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Biomedical subjects

J C Dort

Publications and source records attributed to J C Dort.

29 records · Page 2Linked to original sources
PubMed1994

Cholesteatoma: diagnosis and staging by CT scan.

Chronic otitis media is frequently seen in otolaryngologic practice. Cholesteatoma is less common and can present a diagnostic challenge. Temporal bone imaging studies are often used both to support the clinical diagnosis of cholesteatoma and to ascertain the extent of the disease. The exact role of CT in patients with cholesteatoma is unclear. This retrospective study compares CT with the operative findings in 44 patients operated on for cholesteatoma. Results show that while CT can detect abnormalities in the temporal bone, its ability to diagnose cholesteatoma is poor. We conclude that CT should be used selectively in those patients presenting diagnostic dilemmas or when other concomitant pathology (i.e., complications, recurrent disease, etc.) is suspected.

Adolescent↗
PubMed1993

Solitary fibrous tumour: report of two new locations in the upper respiratory tract.

Solitary fibrous tumours are uncommon spindle cell neoplasms generally associated with serosal surfaces, especially the pleura ('localized fibrous mesothelioma'). Recently, these tumours have been documented in extraserosal sites. We report two solitary fibrous tumours, including one occurring in the paediatric age group, arising in two previously unreported locations, parapharyngeal space and epiglottis. These cases expand the range of sites where this tumour may originate and confirm the tendency of extrapleural cases to involve the upper respiratory tract and adjacent structures.

Adolescent↗
PubMed1991

Primary extramedullary plasmacytoma of the salivary glands.

Primary extramedullary plasmacytomas (PEMP) are uncommon plasma cell neoplasms that generally occur in the submucosal tissue of the upper airway. Salivary gland PEMP is an extremely rare condition. This report describes a unique case of PEMP in the parotid gland associated with pulmonary amyloidosis. A review of all salivary gland PEMP's suggests that they behave similarly to PEMP's in other locations. The treatment of choice for localized disease is radiotherapy which should include regional lymphatics. Local control can be achieved in the majority of cases. The minority of patients develop systemic metastases and die from their disease. Chemotherapy can control disseminated disease and may induce remission.

Aged↗
PubMed1991

Facial nerve schwannomas.

A study of 26 patients with facial nerve schwannomas treated at the University Hospital of Zurich was done. The general clinical features are described, but particular emphasis is placed on tumor histologic findings, recovery of facial function after grafting, and the nature of intracranial facial nerve schwannomas Presenting symptoms are stratified by tumor location, with facial dysfunction being commonest with intracranial tumors, neurotologic symptoms being associated with intracranial tumors, and parotid masses being a feature of extratemporal tumors. We found no differences in tumor histology regardless of site of origin. Clinical, histologic, and radiologic evidence is reviewed, and from this evidence we conclude that intracranial facial nerve schwannomas may be particularly invasive acoustic schwannomas. Recovery of facial movement after grafting the facial nerve is not influenced by graft length or graft type. Prolonged preoperative facial dysfunction has a negative influence on recovery after grafting.

Journal Article↗
PubMed1991

Laryngeal examination: a comparison of mirror examination with a rigid lens system.

Indirect mirror laryngoscopy is the standard screening examination used in patients with complaints referable to the larynx and upper aerodigestive tract. The purpose of this study was to prospectively evaluate, in 100 patients, the diagnostic accuracy and examination success rate of indirect laryngoscopy versus a rigid rod examination. Fifty-two percent of mirror examinations were successful as were 83% of rod exams. This was a significant difference in success rate. From the 29 patients who underwent direct laryngoscopy, one false negative and one false positive mirror examination and one false positive rod examination were found. We conclude that the mirror is a useful screening tool so long as strict examination criteria are used. The rigid rod adds further diagnostic information in those patients who cannot be evaluated with a mirror.

Equipment Design↗
PubMed1991

Long-term results of treatment for children's cholesteatoma.

