Search PubMed⌕ Search

Biomedical subjects

H F Biller

Publications and source records attributed to H F Biller.

At least 127 records · Page 7Linked to original sources
PubMed1987

Ombudsman Rounds on the otolaryngology service.

An attempt to enhance psychiatric teaching on the Otolaryngology Service was undertaken by employing the vehicle of Ombudsman Rounds. The structure of these rounds is dictated by its major goal of maximizing the relationship of the surgeon and liaison psychiatrist as coteachers among the staff of the ENT surgical unit. Surgical residents, surgical clerks, nurses, and the social worker meet with the Chairman of the ENT Department and the liaison psychiatrist in a scheduled weekly conference, which addresses both staff and patient needs on the in-patient surgical service. Through patient interviews, multidiscipline staff presentations, chief of service surgical and prognostic summaries, and liaison psychiatrists' formulations, group discussions are undertaken. Through such an experience the staff become aware of the patient's feelings and understandings about their illness and care. The goal of Ombudsman Rounds is to enhance patient care, advance psychiatric knowledge of the multidiscipline staff, and provide an ongoing vehicle to change attitudes so that they incorporate a biopsychosocial approach to patient management on the ENT Service.

Adaptation, Psychological↗
PubMed1987

Complications in the management of large glomus jugulare tumors.

This study analyzes the complications encountered in the surgical treatment of 17 patients with large glomus jugulare tumors. All 17 patients sustained either new cranial nerve palsies or exacerbation of preexisting palsies. These involved, in descending order of frequency, the facial nerve, the vagus and glossopharyngeal nerves, and the hypoglossal nerve. Postoperative palsies of the facial nerve involved 17 patients, as compared to 5 preoperatively. Fifteen patients had postoperative partial or complete paralysis of the vagus nerve as compared to eight preoperatively. Ten patients had postoperative palsies of the hypoglossal nerve as compared to six preoperatively. Other complications included CSF leak, meningitis, and wound infection. Aspiration and dysphagia were encountered postoperatively in 13 patients. Teflon injection of paretic vocal cords and cricopharyngeal myotomy effectively improved the ability to swallow and the quality of the voice. Prompt recognition and treatment of complications is essential for effective surgical management of large glomus jugulare tumors.

Adolescent↗
PubMed1987

Transtracheal/transesophageal stimulation of the recurrent laryngeal nerve.

A new technique is described which allows stimulation of the recurrent laryngeal nerve (RLN) through intact tracheal and esophageal mucosa. In ten anesthetized dogs, the posterior-lateral tracheal wall and the anterior-lateral esophageal wall were stimulated by a 1 to 2 mA current with a probe placed just distal to the edge of the cricoid cartilage. The tracheal mucosa was approached through a tracheostomy stoma and the esophageal mucosa through the mouth. The resultant vocal cord motion was frequency dependent, with graded abduction occurring below 30 Hz and adduction above 40 Hz. By stimulating the posterior laryngeal mucosa proximal to the cricoid edge, the RLN branch to the posterior cricoarytenoid muscle was activated, causing ipsilateral vocal cord abduction independent of frequency. Monitoring of cardiopulmonary parameters demonstrated no alterations at these amperages. There were no mucosal abrasions noted. The transtracheal and transesophageal approaches to RLN stimulation appear promising as diagnostic techniques for evaluating vocal cord function during laryngoscopy and, possibly, as methods of glottic airway control.

Animals↗
PubMed1987

Thyroglossal duct cysts that mimic laryngeal masses.

Thyroglossal duct cysts are the most common nonodontogenic cysts to occur in the neck, and they often are situated in close proximity to the larynx. Despite this, they almost never present as an intralaryngeal mass. Three cases are cited in which intralaryngeal examination suggested that a larynx lesion was present. In two cases, a submucosal supraglottic mass was seen, while in the third case, the thyroid cartilage was eroded and a laryngeal malignancy was suspected. The role of CT in diagnosing and mapping these tumors is discussed.

Adult↗
PubMed1987

The abnormally large frontal sinus. I. A practical method for its determination based upon an analysis of 100 normal patients.

One hundred normal Caldwell view radiographs were examined on patients who had no signs or symptoms referable to the frontal sinuses. Magnification factors were determined for Caldwell views obtained on a dedicated head unit and as part of a skull series. The areas of the frontal sinuses were actually measured with a Zeiss Videoplan 2 computer and corrected for magnification. The area variation in this normal population was determined. Four linear measurements were individually correlated with these areas. Two of these lines had excellent correlation with the sinus area and if either of these lines exceeds a calculated value, the sinus area exceeds the 99th percentile of the normal population and can be considered abnormally enlarged. This technique provides a rapid, easy, and reliable method for assessing abnormally enlarged frontal sinus areas.

Frontal Sinus↗
PubMed1987

Abnormally large frontal sinus. II. Nomenclature, pathology, and symptoms.

Based on a review of the literature and analysis of six new cases, three categories of enlarged, aerated sinuses are defined, namely: hypersinus, pneumosinus dilatans, and pneumocele. The information gained by our study of the area variation of the frontal sinuses in a normal population (part I of this paper) was utilized to define the term hypersinus. In this condition there is generalized enlargement of the sinus beyond the upper limit of normal in an asymptomatic patient. The principal difference between pneumosinus dilatans and a pneumocele is the presence of bony thinning or erosion in the latter entity. The clinical findings and the possible etiologies of these conditions are discussed.

Adult↗
PubMed1986

Recurrent infiltrating lipoma of the head and neck. Case report and literature review.

