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Biomedical subjects

P H Holinger

Publications and source records attributed to P H Holinger.

At least 19 recordsLinked to original sources
PubMed1981

Vocal cord paralysis and psychopathology. Data and clinical issues.

The nature and cause of psychiatric symptoms associated with the posthyroidectomy bilateral abductor vocal cord paralysis (BAVCP) syndrome are analyzed. The postthyroidectomy BAVCP syndrome is characterized by normal voice, airway obstruction, hypothyroidism, hypoparathyroidism, and psychiatric manifestations. Forty-five (35.2%) of 128 patients with postthyroidectomy BAVCP syndrome had psychiatric manifestations of some kind. The following four categories of psychiatric problems were found: (1) preexisting psychiatric symptoms exacerbated by the postthyroidectomy BAVCP syndrome, (2) psychiatric symptoms initiated by the syndrome, (3) psychiatric symptoms that were etiologically distinct from the syndrome, and (4) misdiagnosis. The variety of psychiatric symptoms, as well as the difficulty in determining the cause of the symptoms, makes it essential that surgeons, internists, and psychiatrists cooperate in the treatment of patients with the postthyroidectomy.

Humans↗
PubMed1980

Psychiatric manifestations of the post-thyroidectomy bilateral abductor vocal cord paralysis syndrome. Cases and theoretical issues.

Post-thyroidectomy bilateral abductor vocal cord paralysis (BAVCP) is a life-threatening syndrome characterized by serious psychiatric manifestations as well as by voice, airway, hypothyroid, and hypoparathyroid symptoms. Of the 128 patients with post-thyroidectomy BAVCP syndrome, 45 (35.2 per cent) had psychiatric complications: 21 of the 128 patients (16.4 per cent) had pre-existing psychiatric symptoms exacerbated by the post-thyroidectomy BAVCP syndrome, 16 (12.5 per cent) had psychiatric symptoms initiated by the syndrome, six (4.7 per cent) had psychiatric symptoms etiologically distinct from the syndrome, and two (1.6 per cent) were misdiagnosed. The role of psychiatric treatment is described. Theoretical aspects of laryngeal dysfunctions associated with psychiatric disorders and psychotropic medications are discussed.

Adult↗
PubMed1978

Respiratory obstruction and apnea in infants with bilateral abductor vocal cord paralysis, meningomyelocele, hydrocephalus, and Arnold-Chiari malformation.

This report describes 21 infants and children with bilateral abductor vocal cord paralysis and associated meningomyelocele, Arnold-Chiari malformation, and hydrocephalus. Two life-threatening forms of respiratory distress are distinguished: (1) upper airway obstruction due to bilateral abductor cord paralysis and (2) apnea. Clinically significant episodes of apnea were documented in 13 infants. Ten infants had evidence of aspiration and dysphagia. Vocal cord paralysis, apnea, aspiration, and dysphagia were frequently temporally related to increased intracranial pressure.

Airway Obstruction↗
PubMed1977

Rhinoscleroma of the lower respiratory tract.

Rhinoscleroma is a chronic granulomatous disease of the respiratory tract endemic to Eastern Europe and Central America which is being recognized with increasing frequency in other countries, including the United States. It was initially described as a lesion of the nose and upper respiratory tract, but is now known to involve the larynx, trachea and bronchi as well to cause slowly progressive asphyxia. Eleven cases of rhinoscleroma with varying degrees of involvement of the lower respiratory tract (larynx, trachea and bronchi) are presented. Present day treatment is both medical, consisting primarily of streptomycin and tetracycline, and endoscopic dilatation. Prolonged medication with careful dose control is necessary. Lower respiratory tract involvement should be considered in patients with chronic destructive granulomatous nasal pathology. This should be especially emphasized if they have an Eastern European or Central American background, or have travelled in these areas in which rhinoscleroma is endemic.

Adult↗
PubMed1976

Anesthetic management for carbon dioxide laser surgery of the larynx.

Fifty-one patients underwent 71 carbon dioxide laser procedures under general anesthesia for various intralaryngeal pathology. Anesthesia was induced with thiopental sodium, followed by succinylcholine to facilitate endotracheal intubation. For maintenance of anesthesia, 70% nitrous oxide was supplemented with halothane, enflurane or small doses of fentanyl. Succinylcholine, d-tubocurare or pancuronium were used to maintain muscular relaxation of jaw, pharyngeal and laryngeal muscles for a smooth lasing procedure. Small diameter (16-22 Fr.), red rubber, cuffed endotracheal tubes provided maximum working space, facilitated the controlled ventilation and reduced the explosion hazard of the anesthetic gases. Safely eyeglasses were used by all the personnel in the operating room against accidental injury to the cornea by the laser beam. Anesthetic management provided excellent operative conditions with maximum safety to the patient and the personnel in the operating room.

Adolescent↗
PubMed1975

Open tube, proximal illumination mirror and direct laryngeal photography.

Equipment is described for mirror and open tube direct laryngoscopic photography. It consists of specially constructed reflex camera systems that provide adequate exposure and depth of the desired field, sharpness of focus, correct color and effective composition for meaningful illustrations. The separate cameras for still and motion pictures consist of units that contain the light source, lenses, optic reflex systems and film chambers. The mirrors for indirect laryngoscopy and the open tube direct laryngoscopes are attached by rigid, easily released clamps for quick interchange. It is stressed that the laryngologist himself must be the photographer. The pictures are adjuncts to case recording, are supportive evidence of investigative work and may be used as chronologic sequences in study of physiology and pathology and in pre- and postoperative evaluation.

Humans↗
PubMed1975

Delayed C.N.S. complications.

Patients with esophageal stricture being treated with dilatation, who developed esophageal perforation or local peritonitis and subsequent central nervous system infection, are reviewed. It is suggested that the vertebral venous system may be the route by which the metastatic infection is carried. Physicians caring for patients with esophageal stricture, who are receiving dilatation, should be aware of the possible intracranial complications and should be alert to the first sign of central nervous system abnormality.

Brain Abscess↗