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Biomedical subjects

L Feenstra

Publications and source records attributed to L Feenstra.

At least 73 records · Page 4Linked to original sources
PubMed1995

Management of acute laryngeal trauma.

Accurate assessment of the extent of an acute laryngotracheal injury has permitted treatment ranging from observation to open reduction. The keystones for successful treatment of acute laryngeal trauma and hence for prevention of laryngeal stenosis are: Accurate evaluation of the larynx using laryngoscopy and CT scanning. Immediate airway management to provide a safe airway. Repair of displaced laryngeal fractures and mucosal lacerations with the placement of a soft silicone stent in the severe cases.

Fractures, Cartilage↗
PubMed1995

Experimental tracheal revascularization and transplantation.

Vascularized tracheal allografts would expand the domain of tracheal reconstructive surgery. The functional capability of vascularized tracheal allografts is closely correlated with immunologic parameters contributing to graft survival, about which little information is currently available. An orthotopic transplant model was developed that allows assessment of allograft function by examining healing at the graft-host junction and graft integrity during normal respiration.

Animals↗
PubMed1994

Effect of homoeopathic medicines on daily burden of symptoms in children with recurrent upper respiratory tract infections.

OBJECTIVE: To investigate the intrinsic effects of individually prescribed homoeopathic medicines. DESIGN: Randomised double blind placebo controlled study. SETTING: Paediatric outpatient department of university hospital. PATIENTS: 175 children with frequently recurring upper respiratory tract infections. Of the 170 children evaluable, 86 were randomised to homoeopathic medicines (47 boys, 39 girls; median age at start 4.2 years; median number of episodes in past year 4) and 84 to placebo (43 boys, 41 girls; median age at start 3.6 years; median number of episodes in past year 4). MAIN OUTCOME MEASURES: Mean score for daily symptoms, number of antibiotic courses, and number of adenoidectomies and tonsillectomies over one year of follow up. RESULTS: The mean daily symptom score was 2.61 in the placebo group and 2.21 in the treatment group (difference 0.41; 95% confidence interval -0.02 to 0.83). In both groups the use of antibiotics was greatly reduced compared with that in the year before entering the trial (from 73 to 33 in the treatment group and from 69 to 43 in the placebo group). The proportion of children in the treatment group having adenoidectomies was lower in the treatment group (16%, 8/50) than in the placebo group (21%, 9/42). The proportion having tonsillectomies was the same in both groups (5%). CONCLUSION: Individually prescribed homoeopathic medicines seem to add little to careful counselling of children with recurrent upper respiratory tract infection in reducing the daily burden of symptoms, use of antibiotics, and need for adenoidectomy and tonsillectomy.

Adenoidectomy↗
PubMed1994

Tracheal autograft revascularization and transplantation.

OBJECTIVE: No vascular pedicle can be obtained reasonably to provide revascularization of a tracheal graft by direct microvascular suture. This study is a morphometric analysis of epithelial regeneration, submucosal revascularization, and mucosal thickness of isolated, tracheal segments revascularized by a lateral thoracic fascial flap. The purpose of the first part of the study is to determine the optimal period of tracheal viability after isolation and revascularization. The second part consisted of a reimplantation of the revascularized autograft into its original tracheal location. DESIGN: A tracheal segment was excised in 30 animals, and the segment was wrapped in the lateral thoracic fascia. The segments were reviewed histologically and morphometrically 2 to 28 days after graft isolation and after injection of the lateral thoracic artery with a blue silicone dye. Twelve grafts were reimplanted. Six segments were reinserted in the original direction and six segments were reinserted in the opposite direction. Tracheal airway clearance was studied by observation of the movement of carbon particles placed at different locations on the native and transplanted tracheal mucosa. MEAN OUTCOME MEASURES: Tracheal autograft revascularization and reepithelialization. RESULTS: Histologic evaluation of the revascularized grafts revealed an optimal viability of the autograft 16 to 20 days after isolation. The autografts could be reimplanted successfully after this period. This demonstrated the viability of the isolated grafts after a revascularization period of 16 days. The original direction of the mucosal clearance was preserved after reimplantation. The clearance in the opposite direction, with the 180 degrees rotated segments, however, had no influence on survival.

