Search PubMed⌕ Search

Biomedical subjects

G R Holt

Publications and source records attributed to G R Holt.

At least 73 records · Page 4Linked to original sources
PubMed1984

The otolaryngologist's role in the craniofacial anomalies team.

The otolaryngologist has a multifaceted role on the craniofacial anomalies team. The diagnosis and treatment of hearing disorders, both congenital and acquired; maintenance of communication through adequate speech and hearing; management of the airway and deglutition; and reconstructive surgery of the head and neck are the primary responsibilities to children and adults with craniofacial anomalies. The complete evaluation and treatment of these disorders can be both very challenging and very rewarding.

Airway Obstruction↗
PubMed1984

Infectious diseases of the sphenoid sinus.

Thirty-one patients with sphenoid sinusitis were treated from 1978-1982. Twenty patients had infections contiguous with other paranasal sinus disease. Five of these patients had fungal sinusitis. Eleven patients were seen with isolated sphenoid sinusitis; 3 were secondary to trauma and 8 were due to nontraumatic causes. Possible etiologies include upper respiratory infections, developmental abnormalities, and water forced into the nasal cavity during swimming. The immunocompromised patient is more likely to present with minimal symptoms with a fungal infection, and aggressive diagnostic and therapeutic measures should be undertaken. Because the symptoms of headache, nasal stuffiness, proptosis, ptosis and decreased visual acuity may be interpreted as an intracranial, neurological, or vascular problem, a misdiagnosis may be made. A high index of suspicion for sphenoiditis should be maintained. Therapy involves a combination of medical (antimicrobial agent) and surgical (sinus drainage and marsupialization) management.

Bacterial Infections↗
PubMed1983

Wound ballistics of gunshot injuries to the head and neck.

It is important for the trauma surgeon to understand the basic principles of terminal gunshot ballistics and the study of the projectile's effect on striking soft tissue. The amount of kinetic energy dissipated to the tissue is directly related to the mass and velocity of the projectile as follows: K = MV2/2. Doubling the velocity quadruples the energy, while doubling the mass only doubles the energy. A temporary tissue cavity is produced as the striking projectile compresses the surrounding tissue; the higher the energy release, the more extensive the inapparent compressive damage. The permanent cavity that remains is the result of extrusion of tissue from the pathway of the projectile. The higher the velocity, the higher the likelihood of extensive damage. If the missile expands or fragments within the tissues, more damage will occur.

Adult↗
PubMed1983

Ocular injuries sustained during blunt facial trauma.

Ocular and adnexal injuries frequently occur during blunt facial trauma but the actual incidence and visual consequence of these injuries have not been heretofore established in any large series. Our review of 1,436 cases of maxillofacial trauma presenting from 1973-1980 outlines the types of fractures, associated specific ocular injuries, and their visual significance. Fifty-one percent (727) of these patients received complete ophthalmologic examination and 67% of these sustained ocular injuries. Seventy-nine percent of the eye injuries were categorized as temporary, 18% were serious, and 3% were blinding. The positive yield for eye injuries approached or exceeded 60% in nasal, midface, and frontal fractures. These data provide concrete evidence for placing high priority on ophthalmologic consultation in all cases of maxillofacial trauma.

Adolescent↗
PubMed1983

Incidence of eye injuries in facial fractures: an analysis of 727 cases.

From 1973 to 1980, 727 patients with facial fractures received formal ophthalmologic consultation. The series included 174 mandible fractures, 29 nasal fractures, 436 midfacial fractures, and 88 frontal fractures. Of these, a total of 67% sustained some degree of ocular injuries. Seventy-nine percent of the eye injuries were categorized as temporary, 18% were serious, and 3% were blinding. Of the mandibular fractures, 29% had ocular injuries, 59% nasal fractures, 59% midfacial fractures, and 89% frontal fractures.

Adult↗
PubMed1983

Combined intracranial and extracranial excision of nasopharyngeal angiofibroma.

