Biomedical subjects
Publications and source records attributed to G M Novotny.
In 17 cases the author has removed intraglandular submandibular calculi by an oral route utilizing blunt soft tissue dissection after an incision of the mucosa only. General anesthesia is used and the patient discharged after an overnight stay. No complications were encountered. All patients were back on full diet in 48 hours.
The greater palatine foramen extends in a posterosuperior direction at an angle of 60-80 degrees from the horizontal plane of the hard palate. A needle can be inserted 22-25 mm without the risk of intracranial or intraorbital injection. Sixty-one patients with posterior epistaxis were treated by greater palatine canal injection of either xylocaine 1% without epinephrine (34 cases) or sterile water (27 cases). There were no serious complications. Effective hemostasis was obtained immediately in 55 cases. Recurrent bleeding occurred in 22 cases, all of which responded to repeat injections.
Unilateral ulceration, bone necrosis, and sequestrum formation in the external auditory meatus are at times confused with the general diagnosis of keratosis obturans. However, the clinical presentation and the radiological and pathological characteristics of this condition are quite distinct from the latter. Initial examination in this situation may raise the suspicion of malignancy. When a true cholesteatoma of the external auditory meatus is found in association with this entity, according to a review of the available literature and personal observation of the authors, it is the result rather than the cause of this pathological process. In order to clarify this relationship, three patients are presented in whom there is radiological and histological evidence of bone necrosis and sequestration of a segment of the temporal bone but no evidence of hyperkeratosis in the ear canal.
An animal model was designed to reproduce conflicting effects of the superior laryngeal nerve (SLN) irritation and hypoventilation found in a clinical situation produced by an upper airway foreign body. The effects of continuous stimulation of the SLN on changes in glottic pressure were studied under conditions of a) normoxia and normokapnia , b) hypoxia and hyperkapnia , and c) normoxia and hyperkapnia . Recorded fluctuations of glottic pressure were found to correspond closely to activity of the muscles of respiration. Condition of combined hypoxia and hyperkapnia seemed to protect animals from disruption of breathing caused by the SLN stimulation, while hyperkapnia itself did not influence significantly inhibitory effects of the SLN stimulation. It has been observed that irritation of the SLN may produce reflex swallowing. In certain animals single shocks delivered to SLN in expiratory phase induced additional breaths. The authors emphasize the importance of the larynx as a receptor organ and a trigger zone for a number of clinically important reflexes.
Auditory brainstem response (ABR) audiometry which monitors the electrical activity of the auditory nerve and brainstem nuclei, has provided a new technique in the diagnosis of neurological dysfunction and peripheral hearing deficits. Brainstem potentials consist of seven waves, each separated in latency by approximately one millisecond and each representing successively higher order neuron activity of the auditory pathway. The criteria used for ABR interpretation are based primarily on the latency of individual were peaks and their interpeak latencies. Due to its consistency and stability, the fifth wave has been considered prominent in the interpretation of auditory threshold sensitivity. Unfortunately, Wave V latency-intensity function may be affected by extrinsic and intrinsic variables. Consequently, in order to establish diagnostic criteria that are comparable, the elimination and/or control of these variables must be examined. Therefore, the purpose of this paper is to report the effects of various pathological and nonpathological conditions which contribute to difference in ABR audiometry interpretation.
Our knowledge and understanding of non-healing granulomas of the nose are from complete. The classification and etiology remain in on-going controversy. This article describes an uncommon case of Wegener's granulomatosis in childhood presenting with granulomatous involvement of the nose and orbit. A review of the literature is made with regard to non-healing granulomatous disease of the nose and some of the controversies in classification are pointed out.
Antibiotic therapy has markedly reduced the incidence of suppuration of the deep fascial spaces of the neck. Affectations of the retropharyngeal space are not commonly encountered. This paper reviews the anatomy of the retropharyngeal space and the pathological processes that involve it. three cases are presented. One patient developed a retorpharyngeal abscess from traumatic perforation of the pharynx secondary to oroendotracheal intubation, another from neoplastic perforation secondary to carcinoma of the hypopharynx. The third patient developed a large retropharyngeal hematoma due to a fracture of the cervical spine, necessitating a tracheostomy.
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Gustatory sweating is a reflex, localized production of sweat associated with sight, smell, or ingestion of food. It involves most commonly the area of the auriculo-temporal nerve where it produces the well known Frey's syndrome. The pathophysiology of the syndrome is described with the aid of diagrams. Anatomically related syndromes are explained, namely the chorda tympani syndrome, crocodile tears, xerophthalmia of the suprageniculate facial nerve palsy, and the partial (otogenic) Horner's syndrome.
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