Search PubMed⌕ Search

Biomedical subjects

L W Tom

Publications and source records attributed to L W Tom.

48 records · Page 3Linked to original sources
PubMed1988

The anterior cricoid split: the Children's Hospital of Philadelphia experience.

The anterior cricoid split procedure (ACS) is an alternative to tracheotomy in selected infants with subglottic stenosis. From February 1983 to October 1987, 26 children underwent ACS at the Children's Hospital of Philadelphia. All children had subglottic stenosis. Six children had previously undergone tracheotomy. A successful outcome, allowing extubation or decannulation, correlated only with decreased pre-operative intubation time and was achieved in 73% of these patients. A failed ACS had little adverse affect on the subsequent management of these children.

Cricoid Cartilage↗
PubMed1987

The sternocleidomastoid tumor of infancy.

The sternocleidomastoid tumor of infancy is an uncommon clinical entity which has received little attention in the otolaryngological literature. The diagnosis must be considered in any infant presenting with a lateral neck mass. Although its natural history favors spontaneous regression, the mass may initially grow in size. The purpose of treatment is the prevention of torticollis and craniofacial asymmetry. The initial treatment is non-surgical, passive and active exercises. Only when this treatment fails should surgery be performed. The disappearance of the lesion is not always a predictable sign. A small number of children will develop delayed torticollis or craniofacial asymmetry. It is important that parents be informed of this possibility and of the necessity for long term follow-up.

Birth Injuries↗
PubMedDate not supplied

Hemoptysis in children.

Hemoptysis is uncommon in the pediatric age group. There is little mentioned regarding this problem in either the pediatric or the otolaryngologic literature. A review of the past ten years' experience at the Children's Hospital of Philadelphia identified 40 patients whose presenting symptoms included hemoptysis. Causes of the hemoptysis included tumor, infection, trauma, and foreign bodies, as well as a variety of other conditions. Based on these findings, a systematic approach to the diagnostic evaluation of the pediatric patient with hemoptysis has been developed. A thorough endoscopic examination of the upper aerodigestive tract is essential in most cases, and can have both diagnostic and therapeutic value. Particular attention is directed toward airway management in patients with massive hemorrhage. Close cooperation among the bronchoesophagologist, pediatrician, and anesthesiologist is mandatory for optimal care of the child with hemoptysis.

Adolescent↗
PubMedDate not supplied

Benign osteoblastoma of the maxillary sinus.

The benign osteoblastoma is an uncommon bone tumor. It is a benign but actively growing neoplasm that must be differentiated from more aggressive bony lesions. A review of the literature indicates that 14% of benign osteoblastomas are located in the head. The clinical, radiologic, and pathologic features and treatment of the benign osteoblastoma are discussed. In addition, the third case of a benign osteoblastoma of the paranasal sinuses, and the first of the maxillary sinus, is described.

Adult↗
PubMedDate not supplied

Mucoepidermoid carcinoma of the hypopharynx.

Mucoepidermoid carcinoma is most commonly found in the parotid gland. It rarely occurs in the larynx and hypopharynx. There are only 32 reported cases from these areas. A case of a mucoepidermoid carcinoma of the hypopharynx is presented. Although the initial impression was squamous cell carcinoma, glandular structures were found in metastatic lymph nodes in the neck specimen, and after mucicarmine stains were positive, the final diagnosis was changed to mucoepidermoid carcinoma. This case illustrates the difficulty in diagnosing mucoepidermoid carcinoma, especially in unexpected locations. Differentiating mucoepidermoid carcinoma from other neoplasms is important because treatment may differ depending on the diagnosis. The pathologic spectrum of mucoepidermoid carcinoma is presented, and the management of these tumors with respect to the histologic grade is discussed.

Carcinoma↗
PubMedDate not supplied

Hyperosmolar nonketotic coma: prevention, diagnosis, and treatment.

With the multi-faceted approach to head and neck cancer today, maintaining caloric intake by long-term enteral hyperalimentation is commonplace. Along with the tremendous advantages of this form of nutrition, the disadvantage of hyperosmolar nonketotic diabetic acidotic coma is present. Mortality rates are quoted from 40% to 70% according to the literature reviewed. Therefore, prevention is the best form of treatment. The cause, diagnosis, and treatment will be discussed.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Development of the paranasal sinuses in children.

The development of computed tomography and functional endoscopic sinus surgery has improved diagnosis and management of sinusitis. It has also renewed interest in the developmental anatomy of the paranasal sinuses. There are significant differences between adult and pediatric sinus anatomy, and to safely perform functional endoscopic sinus surgery in children, the surgeon must be aware of these differences. To define the developmental anatomy of the paranasal sinuses, we analyzed 145 computed tomograms from patients under 18 years of age. The study emphasized landmarks at the level of the maxillary sinus ostium. In addition, distances and angles from the nasal spine to various points in the sinuses were determined. The structures were identified and traced on a digitizing tablet. Means and standard deviations were calculated for each measure as a function of age. This study can aid a better understanding of sinus development in children and provide guidance to the endoscopic sinus surgeon.

Adolescent↗
PubMedDate not supplied

The effects of gelatin film stents in the middle meatus.

Controversy exists regarding the management of the middle meatus after pediatric functional endoscopic sinus surgery (FESS). To prevent adhesions following pediatric FESS, gelatin film stenting of the middle meatus has been recommended. The effects of stenting, however, have not been established. Fifty-one children with similar degrees of bilateral sinus disease had a gelatin film stent placed in one middle meatus on completion of FESS, while the opposite meatus was not stented. Two to three weeks later at the time of a second, staged procedure, the sides were compared for the presence of the stent, adhesions, granulaion tissue, and patency of the maxillary sinus ostia. In 11 children the postoperative findings were more severe in the side without the stent, whereas in 29 children they were more severe in the stented side. There was no difference between the sides in 11 children. Although gelatin film stenting benefits some children, it should not be used routinely following pediatric FESS but should be reserved for children who are predisposed to develop adhesions or have poor prognostic factors, such as immunodeficiency and ciliary dyskinesia.

Adolescent↗
PubMedDate not supplied

Development of the paranasal sinuses in children with sinus disease.

In a previous report, the authors defined the normal development of the paranasal sinuses. Landmarks and dimensions relevant to functional endoscopic sinus surgery were measured on the computed-tomography images of 145 children who were free of significant sinusitis. The present study compares those normal values to the same measurements in 235 cases of sinus disease. No significant difference was found between normal and diseased groups in any of the 10 dimensions originally reported or in six derived measures. There appears to be no association between sinus disease and any of these dimensions. The previously reported norms are applicable to cases of pediatric sinus disease.

Adolescent↗