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Biomedical subjects

I Eliachar

Publications and source records attributed to I Eliachar.

At least 55 records · Page 3Linked to original sources
PubMed1993

Imaging evaluation of laryngotracheal stenosis.

Laryngotracheal stenosis (LTS) may afflict patients in all stages of life. Congenital subglottic stenosis is the third most common upper airway anomaly encountered in infants and neonates after laryngomalacia and vocal cord paralysis or fixation. It is a complex condition that demands arduous, often frustrating, efforts at all stages of management. Prevention of LTS is the most effective management of this problem. This paper will focus on the role of diagnostic radiology in the management of LTS.

Adult↗
PubMed1992

The rotary door flap a breakthrough in laryngotracheal reconstruction.

The sternohyoid myocutaneous vascularized flap--the Rotary Door Flap (RDF),--is optimally oriented to serve in laryngotracheal reconstruction. It provides immediate highly vascularized lining and structural support to the augmented airway. Therefore it is one of the most versatile alternative methods available for surgical reconstruction of the stenosed larynx and trachea. This technique has been applied in 46 patients, of whom 14 were in the pediatric group. The features of the flap and the surgical technique are described.

Adult↗
PubMed1992

Frontal sinusitis with chronic epidural abscess: a case presentation.

The incidence of intracranial complications from acute frontal sinusitis has decreased with improved antimicrobial and surgical therapy. However, the physician must maintain a keen awareness and thoroughly investigate any possible signs of intracranial spread. This article discusses a case in which a chronic epidural abscess developed after inadequate therapy was rendered. It also reviews the presentation of and the factors leading to the development of intracranial complications. The treatment required is to eradicate the disease present and prevent future sinusitis.

Adolescent↗
PubMed1991

Reconstruction of pediatric larynx and upper trachea with the sternohyoid rotary door flap.

The sternohyoid myocutaneous flap, the rotary door flap, is optimally oriented to serve in laryngotracheal reconstruction. It provides immediate, highly vascularized lining and structural support to the augmented airway. Therefore, it is one of the most versatile alternative methods available for surgical reconstruction of the stenosed larynx and trachea. Thirteen of 14 patients who were managed by the rotary door flap technique have been successfully decannulated. The features of the flap and the surgical technique are described with reference to modifications in the pediatric age group.

Adolescent↗
PubMed1991

Fibromuscular temporalis graft implantation for rhinitis sicca.

A surgical technique is described of implanting temporalis fascia and muscle beneath the nasal mucosa to reduce nasal dryness and to attempt to normalize the nasal airflow in selected patients with rhinitis sicca secondary to prior nasal surgery. The surgical technique is described in detail and is illustrated in a case report.

Humans↗
PubMed1990

Prevention of hair growth in myocutaneous flap reconstruction.

Myocutaneous flaps play a prominent role in the immediate reconstruction of surgical defects following ablative oncologic procedures in the head and neck. Transfer of hair-bearing skin into the reconstructed upper digestive tract can be a major disadvantage associated with the pectoralis major flap. De-epithelialization of skin to the dermal level, removing the majority of skin appendages, can convert a myocutaneous flap to a "myodermal" flap. Platysma myocutaneous and myodermal flaps were grafted into the oral cavity of 13 dogs. Gross and histologic evaluation confirmed decreased hair growth in the experimental myodermal flap. Wound complications and graft survival were similar for both techniques. Diminished hair growth further supports the utility of myodermal flaps in hairy male patients undergoing upper digestive tract reconstruction.

Animals↗
PubMed1990

Effect of photodynamic therapy and external beam radiation therapy on juvenile laryngotracheobronchial papillomatosis.

Treatment of juvenile laryngotracheobronchial papillomatosis is currently unsatisfactory and typically involves frequent endoscopic removal of the lesion with cup forceps and laser therapy. Malignant transformation of these lesions is a known complication. A case is reported of an adult patient with persistent juvenile laryngotracheobronchial papillomatosis who developed carcinoma in situ of the trachea and right upper lobe bronchus. He underwent experimental photodynamic therapy using dihematoporphyrin ether and rhodamine B dye laser. In addition, he received external beam radiation therapy. Bronchoscopy revealed no evidence of carcinoma in situ or recurrence of the underlying papillomas for a follow-up period of 24 months. This observation suggests that photodynamic therapy with dihematoporphyrin ether, either alone or in combination with radiation therapy, may have a role in the ablation of juvenile laryngotracheobronchial papillomatosis.