Of all angiofibromas, 10% to 20% may have intracranial extensions or receive vascular supply from the internal carotid artery. Until recently, the treatment of intracranial involvement has been radiation therapy. However, with improved anesthetic and neurosurgical techniques, transfusion capabilities and embolotherapy, the combined intracranial and extracranial excision of an angiofibroma has resulted in a low morbidity and mortality and a greater chance for complete excision of the tumor. The authors present the management of three patients with intracranial involvement of their tumors. Use of the midfacial degloving approach to the nasal cavity and paranasal sinuses has resulted in a significant improvement in the cosmetic appearance postoperatively.

Adolescent↗
PubMed1983

Masked mastoiditis.

With the advent of broad-spectrum antibiotics, the clinical course of middle ear disease has been altered. One result has been the occasional suppression of the presenting signs and symptoms of mastoiditis secondary to acute middle ear disease, causing the clinician to have a false sense of security following apparent resolution of the middle ear infection. The course may be so insidious that the first awareness of the mastoiditis may be following presentation of an intracranial complication such as meningitis, lateral sinus thrombosis, or brain abscess. The authors report 9 patients seen in the past 5 years with masked mastoiditis, ranging in age from 4 months to 43 years. The presenting symptoms were all vague and non-classical; however, intracranial complications of meningitis, facial paralysis, brain abscess, and papilledema were present on admission in 7 patients, and another 2 patients had unsuspected epidural abscess upon surgical exploration. The mastoid radiographs were uniformly positive, while the CT scan was positive in 3/9 patients. All patients recovered following mastoidectomy and intracranial therapy except one patient who expired after brain herniation. The clinician is urged to maintain a high suspicion of masked mastoiditis in the high-risk patient, including newborn, diabetic, elderly, immunosuppressed or debilitated patients.

Adolescent↗
PubMed1983

Autoradiographic evidence of sex steroid receptors in laryngeal tissues of the baboon (Papio cynocephalus).

A number of studies have implicated the gonadal steroids as significant factors in laryngeal development and disease. In addition, antiandrogens are receiving limited trials in the treatment of laryngeal carcinoma. However, there is little experimental data to document the presence, and more specifically the location of receptors for the sex steroid hormones in the larynx. The purpose of this study is to provide such data. Utilizing an autoradiographic technique, tissues from baboons injected with tritiated estradiol (3H-E2) or dihydrotestosterone testosterone (3H-DHT) were examined and analyzed. The data gathered confirmed that the larynx is rich in receptors for these steroids and that there are specific patterns of distribution of receptor positive cells. The vocalis muscle and other mesenchymal tissues contained the largest number of receptors, while ciliated columnar and stratified squamous epithelium were negative. The significance of these findings is discussed.

Animals↗
PubMed1982

Computed tomography in the diagnosis of deep-neck infections.

Computed tomography (CT) of the neck was used to identify deep-neck abscess formation. Twenty-two patients were screened by CT for deep-neck abscesses. Each patient suspected of having a deep-neck infection underwent CT, often with enhancement if the differential diagnosis included the possibility of a tumor or vascular lesion. Six cases were identified, and these patients were taken to surgery for incision and drainage. There were no false-positives or false-negatives in the series. In all six cases of abscesses, the CT scan accurately identified the anatomical location of the abscess, allowing a more accurate planning of the surgical approach. The selective use of CT when deep-neck infections are suspected seems to produce an accurate diagnosis of the presence of an abscess, its location, and the involvement of important surrounding structures.

Abscess↗
PubMed1982

Head and neck manifestations of uncommon infectious diseases.

Certain uncommon systemic infections may be present with head and neck manifestations either initially or during the course of the disease. A high index of suspicion is required on the part of the otolaryngologist with the subsequent procedures leading to the appropriate diagnosis. The manifestations of infectious diseases such as erysipelas, histoplasmosis, rabies, tetanus, botulism, and cysticercosis must be understood by the head and neck specialist. For successful management, many of the infections require prompt identification and initiation of therapy. Airway maintenance, ventilatory support, and medical chemotherapy may be required.

Botulism↗