Fifty-seven of 98 children with cholesteatoma treated between 1976 and 1985 were available for long-term follow-up. The clinical records of the 57 children were analyzed retrospectively. The purpose of this study was to compare the incidence of recurrent and/or residual cholesteatoma, postoperative otorrhea, and hearing results between two groups of patients. One group (n = 40) of children was treated with a radical mastoidoepitympanectomy (RMET) and the other group (n = 17) was treated with intact canal wall tympanoplasty/mastoidectomy (ICWT). Residual cholesteatomas were twice as frequent (17% versus 7.5%) in the ICWT group while recurrent disease was the same. There was no difference in postoperative otorrhea between the two patient groups. Hearing results were equally good in the Type III and in the ICWT group with staged TORP. It is concluded that a Type III tympanoplasty is an excellent one-stage method of hearing reconstruction in patients with good eustachian tube function and an intact stapes and that a correctly performed RMET offers a safe trouble free alternative to ICWT. In selected patients with limited disease and a well pneumatized mastoid, ICWT is still used.

Child↗
PubMed1990

Ear, nose and throat manifestations of Lyme disease.

The manifestations of Lyme disease as they may present to the ENT surgeon are discussed. The most important ENT symptom is facial palsy. Particularly when combined with other cranial palsies, systemic illness or signs of meningeal irritation, the diagnosis must be considered. Three case reports are used to illustrate the presentation and diagnosis and treatment of Lyme disease. The characteristics of the disease are reviewed and the limitations of serological testing outlined. The literature has concentrated on bilateral or relapsing facial palsy. A review of palsies in Zurich that presented to the ENT clinic found only unilateral and partial palsies. The diagnosis should be considered in every case of facial palsy of unknown aetiology especially in children.

Adult↗
PubMed1990

Endoscopic laser surgery for early glottic carcinoma: a clinical and experimental study.

The purpose of this study is to define the indications for using the CO2 laser for the treatment of early glottic cancer. For this purpose, 52 consecutive laser resections of Tis to T2 vocal cord carcinomas were studied prospectively. In addition, laser resection was performed in eight human cadaver larynges, which were then examined histologically using whole organ sections. Both tumor size and tumor location had important influences on tumor resectability by laser. All of the Tis, 78% of T1, and one of four T2 carcinomas were successfully treated by laser surgery alone. Of the 10 carcinomas involving the anterior commissure, only four could completely be resected with the laser; of these four, two recurred in the anterior commissure. This finding is corroborated by the histologic study, which clearly shows that anterior commissure resection poses problems. The only laser resection complication of early glottic cancer was persistent hoarseness in one third of the patients. It is concluded that CO2 laser resection is a safe and effective alternative treatment for patients with Tis and T1 glottic carcinoma, provided the anterior commissure is free of tumor.

Adult↗
PubMed1990

The fallopian canal and facial nerve in sclerosteosis of the temporal bone: a histopathologic study.

Sclerosteosis is an uncommon subtype of osteopetrosis that is frequently associated with recurrent facial nerve palsy. Because of the need for detailed measurements of the fallopian canal and facial nerve in this disease, a study was carried out using a new method of surface area measurement. The results show narrowing of the fallopian canal and facial nerve in the labyrinthine, distal tympanic and mastoid segments. Maximum surface area loss occurred in the labyrinthine segment for both the canal and nerve. In addition, bony occlusion of the stylomastoid artery was found. From these findings we conclude that ischemia and bony compression are the underlying causes of recurrent facial palsy in this disease. We also conclude that because the labyrinthine segment is the most severely affected, surgical decompression must include this portion of the fallopian canal.

Adult↗
PubMedDate not supplied

Fine needle aspiration biopsy findings in lymphoepithelial carcinoma of salivary gland.

OBJECTIVE: To study the fine needle aspiration cytology of lymphoepithelial carcinoma of salivary gland (LECSG). STUDY DESIGN: Needle aspirates from five primary and two metastatic LECSGs were reviewed. RESULTS: Three aspirates showed very scant cellularity with rare tumor cells originally misinterpreted as lymphohistiocytic cells. Six fine needle aspiration biopsies (FNABs) contained medium to large polygonal and spindled cells with one or more prominent nucleoli. Five aspirates also displayed a heterogeneous population of lymphoid cells, while a sixth had much necrotic debris and only a few lymphocytes admixed with tumor cells. CONCLUSION: In the clinical setting of an Inuit or Chinese patient with a salivary gland mass, an FNAB with these features should suggest the possibility of LECSG.

Adult↗