Biomedical subjects
L K Winther
Publications and source records attributed to L K Winther.
[Acute tonsillectomy in infectious mononucleosis].
Enlargement of the pharyngeal tonsils in infectious mononucleosis (MI) is frequently an important component of the clinical picture but pronounced obstruction of the upper respiratory passages is rare. An analysis of 11 cases of infectious mononucleosis with varying degrees of pharyngeal obstruction is presented. During the acute phase of the disease, tonsillectomy was performed and also adenoidectomy in four of the cases. The patients improved rapidly after the operation and were discharged after an average of four days. No noteworthy complications of the operation occurred. An unexpectedly great number of cases of abscess formation were found at operation. Histological examination of the tonsils revealed changes in the lymphoid tissue which were characteristic but not specific for infectious mononucleosis together with extensive necrosis of the tonsillar surface. On the basis of this investigation, the authors consider that acute tonsillectomy is indicated in infectious mononucleosis with threatening occlusion of the upper airway and in cases of suspected peritonsillar abscess. In cases of slight or moderate respiratory obstruction, acute tonsillectomy may be considered in the therapeutic deliberations if the course of the condition is protracted and steroid treatment does not have the desired effect.
[Wallenberg's syndrome. Differential diagnosis study in cerebral apoplexy].
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[Corrosive injury of the esophagus. Causes and treatment of accidental corrosive injuries of esophagus, with suggestions for preventive measures].
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Endoscopy in diagnosis and treatment of choanal atresia.
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[Congenital choanal atresia. Diagnostic deliberations in neonatal and postnatal asphyxia and new therapeutic aspects].
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[Congenital esophageal atresia and tracheoesophageal fistula. A retrospective study of 86 patients, with special reference to primary and late results of treatment].
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Congenital choanal atresia. Anatomic, physiological, and therapeutic aspects, especially the endonasal approach under endoscopic vision.
In four cases of congenital bilateral choanal atresia, endonasal perforation using a modified surgical technique was employed with satisfactory results. In each patient, a polyethylene tube was inserted into the nasal cavity and left in place for varying lengths of time; a period of three months is recommended. This calls attention to a lenient, safe, and relatively easy operative technique that can be applied as soon as the anomaly is detected. By this technique, sufficient nasal respiration, which is of vital importance to the newborn, can be established.
Accidental corrosive burns of the oesophagus. Is their incidence increasing?
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Congenital choanal atresia.
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Oesophageal atresia and tracheo-oesophageal fistula. Early and late results in 86 patients.
A series of 86 infants (54 boys and 32 girls) with congenital oesophageal atresia and tracheo-oesophageal fistula underwent operation during the years 1952--76. The operative technique is described. The average survival rate was 45%, increasing to 56% during the last 10 years. With correction for low birth weight and associated congenital anomalies, the survival rate is considerably increased, in our series to 73%. In most of the fatal cases, the causes of death were suture leakage, pulmonary complications and associated anomalies. Among the 36 survivors, 19 became free from symptoms and 19 had a radiographic stricture, but in the latter group dysphagia was present in only 13, including 10 who required repeated dilatation with a Fogarthy balloon catheter. It is emphasized that correct and early diagnosis and meticulous pre- and postoperative care are of the greatest importance if the cure rate is to be improved further.
Intracranial lipoma. Report of a case and differentiation from other tumours of the cerebellopontine angle.
Teratomata of the cerebellopontine angle are rare. A case of a lipoma of this localization occurring in a 50-year-old man with an interesting case history is reported. The differential diagnosis of tumours of the internal auditory meatus and the surrounding structures is discussed. In cases with an uncharacteristic clinical history suggesting involment of the VIIIth cranial nerve, it is important to focus attention on the existence of rare lesions of the internal acoustic porus. The diagnosis can only be established with operation and biopsy.
Congenital anomaly of the facial nerve.
A case of abnormal course of the facial nerve is described. It was observed in a patient without malformations of the auricle or the external auditory meatus and with a normal otoscopic picture; but multiple malformations, especially of the upper limbs and the genitalia, were present. The chromosome conditions were normal.
Rhabdomyoma of the hypopharynx and larynx. Report of two cases and a review of the literature.
Two cases of extracardiac rhabdomyoma are reported in a 54-year-old man with unexplained difficulty in breathing and in a 39-year-old man with a prolonged history of hoarseness. Attention is drawn to the necessity of doing hypopharyngo-and laryngoscopy in such cases. One tumour was found in the left vallecula in the hypopharynx and the other on the left vocal cord. The literature and the histological findings in 53 cases are reviewed. It appears that this rare tumour is most frequently found in muscles derived from the pharyngeal arches. A total of 40 cases have been diagnosed during the last decade, and this increase is likely to continue in the future. It may turn out that extra-cardiac rhabdomyoma is not so rare as was first presumed.