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Biomedical subjects

G D Lyons

Publications and source records attributed to G D Lyons.

At least 19 recordsLinked to original sources
PubMed1992

Tracheomalacia repair using ceramic rings.

Tracheomalacia resulting from tracheostomy or compressive thyroid disease often represents a difficult problem in airway management. In an attempt to improve this condition, biocompatible ceramic rings were surgically implanted in 16 patients to restore normal patency of the airway by first expanding the tracheal lumen lateral, and then in an anterior dimension. Preoperatively, patients displayed moderate to severe obstruction with marked restrictions in lifestyle, as confirmed by history, physical examination, and airway resistance studies. Additionally, three of these patients were trach-dependent at the time of implantation. Postoperatively all 16 patients have normal airway resistance parameters with a dramatic improvement in lifestyle, whereas the three with tracheostomy were successfully decannulated. The routine use of these rings has alleviated the need for rib/cartilage grafts, primary resections with anastomosis, prolonged periods of cannulation, and multiple surgeries. Our experience in the use of ceramic rings for tracheomalacia repair will be presented, highlighting selection criteria for their use, intraoperative placement, perioperative complications, and post-operative followup for a minimum of 6 months.

Adult↗
PubMed1992

Local anesthesia in rhinoplasty: a new twist?

Twenty volunteers were asked to compare pain upon injection during septorhinoplasty using buffered versus unbuffered local anesthetics. The concentration of the buffer was one part sodium bicarbonate to five parts local. The surgeons performing the operation were asked to identify any difference in hemostasis or duration of anesthesia. Eighteen of twenty patients found the buffered anesthetic to be less painful and better tolerated. No difference in hemostasis or duration of action was noted between the buffered or unbuffered solution, however, faster onset of action was noted with the buffered solution. The addition of sodium bicarbonate as a buffering agent to the local anesthetics lidocaine and bupivacaine can significantly reduce pain upon injection. A solution of 5cc 2% lidocaine with 1:100,000 epinephrine, 5cc 0.25% bupivacaine with 1:200,000 epinephrine, and 2cc of 7.5% sodium bicarbonate mixed just prior to injection is a safe, effective, less painful local anesthetic with rapid onset of action and full efficacy.

Adult↗
PubMed1990

Chronic cough due to angiotensin-converting enzyme inhibitors.

The ACE-inhibiting drugs enalapril and captopril may result in a chronic and sometimes severe cough for which no pathologic cause can be found. Drug-induced cough should therefore be considered in any symptomatic patient taking these medications. In such cases, prompt withdrawal of the drug and substitution of a non-ACE inhibitor is curative and conserves the time and resources of the patient and the physician by avoiding unnecessary diagnostic and therapeutic measures.

Aged↗
PubMed1989

Adhesives in larynx repair.

Guinea pig laryngeal fractures were used as a model to compare the ease of application and effectiveness of the fibrinogen-adhesive system with the ease of application and effectiveness of cyanoacrylate glue and control fractures stinted with contralateral gelatin film. Seven fibrin adhesive-treated and two cyanoacrylate glue-treated guinea pigs were perfused after 60 and 35 days, respectively. The larynges were serial sectioned, and the wound sites were compared. The fibrinogen adhesive system was easier to dispense than cyanoacrylate glue, did not require a completely dry surface, and stabilized within 3 minutes. Cartilage segment alignment with focal, complete fracture healing and symmetrical chondrocyte proliferation were seen in fibrogen adhesive-stinted larynges. In the cyanoacrylate glue-treated larynges, there was no alignment and minimal, asymmetrical chondrocyte proliferation. Gelatin film-stinted controls exhibited similar features. Thus, fibrogen adhesive was easier to apply and more effectively bound laryngeal fractures than cyanoacrylate glue or gelatin film.

Animals↗
PubMed1987

Cholesterol granuloma of the petrous apex.

Cholesterol granuloma of the petrous apex is caused by a foreign body response to cholesterol crystals. This condition has infrequently been described, but it can prove to be highly destructive. Obstruction of drainage, with failure of ventilation of a normally aerated space and subsequent hemorrhage, yields blood breakdown products which liberate cholesterol. Osteitis, bone erosion, and bone resorption have all been reported, but major bone destruction is rare. It should always be considered by otologists and skull base surgeons when evaluating lesions of the petrous apex. This article reviews the more common causes of primary lesions of the petrous apex, with special emphasis on the clinical findings, pathophysiology, and surgical considerations in cholesterol granuloma. Two pertinent case histories are included.

Adult↗
PubMed1985

Fixation of laryngeal stents.

With the advent of the CO2 laser, the transendoscopic placement of stents and keels has become an important adjunct in the surgical treatment of laryngeal webs and stenosis. Fixation of stents, however, is often difficult and cumbersome. Here, we describe two relatively simple techniques of laryngeal stent construction, placement, and fixation.

Humans↗
PubMed1983

Sicca syndrome--diagnostic perplexities.

