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Biomedical subjects

K D Olsen

Publications and source records attributed to K D Olsen.

At least 109 records · Page 6Linked to original sources
PubMed1984

Skin cancer of the head and neck. How to recognize and treat it.

Skin cancer is the most common malignant tumor encountered in humans, with the head and neck being the most likely sites. The physician should be suspicious of malignant disease when evaluating any skin lesion, and a biopsy is easily performed on those that are questionable. The optimal method of treatment is surgical removal of the cancer in conjunction with histopathologic confirmation of the adequacy of excision. Reconstruction of the surgical defect is best performed by someone familiar with the use of local and regional skin flaps in the head and neck region.

Biopsy↗
PubMed1984

Facial nerve paralysis. 1. General evaluation, Bell's palsy.

The correct diagnosis of facial paralysis is not easily made but is important for proper management, since such paralysis is a sign or symptom of an underlying disorder. The clinician must be able to make an accurate and complete assessment of the entire facial nerve. Once a diagnosis is made, information from the history and results of topographic and electrical testing can be used in planning management and treatment. Bell's palsy, which is idiopathic, is the most common cause of facial paralysis. It is acute in onset and can come from a variety of causes. In the large majority of patients, the condition resolves either spontaneously or with treatment. Currently available treatments include corticosteroid therapy and facial nerve decompression, although both remain controversial.

Acute Disease↗
PubMed1984

Facial nerve paralysis. 2. 'All that palsies is not Bell's'.

Management of the patient with facial nerve paralysis challenges the diagnostic skills and clinical judgment of the attending physician. The clinician should not assume that all facial paralysis is Bell's palsy; the disease possibilities are broad and fascinating. Therapeutic options are still being evaluated, debated, and assessed. Appropriate management of the patient with facial nerve paralysis requires a complete history and precise examination.

Adult↗
PubMed1984

Pharmacokinetics and therapeutic efficacy of imipenem, ceftazidime, and ceftriaxone in experimental meningitis due to an ampicillin- and chloramphenicol-resistant strain of Haemophilus influenzae type b.

The pharmacokinetics and therapeutic efficacy of imipenem, ceftazidime, and ceftriaxone were compared with those of ampicillin and chloramphenicol in rabbits with experimental meningitis due to an ampicillin- and chloramphenicol-resistant strain of Haemophilus influenzae type b. The mean bacterial colony counts in cerebrospinal fluid were reduced by 49% (-1.85 log10 CFU/ml), 92% (-3.37 log10 CFU/ml), and 92% (-4.30 log10 CFU/ml) after a single dose of imipenem, ceftazidime, and ceftriaxone, respectively. The median peak cerebrospinal fluid bactericidal titers against this multiply resistant strain of H. influenzae were 1:4 for thienamycin, 1:16 for ceftazidime, and 1:256 for ceftriaxone. By contrast, no bactericidal activity was observed in cerebrospinal fluid and the mean concentrations of H. influenzae were either unchanged or slightly increased in animals treated with ampicillin or chloramphenicol.

Ampicillin↗
PubMed1983

Olfactory neuroblastoma. Biologic and clinical behavior.

The biologic behavior of olfactory neuroblastoma in 21 persons treated at the Mayo Clinic, Rochester, Minn, from 1960 to 1980 is reviewed. Follow-up data of five years or more are available for 19 cases. Findings showed the tendency of these tumors to spread submucosally and intracranially without obvious involvement of the anterior cranial fossa dura. The aggressive nature of this lesion has not been appreciated. Metastatic disease occurred in 62% and local recurrence in 57%. Long-term follow-up showed that recurrent or metastatic disease could occur up to ten years after initial diagnosis. The five-year survival rate was 58%. Only four patients who have been follow-up for more than five years were without local recurrence or metastasis. This review should prompt a change in the current attitudes toward treatment of this tumor.

Adolescent↗
PubMed1983

Radiographic assessment of squamous cell carcinoma of the temporal bone.

