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Biomedical subjects

F J Stucker

Publications and source records attributed to F J Stucker.

At least 37 records · Page 2Linked to original sources
PubMed1997

Major patterns of laryngeal electromyography and their clinical application.

Laryngeal electromyography (LEMG) is clinically valuable in the evaluation of laryngeal dysfunction and vocal fold immobility. To facilitate clinical application of this electrophysiologic test, a detailed description of modified LEMG techniques is presented. The techniques were applied for simultaneous bilateral recordings of the thyroarytenoid, cricothyroid, and posterior cricoarytenoid muscles. The basic patterns of LEMG are classified into three different types: normal, neuropathy, and myopathy. In an attempt to characterize these patterns, we have reported eight LEMG-documented cases: unilateral laryngeal paralysis, bilateral laryngeal paralysis, cricoarytenoid joint dislocation, cricoarytenoid joint ankylosis, laryngeal myopathy, pharyngeal paralysis (soft palate paralysis), spasmodic dysphonia, and unilateral laryngeal paralysis with anastomosis. The significance of the major LEMG patterns is discussed.

Adult↗
PubMed1997

Posterior glottic stenosis mechanism and surgical management.

Posterior glottic stenosis with arytenoid fixation is an uncommon complication of laryngeal injury. Though etiologies vary; the most common is prolonged intubation. Patients with this problem are tracheotomy dependent and have compromised voice production. There has been no acceptable approach to reconstruction of the larynx, the majority of patients being treated with some type of vocal fold lateralization. The success rate with this approach varies, and this procedure does not take advantage of the intact neuromuscular status of the larynx. Over the past 3 years we have utilized an alternative approach, to repair the stenosis and mobilize the arytenoids in 10 patients. Our surgical technique involves laryngeal exposure via a laryngofissure, the removal of posterior glottic cicatricial tissues, and the application of an autologous graft. Subsequently, all but one of the patients were able to be decannulated. Subjective postoperative voice analysis showed improved voice production. The pathophysiology for this disorder and a review of different treatment modalities are discussed.

Adolescent↗
PubMed1997

Laryngeal evoked brainstem responses in humans: a preliminary study.

Laryngeal evoked brainstem responses (LBRs) were recorded in normal human subjects in an attempt to develop a central laryngeal function test and enhance our understanding of neurolaryngologic disorders. The results showed that the human LBR consists of five positive peaks and five negative peaks reproducible within 10 ms after a vibratory stimulation to the superior laryngeal nerve (SLN). The waveform reproducibility was verified by blocking the SLN and topically anesthetizing the hypopharyngeal cavity. The morphology and latency of peak 5 were similar to results obtained in animal LBR experiments. It was concluded that a vibratory stimulation to the SLN was a noninvasive method to elicit far-field potentials from the central laryngeal pathway. These findings encourage further effort to establish normative data and explore clinical correlations.

Adult↗
PubMed1996

Time course of Bell palsy.

This study was designed to quantitatively characterize the time course of facial palsy and the relationship between electroneurography and the facial nerve grading percentage as a function of onset time. Bilateral electroneurographic recordings during different stages in the course of the disease were repeated and compared with categorized videotaped facial movements using the House-Brackmann facial nerve grading system in 32 patients with Bell palsy. Preliminary results of this study demonstrate a time gap between the percentage of electroneurographic response and the category of the facial nerve grading system during the same period of disease progress. A theoretical model of the time course and specific patterns regarding the recovery of facial function is established. The theoretical time course of facial palsy is divided into 3 stages; preclinical, clinical, and postclinical. Based on the time course of electroneurographic and facial grading functions, the period between 10 and 14 days after onset was found to be most valuable for prediction of recovery. According to this theoretical model, a given time course pattern based on the results of serial electroneurographic recordings provides reliable prognostic information on recovery from Bell palsy.

Action Potentials↗
PubMed1996

Effects of brain stem lesions on cochlear function: mechanism of hearing improvement after removal of a brain stem tumor.

EOAEs are well correlated with changes of hearing sensitivity during the clinical course of brain stem lesions, as shown in this case study. They may serve as sensitive indicators to evaluate the possible effects of a brain stem lesion on cochlear function and monitor the attempted preservation of hearing during CPA or brain stem surgeries. It is thereby suggested that EOAEs should be included in an audiologic test battery in a differential diagnosis of retrocochlear lesions.

Audiometry, Pure-Tone↗
PubMed1996

Value of electromyography in differential diagnosis of laryngeal joint injuries after intubation.

Laryngeal joint injury or arytenoid dislocation is not an uncommon complication resulting from intubation trauma, and is best evaluated by laryngeal electromyography (EMG) combined with laryngoscopic examinations. Two cases of cricoarytenoid joint injuries after intubation are reported along with laryngeal EMG findings. Early diagnosis of arytenoid dislocation is important for appropriate surgical management and better prognosis. However, the reported cases, because of delayed referrals, showed prolonged cricoarytenoid joint injuries associated with thyroarytenoid muscle denervation or myopathy, and resultant vocal fold immobility. The results of laryngeal EMG in cricoarytenoid joint injuries can be classified into three different patterns: 1) normal recruitment, 2) myopathy, and 3) denervation or reinnervation of the thyroarytenoid muscles. It is particularly valuable to sample different portions of the thyroarytenoid muscles with EMG in order to evaluate different patterns or pathologic changes of the muscles and nerve paralysis.