Anastomosis, Surgical↗
PubMed1994

Eosinophilic granuloma of the head and neck: CT and MRI features in three cases.

We report the radiological findings and more specifically the MRI features in three typical cases of Langerhans' cell histiocytosis of the head and neck. All three cases were of solitary eosinophilic granuloma of bone: two mandibular and one temporal bone lesion. Reports on the MRI features of head and neck eosinophilic granulomas are rare.

Adolescent↗
PubMed1994

Vascularized fascia as a transferable bed for experimental laryngeal reconstruction.

Laryngeal defects were reconstructed with a combined vascular flap consisting of lateral thoracic fascia used as a transferable vascular bed. A buccal mucosal graft was fixed on this bed as an internal lining. An autogenous cartilage graft, circumferentially wrapped in vascular connective tissue, was used as external support. The first focus of interest of this experimental study was to investigate the necessity of epithelial lining in the repair of a full-thickness laryngeal wall defect. The second focus of interest was to study reconstruction of the posterior glottis by introducing additional supporting material.

Animals↗
PubMed1994

Experimental revascularization of airway segments.

A series of experiments was conducted to assess the possibility of revascularizing tracheal autografts with the rabbit lateral thoracic fascial flap. Injection studies and histological evaluation displayed optimal revascularization and reepithelialization of the graft after 2 weeks.

Animals↗
PubMed1994

Reconstructive aspects of malignant parotid surgery.

High grade malignant tumours of the parotid gland require radical resections. The surgeon is therefore confronted with the problem of a reliable and minimally deforming reconstruction. Due to different manifestations, locations and spread, one should be familiar with a variety of reconstructions. Four case histories are presented, illustrating the necessity of approaching each parotid tumour resection and the resulting defect individually. Technical aspects of different reconstructions are discussed.

Adult↗
PubMed1994

Costs and effects of tracheoesophageal speech compared with esophageal speech in laryngectomy patients.

The hospital costs and the effects on speech are compared for tracheoesophageal (TE) speech and esophageal (E) speech in laryngectomy patients. TE-speech is more intelligible and the rehabilitation is faster (four versus nine months), but it is more expensive for the hospital. E-speech needs more speech rehabilitation sessions (average of 23,422 BF/patient) than TE-speech (7,157 BF). TE-speech involves primary (6,192 BF) or secondary placement (25,357 BF), replacement (average of 19,443 BF/patient/year) and in about ten percent closure of the fistula (39,135 BF/patient) and switching over to E-speech. On the basis of these data the expected average costs per patient can be calculated. These are definitely higher for the TE-speech than for E-speech.

Aged↗
PubMed1993

Experimental transferable vascular bed for laryngotracheal reconstruction: further observations.

Free fascia flaps have proven most reliable in providing a vascular bed for an epithelial free graft without adding bulk. They may be a useful tool for laryngotracheal reconstruction. A free flap consisting of a vascular network running in connective tissue can be developed on the rabbit external ear. The vascular characteristics of this flap were examined to test the reliability of the transferable vascular bed in laryngotracheal repair. The perichondrial free flap is useful for bringing an internal lining inside the lumen and for circumferential protection of supporting tissue. However, the natural tendency for surface contraction of perichondrium is a major disadvantage.

Animals↗
PubMed1993

Experimental tracheal tube created with vascularized fascia.

An experimental fascial transferable bed was developed in the rabbit model. This tissue is reliable in bringing a viable mucosal graft inside the larynx. A vascular connective tissue sheet with full-thickness mucosa and autogenous cartilage for external support are needed. In this study a tracheal tube was preformed to study the use of autogenous cartilage as support for a circumferential lumen.

Animals↗
PubMed1993

Retropharyngeal liposarcoma.

We report a case of a large inhomogeneous tumor confined to the retropharyngeal space, visualised by CT and MRI, which proved to be a liposarcoma. Liposarcoma in the head and neck region is a very rare condition and a retropharyngeal location has only been described once previously.

Adult↗