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Biomedical subjects

H L Levine

Publications and source records attributed to H L Levine.

At least 37 records · Page 2Linked to original sources
PubMed1989

Aneurysmal bone cyst of the mandible.

Aneurysmal bone cyst is an uncommon benign lesion that rarely presents in the craniofacial region. No prior reports of this entity involving the mandible could be found in the otolaryngologic literature, and it has been reported only infrequently in the maxilla. Two previously unreported cases originating in the mandible are presented with a review of the literature, pathology, and diagnosis of this lesion. Treatment of this lesion consists of complete surgical removal and immediate bone grafting for reconstruction.

Adolescent↗
PubMed1989

Near-total laryngectomy with epiglottic reconstruction. Long-term results.

A previous report reviewed the technique and indications for near-total laryngectomy with epiglottic reconstruction in the management of squamous cell carcinoma of the glottis. This approach permits removal of most of both vocal folds, with immediate reconstruction using the epiglottis without the need for stenting or multistage procedures. Forty-eight patients underwent the procedure and were followed up for at least 2 years or until death. Seventeen underwent the surgery for recurrence after failure of radiation therapy for cure. Complications included one wound infection and one laryngocutaneous fistula. All patients underwent decannulation, with little or no compromise of swallowing. All but 1 now have functional voices. Of 8 patients with recurrence, 6 have been salvaged. Two patients died of disease. The value of near-total laryngectomy with epiglottic reconstruction for management of glottic cancer is reviewed.

Adult↗
PubMed1989

Three-dimensional surface rendering of nasal anatomy from computed tomographic data.

This article investigates the potential of using three-dimensional surface-rendered computed tomographic reconstructions for demonstrating normal and pathologic intranasal anatomy. Three-dimensional surface renderings of the intranasal structures were generated in 38 patients from coronal high-resolution computed tomographic images. Because of the complex anatomy, three-dimensional images were believed to be useful for surgical planning. There may be a correlation between the appearance of the uncinate process and severity of inflammatory sinus disease.

Humans↗
PubMed1989

Endoscopy and the KTP/532 laser for nasal sinus disease.

One hundred twenty-eight patients have undergone nasal/sinus operations using endoscopes and the KTP/532 laser. The pathologic processes have included turbinate dysfunction, nasal ethmoid polyps, hereditary hemorrhagic telangiectasia, granulomatous disease (sarcoid), nasal granulation secondary to cocaine abuse, and nasal papilloma. Early follow-up indicates rapid healing with minimal crusting, edema, scar formation, and complications and good resolution of disease.

Endoscopy↗
PubMed1989

Mucosal regeneration of the maxillary sinus after surgery.

The postsurgical effects of the removal of the maxillary sinus mucosa were studied in an animal model. Ten rabbits underwent Caldwell-Luc procedures with the removal of all the maxillary sinus mucosa from one sinus, while the other sinus in each animal was used as a control. After allowing time for postsurgical healing, animals were examined for mucociliary transport and sections for histologic examination were obtained. Respiratory ciliated epithelium was present in seven of the postsurgical sinuses. Marked increases in acute and chronic inflammation, granulation, fibrosis, and ulcerations were noted.

Animals↗
PubMed1989

Pneumomediastinum secondary to a mandible fracture.

Pneumomediastinum may be produced by a simple facial fracture. It may also be a sign of other aerodigestive tract injuries, and this possibility should be ruled out. A minimal patient workup should include panendoscopy and soft tissue neck x-ray films in all cases. If no other injuries are found, resolution of the pneumomediastinum may be expected without further treatment.

Adult↗
PubMed1989

Evaluation of syncope from head and neck cancer.

Five patients suffering from recurrent syncope in association with metastatic squamous cell carcinoma of the head and neck were examined. Two patients had exhaustive diagnostic work-up for syncope, which eventually disclosed previously undiagnosed, recurrent squamous cell carcinoma. Case reports describe glossopharyngeal neuralgia, a well recognized cause of syncope in the head and neck cancer patient, characterized by acute unilateral head or neck pain preceding each syncopal episode. The literature on the diagnosis of syncope is reviewed, and the syncopal mechanisms unique to the head and neck cancer patient are analyzed and discussed. A diagnostic approach to syncope in head and neck cancer is proposed.

Carbamazepine↗
PubMed1989

Squamous cell carcinoma of the paranasal sinuses: the Cleveland Clinic experience 1977-1986.