Adult↗
PubMed1996

Supraglottic laryngeal or base of tongue cancer involving vallecula.

To determine the outcome of patients with supraglottic laryngeal or base of tongue cancer affecting the vallecula relative to the applied method of definitive treatment, a retrospective analysis was performed of 30 consecutive patients treated during a 12-year period (1981-93). Management consisted of surgical resection with adjuvant radiation in 19 patients and radiotherapy in 11 patients with adjuvant chemotherapy (n = 4). The overall actuarial survival rate was 20% at 2 years. Among the 29 evaluable patients, the locoregional failure rate was 52% and the distant failure rate was 31%. Surgery with radiotherapy was associated with better survival (p > 0.20) and less locoregional failure (p > 0.05) but more systemic failure (p > 0.20) than the nonoperative method(s) of treatment. Cure rate by conventional therapy in supraglottic laryngeal or base of tongue cancer involving the vallecula is dismal. In light of these observations, the multimodality treatment approach may have to be considered in the overall management of the disease.

Adult↗
PubMed1995

Perineural invasion in skin cancer of the head and neck: a review of nine cases.

PURPOSE: To review the management and outcome of skin cancer of the head and neck with perineural invasion, a relatively uncommon and complex condition, in nine patients treated between 1965 and 1991. PATIENTS: Seven patients had skin cancers that were larger than 2 cm. All lesions were moderately or poorly differentiated. Curative surgery was performed in all nine cases, with or without radiotherapy. RESULTS: Local recurrence or regional disease appeared in three individuals; surgical salvage produced satisfactory results. At last follow-up (median, 45 months; range, 18 to 201 months), no one had developed intracranial or skull base metastasis; lung cancer was detected in one patient. The crude survival rate was 33% at 5 years and 22% at 10 years. The median survival was 25 months in patients who presented with neurologic symptoms and was 49 months in asymptomatic persons. CONCLUSION: Although the prognosis in patients with skin cancer of the head and neck complicated by perineural invasion is expectedly poor, long-term disease-free survival is attainable with the use of aggressive therapy.

Adult↗
PubMed1995

Head and neck squamous cell carcinoma metastatic to the orbital apex.

Primary squamous cell carcinoma of the head and neck most commonly metastasizes to the lymph nodes, lung, bone, and liver. Many other rare sites of metastatic disease have been reported. To date, metastatic squamous cell carcinoma of the head and neck to the orbital apex has not been described. Presented are two cases, one tonsil and one parotid primary with metastatic disease to the orbital apex. Many tumors have been found to metastasize to the eye and orbit, but head and neck neoplasms are rarely reported. A review of the literature is presented in addition to the detailed case reports with their radiologic findings and clinical course. Surgical resection followed by postoperative radiotherapy appears the treatment of choice at this time.

Case Reports↗
PubMed1995

The use of tissue expanders in the correction of ectropion in an animal model.

The use of tissue expanders in eyelid reconstruction has seen limited application. To determine the efficacy of tissue expanders in the correction of cicatricial ectropion, an animal model was developed. Lower-eyelid blepharoplasty with overcorrection was performed on 18 New Zealand white rabbits. After 1 month, if significant ectropion was present, tissue expanders (1.8-cm3 Cylindrical/Microdome [CUI Corporation, Carpinteria, Calif.]) were inserted on one side, the other eye being the control. These were inflated in the following weeks to a total volume of 2 cm3. The tissue expanders were then removed, and the animals were followed for 1 month. Although the early results were encouraging, the ectropion progressed toward its preoperative severity. It appears that lower-eyelid ectropion remains a therapeutic problem that is only partially corrected with tissue expansion alone.

Animals↗
PubMed1995

Rhinophyma: review of pathophysiology and treatment.

Rhinophyma is an uncommon condition that often results in both functional as well as cosmetic impairment. Different treatment modalities have been devised, with varying degrees of success. A review of the pathophysiology of this condition, together with the authors' experience in managing 76 cases utilizing six different treatment methods, is presented. A simple and atraumatic surgical method has evolved using a Weck blade and argon beam coagulator. The operating time is decreased significantly when compared to other techniques with equal to superior cosmetic results.

Humans↗
PubMed1994

Nasal reconstruction with conchal cartilage. Correcting valve and lateral nasal collapse.

OBJECTIVE: To analyze the causes and the subsequent management of a collapsed valve and lateral nasal wall. The causes, including both predisposing anatomy and the surgical contributions, are presented. DESIGN: Analysis of consecutive patients with lateral nasal wall collapse corrected surgically with autogenous conchal cartilage grafts. PATIENTS: Fifty-six patients (37 women and 19 men; age range, 19 to 71 years) with nasal wall collapse were operated on. Forty-one of these patients had undergone at least one previous nasal procedure. The collapse of the nasal wall as a result of senescence was repaired in 13 patients. Two instances of nasal collapse were thought to be due to trauma. Forty-five patients had bilateral involvement. RESULTS: All 56 patients showed subjective improvement in nasal airway breathing. Rhinomanometry was performed in 24 patients and documented the improvement in all 24. Fifty-three patients noted an improvement in the appearance of their noses. Minimal morbidity was noted and no major complications were seen. Follow-up ranged from 18 months to 13 years. CONCLUSION: Surgery is very beneficial in cases of severe nasal collapse. This major functional complication warrants this major surgical reconstructive procedure and, as the results of this study demonstrate, predictable positive results with little morbidity and no major complications are possible.

Adult↗