treatment is either conservative, by local cleansing of the pocket in the outpatient clinic, or surgical, by wide excision of the pocket and necrotic bone, then covering the area with temporal fascia. When the disease is detected early, treatment is simpler and shorter, and the outcome better.

Aged↗
PubMed1991

Pressure chamber tympanometry in diving candidates.

The currently recommended examination for diving fitness ascertains middle ear autoinflation ability only under surface pressure conditions. The purpose of our study was to document and quantify middle ear pressure equalization failure during simulated dives among diving candidates who had otherwise met the otologic criteria for diving fitness. Forty-two candidates for regular naval diving activity were included in the study. Tympanograms of both ears at 1 and 1.1 absolute atmospheres (ATA) were taken inside a pressure chamber with the subjects in two positions: seated and supine. At a pressure of 1 ATA, type A tympanograms were found in all 84 ears examined. At a pressure of 1.1 ATA, with subjects in the upright position, 19 (22.9%) of the ears had type C and 2 (2.4%) type B tympanograms, while with subjects recumbent during descent, 6 of the ears (7.2%) had type C and 7 (8.4%) type B. Our results suggest that successful autoinflation at surface ambient pressure does not necessarily reflect middle ear pressure equalization ability during descent in a dive.

Acoustic Impedance Tests↗
PubMed1990

[Neonatal respiratory distress due to congenital laryngeal cyst].

Severe, progressive, neonatal respiratory distress in a 27-month-old girl which required endotracheal intubation, was due to a congenital supraglottic saccular cyst, a rare cause. Aryepiglottic fold bulging and medial displacement of the left side of the larynx, resulting in considerable narrowing of the air-way, were prominent direct laryngoscopic findings. Transoral needle aspiration temporarily improved the infant's condition, but recurrences required repeated endotracheal intubation and needle aspiration. CT imaging demonstrated an intralaryngeal, supraglottic saccular cyst. At 2 months of age the cyst was successfully excised via a paramedian thyrotomy, and tracheotomy avoided. We suggest surgical excision of congenital saccular laryngeal cysts in infants who do not respond to repeated needle aspiration, as effective definitive treatment.

Cysts↗
PubMed1990

Surgical management of congenital supraglottic lateral saccular cyst.

A case is described of a neonate with a rare, congenital, supraglottic, lateral, saccular cyst presenting with stridor and asphyxia. Repeated needle aspirations of the cyst failed to provide sustained clinical improvement. CT scans proved useful for precise intralaryngeal location of the cyst and planning of the surgical excision. At two months of age the cyst was successfully excised by a paramedian thyrotomy via an external cervical approach, avoiding tracheostomy.

Cysts↗
PubMed1985

Noma in a full-term neonate.

Noma is an uncommon gangrenous process usually affecting malnourished children. A full-term neonate with orofacial noma, bilateral choanal atresia, and transient neutropenia with B cell deficiency is reported. This unusual appearance of noma in a well-nourished newborn might be related to the combination of choanal atresia and transient immune deficiency.

Agranulocytosis↗
PubMed1985

Fourth pharyngeal pouch sinus.

This is the first description and documentation of an extremely rare developmental anomaly of the pharyngeal apparatus in a 15-year-old female. The clinical, radiological, histological, and anatomical findings indicated that the anomaly originated in the pharyngeal fourth pouch. It presented as a recurrent lateral neck abscess which was due to a paratracheal sinus. This sinus penetrated the larynx and after a translaryngeal course ended in the pyriform sinus. It was caudad to the superior laryngeal nerve and external to the recurrent laryngeal nerve. Its penetration into the larynx at the cricothyroid joint region could serve as a useful surgical landmark.

Abscess↗
PubMed1984

Bilateral tension pneumothorax during pediatric bronchoscopy (high-frequency jet injection ventilation).

Bilateral tension pneumothorax complicating high-frequency jet injection ventilation during rigid open bronchoscopy for foreign body removal in a 3-year-old child is reported. Subcutaneous emphysema, bradycardia and low voltage of the QRS complex were the presenting symptoms. Disparition of heart dullness by percussion was the most suggestive clinical sign while auscultation of the breath sounds was not conclusive. It is stressed that tension pneumothorax is a potential life-threatening complication of high-frequency injection ventilation and should be promptly considered in any case of persistent cardiac deterioration during pediatric bronchoscopy.

Airway Obstruction↗
PubMed1984

Ciliary beat frequency of human middle-ear mucosa measured in vitro.

Brush biopsies from the middle-ear (ME) and nasal mucosa were taken from a 4-year-old girl with complete situs inversus, recurrent otitis media and tonsillitis, who underwent tonsillectomy, adenoidectomy and bilateral myringotomy with insertion of ventilation tubes. Ciliary beat frequencies (CBF, Hz.) of the ME and nasal samples, measured by a photoelectric system equipped with a fiber-optic probe, were 9.5 Hz. (+/- 1.2) and 13.7 Hz. (+/- 4.1) respectively. These values are similar to CBF of nasal samples obtained from normal subjects. In vitro CBF assessment is a useful investigative tool for the study of mucociliary activity in the ME, as in patients suspected to have ciliary dyskinesia syndrome.