Squamous cell carcinoma of the temporal bone usually presents with tumor and edema occluding the external auditory canal. Accurate evaluation of the extent of such a tumor is therefore difficult. Assessment of these tumors and subsequent surgical management depends primarily on the preoperative radiographic findings. This paper discusses the evolution of the radiographic assessment of carcinomas of the ear canal. Certain cases have been selected to demonstrate the advantages and disadvantages of the radiographic studies in use. Mastoid x-ray views and petrous tomograms have been the standard methods of studying these lesions. Their interpretation, however, often exaggerates or underestimates the true extent of these carcinomas. Early and later generation computed tomography (CT) scans offered improvement in determining tumor involvement but still did not give the needed detail for surgical planning. High-resolution CT scanning of the petrous bones now offers the surgeon excellent views of these tumors. This paper places special emphasis on this technique and also discusses indications for operability.

Adult↗
PubMed1983

Upper airway obstruction and disordered nocturnal breathing in children.

Fourteen children with disordered breathing during sleep (obstructive apnea, obstructive hypopnea, or snoring) and anatomic obstruction of the upper airway were studied. Twelve children had hypertrophied tonsils and adenoids, and two had a deviated nasal septum. No child had sequelae of severe sleep apnea--that is, cor pulmonale, pulmonary hypertension, or alveolar hypoventilation. Results of polysomnographic studies were abnormal in all and revealed that obstructive hypopnea (increased respiratory effort with decreased airflow) was more common than obstructive apnea (increased respiratory effort without airflow). Surgical removal or correction of the upper airway obstructive lesion in 12 children resulted in normal nocturnal respiration. Surgical intervention was declined in two patients, and their symptoms persist. We conclude that surgical removal of upper airway obstructive lesions in children with disturbed nocturnal sleep should not be reserved only for those with serious sequelae of obstructive sleep apnea; considerable benefit is gained in selected patients with mild obstructive sleep apnea or hypopnea.

Adenoids↗
PubMed1980

Nasal septal injury in children. Diagnosis and management.

Although nasal injury is common-place in childhood, nasal septal trauma often is neglected and frequently goes undiagnosed until complications ensue. Only a complete intranasal examination in all cases of nasal trauma will detect intranasal fractures, dislocations, lacerations, hematomas, and abscess formation. Untreated, these septal and associated injuries can lead to considerable functional (nasal respiratory) and cosmetic (external) abnormalities. We report a case to illustrate the destructive sequelae of a "minor" nasal injury. Treatment may require formal surgical exploration with hematoma evacuation, reconstruction of the septal skeletal structures, and repair of lacerations of the intranasal mucosa. We review the management of cartilage resorption secondary to hematoma or abscess formation. A technique for replacing the caudal end of the septum is discussed and illustrated.

Cartilage↗
PubMed1980

First branchial cleft anomalies.

Our experience with anomalies of the first branchial cleft is reviewed. This includes 38 cases, the largest series collected to date. A new classification is proposed based on the anatomic findings--whether cyst, sinus, or fistula is present. The embryology and pathology of first cleft anomalies are discussed and an approach to the diagnosis and management of these lesions is given. In addition, a patient with a branchial cleft defect involving the middle ear space is reported.

Adolescent↗
PubMed1980

Lymphocytic lymphoma involving the middle ear.

A patient with lymphocytic lymphoma involving the middle ear had otalgia and facial palsy as his initial symptoms, and the definitive diagnosis was made by means of biopsy of the tumor in the middle ear. Review of the literature revealed only one other case with clinical involvement of the middle ear space.

Aged↗
PubMed1980

Pectus excavatum: resolution after surgical removal of upper airway obstruction.

A six-year-old child with obstruction of the upper airway and a pectus excavatum defect ("funnel chest") is presented. Correction of the funnel-chest deformity was observed four years after the performance of a tonsillectomy and adenoidectomy to relieve the obstruction of the upper airway. The relationship between chronic upper-airway obstruction and a pectus excavatum deformity is discussed, and the reversibility of such a deformity is documented.

Adenoidectomy↗
PubMed1979

Nasal septal trauma in children.

If the septal component of a nasal injury is adequately managed, usually the entire nasal injury will be well managed. Major or minor nasal trauma can cause cartilage fracture, deviation, dislocation, hematoma, or abscess formation, and the various associated sequelae, some of them life-threatening. A negative x-ray report should never be used as a substitute for a complete intranasal examination in any child with nasal trauma. Any nasal abnormality should be referred for immediate evaluation and treatment.

Child↗
PubMedDate not supplied

Base of tongue carcinoma: patterns of failure and predictors of recurrence after surgery alone.