Patients presenting with xerostomia and other signs of Sjogren's syndrome pose diagnostic problems. Many other underlying diseases cause these symptoms and a systematic evaluation is necessary to make an accurate diagnostic assessment. There are immunological tests and histological studies which help make them distinctive and are herein outlined. Patients with this information presenting with sicca syndrome, therefore, can be more accurately assessed and have better treatment regimens instituted. The "sicca syndrome," which is a disorder discussed primarily in the rheumatology literature, is rarely a topic in the otolaryngology literature, although there are often presenting symptoms of this problem in the head and neck. This paper reviews this problem, discusses the confusion regarding terminology, and outlines a practical method of diagnosis for the clinician.

Adolescent↗
PubMed1981

Argon laser destruction of cutaneous telangiectatic lesions.

An ophthalmological slit lamp argon laser was used on 8 patients with multiple cutaneous and mucosal telangiectasis; 6 patients had telangiectatic lesions of various etiologies and 2 had hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease). Bleeding from trauma was the primary symptom with cosmesis as a secondary consideration. The telangiectatic lesions were photocoagulated using the argon laser with precise microscopic control. The optimum dose was determined by varying the spot diameter, beam power, shutter speed and number of applications until the lesions were visually ablated. All treatments were accomplished on an outpatient basis with no anesthesia or sedation and minimal reported patient discomfort. No lesions have recurred over a 12 month follow-up.

Female↗
PubMed1980

Carbon dioxide laser treatment of laryngeal stenosis.

Six patients ranging from 3 to 67 years of age were treated for acquired laryngeal stenosis. Five of these patients were considered failures from conventional surgical techniques including multiple open endolaryngeal procedures and repeated dilations. Using the carbon dioxide laser, the various obstructing lesions were excised microendoscopically and injected with interstitial steroids. After one to six procedures, all of these patients now have adequate airways and serviceable voices.

Adult↗
PubMed1978

Bone-conduction electrocochleography: clinical applications.

Cases are presented which show the clinical utility of recording an electrocochleographic response to bone-conducted stimuli. The procedure is fraught with problems of acoustic control and artifact generation, but has distinct although limited values in clarifying masking dilemmas in patients with bilateral hearing loss.

Adolescent↗
PubMed1978

Round window rupture secondary to acoustic trauma.

Perilymph fistulas are a known cause of sudden hearing loss. The two cases presented illustrate round window ruptures secondary to acoustic trauma. The important considerations are early diagnosis and treatment, the possibility of associated congenital anomalies, and future protection against sound.

Adult↗
PubMed1978

Laser surgery and immunotherapy in the management of laryngeal papilloma.

Twenty-three cases of laryngeal papilloma have been treated and followed for four years utilizing laser excision and laser excision/immunotherapy. Fourteen cases responded well to laser excision alone, nine did not and immunotherapy was instituted as adjunctive treatment. To date, immunotherapy has contributed little to the relief in this group of refractory cases.

Carbon Dioxide↗
PubMed1978

Anatomical consequences of CO2 laser surgery of the guinea pig ear.

A modified American Optical (Model 100) CO2 laser was used to produce lesions in the tympanic membranes, ossicles, and cochlear capsules of guinea pigs. Even with the lowest available intensities and durations (0.4 watts, 50 msec), there was damage to the inner ear. Although laser surgery of the ear can avoid mechanical trauma and bleeding as well as increase accuracy, the use of commercial lasers in ear surgery should be avoided until a proven unit is available.

Animals↗
PubMed1977

CO2 laser as a clinical tool in otolaryngology.

The CO2 laser has been used in a variety of lesions for two and one half years in areas other than the larynx. These lesions include viral papillomas, leukoplakias and erosive lichen planus in various otolaryngological sites. Laser therapy is compared with other modalities of treatment for similar lesions and the advantages and disadvantages of this type treatment is evaluated.

Adult↗
PubMed1977

Morphologic analysis of tympanic membrane grafts.

Many materials are presently used for repair of tympanic membrane defects. Since the microscopic organization of these tissues may play a role with respect to the suitability of replacement of one with the other, a comparative electron microscopic study of temporalis fascia, fresh and preserved amniotic membrane was undertaken. An effort was made to determine the similarities and differences of these tissues and our clinical experience with their use is presented.

Amnion↗
PubMed1976

The otological aspects of palatal myoclonus.

Palatal myoclonus with its concomittant objective tinnitus is often a missed diagnosis and poses a problem to the clinician in separating it from other middle ear anomalies. The etiology and symptomatology is outlined, but as suggested by our case presentations are not always diagnostic. The anatomical pathways of palatal myoclonus are traced, and its etiological complexities are realized when any locus or pathology along these tracks may create the characteristic chronic rhythmic contractions. We have experienced excellent results in determining a differential diagnosis of palatal myoclonus from other middle ear problems by the correlations of impedance audiometry with our clinical findings. Although the etiology is not defined the target structures can be separated from this test method and, therefore, enable more specific therapy.

Adolescent↗
PubMed1976

CO2 laser laryngoscopy in a variety of lesions.

We have had the opportunity to employ the CO2 surgical laser with suspension laryngoscopy and microscopic adaptations to treat a variety of laryngeal conditions over two years. Each type of laryngeal condition is discussed, and the benefits of laser management is evaluated. This type of laryngeal management is compared with other forms of treatment such as the standard surgical approaches, electrocautery, and cryosurgery.

Aged↗