Fifty-four of 103 malignancies of the paranasal sinuses treated at the Cleveland Clinic Foundation between 1977 and 1986 were squamous cell carcinomas. Six arose from the ethmoid sinus and 48 from the maxillary sinus. Of the maxillary sinus patients, 11 presented with T1 or T2 lesions, 20 with T3, 16 with T4, and 7 of these had nodal disease. Treatment was surgery and/or radiation therapy. There was local recurrence in 25 of 48 maxillary sinus patients and in 1 of 6 ethmoid patients. Overall 5-year survival was 38.2% in the maxillary sinus group: T1, 100.0%; T2, 85.7%; T3, 31.8%; and T4, 6.7%. Three of six patients with ethmoid tumors were cured. There was a statistical trend for better prognosis in those patients presenting with ethmoid primaries, with early lesions, treated with both radiation and surgery, and with history of inverting papilloma. There were complications of treatment in 10 patients, four of which resulted in death. Local control was the major problem for these patients; therefore, early detection and aggressive local treatment are desirable.

Adult↗
PubMed1989

Rigid endoscopic repair of paranasal sinus cerebrospinal fluid fistulas.

The advent of functional transnasal endoscopic sinus surgery has brought new opportunities in the repair of difficult cerebrospinal fluid leaks of the paranasal sinuses. The following four case reports illustrate the repair of cerebrospinal fluid leaks with the use of rigid transnasal endoscopy for enhanced angled visualization and illumination. A description of surgical techniques and instrumentation involving transnasal endoscopy in repair of sphenoidal and ethmoidal cerebrospinal fluid fistulas is reported. A discussion of etiology, diagnoses, and conservative versus surgical management of cerebrospinal fluid rhinorrhea is presented.

Adult↗
PubMed1989

Facial fuzz and funny findings. Facial hair causing otalgia and oropharyngeal pain.

Three patients with referred otalgia and/or oropharyngeal pain due to ectopic facial hair found in either the external auditory canal or oropharynx were treated at the Cleveland Clinic Foundation, Department of Otolaryngology and Communicative Disorders. In each of these patients, annoying symptoms were relieved by simple removal of the misplaced facial hair. Sensory nerve innervation of the external ear and oropharynx and their interrelationship in referred pain are described in detail following the case reports.

Adult↗
PubMed1989

Cancer of the periauricular region.

Cutaneous carcinoma of the auricular and periauricular region can be diagnosed early and often can be cured; however, many of these tumors become difficult to treat because of local spread and regional metastasis. Those tumors that are not treated early often require more aggressive treatment with ear canal resection, partial temporal bone resection, or even parotidectomy and radiation therapy. Mohs histographic surgery combined with conventional excision affords the best marginal control for local eradication of these tumors.

Ear Neoplasms↗
PubMed1989

Lasers and endoscopic rhinologic surgery.

Lasers are playing a more important role in rhinologic surgery. A new laser, the KTP/532, provides flexible fibers that can be combined with nasal endoscopes to reach the recesses and spaces of the nasal cavity. It can deal effectively with turbinate dysfunction, bleeding disorders, polyps, and scarring. The author's experience with the use of this laser is described.

Endoscopy↗
PubMed1988

Intranasal endoscopic analysis of dacrocystorhinostomy failure.

Intranasal abnormalities are the most common cause of dacryocystorhinostomy failure. The nasal endoscope facilitates recognition of these abnormalities and provides photo documentation to guide the surgeon to the appropriate postoperative management.

Dacryocystorhinostomy↗
PubMed1988

Squamous cell carcinoma of the head and neck in patients 40 years of age and younger.

Squamous cell carcinoma of the head and neck is largely a disease of the middle-aged and elderly. When it occurs in younger patients, the prognosis for long-term survival appears to be worse than in the older age group. The records of 41 patients aged 40 years and younger who presented with squamous cell carcinoma of the head and neck were reviewed. Twenty-eight of these patients (68%) developed recurrence; of these, 21 (51%) died with disease, and two are alive with disease. These results indicate a trend toward poorer survival than previous rates reported nationally for all patients with carcinoma of the head and neck over a similar time period. Lesions of the oral tongue, nasopharynx, and paranasal sinuses seem to have a particularly poor prognosis.

Adult↗
PubMed1987

Conformation and stability of two recombinant human interferon-alpha analogs.

Structural features of a recombinant E. coli derived interferon-alpha analog, interferon consensus1, was studied by circular dichroism and fluorescence spectroscopy. Circular dichroic spectra of the purified protein showed that it has about 70% alpha-helix and a distinct tertiary structure. These structural features are similar to those for a natural interferon-alpha subtype, interferon-alpha 2, indicating that the amino acid substitutions in interferon consensus1 apparently did not alter the protein structure. Another analog, interferon consensus5, which has Ser instead of Cys at residues 1 and 99 but is otherwise identical to interferon consensus1, was prepared to study the role of the disulfide bond between Cys 1 and 99. Circular dichroic and fluorescence spectra indicated similarity in the structure of these two analogs. However, interferon consensus1 was significantly more stable than interferon consensus5 against denaturation. pH unfolding experiments indicated that the former protein is more stable in the transition region by about 1.6 kcal/mol, which was interpreted in terms of the increased free energy of the denatured state due to an extra disulfide bond in interferon consensus1.

Circular Dichroism↗