Between January 1971 and December 1986, 55 patients with squamous cell carcinoma of the tongue base underwent complete surgical resection with curative intent. No preoperative or postoperative adjuvant therapy was administered. The study group consisted of 41 men and 14 women (median age 61 years). All patients were followed until death (39 patients) or for a median of 9.4 years. Local control at 5 years was 74%. No predictors of local recurrence were discovered. Control in the dissected neck at 5 years was 68%. Control of cancer above the clavicles at 5 years was 48%. Distant metastases developed in 14% of the patients by 5 years. Cause-specific survival at 5 years was 65%. A Cox multivariate regression analysis revealed that pathologic N stage was the only significant independent predictor of recurrence in the dissected neck, recurrence above the clavicles, and cause-specific survival. The 5-year overall survival was 55%. Surgical mortality was 4%.

Adult↗
PubMedDate not supplied

Laryngectomy alone for T3 glottic cancer.

BACKGROUND: The long-term survival of 81 patients with T3 squamous cell carcinoma of the glottic larynx treated with laryngectomy alone is presented and pathologic predictors for cancer recurrence above the clavicles and cancer death are identified. METHODS: Clinical records, operative notes, and pathologic slides were reviewed. The major end points were failure above the clavicles, cause-specific survival, and overall survival. All patients were followed until death or a minimum of 10.8 years. RESULTS: The main pattern of treatment failure was within an undissected ipsilateral or contralateral neck. Subglottic extension and nodal metastases predicted failure above the clavicles and delayed metastasis within an undissected neck. The 5-year rate of control of disease above the clavicles, cause-specific survival, and overall survival were 74.1%, 73.7%, and 54.3%, respectively. CONCLUSIONS: Patients treated with laryngectomy for T3 glottic cancer who have pathologic evidence of subglottic extension or nodal metastasis are at higher risk for recurrence above the clavicles, particularly within an undissected neck.

Adult↗
PubMedDate not supplied

Parapharyngeal space neoplasms.

BACKGROUND: Primary parapharyngeal space neoplasms are rare. Tumor distribution characteristics and long-term outcome have been quite variable in the recent literature. We report the results of a retrospective review of 172 patients with primary parapharyngeal space neoplasms treated surgically from 1960 to 1990 at a large multispecialty clinic and teaching hospital. METHODS: Initially, 195 patients seen at our institution were found to have parapharyngeal space neoplasms. Twenty-three patients previously treated elsewhere were excluded. The remaining 172 patients (96 female and 76 male) were from 11.7 months to 91.5 years of age. All patients were treated surgically; the transparotid-cervical approach was most widely used. RESULTS: One hundred thirty-seven tumors (80%) were benign and 35 (20%) were malignant. High-resolution computed tomography or magnetic resonance imaging was essential in the diagnosis and presurgical planning. Fine-needle aspiration specimens were accurate in the diagnosis of 8 or 9 cases. Pleomorphic adenoma was the most common neoplasm (40%), followed by paraganglioma (20%), neurogenic tumor (14%), malignant salivary gland tumor (13%), miscellaneous malignant tumors (7%), and miscellaneous benign tumors (6%). Mandibulotomy was required for only 6% of all tumors; its use was reserved for malignant lesions and large skull base tumors when risk of tumor rupture was high. Recurrent or persistent disease was recorded in 27 patients with malignant tumors; of these, 24 (89%) are likely to die of disease. CONCLUSIONS: The transparotid-cervical approach is the preferred procedure for most parapharyngeal tumors and can be combined with midline mandibulotomy for large vascular or selected malignant tumors. Recurrence after removal of pleomorphic adenomas is only 4%. Recurrent or persistent malignant disease is nearly always fatal. Perioperative mortality is zero, and morbidity is most often associated with cranial nerve neuropathy.

Adolescent↗
PubMedDate not supplied

Partial vertical laryngectomy--indications and surgical technique.

Partial vertical laryngectomy is a treatment option for certain T1 glottic cancers. Selection criteria and surgical technique are reviewed. Partial vertical laryngectomy for early vocal cord cancer is considered by some to be an obsolete procedure. However, as outlined in this paper, we believe it is a realistic treatment option for T1 glottic cancers that cannot be removed endoscopically.

Carcinoma, Squamous Cell↗