Biomedical subjects
Publications and source records attributed to J W Templer.
Presently available equipment for nerve stimulation includes the relatively expensive multifunction pulse generators and the disposable dc stimulators. We have designed a semidisposable, two-transistor pulse generator that is portable, inexpensive, and capable of dynamic nerve stimulation.
Peripheral lymphocytes from 12 patients with squamous cell carcinoma of the lead and neck were incubated with autologous tumor explants. Four of the 12 patients demonstrated lymphocyte induced tumor cytotoxicity. These lymphocytes adhered to the tumor cells and deposited a radioactive label from their surface onto tumor cells. The deposition of this label was associated with tumor death. Tissue sections from those patients who demonstrated lymphocyte cytotoxicity showed a marked plasmacytic infiltration. This was in contrast to non-responders where only a desmoplastic tissue response was observed with few inflammatory cells.
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Parotid fistula is most commonly a posttraumatic situation. In posttraumatic cases, spontaneous closure of the fistula is the general rule. Conservative approaches to the occurrence of a parotid fistula are eliminating oral intake by the patient and applying a pressure dressing while maintaining nutrition by the intravenous route. Anticholinergic drugs decrease the production of saliva and thus would appear to be beneficial. When a parotid fistula does not heal under these conditions, then more aggressive treatment is indicated. Treatment should be based on whether the fistula is ductal or glandular in origin. Several methods of treatment have been advocated in the past. Low dose radiotherapy has been mentioned by some authorities as the treatment of choice for parotid fistula. This was used in one of our patients without response. Excision of the fistulous tract with ligation of the parotid duct has been advocated by some authorities. Tympanic neurectomy appears to be a satisfactory method of dealing with selected parotid duct fistulas, and glandular fistulas are best treated by tympanic neurectomy. Suppression of parasympathetic activity by the use of tympanic neurectomy has been said on some occasions to be transient (for example, Frey's syndrome). In dealing with parotid fistulas it would not appear to matter whether the effects are transient or permanent. The suppression of activity by tympanic neurectomy lasts long enough to allow for healing of the fistulous tract and relief of symptoms.
Our experience with 119 cases of peritonsillar abscess supports the experience of others, that immediate tonsillectomy is a safe treatment which provides prompt, complete drainage of the abscess. There was one episode of immediate postoperative hemorrhage and one of delayed bleeding, but there were no anesthetic complications. If one believes that the abscess is an indication for tonsillectomy and plans to perform the procedure at some time, we recommend that it be performed as the drainage procedure. The total hospitalization time will as a rule be shortened and a second convalescent period avoided. Its major drawback is the inconvenience of inserting a relative emergency into the schedule.
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Eversion of the laryngeal ventricle is a rare lesion that presents with cough and/or voice changes. Laryngoscopy reveals a polypoid mass arising from the ventricle. Microscopically a polyp covered with ventricular mucosa and containing normal laryngeal mucous glands is seen. Chronic inflammation is usually present. Treatment in symptomatic cases consists of surgical removal endoscopically or by laryngofissure. The management of one patient is reported with a discussion of the cause, symptoms, and treatment of this condition.
The nevus sebaceous of Jadassohn is a little known entity to most otolaryngologists. Most of the reported cases have occurred on the face or scalp. The lesion is usually congenital. It is a hairless, yellowish-red plaque until puberty when it becomes verrucous and unsightly. Benign or malignant tumors frequently develop. Associated ocular and central nervous system defects are occasionally present. The treatment is full-thickness excision as early as is feasible for cosmetic purposes and to avert the potential development of benign or malignant tumors.
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One recurring problem for otolaryngologists is the patient with vocal cord paralysis after thyroid surgery. We review the literature to assess the magnitude of this problem and to assess presently available techniques for sparing the recurrent laryngeal nerve. We present a new system for intraoperative recurrent laryngeal nerve location during thyroid surgery.