Lipomatous tumors with intramuscular infiltration are uncommon in the head and neck. Oral lipomas have been recorded in the literature; however, infiltration and recurrence have rarely been documented. We describe a case of an oral lipoma that did not have microscopic characteristics of malignancy, lipoblastomatosis, or atypia, but which showed intramuscular invasion and recurred twice after surgery. Although certain characteristics distinguish our case from congenital lipomatosis, the clinical picture is quite similar. Lipomas with intramuscular invasion uniformly tend to recur when they are not widely resected, whether in the trunk and extremities or in the head and neck. These lesions can rapidly enlarge and infiltrate local tissues, and they require wide resection with an attempt at preservation of important structures. Preoperatively, computed tomographic analysis allows a lipoma to be diagnosed by its low attenuation, and a grossly infiltrating tumor can be distinguished from the ordinary well-encapsulated lesion.

Child, Preschool↗
PubMed1986

Ethmoid sinus disease: CT evaluation in 400 cases. Part I. Nonsurgical patients.

The unique anatomy of the ethmoid sinuses makes it difficult to interpret "soft-tissue clouding," especially on plain films. The clinical significance of isolated or generalized soft-tissue disease within ethmoid cells is unclear, and the patterns of bone erosion or remodeling must be relied on in establishing a specific differential diagnosis. Of 400 patients studied, 186 had inflammatory disease and 214 had tumors. Squamous cell carcinomas, metastases, and a few aggressive sarcomas were found almost exclusively to have bone destruction, while 94% of the remaining neoplasms were characterized by cavity remodeling. Further differentiation was sometimes possible because of the pattern and degree of tumor enhancement. Of the neoplasms, only the minor salivary gland lesions and neuromas had nonhomogeneous enhancement. Malignant lesions cannot be diagnosed with computed tomography (CT) unless bone destruction is present. Similarly, although the significance of persistent, benign-appearing soft-tissue disease during chemotherapy is unclear, tumor must always be suspected, even after many months of a stable CT appearance.

Diagnosis, Differential↗
PubMed1986

Ethmoid sinus disease: CT evaluation in 400 cases. Part II. Postoperative findings.

Clinical, pathologic, and computed tomographic (CT) findings were reviewed in 400 patients with ethmoid sinus disease, including 272 who had undergone surgery. The postoperative appearance of ethmoid sinuses on CT scans is a highly neglected subject in radiologic literature. The unique ethmoid anatomy permits a variety of surgical approaches, and radiologists must be familiar with the postoperative appearances if they are to recognize the effects of prior surgery and detect, when possible, the recurrence of disease. It is often difficult to evaluate the clinical significance of soft-tissue disease, despite good clinical correlation.

Ethmoid Sinus↗
PubMed1986

Ethmoid sinus disease: CT evaluation in 400 cases. Part III. Craniofacial resection.

Of 400 patients with ethmoid sinus disease, 18 had undergone craniofacial resection. This operation is an aggressive surgical procedure directed at total en bloc extirpation of tumors that extend through the floor of the anterior cranial fossa. Recent advances in surgical technique have made it the procedure of choice for sinonasal tumors that extend through the cribriform plate, fovea ethmoidalis, and orbital roof. Specifically, this operation has had excellent results in patients with esthesioneuroblastomas. Radiologists must be aware of the possible pitfalls in interpreting the postoperative computed tomographic scans and the findings that suggest tumor recurrence.

Carcinoma↗
PubMed1986

Complications of hyperbaric oxygen in the treatment of head and neck disease.

Hyperbaric oxygen has been advocated in the treatment of many head and neck diseases. Reports of such treatments have described eustachian tube dysfunction as the only complication. A review of patients receiving hyperbaric oxygen for head and neck diseases at The Mount Sinai Medical Center revealed serious complications, which included seizure, stroke, and myocardial infarction. In addition, follow-up study of these patients demonstrated that 11 patients treated for radiation-induced necrosis had an undiagnosed recurrence of cancer.

Adult↗
PubMed1986

Transcutaneous electrical stimulation of the recurrent laryngeal nerve: a method of controlling vocal cord position.

This study was designed to examine the feasibility of transcutaneous stimulation of the recurrent laryngeal nerve. Electrical activation of the recurrent laryngeal nerve was achieved by applying a blunt electrode to the intact neck skin at specific points along the tracheoesophageal groove in anesthetized adult dogs. The stimulus consisted of 10 mA cathodal pulses, each of 1 msec duration, delivered at a frequency of 10 Hz and increased by 10 Hz increments up to 100 Hz. Vocal cord excursion was directly related to the frequency of applied current. In all six dogs studies, stimulation at 30 Hz resulted in maximal ipsilateral vocal cord abduction, while stimulation at frequencies greater than 40 Hz resulted in ipsilateral vocal cord adduction up to or across the midline. Vocal cord movement was immediate and persisted for the duration of the stimulus train. Surrounding neck muscles were not visibly activated. We propose that the observed frequency-dependent movement of the vocal cords occurred because of the difference between the contraction times of the intrinsic abductor and adductor muscles of the larynx. Transcutaneous recurrent laryngeal nerve stimulation appears promising, both as a diagnostic aid in laryngoscopy and as a therapeutic tool in controlling the glottic aperture.

Animals↗
PubMed1986

Partial laryngectomy for vocal cord cancer with marked limitation or fixation of the vocal cord.

Partial laryngectomy was the procedure utilized to treat 26 patients with either marked limitation of vocal cord motion or fixation. The absolute 24-month tumor free control rate was 73% (19 of 26). Extended hemilaryngectomy with cricoid resection should be performed if subglottic extension of 5 mm or greater is present. Extended hemilaryngectomy has a greater complication rate than the classical hemilaryngectomy.

Cricoid Cartilage↗