Cell Movement↗
PubMed1984

Bone conduction evaluation related to mastoid surgery.

The bone conduction threshold changes of 97 patients (100 ears) who underwent mastoid surgery were determined by comparing the last preoperative audiogram with the 1 year postoperative audiogram. Three types of mastoid surgery were evaluated: radical mastoidectomy, modified radical mastoidectomy, and intact wall atticomastoidectomy. The average three speech frequency preoperative bone conduction threshold was 17.4 dB (S.D. 11.5) in the radical mastoidectomy group, 10.1 dB (S.D. 9.6) in the modified radical mastoidectomy group, and 10.7 dB (S.D. 8) in the intact wall atticomastoidectomy group. The difference between the average three speech frequency preoperative bone conduction threshold of the radical mastoidectomy group differed significantly when compared to the modified radical mastoidectomy or intact wall atticomastoidectomy group. The postoperative average three speech frequency bone conduction threshold did not change significantly following the three surgical procedures evaluated.

Adult↗
PubMed1984

Otitis media: the middle ear effusion total white cell count.

The middle ear effusion (MEE) total white cell count (TWCC) was correlated with clinical and bacteriologic data in 184 MEEs from 125 patients diagnosed as having acute primary and recurrent otitis media and chronic otitis media with effusion. The MEE total white cell count was classified as high, low, or acellular. Polymorphonuclear leukocytes predominate in the MEE having a high TWCC. The overall incidence of culture-positive MEE was 62.5 percent. A cellular component was found in 81 percent of the MEEs, 63 percent having a neutrophilic-predominant high TWCC. In very young children (up to 2 years old) a neutrophilic-predominant high TWCC was found in 80 percent of MEEs as compared with 28 percent in patients over 5 years old. According to the MEE type, neutrophilic-predominant high TWCCs were found in 89 percent of the purulent effusions, 46 percent of the mucoid, and 35 percent of the serous effusions. The incidence of neutrophilic-predominant high TWCC was 78 percent in acute primary 76 percent in recurrent otitis media and 18 percent in chronic otitis media with effusion. The impact of age on the MEE cellularity was shown to be independent of the chronicity of the disease. The incidence of neutrophilic-predominant high TWCC in MEE in which Streptococcus Pneumoniae or Hemophilus influenzae was identified was 85 percent and 92 percent respectively. The diagnostic value of a high TWCC in predicting a culture-positive MEE was shown by a sensitivity of 83 percent, false positivity of 25 percent, and false negativity of 27.5 percent.

Acute Disease↗
PubMed1983

Cholesterol granuloma in a thyroglossal duct cyst. A case report.

A case of cholesterol granuloma (CG) in a thyroglossal duct cyst is presented. The main pathogenic theories of this entity are described. It is suggested that chronic or recurrent infection and inflammation may play the major part in the pathogenesis of CG.

Adult↗
PubMed1983

Bacterial colonization of the nose and external ear canal in newborn infants.

The bacterial flora of the nose and external ear canal of 132 newborn infants, aged 3 days and 4 to 7 days, was examined. Cultures taken from the nose showed the following pattern of bacterial colonization: normal flora (39%); potentially pathologic gram-positive microorganisms (23%); gram-negative enteric rods (16%); and sterile cultures (22%). The most frequent bacterial cultures from nostrils were Staphylococcus epidermidis (39%); Staph. aureus (11%) and Escherichia coli (8%). The cultures from the external ear canal showed normal flora (37%); potentially pathologic gram-positive microorganisms (5%); gram-negative enteric rods (24%); and sterile cultures (34%). The most frequent bacteria cultured from the ear canal were: Staph. epidermidis (37%); E. coli (8%); and Klebsiella pneumoniae (7.5%). Of several factors studied, the type of delivery, Apgar score and the duration of hospitalization were found to have a significant influence on the pattern of bacterial colonization.

Apgar Score↗
PubMed1982

Antigenic determinants detected on adenoid lymphocytes.

This study was undertaken to detect the antigenic determinants expressed by adenoid lymphocytes. For this purpose, adenoid and peripheral blood lymphocytes obtained from the same patient were subsequently tested with human and hetero antisera. The research was based upon microlymphocytotoxicity where the various lymphocyte subsets were incubated with the antiserum and complement. The reactions were scored by the dye exclusion technique. The results indicated that: 1) compared with peripheral blood, the expression of the major histocompatibility gene products is enhanced by adenoid lymphocytes; 2) adenoid T lymphocytes express DRw antigens. These antigens were thought to be restricted to B lymphocytes and macrophages but have later been detected in T lymphocytes activated in vitro. Thus, lymphocytes derived from hypertrophied adenoids may simulate a culture activated in vivo; 3) because of their higher sensitivity to antibodies and complement-mediated cell lysis, adenoid lymphocytes may be useful in detecting minor histocompatibility gene products and differentiation antigens. It is concluded that adenoids represent a highly active lymphoid organ probably actively participating in the host's immunological defence mechanism.

Adenoids↗