Adult↗
PubMed1990

New stoma stent applicable in long-term tracheostomy.

As long-term tracheostomy becomes a more common procedure, the need has arisen for a means of maintaining stoma patency. This article presents a new self-retained physiologic prosthesis intended for use as a stoma stent in long-term tracheostomy. It may also be applied in a wide range of short-term conditions. The concepts and techniques of long-term tracheostomy are highlighted. Experience in applying this stent in 75 patients with a followup of more than 28 months is presented.

Adolescent↗
PubMed1989

Advantages of the rotary door flap in laryngotracheal reconstruction: is skeletal support necessary?

Most attempts at laryngeal reconstruction have sought to reestablish skeletal support. Bone and cartilage grafts have been used for this purpose, but they have often failed to maintain position in the larynx and/or trachea following reconstruction, and they tend to be reabsorbed. The rotary door flap can provide an undelayed, one-stage epithelial resurfacing of the larynx and trachea while simultaneously restoring luminal support without the need for transfer of cartilage or bone. Luminal support for the trachea is provided by the bulk, turgor, and anterior traction of the intact sternohyoid muscle, which serves as the carrier for the rotated skin island. During inspiration the intact muscle, whose points of attachment are anterior to the plane of the larynx and trachea, contracts and tends to open the airway to provide dynamic luminal support. The need for internal stenting is minimized. The technique is described and experience in 20 patients is presented.

Adolescent↗
PubMed1989

[Evaluation of VIIIth nerve disorders in learning-disabled children].

Recent research indicates that a subclinical VIIIth nerve defect can be a major contributing factor to, if not a cause of learning disabilities. A battery of tests developed for evaluation of VIIIth nerve function is presented. These tests include assessment of vestibular function and evaluation of auditory figure ground abilities. 70 primary school children diagnosed as learning-disabled by child study teams were tested using this battery. 94% had abnormal findings in the electronystagmographic test and 22% in the auditory figure ground test. This battery of tests can detect subclinical defects in learning-disabled children which can be alleviated by a combination of proper medical treatment and an appropriate educational plan.

Child↗
PubMed1987

Laryngotracheal reconstruction. Sternohyoid myocutaneous rotary door flap.

The vascularized sternohyoid myocutaneous rotary door flap has been used for laryngotracheal reconstruction in ten patients in the past two years. Nine were reconstructed for laryngotracheal stenosis and one for immediate reconstruction after conservation laryngeal surgery for carcinoma. Before reconstruction, the nine patients with stenosis had each undergone a mean of eight surgical attempts at correction. Eight patients were tracheostomy dependent, and only two patients had effective voices. To date, seven patients have been decannulated and all ten have effective voices. No significant complications have been noted. This flap can provide a readily applicable, dependable technique that is useful in management of difficult laryngotracheal stenosis and for reconstruction after conservation laryngeal surgery.

Adult↗
PubMed1987

Planning and management of long-standing tracheostomy.

Long-term effects of tracheostomy can include structural changes in the anterior tracheal wall and larynx as a result of pressure, friction, and deformation by the relationship between the curved cannula, the trachea, the larynx, and the upper border of the sternum. High-placed stoma, flexed cervical position, and short, obese necks are predisposing anatomic relationships. In some long-standing tracheostomies, progressive erosion of the upper anterior tracheal wall and cricoid arch is observed, often with secondary subglottic stenosis. No discussion of measures to prevent or correct these problems was found in a review of the literature. This article discusses surgical techniques to (1) prevent laryngotracheal erosion and (2) repair and reconstruct an airway that is already damaged. A superiorly based tracheostomy flap and a muscular sling are designed to buttress the tracheostomy. Results and follow-up are also reported.

Follow-Up Studies↗
PubMed1987

A vented laryngeal stent with phonatory and pressure relief capability.

This prototype vented laryngeal stent incorporates a dome-shaped, one-way valve that allows articulation of transmitted vibrations to produce speech, while preventing aspiration and not interfering with deglutition. The stent is placed endoscopically and is used in conjunction with a T-tube or a tracheostomy tube. The stent has been placed in seven patients for chronic aspiration, after partial laryngectomy, and with laryngotracheal reconstruction for stenosis. Aspiration pneumonia has not been seen in any patient after placement of the appropriate stent, with follow-up of 2 to 6 months. One patient's swallowing improved and none deteriorated. All patients were able to phonate with the stent in place. No significant long-term sequelae are apparent in three patients whose stents were removed after resolution of their primary diseases.

Adult↗