Search PubMed⌕ Search

Biomedical subjects

R L Hybels

Publications and source records attributed to R L Hybels.

At least 37 records · Page 2Linked to original sources
PubMed1980

Venous air embolism in head and neck surgery.

Venous air embolism can occur under many circumstances, including head and neck surgery when the head is elevated. Embolized air obstructs the pulmonary outflow tract of the right ventricle or the pulmonary arterioles. Small volumes are tolerated or dispersed, but larger volumes can lead to severe physiologic changes. The Doppler precordial monitor is the most effective means of detection and should be used in major operations on the head and neck. Treatment methods are discussed and should be understood by all otolaryngologic surgeons.

Animals↗
PubMed1980

Combined otolarygologic and neurosurgical approaches to tumors of the temporal bone and skull base.

Craniofacial resections are extensive procedures with serious potential complications and may not lead to cure but appear to offer an appreciable palliative benefit. This is acceptable for situations normally considered inevitably fatal. Most neoplasms of the head and neck are relatively slow growing and metastasize to distant sites late in their course. This can lead to months or years of suffering. Eliminating a bulky, unsightly, painful neoplasm can make remaining life more tolerable. Further, if cure is to be at all possible, an attempt must be made at total excision. In the recent experience of the Lahey Clinic with five patients utilizing a combined approach, results have been gratifying for both patients and surgeons.

Ear Neoplasms↗
PubMed1979

Evaluation of frontal sinus fractures.

Forty-six instances of frontal sinus fracture were reviewed to determine the factors that are important in the initial clinical and radiologic evaluation. Associated injuries, the appearance of the forehead, and roentgenographic studies were all considered. Polytomography is the most accurate diagnostic technique and is justified in all patients. The otolaryngologist must examine all roentgenograms personally, with particular attention paid to the nasofrontal duct region and to the magnitude of depression of fracture fragments.

Accidents, Traffic↗
PubMed1979

Intranasal approach to the sella turcica.

A transseptal approach to the sella turcica is described which is entirely intranasal and avoids the sublabial incision. The first incision is unilateral along the caudal edge of the septum, and the second incision is made across the base of the nasal columella. This allows the speculum to open the width of both nasal chambers, giving adequate exposure. The septal cartilage is either preserved or resected except for a caudal strut. The difficult dissection of mucosa from the nasal floor and maxillary crest is avoided. This technique is rapid and straightforward and results in a cosmetically acceptable scar.

Humans↗
PubMed1978

The mass in the neck.

A cervical mass should be approached in a systematic manner with a full knowledge of the possible etiologies and their consequences. The approach taken with a child differs markedly from that taken with an adult. Cervical masses in children are likely to be congenital or inflammatory. In adults, neoplastic masses are most common; most of these are metastatic. Indirect laryngoscopy, important in the search for the primary lesion, should be performed on all patients.

Adult↗
PubMed1977

Posterior table fractures of the frontal sinus: I. An experimental study.

Experiments using cats were performed to examine the natural history of posterior table fractures of the frontal sinus and the methods available for treatment. Elevation of depressed fractures and obliteration by either fat or osteoneogenesis and fibrosis were the modalities of treatment used. Comparisons were made with untreated controls. Fascia reinforcement of the dura and plugging of the nasofrontal duct were variables. The nasofrontal duct is critical in the natural history of these injuries. All fractures of the posterior table heal if drainage into the nose is maintained. Fractures which are elevated heal by bony union with associated mucosal and dural healing. Loose fragments of the posterior table heal if left in place. Mucoceles form if the nasofrontal duct is obstructed, if mucosa is inadequately removed during obliteration and, in some instances, where islands of mucosa are isolated by mucosal laceration. Viable adipose tissue in the sinus prevents significant ingrowth of mucosa from the nasofrontal duct. Growth of mucosa into fracture lines was not a problem. Both adipose transplants and intrasinus fascia reinforcement appeared to contribute to well defined posterior table healing.

Animals↗
PubMed1976

Lymphomas of the masticator space.

Lymphomas that involved the masticatory space occurred in three patients. In one patient, the masticator space remained the sole manifestation for many years; in the other two patients, the masticator-space involvement was a local manifestation of constitutional disease. In all three patients, excisional biopsies and microscopical tissue examinations were carried out because of a mass deep to the parotid gland. The symptoms and signs are quite similar to those manifested in patients with infection. Surgical procedures other than incisional biopsy are not indicated. Irradiation and chemotherapy appear to be the treatments of choice.

Adult↗
PubMed1976

Neuro-otologic manifestations of sarcoidosis.

Sarcoidosis is an idiopathic disease which presents in anatomic areas of concern to otorhinolaryngologists. It can cause dysfunction of both auditory and vestibular systems. In patients known previously to have sarcoidosis, this disease should be seriously considered. In patients presenting with otologic disorders and associated facial nerve paralysis or other neuropathies, uveitis, granulomatous meningitis or diabetes insipidus, sarcoidosis should be suspected. An examination of the eyes as well as a chest X-ray is imperative. Sudden and fluctuating neurosensory hearing loss has been reported. There is a great need for the study of temporal bones from sarcoidosis patients.

Adult↗
PubMed1976

Tuberculosis of the larynx.

Tuberculosis of the larynx, once a common disease, has become quite rare with the advent of anti-tuberculous chemotherapy. In the pre-antibiotic era two modes of laryngeal infection were recognized; bronchogenic and hematogenous. The literature is briefly reviewed. Thirteen patients in the past 15 years in whom tuberculous laryngitis was diagnosed upon indirect laryngoscopy by members of the University of Michigan Department of Otorhinolaryngology are presented. Bronchogenic infection was present in 11, and in two patients the disease was consistent with hematogenous spread. Tissue biopsy from a case of bronchogenic contamination demonstrated epithelioid tubercles, while numerous subepithelial acid-fast bacilli without typical tuberculous histological change were present in a case of hematogenous laryngeal infection. A case of cicatricial laryngeal stenosis was successfully treated surgically by laryngofissure, excision of fibrosis with arytenoidectomy, and free mucous membrane grafting. Finally, the initial subtle presentation of many of our patients emphasizes the importance of a consideration of tuberculosis in the differential diagnosis of chronic laryngitis.

Adult↗